Another person with high Lipoprotein(a)

[purposefirst]

I am concerned about my very high level of lipoprotein(a). It is 95 mg/dL per a very recent test (Sept. 5th). I would greatly appreciate advise or suggestions.

Background: male, age 72. Due to rather severe intermittent chest pain last year I saw a cardiologist in December who tested and determined that I have atherosclerosis/"multiple coronary ischemia." He immediately made an appointment for me to go into another hospital in a few days for either stents or bypass surgery – to be determined at that time by an angiogram. But after only 2 days of cutting way back on food intake I felt improved enough that I cancelled the hospital appointment.

I decided to alternatively go the route of nutrition-supplements-exercise, and look into EDTA chelation. I dropped 20 lbs in 4 weeks and started oral EDTA. A "challenge test on April 3rd showed that I was very high on lead and moderately high on mercury and cadmium. So for both that and my atherosclerosis I started IV EDTA, but quit it at the first sign of kidney pain. Incidentally, among the many items tested on April 3rd was Lp(a), which was 99 mg/dL, but the chelation doc never mentioned it and I did not know what it meant at that time.

Next I adopted a modified version of Chris Shade's regimen of upgrading glutathione for detox and general health. By June I was doing megadoses of Vit C. In July I learned about Paulings approach and began to include it. Also added liposomal C and lipo GSH from Livon (and later liposomal R-lipoic acid). In August I upgraded supplement quality by getting C powder and Cardio-C from the Vitamin C Foundation. By August I was taking 12-15 gms/day of C, 6 gms of lysine + 1 of proline, 2 gms/day of lipo C. From day one I kept adding various supplements ranging from vitamins and minerals to antioxidants, amino acids, herbs, etc. (I'm currently taking 60-70 different supplements daily!!)

By Sept. 5th perhaps I had not been on the Pauling protocol long enough to affect the Lp(a)?? But most of the various cholesterol numbers have improved considerably since April 3rd. Maybe I am one who has a genetic proclivity toward high Lp(a)?

I do aerobic exercises morning and evening, every day. The angina has greatly improved since December, but there is still a problem apparent. When I exercise I feel a tightness in the left upper chest, not pain, but a tight feeling. So I know I'm not out of the woods yet.

I know that niacin is supposed to help reduce Lp(a). But long ago I tried high doses of niacin as an experiment, ramping up to 1000mg/day. I did not mind the flush (even liked it), but the higher doses made me feel extremely depressed, so I quit. But since getting the recent test results I added 200mg/day of niacin to the regimen – okay so far. Will increase gradually. What would be an appropriate dose?

Also very recently I upped my Vitamin K2 from a small amount of MK7 to 15mg/day of MK4. Also recently took steps to increase nitric oxide. Also just added Unique E tocotrienol, and l-glutamine.

I noticed on the other recent Lipoprotein(a) thread that pamojja listed peronal Lp(a) readings over a period of several years. S/he certainly improved, but apparently VERY gradually. How long might it take optimally to improve?

Advice or suggestions would be welcome and appreciated.

[pamojja]

I noticed on the other recent Lipoprotein(a) thread that pamojja listed peronal Lp(a) readings over a period of several years. S/he certainly improved, but apparently VERY gradually. How long might it take optimally to improve?

Although not feeling myself an exception in having difficulties bringing my Lp(a) down. For the only reason of having no value of Lp(a) before starting supplementing - whether high dose vitamin C/lysine helped - I only can speculate now. Maybe it has even been as high as yours.

Despite the lack of the before-data, the initial years of supplementing seemed even to increase Lp(a). That's why I added every other known possible therapeutics:

Low-carbohydrate high fat diet
Flaxseed and almonds
High dose fish oil
Soy proteins
Alcohol
Coenzyme Q10
L-carnitine
Gingko biloba
Niacin
Homocysteine reduction with B2, B6, B9, B12, Choline, TMG, SAMe
N-acetylcysteine
DHEA
Thyroid hormone

Only with the soaring of my serum DHEAs after doubling it's intake and most optimal thyroid values did I see the improvement you talk about.

How long might it take optimally to improve?

The favorite therapeutic of nutritionally oriented cardiologist Dr. Davis is high dose fish oil (total EPA/DHA content of 6 gram per day), which works in his clinical experience after 2-3 years of use, and after which he witnessed drops down in 60% of users. Sadly, I was not one of them, as well as not one of the 100% of Pauling Therapy users whose Lp(a) dropped to zero, as Oven recently grossly exaggerated.

Options not seriously tried:

Estrogen for females
Testosterone for men (like me)
Weight loss (with BMI of 20, not much to loose..)
Aspirin (get bloody stools even with a baby aspirin)
Diabetes treatment (metformin gives me terrible nausea)
Fibrates

[purposefirst]

Thanks, pamojja, for your response.

