rising lipoprotein a

[acousmetre]

Hello,

What might it mean when Lipoprotein(a) levels are above reference range and rising? From what I've read they should be relatively stable and the levels determined by genetics. Since 2017, when I had thyroid cancer and a thyroidectomy my lipoprotein a levels have risen steadily from the low 50s to 90.5 in a recent blood test (ref. range is inferior to 30 mg/dL). My cholesterol readings had started to rise and last year I started taking rosuvastatin. That dropped the levels considerably. On this last test however, the total cholesterol has risen again to over 200mg/dl and the bad cholesterols also almost back to where they had been before I started taking statins. Blood pressure had also risen and I started taking valsartan a few months ago. BP is now under control.

Is this anything to worry about? I am a 57 year old man and not particularly overweight. In fact I have lost about 7kg since the beginning of the year but this may be due to sulfasalazine which I take for psoriatic spondylitis . I now weigh 89kg and I am 187cm tall.

Thanks

[Gail1967]

My understanding is that LPa levels are pretty static although I have read that statins can elevate it. It’s all a bit of a mystery & I didn’t know I had an LPa issue until after my heart event (bypass). They seem to manage it like they would for someone with high cholesterol - so I’m hoping that will now keep me safe!

[JennyRx]

I have very elevated lp(a). Mine is managed as if ive already had a HA.m: LDL not to rise above 1.8. Exercise. BMI less than 24. Keep out of prediabetic zone. I have angina managed with meds and stents. The angina was probably caused by the elevated lp(a). It’s an inherited factor so my children and my siblings had to be tested. In USA a lot of people take high dose niacin and Vit C to lower lp(a) but in U.K. and Europe they both longer use this approach as it has side effects - liver damage- and hasn’t been shown to reduce cardiac events or strokes. There are drugs in trial but the treatment criteria will be tight. And will be another year or two. Some people have elevated lp(a) and have no effects. It’s still an area of much research

Lp(a) can sometimes rise after illness. I think mine went up after cancer. In the U.K. we only test once but Americans get obsessive and test all the time.

[acousmetre in reply to JennyRx]

Thanks Gail1967 and JennyJennyRx . Yes, it seems cancer, infections and chronic inflammatory diseases can raise the levels. My spondylitis is probably what has caused the elevation in mine. Found this article on the subject: ncbi.nlm.nih.gov/books/NBK3...

[JennyRx]

That article mentioned lupus and my mum had lupus. There are a lot of autoimmune diseases on my brothers side but his lp(a) was just about ok. Some genetics never manifest.