A great video. You explained this like no one else could. I went through this with my primary Dr. and I will also show this to him. Thanks….looking forward to hearing more. All the other doctors just say…..take a statin.?….
@@drjcasale My gen doctor prescribed a low dose statin when my Lp(a) came back 53mg/dl (other chol levels normal range, LDL 109). No other risk factors. I can't get referral to a cardiologist so just being managed by my general doc who I don't know is aware of best way to treat other than statin,
The last thing you want to do is tamper or try to lower your Lp(a) levels which are in your genetics for a reason to live a long healthy life. 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study).
This is why we can't look at biomarkers in isolation. This video is meant to be a distillation of ideas but not all-encompassing. There have been plenty of studies done since the one you referenced with higher levels of evidence showing that high Lp(a) is associated with higher all-cause mortality and CVD (link below). Just like any biomarker, I believe there is an optimal range. Perhaps a 20-30% reduction in some patients may decrease their risk for CVD while still maintaining the anti-neoplastic effects of Lp(a). Time will tell as long as we continue to have new data to explore :) pubmed.ncbi.nlm.nih.gov/36708412/
@@drjcasale I already showed 2 weeks ago that centenarians had elevated levels of Lp(a). Newer studies are trying to create a problem so they can sell you a solution for a problem that never existed. If someone told you that 20% of the population blinks their eyes the wrong amount of times per minute and they have a special pill to correct this problem would you believe it?
Maybe that is having too low of levels. Like with anything there is a balance. What researchers are trying to figure out is what are the optimal levels based on lowering chances of heart disease.
Love it when all of the pharmaceutical companies create a drug to lower a particular risk factor like LDL cholesterol - but the moment a non-patentable supplement like Niacin also lowers that very same marker they insist that it has no effect on mortality reduction! Lowered my Lp(a) 30% with Niacin.
I read in another post that he/she lowered her LDL by 100 points in three months with 1 tablespoon psyllium husk in 8 oz water twice daily with meals I thought was quite impressive.
@@R.R.Brahma yes! I currently take Klaire labs niacin. No side effects except occasional flushing. It’s supposed to be slow release with no flushing but I still get it occasionally
Elevated Lp(a) is usually caused by an allele on chromosome 6. CKD 4 & 5 can also elevate it 2-5x. Can niacin and PSK9i that lower the genetically driven elevation work on the CKD-driven elevation? Regards
Apo A is a structural component of HDL which helps to remove lipids from white blood cells. Lp(a) contains Apo A but is a separate and distinct molecule. Hope this helps!
@@staplerfish I'm not sure yet. The last batch I took had little to no flushing but my current batch makes me flush like crazy which is undesirable. Will check my labs and see the difference it's making!
@@drjcasale My latest notes re niacin: Used to lower Lp(a) by up to 30%. People say that despite this, it doesn't stop death from CVD. High Niacin may cause inflammation and plaque formation (research came out in 2024). Metabolite 4py is linked to bad artery health. For now not using it.
"Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio. "Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
Apparently the human body has evolved to hurt itself. And certain unlucky folk lose the genetic lottery and have no way to avoid this condition. Or perhaps what you are describing is not the full story and not the root cause but rather the symptom caused by other factors. Hmmmm.
@@michaelsliwinski8044 This video is about cardiovascular risk and Lp(a). There are entire textbook chapters about this subject and to be succinct I couldn’t mention all of the information. But the human body has not evolved to hurt itself.. there is certainly a biological function to lipoprotein a, such as wound healing and fibrin deposition. There is no way to cover everything in a short video.
A great video. You explained this like no one else could. I went through this with my primary Dr.
and I will also show this to him. Thanks….looking forward to hearing more. All the other doctors just say…..take a statin.?….
Thank you! Yes, since Lp(a) isn't as highly studied, many doctors are unaware of it as a risk factor for CVD and how to treat it.
@@drjcasale My gen doctor prescribed a low dose statin when my Lp(a) came back 53mg/dl (other chol levels normal range, LDL 109). No other risk factors. I can't get referral to a cardiologist so just being managed by my general doc who I don't know is aware of best way to treat other than statin,
The last thing you want to do is tamper or try to lower your Lp(a) levels which are in your genetics for a reason to live a long healthy life. 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study).
