I am so thankful for this information. I got a lipid panel with a wholistic MD a couple years ago as part of a wellness check and was told that all of my numbers were great, but I noticed the LP(a) number was off the chart (105 mg/dl)... When I asked my doctor about it he said it wasn’t anything to be concerned with because it was just something I inherited and couldn’t do anything about. So I never thought about it again until reading Outlive. I’m 35 years old and am so grateful to have read this book. Before reading it I was under the impression my risk for cardiovascular disease was was very low. Now that I know what I’m up against, I can pay special attention to mitigating other CVD risk factors…and stay on top of any new developments that come about

@blahblahblah9376

Жыл бұрын

"Off the chart" is relative. I continue to see people who overthink KZread video's. At some point folks you have to ask yourself if just maybe....you are a bit of a hyppchondriac? Why the need to report your own personal numbers? No one knows you here, the Dr's are not going to reach out to you...What attention are you truly seeking? Mental health is just as important.

@taylorsonstrucking9118

Жыл бұрын

Ironically you make a good point.. alot of this shyt is mental control, mental bandage

@cyunks3232

11 ай бұрын

Thank you for sharing your experience. This is a scary journey with most docs ignoring LP(a) or blanketly prescribing a statin. My LP(a) was 173. Yikes

@kate-lq3xg

9 ай бұрын

What are you doing for your lpa mine is 143

@Dfl87165

7 ай бұрын

@@kate-lq3xgListening to the discussion would give you a better answer than asking a random person who most likely does not have secret knowledge about lp(a) lowering methods that neither of the MDs in this discussion have. It is currently still subject of research how lp(a) can be lowered and if that will have measurable impact.

good discussion I worked in Cardiology research for 20 yrs and am glad, that Peter makes these interviews public

Well, as someone who just got LPa tested at 234 nMol/L, I can say this is a much appreciated but very discouraging conversation.

@plants_and_wellness1574

2 жыл бұрын

Mine was 246 nmol/L. If you can get your ApoB and LDL lower, it can help. I did read one study that showed a plant based diet was able to lower LPa and we know it lowers ApoB and LDL, so maybe try that. I’ve been 100% plant based since getting my results.

@markplaton84

2 жыл бұрын

@@plants_and_wellness1574 Interesting :)from what i understand nothing change's it not even plant's hardly ever eat meat or plant based food's and my score is 9 nMol/L also normal LDL normal HDL range just saying.my Dr still want's me on statin's.

@plants_and_wellness1574

2 жыл бұрын

@@markplaton84 LPa is based on genetics, so if yours isn’t high then you probably don’t have the gene that causes it to be. Mine was 312 before going plant based and as of July it’s 246. I’m getting it checked again soon. Why does your doc want to put you on a statin?

@markplaton84

2 жыл бұрын

@@plants_and_wellness1574 My LPa is 9 first he used family history my age 65 i smoke like 6 a day for years maybe 10 pounds over weight 150 LDL 40 HDL CAC score 237 all my other blood work and liver work is normal which he never seen until after telling me i need a stain :)

@plants_and_wellness1574

Жыл бұрын

@@markplaton84 did he check your ApoB? Your LDL is quite high, it’s supposed to be under 100 but many doctors say it needs to be closer to 70. APOb is what really matters and if your LDL is high, then most like your ApoB is high.

Checked my Lp(a) just recently, after hearing about it a lot. My levels were undetectable- below the threshold of the lab, at any rate. I found that quite pleasing and reassuring, ngl. I didn't even realise a "you have so little our lab equipment just throws up a zero" result was a possibility.

Wonderful discussion, thank you for addressing this big issue that the vast majority of cardiologists and GPs do not care to look into and when you ask them to do those tests mentioned they do not really want you to do. This will include the Lipid Subfractions

My Lp(a) is non-detect,

@steinervision7643

24 күн бұрын

You seem in very good shape, keep on trucking!!!

One of your best yet. Masterfully brought the complexities of the subject to a very understandable level. Even at 1.2x speed :-)

@dinomiles7999

2 жыл бұрын

And how did it change your behavior ? NOT !

@EarlLedden

7 ай бұрын

How dare you bring us back to reality?! I had to listen twice to get to the understandable level. I just want to be able to intelligently discuss this with my dr. next visit, and perhaps run the particular tests next blood test.@@dinomiles7999

This is a gift! Thank you for sharing your immense knowledge.

omg I'm 58 and have been waiting for a treatment for 2 decades now :( I've tried getting in the trails but there is not one near me :( I'm the oldest living male in my family by 10 years with high lpa. I guess I'm lucky to live this long... but I'm waiting for a treatment still.

@plants_and_wellness1574

2 жыл бұрын

pubmed.ncbi.nlm.nih.gov/30014498/ this study shows that a plant based diet can reduce LPa. A plant based diet will also lower ApoB and LDL. Maybe give it a try. My LPa came back at 246nmol/L and I immediately went on a plant based diet. My ldl dropped just a few weeks in but I haven’t retested ApoB or LPa yet. Will do that soon to see if it’s helped at all

Statins definitely lower, LDL and APO B.. PSK9 inhibitors obviously do the same thing, but even more pronounced! So riddle me this, why is cardiovascular disease still the leading cause of death. It makes tjis last pandemic look like child’s play. I think it’s much more complicated. I believe clotting, Blood pressure, metabolic disease, pre-diabetes. And constantly high insulin levels played in a bigger role. When I used to do heart anesthesia, I would say 60% of my patients for coronary artery bypass graft surgery had normal LDL’s. However, they were metabolically broken. So I don’t think we have all the answers. However, not sure driving LDL down to the 30’s is a good idea. It might be. However, I don’t think it’s that simple.

