Lipoprotein(a) is reduced by:
is the most effective direct treatment for Lp(a). However, higher doses may be required than for other abnormalities like low HDL or small LDL. The niacin preparations we favor are prescription Niaspan® (Kos Pharmaceuticals) or over-the-counter Slo-Niacin® (Upsher-Smith). Both are better tolerated than over-the-counter “immediate-release” niacin, which tends to cause intolerable hot flushing. However, immediate-release niacin is otherwise safe but should not be taken more frequently than twice a day. All three preparations are very safe, with little risk of liver toxicity if taken properly. Total daily niacin doses of >500 mg should be taken with the supervision of a physician.
in females may lower Lp(a) around 25%, though estrogen, of course, has other considerations that need to be fully discussed with your doctor. Testosterone can be helpful for men and reduces Lp(a) by 25%. We use testosterone cream with great success. (A common dose for men >50 years old is 50 mg twice per day of a topical cream; dosing is best based on blood levels and must be prescribed). For any hormonal preparation, we advise bio-identical human preparations, i.e, preparations that are identical to the human form, not Premarin® or other non-human forms.
can be a useful nutritional supplement; 2000–4000 mg per day (e.g., 1000 mg twice a day) can reduce Lp(a) 7–8%, and occasionally will reduce it up to 20%. The only drawback is cost; it can be pretty pricey. L-carnitine is not powerful enough to be used as sole treatment, however. It’s better as an adjunct with either niacin and/or hormones.
* Ground flaxseed
(2–3 Tbsp/day) exerts a modest effect of no more than 7% Lp(a) reduction, but it’s healthy effects on reducing LDL and perhaps small LDL make it a useful adjunct. Use it as a hot cereal or added to yogurt or other foods. The seeds must be ground (e.g., purchased ground or ground in your coffee grinder).
—Preferably raw or dry roasted (with no added ingredients like hydrogenated oils), ¼–1/2 cup/day, are our favorite, as they not only reduce Lp(a) but also reduce LDL and partly counteract the small LDL particle abnormality.
* Vitamin C
—1000–3000 mg/day, with reported reductions of approximately 7%.
Track Your Plaque target: If measured in nmol/l, <75 nmol/l is desirable. In mg/dl, <30 mg/dl is desirable. (However, because of the lack of standardization, “normal” values in your laboratory may vary, depending on the means of measurement; discuss with your doctor.)Copyright 2006, Track Your Plaque