I take everything on your first list except soy and alcohol (alcohol??), and more.

My diet is close to Paleo, but I'm going to cut back more on the fruit (although I love fruit).

I've long been hypothyroid. Just recently switched from Armour Thyroid to Synthroid - 100 mcg.

Interesting point about DHEA. I'm taking only 25 mg, plus a little progesterone. So increasing your DHEA and thyroid med helped to bring down your Lp(a)?

I take fish oil and krill oil daily, plus eat sardines and salmon about twice weekly. It's great that some had significant improvement in Lp(a) with fish oil, but why 2-3 years?

Fred

[pamojja]

Yes, alcohol. Started to take a glass of red wine with dinner.

I've long been hypothyroid. Just recently switched from Armour Thyroid to Synthroid - 100 mcg.

Interesting point about DHEA. I'm taking only 25 mg, plus a little progesterone. So increasing your DHEA and thyroid med helped to bring down your Lp(a)?

I also only took about 25 mg and 50 mg pregnenolone, which gave an serum level of about 250 ng/dl. Then I run out of the pregnenolone and therefore made the trial of doubling DHEA, ending up at 755 ng/dl. Since discontinuing back down to 200 somewhere. With my next serum DHEAs I'll have opportunity to verify.

The problem in the European country I live is, these hormones are not available over the counter, it's risky to import them illegally because of very high fines. However, on a trip to India I got my hands on some packets of generic liothyronine, T3, and that has seemed enough to kick-start my thyroids to still have the best thyroid values a year later.

[purposefirst]

In addition to the 5 grams/day I've been getting from Cardio-C, I had been adding a gram of L-lysine from Carlson. I did not know how good Carlson quality is, so I recently ordered some "Pure Encapsulations" L-lysine as I know that company to be high quality. Interestingly, the Carlson product (which come as powder) dissolves readily in water, while the Pure Encapsulations product (which comes in capsules) does not dissolve at all. (I open the capsules.) Maybe something is done to the Carlson product to make it soluble... OR... could it be that this has to do with a difference in the quality of the lysine?

Anyway, with no further info, I'll stick with the Pure Encapsulations brand. Also this week I upped my daily dose of lysine to SEVEN grams (including the 5 grams from Cardio-C)

By way of further clarification, I mentioned that the angina pain that I would get during exercise last December has now diminished during exercise to just a mild feeling of tightness in the left upper chest. I should add that the duration and intensity of my workouts has greatly increased since December, so there has been a LOT of improvement -- despite the fact that my Lp(a) number is still VERY high.

[purposefirst]

Correction: The brand of the new Lysine I'm taking is DaVinci Laboratories of Vermont. (Indication are quality should be good.)

I'm a bit disappointed that Owen or Johnwen have had nothing to say regarding my comments and questions on this thread. But that's okay, Owen, I still appreciate very much what you are doing. I even ordered your book. (It's on the way from Amazon.)

[ofonorow]

Sorry for the delayed response (and johnwen is recently out of the hospital after a hernia operation). And thanks for buying my book.

A general note, when posts are long it is more difficult to answer and they are usually put aside for the "future" when there is more time, which these days, probably because of the Ebola fright - there doesn't seem to be any.

Upon reading your first post, my first thought was are you sure the 99 mg/dl wasn't 99 nmol/l? First is very high, the second is almost "normal." Units make all the difference.

But assuming that your Lp(a) is high, then the Pauling/Rath invention of Lp(a) binding inhibitors - which you seem to have adopted - make a great deal of sense to neutralize the sticky Lp(a) in your blood. Your supplement program appears excellent and please keep us informed.

I will say that I don't know of any "claim" that the Pauling therapy lowers Lp(a)? (We think it might). In the first Pauling/Rath experiments with guinea pigs - the animals on normal (healthy) amounts of vitamin C in the diet never had elevated Lp(a). The Lp(a)only rose in animals deprived of vitamin C.

This supported the Pauling/Rath theory that elevated Lp(a) acts as a surrogate for low vitamin C.

I have found no experiments that show elevated Lp(a) can be lowered, but it seems to make sense that it might. We have reported anecdotal experience here at this forum that seems to support the idea. Particularly when Proline is added to the Vitamin C and Lysine. There is the New York Med School prof monitoring his own blood Lp(a) every six months, and with only vitamin C and lysine, his Lp(a) dropped about 30% which is basically what most experts would predict with vitamin C (or niacin) alone. Then he added proline, for got to take a six month measurement, but a year later his Lp(a) became zero - that is when he called me

I know mine was measured around 2 mg/dl and heart disease is prevalent in my family. If memory serves, johnwen has a similar number these days.

[purposefirst]

Hi Owen,
I appreciate your response.

