Lipoprotein A or Lp(a) is a subtype of cholesterol. The BaleDoneen Method calls Lp(a) the "mass murderer" because elevated levels of Lp(a) triples your risk of heart attack and stroke! 

Elevated Lp(a) affects around 20% of the population.  Yet it is not included in standard lipid testing.  In the past, it was an expensive test.  Now it costs about $10.

Lp(a) is made of cholesterol, protein and fat.  Elevated levels (>75 mg/dl) increase the development of atherosclerosis, leading to heart attack and stroke.  Elevated Lp(a) is a genetically determined risk factor with little impact from lifestyle.  It increases the likelihood of a heart attack or stroke because it makes blood clot more rapidly when plaque rupture or erosion create an occluding blood clot.


Lipoprotein subclasses.png

When combined with high levels of inflammation, elevated Lp(a) fuels inflammation in the artery wall and leads to the formation of plaque.  It makes blood clot more rapidly when plaque rupture or erosion creates an occluding blood clot, causing more damage.

Lp(a) is not included in standard lipid panels ordered by your doctor

While it's effect is often lost in the statistics of large population studies, Lipoprotein (a) can be lethal for the significant minority with significantly elevated levels.   Everyone should have it measured, especially if you fit the risk profile below.  If it is normal, it should not be repeated.  It will not rise.  

But if it is very high, you should know.  You should control other risk factors optimally.  Niacin is the most effective supplement/drug to reduce levels of Lp(a).  We have also seen response to Bergamot BPF, an effect we have not seen reported in the literature but have observed incidentally.


Elevated Lp(a) is more likely if you have:

  • Family members who had a heart attack or stoke at an early age

  • Premature vascular disease

  • Familial hypercholesterolemia

  • Family history of elevated Lp(a)


Treatment and Effects 

High lipoprotein (a) is a genetic trait linked to chromosome 6. If you have it, it is likely your parents and grandparents had it and that your children are also affected.

Lifestyle and statins tend to have very little effect on reducing high levels of Lp(a). They can reduce other risk, so knowing about the increased risk from Lp(a) can motivate more proactive measures to control these other root causes.

Niacin (Vitamin B3) is often effective in lowering the Lp(a).  We have also discovered that Bergamot BPF has a favorable effect that rivals or exceeds niacin in some cases. And it doesn’t worsen diabetes risk. In fact it has a favorable effect on insulin resistance, an almost universal root cause for atherosclerosis.

Small decreases can yield more risk reduction than similar reductions of LDL!

Knowing about the presence of a "mass murderer" in your neighborhood will make healthy diet, exercise and other risk reductions more imperative.  Information is power.

Here is a link with the Bale Doneen take on Lipoprotein (a):