This is why we can't look at biomarkers in isolation. This video is meant to be a distillation of ideas but not all-encompassing. There have been plenty of studies done since the one you referenced with higher levels of evidence showing that high Lp(a) is associated with higher all-cause mortality and CVD (link below). Just like any biomarker, I believe there is an optimal range. Perhaps a 20-30% reduction in some patients may decrease their risk for CVD while still maintaining the anti-neoplastic effects of Lp(a). Time will tell as long as we continue to have new data to explore :) pubmed.ncbi.nlm.nih.gov/36708412/
@@drjcasale I already showed 2 weeks ago that centenarians had elevated levels of Lp(a). Newer studies are trying to create a problem so they can sell you a solution for a problem that never existed. If someone told you that 20% of the population blinks their eyes the wrong amount of times per minute and they have a special pill to correct this problem would you believe it?
Maybe that is having too low of levels. Like with anything there is a balance. What researchers are trying to figure out is what are the optimal levels based on lowering chances of heart disease.
Love it when all of the pharmaceutical companies create a drug to lower a particular risk factor like LDL cholesterol - but the moment a non-patentable supplement like Niacin also lowers that very same marker they insist that it has no effect on mortality reduction! Lowered my Lp(a) 30% with Niacin.
That's a remarkable reduction. Wow! Does it make you flush?
@@drjcasale No. Only 150mg 2x daily.
@@truerockrealty3077what kind and brand please
What brand do you take?
Hey doc what were your lp(a) levels when you got them tested?
I read in another post that he/she lowered her LDL by 100 points in three months with 1 tablespoon psyllium husk in 8 oz water twice daily with meals I thought was quite impressive.
I did the same thing eating FATTY RED MEAT
@@paulhailey2537 did it worked for you?
There are several books written by PhD doctors about niacin therapy for Lp(a). Why have you not considered? Are there severe side effects?
@@R.R.Brahma yes! I currently take Klaire labs niacin. No side effects except occasional flushing. It’s supposed to be slow release with no flushing but I still get it occasionally
Elevated Lp(a) is usually caused by an allele on chromosome 6. CKD 4 & 5 can also elevate it 2-5x. Can niacin and PSK9i that lower the genetically driven elevation work on the CKD-driven elevation? Regards
@@ddutton4716 I’m not sure if this has been studied. But I would suspect that both would have a similar effect on Lp(a)
What is the relationship of Lipoprotein(A) and Apo-A? My Lipoprotein(A) is very low but LDL is high, how to read this? Thanks!
Apo A is a structural component of HDL which helps to remove lipids from white blood cells. Lp(a) contains Apo A but is a separate and distinct molecule. Hope this helps!
Your thoughts about Repatha please, injectable
What berberine and niacin products you recommend?
I take Klaire labs Niacin-SR and Integrative Therapeutics Berberine
Thanks!!!
Do u take Berberine with food or empty stomach?
@@jeyagovindaraju471 I have stopped taking it since this video because I ran out but I used to take it with Greek yogurt in the morning
Doctor,
300mg of bernerine twice a day. Does it mean 600mg a day?
@@R.R.Brahma that’s how much I used to take. I recently stopped. No particular reason, I just ran out
@@drjcasale Will you get more, or na? It's hard to continue taking supplements if you don't test and see a reduction in Lp(a). Mine is sky high.
@@staplerfish I'm not sure yet. The last batch I took had little to no flushing but my current batch makes me flush like crazy which is undesirable. Will check my labs and see the difference it's making!
@@drjcasale My latest notes re niacin:
Used to lower Lp(a) by up to 30%.
People say that despite this, it doesn't stop death from CVD.
High Niacin may cause inflammation and plaque formation (research came out in 2024).
Metabolite 4py is linked to bad artery health.
For now not using it.
"Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
What levels are considered “high?”
@@quart2knee High levels would be more than 150 mg/dL or more than 400 nmol/L.
Apparently the human body has evolved to hurt itself. And certain unlucky folk lose the genetic lottery and have no way to avoid this condition. Or perhaps what you are describing is not the full story and not the root cause but rather the symptom caused by other factors. Hmmmm.
@@michaelsliwinski8044 This video is about cardiovascular risk and Lp(a). There are entire textbook chapters about this subject and to be succinct I couldn’t mention all of the information. But the human body has not evolved to hurt itself.. there is certainly a biological function to lipoprotein a, such as wound healing and fibrin deposition. There is no way to cover everything in a short video.