@davidzip8841

6 ай бұрын

You need to learn about independent risk variables. Obviously someone who is diabetic is at increased risk of cardiovascular disease. But if they have elevated ApoB they are also at risk irrespective of their insulin levels. These are independent risk variables, and both should be addressed.

So proud to see all this research from Quebec. Also studied engineering at Laval University, but this fascinating discussion is way above my understanding. Really grateful you do them. I'm definitely going to ask for my LPa and apoB tested. Been WFPB for 7 years and high level endurance athlete and never tested since, but all previous tests I had high LDL, so does my family.

@plants_and_wellness1574

Жыл бұрын

Did you ever get tested? My LDL went down since going PB but my Lp(a) is not NT from 246 last June to now 380 😮 so it went way up since going PB 😢

@purpleblueunicorn

Жыл бұрын

@@plants_and_wellness1574 Should not be related and should not change either. Maybe it's a test sensitivity issue. Will get tested in the following month, lost my family doctor and process to get tested can be long here.

@plants_and_wellness1574

Жыл бұрын

@@purpleblueunicorn if you’re in the states then you can order your own lab work online and go to any Quest and get your blood drawn. That is what I have always done. I’ve also used the exact same lab for all of my blood work so I don’t know why my LPa keeps going up. Up over 100 just from June.

@purpleblueunicorn

Жыл бұрын

@@plants_and_wellness1574 I don't know about the change, but since Lp(a) do have an apoB marker, the apoB (count) test should encompass the Lp(a) result and if your apoB count is low, you should be fine. But it seems important to know the count, not the mass, because that's what causes trouble with Lp(a) being even more dangerous if I understand correctly. What units are your Lp(a) and did you get an apoB result? I'm in Canada, so have to deal with long wait times, but I should be able to get those tests for free if I can convince a doctor to give me the tests.

@purpleblueunicorn

Жыл бұрын

@@plants_and_wellness1574 Also seems to be some reliability issues with Lp(a) measurement, I would contact your assay provider and let them explain the results, because it should not change. Here's a good article on the subject if you can access it: pubmed.ncbi.nlm.nih.gov/33040574/

I've listened to over 50 talks on this matter, not to mention addicted to Dr Attia's talks and it's this talk that's convinced me to subscribe to membership 🙌🏻 I must also say that I had to describe what LPa and APOb was to my doctor!!

what percent of all clinical atherosclerosis is caused by elevated lp(a)?

Very informative podcast... For info, here in the UK the experience of me and people I know is that on average GPs are extremely reluctant to offer either ApoB or LP(a), unless you get lucky with a GP who is either really open minded or up to date on the research.

The Niacin is very confusing. How can it do all those positive things and not reduce outcomes? How can Don Layman sit here and say saturated fat and cholesterol intake dont matter if you are healthy? Layne Norton said it is “energy toxicity” …. For the love of God I have no idea what I am supposed to eat. There is so much evidence saying what you eat doesnt matter. So is it just as simple as people that eat fish and fiber tend not to be obese and over eat and therefore they have fewer events across an entire population? Is it just all about over consuming calories? Being overweight? I wish I had more knowledge.

I have elevated lipo protein A .. found out after having stents for 80+ occlusion in multiple coronary arteries. Found out after being blown off by my physicians. I’m fit thin. Ride my bike. My brother/ mother died of SCD so I pushed the issue. Now post stent am refractory to statins and on Repatha

Thank you so much for this informative episode, under appreciated topic indeed.

I thought part of the lack of benefit from the Niacin(Niaspan) test was due to the addition of chem that reduced flushing. Either way..if something reduces LPA, and LP(a) and increases HDL yet provides no benefit one must question whether the numbers mean much of anything (at least in terms of reducing risk)

@dr.proteomix1257

Жыл бұрын

I heard the same through Dr Ford Brewer, niacin seems to be one of his favorites

@benphartine

11 ай бұрын

These discussions always seem to miss anything about the inflammatory nature of seed oils and the benefits of reducing or eliminating them from our diets. There are only a couple of people on KZread that talks about them; notably one being Tucker Goodrich and the other is Dr Chris Knobbe. Here are two good videos, one with each of them. kzread.info/dash/bejne/mnqatMulo5eTiaQ.html kzread.info/dash/bejne/lJxpx7aiac26gNo.html . Seed Oils are the #1 Problem in Your Diet / Chris Knobbe, MD | Peak Human Podcast kzread.info/dash/bejne/nI2Fk8SGlcaZd7A.html Omega-6 oils in our body fat, the half-life is 680 days. I found that at about the 48:00ish minute mark of kzread.info/dash/bejne/lqt2s6lpdcScj6w.html

I've got extremely high LP(a), about 100 points above the reference as stated by Quest Diagnostics. From what I understand there's not much I can do about it (because it is almost completely genetic) except try to lower my LDL cholesterol as much as possible.

@a.g.hustlegarland4197

2 жыл бұрын

What's your number in noml/l?

@donwinston

2 жыл бұрын

@@a.g.hustlegarland4197 191 nmol/L. They say the normal level is < 75 n

@debstayblessed9549

2 жыл бұрын

Niacin effective. Book: Cholesterol, Cure. Must monitor liver.

@plants_and_wellness1574

2 жыл бұрын

Mine is 246 nmol/L as of July. I switched to a plant based diet since there was one study that showed it was able to lower it, that and it lowers ApoB and LDL.

