How to Lower Lp(a) Naturally

Elevated Lp(a), also known as lipoprotein (a), is a genetic condition that can increase your risk of heart disease and stroke. Elevated levels are those >30 mg/dl, and this abnormality affects about 25% of the population. Lp(a) should be tested in all individuals at least once as a screening test. Lp(a) is a type of cholesterol particle that is made up of a protein called apolipoprotein(a) and a low-density lipoprotein (LDL) particle. I tell patients that elevated Lp(a) is 90% genetic and statins do not help. New drugs are on the horizon that can help, but most want to know what else can be done to lower Lp(a). Elevated levels of Lp(a) are associated with a higher risk of cardiovascular disease, particularly in individuals with a family history of heart disease.

While medications such as statins are often prescribed to lower cholesterol levels, they are not effective in lowering Lp(a) levels. Looking at multiple combined studies on the effect of statins on Lp(a) there is a general trend toward statins increasing Lp(a) levels. Additionally, statins can come with side effects that some individuals may prefer to avoid. PCSK9 inhibitors such as Repatha and Praluent may lower Lp(a), but only modestly (in some studies by up to 40%), by reducing apoliprotein(a) synthesis. Thus, the present medications for cholesterol do not do an adequate job of addressing elevated Lp(a) levels. Many patients with premature coronary artery disease have markedly elevated Lp(a) levels and need drastic lowering of Lp(a) to lower their future cardiovascular risk. 

Several drugs are currently being tested to lower Lp(a) levels, with the hope of reducing the risk of cardiovascular events in high-risk individuals. 

One of the drugs being investigated is an antisense oligonucleotide called AKCEA-APO(a)-LRx. This drug works by targeting the messenger RNA responsible for producing Lp(a) in the liver, ultimately reducing the levels of this lipoprotein in the bloodstream. In clinical trials, AKCEA-APO(a)-LRx has been shown to significantly lower Lp(a) levels in patients with elevated levels of this lipoprotein by up to 99%! The drug is undergoing phase 3 trials to evaluate further its effectiveness and safety in reducing cardiovascular events. 

Another drug being tested is a monoclonal antibody called Inclisiran. This drug targets a protein involved in the production of Lp(a) in the liver, leading to lower levels of this lipoprotein in the blood. In clinical trials, Inclisiran has been shown to reduce Lp(a) levels by up to 80% in patients with elevated levels of this lipoprotein. The drug is currently under review by regulatory agencies for approval as a treatment for high Lp(a) levels. (Approval will likely come in late 2025 or 2026.)

Other drugs being investigated include small molecule inhibitors and gene editing techniques that target specific pathways involved in the body’s production and clearance of Lp(a). These drugs aim to provide more targeted and effective treatments for individuals with elevated levels of this lipoprotein, ultimately reducing their risk of cardiovascular events. The reduction levels seen in the studies of these new Lp(a) lowering drugs are impressive, with some studies showing reductions of up to or greater than 90%!

While the results of these trials are promising, more research is needed to fully understand the long-term effects of these drugs on cardiovascular outcomes. It is essential for individuals with high Lp(a) levels to work closely with their healthcare providers to monitor their levels and discuss potential treatment options. By lowering Lp(a) levels, these drugs have the potential to significantly reduce the risk of heart attacks and strokes in high-risk individuals, offering new hope for those at risk of cardiovascular disease.

Until those new drugs are available, what can a person do if they have elevated Lp(a) levels? Luckily, natural treatment options can help lower Lp(a) levels and reduce your risk of heart disease.

Next, we will explore some natural treatment options for elevated Lp(a) and how to incorporate them into your daily routine to improve your heart health.

Dietary changes

Changing your diet is one of the ways to lower Lp(a) levels. Incorporating heart-healthy foods such as fruits, vegetables, whole grains, and lean proteins can help lower cholesterol levels and reduce your risk of heart disease. Some specific dietary changes that can help lower Lp(a) levels include:

Eating more fiber: Foods high in fiber, such as oats, fruits, and vegetables, can help lower cholesterol levels and reduce Lp(a) levels.