Upon reading your first post, my first thought was are you sure the 99 mg/dl wasn't 99 nmol/l? First is very high, the second is almost "normal." Units make all the difference.

I don't know what second number you are looking at. I gave two Lp(a) numbers: My April test (by BioReference Laboratories) read 99 mg/dL, and my September test read 95 mg/dL. Nearly the same, and both labeled as high on the reports. I checked again, and yes, those are my lipoprotein(a) numbers and both as mg/dL. Both reports say the number should be below 30. The first report (by Health Diagnostic Laboratories) gives the reading as being of "Lp(a) Mass" -- What does "Mass" mean?

But it makes sense that my Lp(a) would be likely to be high as I understand that high Lp(a) is particularly genetic, and there is a history of a lot of heart attacks in my family.

Your additional information above gives me hope. I recently upped my lysine to seven gms/day. Just today my order of Douglas L-Proline arrived. I am adding a gram/day of that to my Cardio-C (totaling 2 g of proline). I'm making sure that my supplements are of high quality!! Do you think I can go higher on these amounts?

Your book arrived yesterday and I started to read it last night. I see you have gone into great depth in your book regarding lipoprotein(a). I'll be reading more of it tonight. Your writing is very clear and easy to comprehend -- very well done! When I'm finished I'll write a review to appear in Amazon.

Thanks again, you are doing a wonderful job!

[ofonorow]

As far as lysine - I hope the topic is still around where Johnwen computed the "highest" safe level of lysine... Maybe 12 grams, but from our experience 5 or 6 grams should do the job, and as little as 2.5 g lysine daily cleared my uncle's 70% blocked carotid artery.

We make proline so deciding on the optimal amount is trickier. The Heart Technology product, which forms the basis of almost all the early testimonials, from memory, has about 400 mg of proline per serving. Most people with CVD took 2 servings daily, or 800 mg of proline. (I know some alt docs recommend as much as 2000 mg daily. I wouldn't go higher myself, unless my Lp(a) was extremely high.)

As far as "mass" it leads to an interesting discussion. As Pauling/Rath point out in their first patent, there is a very wide distribution of Lp(a) in human beings - both amount in the blood and size of the particle. (This supports the idea that Lp(a) is a rather recent evolutionary development in humans.)

The common way in the US to measure cholesterol, and Lp(a) is a variant of Low Density Cholesterol (LDL) is mg/dl.

However, because a large mass (mg) is actually better than a lot of smaller mass Lp(a) particles, Atherotech via their VAP test would report Lp(a) in terms of ordinary LDL particles - more of a count of particles than mass.

Lately, because of this issue (the number of particles is more important than the total mass as large particles are less "atherogenic") the new units are in nano moles per liter - a number of particles. From memory, that number is normally around 90 nmol/l - which triggered my question.

[purposefirst]

Owen,
First, in reference to the part of your earlier comment above from which I quoted, I misunderstood. (I see now that when you said, "the second is almost 'normal,'" you were referring to the second part of your question to me (a matter of mg/dl versus nmol/l.) I apologize!

So as I understand the situation now, Lp(a) lab results are not sufficiently standardized and may not be accurate or reliable. "Calculated" results for Lp(a) are pretty much worthless. We want to see "measured" results. Also, measured results expressed as number of particles -- nmol/l -- are much preferred over measured results done as mass mg/dl. Do I have that right?

I contacted one of my labs today to ask whether my test was calculated or measured. They said talk to my doc. I emailed the lab who did the other test with the same question, no answer yet.

On page 63 of your book you recommended 3 labs, first choice going to Atherotech. When I next see my doc, I'll talk to him about this. Thanks again, Owen!

[johnyascorbate]

I don't understand- if a lab measures in in mg/dl wouldn't you just have to multiply hat number by 2.5 to get the Lp(a) in nmol/l? My recent Lp(a) was measured at 20.7 nmol/l. Doesn't that equate to around 8 mg/dl?

[purposefirst]

I don't understand- if a lab measures in in mg/dl wouldn't you just have to multiply hat number by 2.5 to get the Lp(a) in nmol/l?

The following from Owen's book, page 62:
"Unfortunately, ... according to the Lp(a) experts, there is no way to accurately convert from one measure to another."

Lp(a) particles vary in size. The smaller the particles, the more dangerous. When the measure is done in mg/dl, that is a measure of "mass" of particles per a certain volume and makes no distinction regarding size. But when the measurement is in nmol/l, that is of the number of particles within a certain volume. A higher number of particles implies smaller size. It is pretty confusing, but I think that is correct...

[ofonorow]

Given this complexity, there is one number easy to understand. Zero. When measured Lp(a) goes to zero (there is none, or a very low number) and you are taking optimal vitamin C to keep your total cholesterol around 180 mg/dl, then you should feel pretty good about your cardiovascular health.