@yl1487

Жыл бұрын

Either (V)LF-(oil free) plant based or its apparent opposite, (V)LC-(V)HF, seem like they can be effectively implemented as part of a strategy with potential to do a very great deal - much can be done. Be wary of what are misleadingly described LF-HC or LC-HF which are often, in actuality, far from being low in anything, just muddying the waters.

Most cardiologists ( nevermind other specialties) are so inadequate that it is truly embarrasing. Medical decision making over a lifetime is the leading cause of mortality and morbidity.. There is no getting around it, if you value your life and health, make properly informed choices. Ira Goodman MD

@jaymehatfield9540

9 ай бұрын

Wonderful sentiment DocGoodman but you know it's a minefield out here. The dogma in MDs is stunning... who never ask one single question about diet or stressor as factors. No healing only amelioration.

I would love to see a study of all of these levels pre- and post-liver transplant.

1:07:20 - as one who’s both parents had normal Lp(a) but mine very high, I’m totally aligned. Check before 18, and in light of the potential that estrogen may mitigate (mask/lower) levels, before first menses in girls.

I wish someone would speak about the major LP(a)SNPs and their variants. If the SNPs are ‘normal’ ( no variants) is LP(a) still as dangerous ?

@TheShumoby

Жыл бұрын

I don't have the variant and my lpa is less than 8.4nmol/L on low carb

Really helpful - thank you for posting this

LPa is associated with CV, but it's not the cause. And for anyone to say it is a genetic marker that can't be lowered is absurd. In addition, please do explain how 25% of centenarians studied had an LP(a) level of over 30 mg/dL

Had an LP(a) of 144 nmol/l and high LDL (4.2 mmol/l). Had a sudden heart attack age 53. Extensive ASCVD and stenting. After lifestyle changes, intensive statin therapy and more recently Inclisiran my LDL is 1.2. Having my LP(a) tested again in 4 months time, hoping that Inclisiran reduces it by 25% to reduce residual risk. Fingers crossed.

@stephenrose9157

Жыл бұрын

Good luck

I literally feel like I am becoming an educated physician watching your videos and im just a pot grower lmao

@mz4987

4 ай бұрын

Don’t delude yourself.

- Lp(a) is a large lipoprotein made by the liver. - Since it is naturally made by the body, is there a biological purpose for it? Why did we evolve to produce Lp(a)? - Does attempting to significantly / aggressively reduce it, potentially cause a risk for an adult ... by not having enough Lp(a) available to assist in the repair process? - Lastly, does Lp(a) in a person with very low inflammatory markers and an optimal metabolism ... pose the same risk cardiac risk? You always say that everyons eventually gets atherosclerosis no matter what ... what is the differnece in the ones that pass away from it and the ones that don't?

@hypnotiqpits13

11 ай бұрын

From what I’ve read LDL kind of came in to take the place of vitamin C and some humans, however many thousand years ago. And it does help the repair process. The only downside is it apparently it helps the repair process and the vascular system so aggressively. It causes the blockage.😢 and that kills us. I died on the table once in the Cath Lab already.

@anara5570

6 ай бұрын

Great questions! I was thinking in the same direction.

👍 This is a huge treat on Lp(a) pathology, soo informative and beneficial, reealy enjoyed it, thank you so much Peter and the guest 👍 Unsolved: the conversion between mg/dl and nmol/l - Lp(a) has a molecular wt of 300k-700k Da. So the conversion factor = mg/dl x 10 dl/l x 1000k ng/mg / 500k ng/nmol = mg/dl x 20 (nmol/l) as compared to 2.5 as said here. What is wrong ??

If the blood work shows Apo B is high, but Lipoprotein a is extremely low, how does that rank as cardiovascular risk for a person on low glycemic index nutrition??

Excellent discussion! good to know the relationship between LPa and risk, but there is always that lingering sense of a piece of the puzzle is missing, the genetic would of been around for thousands of years, why wasn’t CVD a prevalent cause of death throughout human history? I do think like Apoe4 , context of environment and diet plays more of a deciding role in the outcomes……just a thought

@dinomiles7999

2 жыл бұрын

So what can we do ?

@megan_kal

2 жыл бұрын

This is an interesting thought... my two cents is that heart disease takes years to develop (a strong genetic cause would still see early heart attacks in 40's and 50s), so for thousands of years, humans didn't often live past 30 years old.. they died before heart disease could manifest with visible symptoms. It was probably there but just didn't have time to be the ultimate cause of death as so many other things ended human lives quicker than heart disease.

@robert111k

Жыл бұрын

@@megan_kal, the 30-year-old-daying thing is a myth. The Life expectancy was low because half of the people died before they turned five.

@Rina-ie2sz

Жыл бұрын

@@megan_kal I have slightly elevated LPa but only my great grandfather died from heart attack at 73. All my other relatives died at 80 or older. My father died from cancer early but it’s probably related to Chernobyl as he lived in Ukraine.

@findingthereal9052

Ай бұрын

Evidence from ancient mummified Egyptians demonstrates CVD, arteriosclerosis, etc. Death from heart disease mostly occurs after reproduction so hasn’t been eliminated from the gene pool.

Why do atherogenic plaques build up only in pressure aortas? why dont the plaques form on non pressure sides? why lipids are considered the culprit since if they are running fine unoxidezed the body should eflux them normally .. the idea that cholesterol is the marker for cvd starts to become really stupid when there are clearly other markers for metabolic disorders that are really raising enormously

@PestisNonSapien_GMO_exHuman

2 жыл бұрын

Type 2 diabetes has a hazard ratio of 10.2. Insulin resistance 6.4. Obesity 4.3. Smoking 3.9. LDL 1.6. Why focus on cholesterol when blood sugar is much more of a risk? He explained it near the end when he mentioned his conflict of interest. He's a vegan so he must demonize fat and praise carbs. BTW, smoking spikes cortisol. Chronic high cortisol results in cortisol induced insulin resistance. Which is why smoking is a risk factor.

