Lipoprotein(a) Cholesterol Guidelines

by Dr. Stephen Sinatra
Filed Under: Heart Health, Cholesterol
Last Reviewed 03/27/2014

Lipoprotein(a) cholesterol has been of great interest to many of you, and we’ve had many comments posted on the topic. I’d like to take the opportunity to answer a sound question about Lp(a) cholesterol guidelines from a concerned mom, because it is an example of what folks often ask that all of you can benefit from it. 

Lipoprotein(a) Cholesterol Guidelines Like many of you looking at the results of your cholesterol profiles, she reports that she is not sure what constitutes an alarmingly abnormal Lp(a) value. In her 50-year-old daughter’s case, the blood work read as follows:

  • Total Cholesterol: 173
  • HDL: 74
  • LDL: 87
  • LDL cholesterol-C: 90
  • Lp(a): 12

In this particular case, there is no family history of cardiovascular disease, and the lipid panel results were within normal limits. 

As with other blood level parameters, there may be some variation in normal ranges for lipoprotein(a) as reported by different labs. I have seen some labs where up to 30 was within the normal range for the equipment and reagents they use. Our concerned mom reports that, for her daughter’s lab, anything over 10 is out of the normal range; hence her concern.

Her question is a good one. In the absence of any family history of cardiovascular problems and good cholesterol levels, how much should one be concerned about slightly elevated lipoprotein(a)?

Lipoprotein(a) Cholesterol Guidelines

In this particular case, Dr. Sinatra and I would like to reassure her not to worry about this finding.

  • First of all, her daughter’s Lp(a) is only elevated two points (or 20 percent above the limit).
     
  • Secondly, her high HDL “good” cholesterol levels of 74 (HDL > 60 for a woman,  and > 45 for men is considered desirable) is a very protective component.
     
  • And, thirdly, there is no family or personal history of heart disease.

When do we get concerned? Dr. Sinatra takes action when he sees Lp(a) levels that are twice the normal limit (he sees some that are even four times higher or more!). In those cases, he recommends fish oil (a total of 2 grams/day in divided doses) and nattokinase (50 mg twice daily).

If your Lp(a) levels are normal, borderline or even slightly elevated and you want to be more aggressive in your preventive medicine efforts, just be sure that omega 3s are part of your daily vitamin and mineral plan. About 1 to 2 grams of a high-quality fish oil—or squid oil—should do the trick.

Learn More About Cholesterol Guidelines

Lp(a) may still be a new blood component to many of you. Be sure to watch for an upcoming newsletter article on the seriousness of this risk factor. For other cholesterol guidelines, visit Dr. Sinatra's Web site. While there, don't forget to sign up for his FREE eLetters!

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