Davin8r
#51
Ok so I called my local lab and figured out they entered the units all wrong, so at least my “175” is in nmol/L not mg/dL (but still way to high!), but it still doesn’t explain why my numbers have gone up from 98 → 111 → 121 → 151 → 175 over just the past 2 years(!!) All tests were done at Mayo Clinic Labs, so I left a message to find out if they’re doing something different with their assay because this just isn’t making any sense.
3 Likes
Radiata
#52
Just saw this chain of recent comments and was going to suggest the unit issue. It sure looks to be a mix of units. The problem is, you don’t know what they used when, mg/dL or nmol/L. Your table for Dec 21, 2021 - Oct 4, 2022 has both units listed!
The conversion factor is roughly 2.5 x to go from mg/dL to nmol/L. It is not precise because Lp(a) doesn’t have a precise molar mass, or else they could just do it in mg/dL.
But yeah, it’s still confusing because you are effectively back up to 70 mg/dL on your recent test (175 nmol/L) from 49 mg/dL a couple years ago.
5 Likes
Davin8r
#53
Yes, when I look at each result separately, it gives the correct units (nmol/L) for every test done since December of 2021. It’s when I click on the “Trends” button to look at the results on a table (the one I printed out) that the lab somehow screwed up the data consolidation.
Now just have to figure out why the heck the value has increased so dramatically for a test that is supposedly so “stable” over time, especially when I’ve been on a PCSK9 inhibitor since late 2019.
2 Likes
Neo
#54
Scientific Statement on Use of Lipoprotein(a) in Clinical Practice
Last Updated: Thursday, 07-Mar-2024 15:00:00 EST
The lipoprotein(a) [Lp(a)] field is rapidly evolving on many fronts, including understanding of the association between Lp(a) levels and cardiovascular disease (CVD) risk in different contexts, and how best to manage other CVD risk factors in patients with elevated Lp(a). Considering new insights into the clinical management of these patients, and in the absence of FDA-approved therapies to specifically lower Lp(a) levels, the question of in whom Lp(a) should be measured has become an increasingly important issue in clinical practice.
Full paper
3 Likes
adssx
#56
High Lipoprotein(a): Actionable Strategies for Risk Assessment and Mitigation 2024
Novel therapies that target apo(a) are at different clinical trial stages and substantially lower Lp(a) levels in patients with high Lp(a). This is critically important in the context of Lp(a) level population distribution, which is generally skewed, and has more than a 1000-fold range of concentrations between individuals. Therefore, those with the highest levels of Lp(a) will likely require large, absolute reductions in Lp(a) levels to effectively manage their CVD risk.
Two are in Phase 3: pelacarsen & olpasiran. We can expect approval in 2026 at best. Most likely 2027–2028.
They also mention obicetrapib which divides Lip(a) by 2 (see also the dedicated topic: Obicetrapib (CETP inhibitor for dyslipidemia) - #48 by adssx ).
5 Likes
And then the challenge will be coverage/availability. Those of us with high Lp(a) but no history of actual cardiac events may not qualify for coverage for primary prevention. Hopefully it will be available from India 
3 Likes
Neo
#60
Chris, can you give a one sentence intro or summary about the video - there are so many videos posted that most of us have to choose which ones to engage
And unlike links to papers or blogs, etc, one cannot “skim” a video to determine if one should invest in it or to just take away the high level.
Think it would be a great best practice for how we all can help each other in the most efficient and impactful ways.
3 Likes
FWIW: This is a short video.
3 Likes
It’s about 20 seconds long. For shorts, the summary is the title.
However, I could say short video at the top and you can read the title of the video.
Justin
#63
You wrote: “I take 2.125g of immediate release metformin”
You take two, 125 grams immediate release metformin–that’s a mighty big tablet, I would think since each would contain 125,000mgs Metformin… ??
Pioglitazone seems scary… But then diabetes is scary too…
J0hn
#64
No, I don’t take it all in one go, and I have cut back on the total dose of metformin I now take. As it’s immediate release, I take it (1/2 of 750mg tablet) an hour before meals, and just before bedtime.
I’m going to order some extended release metformin and do a head-to-head study whilst wearing a CGM.
Yes, Pioglitazone is a bit ‘scary’, with its risk of bone fractures etc, I used to work (in drugs research) with its cousin Rosiglitazone. I take a micro dose 1/4 of a 30mg tablet, so 7.5mg dose, which has been shown to be efficacious
I take the pioglitazone along side a 1g omega 3 soft gel to boost the efficacy
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30237-0
3 Likes
Ludovic
#65
Interesting info! How long have you taken the pioglitazone and did you notice any changes in blood parameters?
J0hn
#66
I’ve taking it for about a year now, I’ve only started taking measurements recents HbA1c etc so can really say.
Now I’ve got my blood pressure meds sorted, I’m planning on stopping my glucose meds (to get a baseline) and re introducing them slowly to see what works for me and what doesn’t.
2 Likes
Thanks for the feedback, keep us updated!
This is a link to register for clinical trial for Lp(a) - lowering med (I’m not sure which one)
I registered and got a text saying they’ll let me know if/when a trial is taking place in my area 
2 Likes
RapAdmin
split this topic
#69
A post was merged into an existing topic: The Carnivore Diet and Rapamycin
In fact, not in any way related to the topic of new Lp(a) lowering drugs or Lp(a). Why post it here? You could create a new thread instead of derailing the subject of this one.
1 Like
SNK
#71
Not quite true what you are saying. I thought level of Lp(a) is in fact somehow related to what people eat, no? I guess you could swipe left if you don’t like something you read! Plus, sharing what works and what doesn’t for certain health condition should be considered kosher for these boards, no?