@PestisNonSapien_GMO_exHuman

2 жыл бұрын

Diabetics get similar damage to the capillaries in their eyes. Resulting in various eye diseases. You can even watch drug commercials which admit that high blood sugar caused the damage. Yet they refuse to make the same connection to arterial damage. Instead they resort to blaming the firefighter(cholesterol) for starting the fire.

@donwinston

2 жыл бұрын

@@PestisNonSapien_GMO_exHuman You are full of crap.

@TheShumoby

Жыл бұрын

@@PestisNonSapien_GMO_exHuman yeah, I'm a low carber who eats mostly red meat 90% of the time and my LP(a) is less than 8.4nmol/L.

Quest diagnostics in Florida measures in nmol/L

Thank you for covering LP(a) this thoroughly. It’s good to know we only need to take this 1 test 1 time to determine our levels and they are pretty constant throughout our lives. #KickAss100YrOld

@dinomiles7999

2 жыл бұрын

So whats your point ?

@jimking6484

2 жыл бұрын

@@dinomiles7999 my point is LPa is not like HDL or triglycerides or even LDL which change annually depending on diet. Everyone gets or should get annual bloodwork. It’s part of your physical. An LPa test has to be paid for outside of regular bloodwork. If you are monitoring your bloodwork regularly you only have to pay for 1 LPa test to know that it will basically be the same 10 years from now. I thought you would have to test it annually in an Ion test like ApoB or CRp. Basically it’s pointless to pay for more than 1 LPa test in your lifetime.

@jimking6484

2 жыл бұрын

@@kevinjones7505 wow. My Gp won’t even do an LPa test. I have to go to a functional med doctor and it’s expensive. How often to you test your LPa. I get once a year blood tests but my functional med doc said it’s not like APOb or triglycerides that change enough month to month. LPa is more of a genetic predisposition. Do you have a disease?

@bobbymath2813

2 жыл бұрын

@@jimking6484 I just went into a Quest Diagnostics lab near me to get it done - $60 bucks. Didn’t even go through my physician at all. For something like this, it was so important for me to get a sense of where I stand-and as soon as possible-that I just felt comfortable taking things into my own hands. If results come back suggesting I’m elevated, I’m prepared to absolutely obliterate ApoB!

@jimking6484

2 жыл бұрын

@@bobbymath2813 I’m going to do it as well. Thank you for sharing. I’m going to check the prices on APOb, and CRP as well. Thanks!

I'm unable to keep up with this one. 😥 My brain fries with so many acronyms. Can't process all this info. Will have to do some digging on my own.

@EarlLedden

7 ай бұрын

I understood this 50% more second time through and am with you 100% on the acronyms.

@jaymehatfield9540

6 ай бұрын

Acronyms are a curse of our trending communication style. I feel your frustration. On paoer, in texts, in emails, in person, people cannot say the words. Everything in life is now abbreviated.

What a great informative video!! Thank you!

Maybe low levels of Lp(a) are not that good? The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. 2012 article: CIMT in asymptomatic subjects with low Lipoprotein(a) levels.

@Carlosconga

Жыл бұрын

What is considered low?

@StanDupp6371

Жыл бұрын

@@Carlosconga Ask the doctor running this site.

@hypnotiqpits13

11 ай бұрын

I have extremely high Lpa I have 8 coronary artery stents now over 11 years First was massive heart attack

@StanDupp6371

11 ай бұрын

@@hypnotiqpits13 "Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.

Hello @peterattiamd I did a test recently and the numbers are as follows: HB1AC: 6.0 %; Lp-a: 45 mg/dl; Total Chol:148 mg/dl; TGL: 120; mg/dl HDL:42; mg/dl LDL: 82; mg/dl VLDL: 24 mg/dl; APO-B: 102.2 mg/dl; HS-CRP: 0.58 mg/l; Homocysteine: 8.9 umol/l; How high is my risk of CVD and what can be done about it?

@jt8142

Ай бұрын

You’re pre-diabetic so you should work hard on lowering your HbA1c by consuming fewer carbohydrates/processed food and minimal seed oils.

what do you mean that measurement of LP(a) is stable over time, I've measured it 2 times in a span of 23 days, it increased by 17.9 from 68.5 mg/dl its stable 26% alright :) while LDL-C measured directly decreased by 4.4 from 168.6, HDL-C increased by 1.5 from 42.6, and TG decreased by 44.3 from 127.5, tests were done by the same lab. since I cannot measure my LDL-P, could it be if LP(a) is stable, then my LDL particle size should drop and its count should increase in order to accomodate this 26% LP(a) increase?

Excellent content. Surprised no discussion re ezetimibe. Can mitigate statin side effects allowing lower, even intermittent dosing (eg as little as once weekly 20 mg rosuvastatin), which is important when discussing commitment to lifelong primary prevention and someone as young as Ben.

@jaymehatfield9540

9 ай бұрын

I would love to read a study of significance this. Etizimbe and rosvastatin ok that's my boat but I don't want to get in. are you saying medicos don't know how to heal this, only ameliorate?