Consuming healthy fats: Foods rich in omega-3 fatty acids, such as salmon, walnuts, and flaxseeds, can help lower cholesterol levels and improve heart health.

Limiting saturated and trans fats: Foods high in saturated and trans fats can raise cholesterol levels and increase your risk of heart disease. Restricting your intake of these fats can help lower Lp(a) levels.

One caveat about diet is that low-fat diets may increase Lp(a) by as much as 30%!

Regular exercise

Regular physical activity is another vital component of a heart-healthy lifestyle. Exercise can help lower cholesterol levels, reduce inflammation, and improve cardiovascular health. Aim for at least 30 minutes of moderate-intensity exercise most days of the week to help lower your Lp(a) levels and reduce your risk of heart disease.

Weight management

Maintaining a healthy weight is essential for reducing your risk of heart disease and lowering Lp(a) levels. If you are overweight or obese, losing even a small amount of weight can help improve your cholesterol levels and reduce your risk of cardiovascular disease. Focus on eating a balanced diet and getting regular exercise to help achieve and maintain a healthy weight.

Supplements

Several supplements have been shown to help lower cholesterol levels and reduce your risk of heart disease. Some supplements that may be beneficial for individuals with elevated Lp(a) levels include:

Coenzyme Q10: Coenzyme Q10 is an antioxidant that can help lower cholesterol levels and improve heart health. It has been shown to cause a mild reduction in Lp(a) levels.

Niacin: Niacin, also known as vitamin B3, can help lower LDL cholesterol levels, raise HDL cholesterol levels, and reduce Lp(a) levels, but in extensive studies, it has failed to show a reduction in cardiac event rates. It should be noted that those trials were looking at Niacin for Lowering LDL and raising HDL and were not able to honestly assess whether lowering Lp(a) in patients with high Lp(a) levels may reduce cardiac events.)

L-carnitine is required to break down fats and glucose into energy and has been shown to reduce Lp(a) slightly.

Some studies have shown that Xuezhikang, a component of red yeast rice, lowers Lp(a) by up to 30%.

(Before starting any supplements, speak with your healthcare provider to ensure they are safe and appropriate for your health needs.)

(As a side note, my Lp(a) is elevated, and the combination of the above supplements has lowered my Lp(a) by 31% in 60 days.) 

Stress management

Stress can negatively impact heart health and elevate Lp(a) levels. Stress-reducing techniques such as meditation, yoga, deep breathing exercises, and time in nature can help lower stress levels and improve cardiovascular health. 

Quit smoking

Smoking is a significant risk factor for heart disease and can elevate Lp(a) levels. Quitting smoking can help lower your cholesterol levels and reduce your risk of heart disease. If you need help quitting smoking, speak with your healthcare provider about resources and support available to you.

In conclusion, elevated Lp(a) levels can increase your risk of heart disease and stroke. Still, natural treatment options are available to help lower your Lp(a) levels and improve your cardiovascular health. The medications that can dramatically lower Lp(a) are 1-2 years away and will be a Godsend for many patients struggling with early coronary artery disease and elevated Lp(a). Making changes to your diet, incorporating regular exercise, managing your weight, taking supplements, managing stress, quitting smoking, and trying herbal remedies are all effective ways to lower your Lp(a) levels and reduce your risk of heart disease. Working with your healthcare provider to develop a personalized treatment plan that addresses your individual health needs and risk factors is essential. By making these natural treatment options a part of your daily routine, you can take control of your heart health and lower your risk of cardiovascular disease.

Remember, maintaining a healthy lifestyle is critical to reducing your risk of heart disease and improving your overall well-being. By making small, sustainable changes to your diet, exercise routine, stress management techniques, and habits, you can lower your Lp(a) levels and support your heart health for years. Take charge of your health and prioritize your cardiovascular well-being by incorporating these natural treatment options into your daily routine. Your heart will thank you for it.

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