What a shambles when it comes to lipoproteins. One misunderstood and maligned particle category after another ... I say this on account of a related video in the suggestions pane - "Professor Steven Nissen - Lipoprotein (a): a new target for therapeutic intervention" Ever new heights of ludicrous absurdity ... let's take a physiologically significant particle with key functions across the human's organism and try really hard to ignore any sense of curiosity with regard to their ultimate relevance, instead try to figure out how to 'treat' it - all the while relying on obfuscatory technical explanation-like chatter to distract the hapless 'audience' from the fumbling fingers hidden in pretentious gloves. My goodness. Siobhan Huggins at least makes an effort to resist the collective mind numbing codswallop that we are all inviting to our door with our collective lack of curiosity.

@AMogus-jr6qk

Жыл бұрын

The fuck are you talking about

I have very high LPa age 60 but zero CVD.

@plants_and_wellness1574

2 жыл бұрын

Do you remember your number? I just got my labs back and it shows 246 nmol/L. Also, do you have high LDL or ApoB?

@navirose9133

Жыл бұрын

@@plants_and_wellness1574 Mine and 1 sister's is over 300. We both have Von Willebrands disease.Other sister doesn't have it. I'm 68 years old, parents survived to 83 and 91. No heart disease. My other numbers are normal. Doctors conflicted about whether to put us on statins. Looking forward to advanced treatments coming soon.

My LP(a) is less than 8.4 nmol/L. I didn't ever hear anyone having a heart attack on both sides of my family. There were stroke due to hypertension on my dad's side.

Lpa 124.5 nmo/l and Apob 70 - should I ask my MD for PCSK9i ?

Why aren't blood thinners prescribed for elevated LPa when a person has a stroke? This happened to me but only because I went to an electrophysiologist after having an ischemic cerebral stroke. He found that I had a very mild A-fib which is why he put me on the blood thinner at age 80. I feel the blood thinner is protective for future strokes. I requested a low dose (10mg) statin to bring my elevated LDL of 104 down to 77 plus I'm a whole food plant based eater and stay strictly away from saturated fat. I only discovered a low level elevated (85 out of 50 norm) LPa when I did research and requested the test for LPa. No doctor ever suggested I be tested for it even after I had the stroke. No arterial plaque was noted in my workup following the stroke and no stenosis. US medical care mostly sucks at least based on my ´experience unless you find an unusually astute doctor which I think I have now found.

QUESTION: So really, we don’t have a conclusive answer on lifelong treatment with niacin for the reduction of Lp(a)? It may provide a benefit, just not one that would identified in the outcomes trial?

@beepbeepnj2658

Жыл бұрын

"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

I would like to see Paul “celebrate your high LDL” Saladino’s response to this

@Patricia-lz2zo

Жыл бұрын

I've been on the carnivore sights asking about promoting such a diet, for those who don't know they have LP(a). Also asked if they know what that diet would do to them. Waiting for responses...

@metalrunner4398

Жыл бұрын

@@Patricia-lz2zo I hate dietary cults of any sorts. And I am Vegan. However, it is for me purely ethical thing and I don’t claim it is the healthiest diet. So while I am a devoted vegan I hate “plant based” cherry picking and quackery. But carnivores are absolute champions of cherry picking (vegans at least cherry pick human studies, carnivores cherry pick rodent mechanisms), quackery and cultism. They are extremely agressive and while some vegans promote malnutrition (frutarians,…), carnivores promote inevitable ASCVD for most of long term followers. I told my carnivore friend that my apoB is 61 and he told me that no human being should walk around with such low amounts of cholesterol 😂

amazing. they are real deals with researches \studies\ with caring mind for patients

Great discussion!

two children with high Lpa and Von Willebrand diease type 1, I was told the second disorder could mitigate the effects of Lpa. We are hoping this is true.

Repatha have any effect on particle size???

Quest Diagnostics just did my LP(a) in nmol/l - it was 242 nmol/l

Anybody else find it strange that any over the counter treatment is always useless. Niacin reduces LPa 20 to 30% and increases HDL and it is not recommended???

@villamartignoni

3 ай бұрын

Unfortunately, niacin did not reduce mortality. This means it “cleans” the test results, makes it look pretty, but patients taking it did not have much benefit when compared to those not taking it.

My Mayo Clinic cardio doc will not allow me ask about particle size or receive tests for inflamm. He is is obsessed with Total Choles and generic LDL and mega-doses of statins. The Clinic has him under their thumb like ""The Firm"".

@miroeight

2 жыл бұрын

i don't get it, why do americans (apologies if assumption is wrong) have to go through their doctor to get blood tests. can't you just do them on your own?

@DrAdamHotchkiss

2 жыл бұрын

Order your own labs! There’s plenty of online places you can do this like Marek Health etc and have some freedom over your health

@chuckbecker8735

2 жыл бұрын

@@DrAdamHotchkiss Thank you. I shall because I now need to be swiftly proactive rather than merely trying to be more persuasive... [ thus passive ] .

@DrAdamHotchkiss

2 жыл бұрын

@@chuckbecker8735 couldn’t agree more! It’s too bad Institutions and insurance companies dictate what physicians (and ultimately patients) can and cannot do

@danielmccarthyy

2 жыл бұрын

Mayo is awesome for using outdated snd ineffective treatment protocols to exacerbate CVD.

Is Lp(a) not associated with clotting factor of blood? which may have some past benefit? I personally heal quickly from wounds. Pcsk9 inhibitor seem to drop lo(a) +/- 30% Notable, I have been taking zedia as a monotherapy , which achieved a 41% drop in apo b, lp(a) also dropped ( 30%) to 195nmol/l (still very high)in my case. As for increasing calcification, I have a zero cac at 57.

I’m confused at the end why Benoit put himself on a statin because his high LPa if they established that statins actually increase LPa. What is the benefit then?

@adamtraininglog4112

2 жыл бұрын

Reduces LDL which LPA rides on. Also stabilises plaque and mortality.

@purpleblueunicorn

Жыл бұрын

They also covered why statins are still beneficial even though it raises LPa. It might just be a measurement effect.

Look at TRPV4 that causes the break in the endothelial monolayer and causes monocytes to become M1 inflammatory macrophages that produce ROS that oxidized LDL and phagocytizes the LDL. TRPV4 does this in response to stress from hypoosmolarity such as in hyponatremia. TRPV4 does this in osteoblasts that lead to osteoclasts that go into the RANKL and bone breakdown.

I am new to this. Thank you! 🙏👍🙏

which takes precedence, apoB or LPa? Confusing. Update: guess that was answered. wondering at what age is LPa begin to stay consistent

I think that guest often says “lpa” when thinking “lp little a” 🙄, almost impossible to follow and comprehend…😏 yet such a wonderful and eye opening pod…guest is fantastic!

What do you say to people who lower their Lp(a) by almost 80% using Pauling Protocol? Anecdotal even with lab reference evidence? Is it fair to say that it isn't understood enough to call it dangerous? Why statins? Why are you recommending poison?

Is LP(a) not mainly the best marker for oxidised LDL? And the oxidation of the LDL the real arterogenic causal factor? Which doesn’t mean that I think the influence on fibrinogen/clotting has no role.

@ipomoea_batata9906

Жыл бұрын

Yes ... concur ... I guess that you may already be aware of LP(a), and small oxidised LDL also being able to be joined by ratio of triglycerides to HDL, emphasised by Robert Lustig among others as a more meaningful measure - a good so called poor man's indicator for damage ... and fibrinogen ... yea give us a break please Peter, and to throw the phrase back at him: appropriate in this context - necessary but not sufficient ... a phrase which Peter has been known to use rather inappropriately, when talking with Dave Feldman.

@dougstephens1923

Жыл бұрын

My thoughts too. Have you ever seen a source that documents the process of phospholipid oxidating? For example, at what blood sugar level does it occur? Is there the potential to control blood sugar so that it does not occur? So many questions but I'm hoping that blood sugar control can pre-empt the pressure towards using statins.

I have high LPa. How can I find out about getting involved in new clinical trials or studies?

You are referring to people in Amsterdam like John Castelijn, probably Jonas Castelijn and Eric Strews. I can’t find Eric Strews could you please give his correct name. I am in Holland. LPa pateint, and would love to consult with him. Normal physicians here do not know about LPa and reject my telling them this is an urgent problem.

If someone has elevated LPa they can certainly get BASELINE Cardiac Cath. If clear - every 5 years. If ASCVD can get stents, meds, etc. or just decisions made about low dose contrast repeat Cardiac Caths. If no ASCVD with elevated LPa on heart arteries, maybe less risk in brain arteries as well.

@jaymehatfield9540

9 ай бұрын

Stents. Mere amelioration. Collectors. good for 3 or 4 years

@Davidssss-rb6bh

6 ай бұрын

Very illogical considering the risk of cardiac caths every 5 years

Anyone know if Lp(a) is Apolipoprotein A1 or is that something different?

@test_account3536

2 жыл бұрын

Those are two different things. ApoA1 is one of the proteins that sit on HDL particles. It serves as marker of HDL particle count.

@jt8142

Ай бұрын

Lipoprotein (a) = Lp(a)

Roche are already manufacturing gen 2 Lp(a) assay (nmol/L) for clinical blood sciences labs here in U.K.

You said almost vegetarian diet- would you consider a low fat vegan diet? Dr Gregor speaks of a study where it was found to help.

Exercise, stay lean, no junk food, get sleep, reduce stress, fast and eat low carb/0 carb to drive insulin down to baseline, get outside as much as possible. Our body doesn’t make all the millions of processes to kill us! Inflammation causes all these blood markers to make us ill.

Oh, yeah. I order my own blood tests and decided this year I would check for APO-B. There was a mysterious Lp(a) result. Had no clue what that was so searched and was rather stunned. I take vaccines but I do not do drugs (ok, I take aspirin or acetaminophen a couple of times a year) so I had turned down my doctor’s advice to take statins for my high total cholesterol (270) back when I was still going to the doctor, like 5 years ago. Anyway, my current total cholesterol, after 7 years of being a vegan, made it down to 220. Yahoo! But Bummer, my APO-B was 1844 nmol/L (the “very high” bar is 2000!). Then this mystery Lp(a) was 312 nmol/L (the reference level was should be 125! That extremely high APO-B particles (1844 nmol/L) and very low triglycerides😂 (77 mg/dL) means my LDL cholesterol of 148 mg/dL + the triglycerides are distributed over quite a number of small LDL particles, 576 nmol/L, which shows on the test report as being at the larger end of the small particle size range AND at the 50% point of the population. my large LDL particles are at the smaller end of the large particle range. In short, at 50 lbs overweight and old (73), I am a ticking time bomb for a heart attack. I do exercise an hour a day on my treadmill, set at 4% incline, at a particular heart rate, 110 BPM, and once a week I take it up to my max of 148 for 1 minute. And I do some weight work. Have I done anything to fix my cholesterol level other than staying on my low fat vegan diet? Not yet. I am trying to lose weight but in the dead of winter, that is like slogging thru mud. When a healthy vegan diet of only soy milk and tofu as processed foods does not keep you thin, then weight loss requires eating fewer carbs…it is difficult. Oh, like find a doctor….I might do that. I would like to know how my aortic valve is doing; calcified valves do not work very well. Anyway, you should listen to these good Canadian doctors and find out your numbers. The buzz on the other good sources on the internet is that your children should be checked for Lp(a) once at age 2.

@jt8142

Ай бұрын

Your so called healthy vegan diet is not working if you’re pre-diabetic. You need to get your HbA1c down to 5.5 or lower. You’re clearly consuming way too many carbohydrates and probably a bit of processed food, and seed oils. Good luck.

LPa is covered by Medicare/insurance?

@Carlosconga

Жыл бұрын

Usually not

@jt8142

Ай бұрын

My cardiologist at UCLA ran the Lp(a) test on me recently and it was covered by my PPO insurance. My result was low normal:

Such a wonderful and informative video. But if you look at the comment section, it is full of so much misinformation one has to wonder whether anyone actually watched the video. If you have high Lp(a) you need to address every other risk factor for cardiovascular disease. One of those is reducing your ApoB as low as possible (I.e., below 50). Unless you are very lucky genetically, that will likely involve more than one pharmacological intervention starting with a statin in most cases. Hopefully, in another five years we will have drugs that can target Lp(a).

32:00 minute mark. But statins accelerate the calcification of your arteries. I know this as I have had 4 CAC scores before and on statins. Before statins I had a 25% annual increase in my CAC score. On a statin I had a 45% annual increase. So if someone has a high LPa and have a CAC Score of say.. 400 should they take a statin? Sounds like Repatha would be better but insurance probably wont cover it.

@bloominglilacsangha7464

2 ай бұрын

This is only true for some people. A statin can exacerbate hypercalcemia in a patient with underlying hyperparathyroidism and maybe other reasons. But it does not appear to be universally true. "A study performed by Hernández et al. in 2012 compared 478 statin users to 1837 non-statin users, with 84% of statin users having been on the medication for more than one year. Contrary to our observation, they showed no significant difference in the blood levels of calcium, 25-OH vitamin D, and PTH when comparing the two groups." www.ncbi.nlm.nih.gov/pmc/articles/PMC10905201/#:~:text=The%20drug%20has%20known%20adverse,additional%20rise%20in%20calcium%20levels.

Is there a direct consumer company to have an Lp(a) genotype done through that someone is familiar with ?

@TheShumoby

Жыл бұрын

23&me and Ancestry DNA has LPa snps rs3798220 (T/T) and rs10455872 (A/A). I have both typical snps and my LP(a) was less than 8.4nmol/L, and my husband has the same typical snps and his LP(a) was 20.1nmol/L.

In France too we still use LDL as a metric instead of Apo-B, I think nobody in my family had apoB or LPa tested

@thefreshprinceofnohair9703

Жыл бұрын

They still use LDL in Canada as well , you have to request the Apo-B or LPa test specifically and some doctors don’t even know what it is.

@reginawhite993

6 ай бұрын

I relocated to France from the US a couple of years ago. I have very high LDL and asked my cardiologist for ApoB test to confirm and he said it wasn't necessary. Today I took his script for a generic lipid and fasting glucose test on orders to retest after 6 months of tweaking an already good mediterranean diet. I also took with me a list of my own - ApoA, ApoB, lp(a) and A1C - and paid for those myself. Well worth the 50€ it cost me. In the states I'm sure it would have been triple that.

I just don’t agree when he says it’s not worth re-checking any more in life. There’s studies show you things that you can do to reduce it there’s one or they did a vegetarian diet that reduced it however, when you look at the specifics, they also reduce drain consumption by almost 100% at the same time along with dairy. So maybe you can eliminate one thing at a time and see what works for you so far I am able to figure out do you know mine swings 200 points with the same lab every few months

@StanDupp6371

11 ай бұрын

An individual's Lp(a) level is 80-90% genetically determined in an autosomal codominant inheritance pattern with full expression by 1-2 years of age and adult-like levels achieved by approximately 5 years of age. Outside of acute inflammatory states, the Lp(a) level remains stable through an individual's lifetime regardless of lifestyle. From American College of Cardiology.

Peter, loved the podcast and all the information but PLEASE stop interrupting and talking over your guests. It’s an immediate turn off and I usually will turn off whatever I’m listening to based on that because it drives me crazy and is so disrespectful . Please let your guest finish what they are saying 🙏

@obtuseangler768

Жыл бұрын

Nope, I have to interrupt you... There is no point in one person pursuing a subject any further if there needs to be clarification for greater benefit. If we are ever speaking in person, please ask your question right away. You'll be on your second question instead of your first one and after a few minutes you may know what you need to know. This is science. If Benoit doesn't like Peter's manners he doesn't need to participate again. He's an adult judging by his facial hair. Just revel in the fact that Peter is human, sometimes when he interrupts he's wrong. But then the conversation goes down a different road for a few minutes and I get to learn more...talk about a win win!

@alexanderohanlon8825

11 ай бұрын

And no one hits on oxidised ldl/ldl-a for why those with high level may be fine/no disease.

@plants_and_wellness1574

11 ай бұрын

@@alexanderohanlon8825 my mom has high Lp(a) and turns 70 next month. She didn’t even know until I paid to get her tested. She has smoked almost a pack a day for 50 years and has never had heart problems at all. She also didn’t have the best diet but she does eat better now. She has a low LDL though, like it’s 80. I think that has something to do with it.

@MrGarystanislawski

10 ай бұрын

If it bother you just don't listen or get your own podcast

@Annie-uo5mp

Күн бұрын

I,m French Canadian. I’m sure Benoit doesn’t even pay attention to the interruption. It’s just the way people speak.. no offence

Well I went carnivore. Lost 30 lbs. been working out and running consistently for 30 years. Total c 349/ ldl248/ HDL 47/ triglycerides 51. Glucose 80. A1c 4.9. I’m leaner. Can see my abs. Skin disorders are gone. Blood pressure normal. I think I’ll take my chances with high cholesterol. Gods bless

Love how the dude schooled Attia on the genetics (like a tap dancer) and Attia just brushed on by.

I think they are getting too focused on this and cholesterol in general. How they are saying some that have high lpa don’t get it and others with low lpa do. I think the body is just trying to repair damage caused to the epithelial cells due to high pressure environment and certain conditions that cause damage to glycocalax and these molecules repair them in the arteries but these plaques are just places that are repeatedly damaged and repaired and the process is overwhelmed. Instead of trying to control these intensely complicated processes and molecules that are so important to other bodily functions that messing with them can cause more issues we should worry about not damaging the epithelial glycocalax

Can you not stop or slow calcification with D3/K2 supplements??

@KevinSmith-4Liberty

7 ай бұрын

No clinical studies on it. Statins turn off the ability for K2 to work. So if you are on a statin don't bother taking K2. You would be wasting your money. Statins can accelerate the calcification of your arteries. Some believe this is called "stabilizing plaque".

@ladagspa2008

6 ай бұрын

No good proof of this. But it's cheap with low side effects, so take it

For someone wanting help pronouncing Kåre: Hard K. Å is like the o in "core". The R has no equivalent in english, but imagine the R in speeches by Hitler. The E is like the eh in "meh". For the lazy: "core" is better than "carey".

best informative interview

Is plasma pharesis indicated?

I have it at 50.5 mg/dL :(

Based on solid research you are looking at the wrong end. You need to look at your vitamin C dose, for when you take enough C, Lpa is not a problem.

I am a 73 yr old male and had a heart attack 2 yrs ago. Always been in very good shape--handball, hiking,etc. No weight issue either. My cardiologist prescribed 40mg of atorvastatin. In addition he has me on two 500 mg of niacin- am and pm. Told me right away that I was an LP little a patient. Is niacin an often prescribed med?? And thanks, Dr Attia, for your informative programs!!

@dinomiles7999

2 жыл бұрын

Apparently you were not in good shape or health you missed it good luck

@plants_and_wellness1574

2 жыл бұрын

Hey Dan, do you remember what your LPa number was? Mine just came back at 246 nmol/L.

@debstayblessed9549

Жыл бұрын

Niacin is vitamin b3. In high dosage it can be therapeutic. You and your doctor have to monitor your liver. It helps with lowering cholesterol and lp(a). Eating oat bran along with taking niacin is helpful. The book, The Cholesterol Cure by kalwaski (sp) is good resource. With all due respect You have to do your own research and not rely so much on medical professional.

@dinomiles7999

Жыл бұрын

Stop eating JUNK !!! Eyes mind heart and SOUL wide open.... NO FEAR !!!!

@hypnotiqpits13

11 ай бұрын

I read that niacin lowers it, but does not change mortality rate Same with psk9

Statins a good medication!!!! Statins block the production of mevalonate in every cell, every intermediate molecule between mevalonate and cholesterol is blocked! Examples, important CoQ10 needed for the production of ATP, Insulin Resistance problems .. etc. Statins give you a higher risk for heart problems!

@donwinston

2 жыл бұрын

You are full of crap. Stop spreading misinformation.

@ladagspa2008

6 ай бұрын

Wow, you must have 5000iq

The camera positioning is really bad shoing the head of Peter while the speaker is shown

This man kept being interrupted. :(

Great info, but the camera angle (with Peter’s out of focus head in the foreground) makes the interview seem strange.

“The results on plasma lipid is pretty good with niacin”…. Lol and attia hates it because of 2 large trials… penguin hole. Side effects of flushing is a joke. These guys seems to move pharma drugs. Niacin is cheap and has proven not to harm

@42dunbar

2 ай бұрын

There was no benefit found in lowering in lp(a) with niacin.

Then you have the people who eat very low fat plant based....they have the same rate of high Lp(a)yet no heart disease. Studies looking at LP(a) are not done on people eating a very low fat plant based diet with less than 10% of calories coming from fat.

@bloominglilacsangha7464

2 ай бұрын

I eat very low fat plant based and still have heart disease. . I have some coronary arteries that are 50% to 80% clogged with plaque. Lp(a) is the cause.

Come on, Peter, follow the money 💰

Association and correlation… are not CAUSATION! Another push for statins?

@ipomoea_batata9906

Жыл бұрын

Yep.

@beepbeepnj2658

Жыл бұрын

"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 all this discussion tells me is that doctors must be horribly overwhelmed and that the entire medical industry has the potential to be immensely benefited from AI assistance.

don’t you need apo b so you don’t get diabetes?

It is really disturbing to watch attias interviews. He is like a narcissist with no sense of basic politeness. And how he keeps advocating he's own choices, that base on conflicting studies, is just sad.

I have a high LPa and my doctor won’t prescribe Repatha

@KevinSmith-4Liberty

7 ай бұрын

Have your doctor refer you for a CAC Scan. If your calcium score is high and you have a high LPa then maybe insurance will cover it.

@TG-vg3qe

7 ай бұрын

My doc said you had to not be able to tolerate 3 statins to get it.

The chance that this matters 1% is questionable.