Do statin drugs reduce lipoprotein(a)?

Alex had lipoprotein(a), Lp(a), at a high level. With a heart scan score of 541 at age 53, treatment of this pattern would be crucial to his success.

Part of Alex's treatment program was niacin. However, Alex complained about the niacin "flush" to his primary care physician. So, his doctor told him to stop the niacin and replace it with a statin drug (Vytorin in this case).

Is this a satisfactory replacement? Do statin drugs reduce Lp(a)?

No, they do not. In fact, that's how I often meet people who have Lp(a): Their doctor will prescribe a statin drug for a high LDL cholesterol that results in a poor response. The patient will be told that statin drugs don't work for them. In reality, they have Lp(a) concealed in the LDL that makes the LDL resistant to treatment.

Lp(a) responds to a limited number of treatments, like niacin, testosterone, estrogen, and DHEA. But not to statin drugs.

Now, statin drugs may still pose a benefit through LDL reduction. But they do virtually nothing for the Lp(a) itself. Unfortunately, most practicing physicians rarely go any farther than Lipitor, Zocor, Vytorin, and the like.

If your doctor tries to shove a statin drug on you as a treatment for Lp(a), put up a fight. Voice your objections that statins do not reduce Lp(a).

Comments (17) -

  • Rich

    8/25/2007 1:19:00 AM |

    As an Lp(a)-er, I'm very interested in Dr. Davis's guidance on this topic.

    Here's a question to which there may be no answer right now:

    The makers of Krill Oil have published a paper in a c-level journal claiming spectacular improvements in LDL and HDL.
    If this is true, I wonder if Lp(a) might be improved by this stuff?

  • Dr. Davis

    8/25/2007 2:54:00 AM |

    Hi, Rich--

    Yes, you are right: there's simply insufficient information.

    I do hope that krill oil provides benefits above and beyond fish oil, but we need to develop an experience with it first.

  • aspTrader

    8/28/2007 9:03:00 PM |

    Thanks for this blog.

    High LP(a) levels run in my family although I don't have a problem with it.  I have a brother who has had a chronically high LP(a) number (between 70 and 90) for a number of years and had a mild heart attack 10 years ago at age 42 and a triple by-pass (no heart attack) 5 years ago.

    He is now doing 80mg Lipitor and 10mg Zetia and tabs of pomegranate extracts and his LDL is now at 85.  (I guess one partial treatment is to get LDL as low as possible.)

    I do a google search for LP(a) treatments every few months and, of course, there isn't anything appearing to be proven to get the LP(a) number into the normal range.

    For a while now, I've read online about massive doses of C, Lysine, etc. discussed at sites like that shown at the following link.

    This is essentially what I understand to be the Pauling/Rath treament recommendation for LP(a) treatment.  A good deal of the discussion at the site and at Rath's site is informative and convincing.

    However, it's difficult to understand why this treatment hasn't been studied in a scientific study (or maybe I'm mistaken and it has).

    What do you think about it?


  • Dr. Davis

    8/28/2007 9:15:00 PM |

    The Rath-Pauling approach has not worked in our limited experience. We've not witnessed any substantial drop in lipoprotein(a).

    However, I would stress that, despite the difficulties presented by lipoprotein(a), it can be a very controllable genetic pattern. In fact, our current record holder for plaque regression (63% drop in heart scan score) has this pattern.

    I invite you to read the full conversation about the methods we use on the Track Your Plaque website.

  • Anonymous

    8/29/2007 3:30:00 AM |

    Thanks for your comments.

    Regarding the Heart Scan Test...  I have read that a person who has had stents implanted or a bypass cannot take the test.

    Is there some other means for establishing a baseline score for existing plaque?

    Thanks again.

  • Dr. Davis

    8/29/2007 12:29:00 PM |

    Carotid ultrasound is a crude second choice as an index of bodywide atherosclerosis. It is a relatively non-quantitative test that correlates only about 60-70% with coronary disease, but that is the only other truly practical gauge. If you've had only one artery stented, however, a CT heart scan can still be performed and yield useful information.

  • Mid Life Male in CA

    8/29/2007 1:17:00 PM |

    Dr. Davis,

    Every year or so for the last 10 years, I have spent a couple of days googling and browsing the 'net to try to figure out the latest and greatest heart related therapies for myself and my family.  (High LP(a) being a significant issue.)

    Since the last time I did this, you came online with this blog and through it I discovered TrackYourPlague.

    I would just like to say Thank You for sharing your insight online.  Given my history, it has struck me that my understanding of effective therapies were different and sometimes even on a par with the medical professionals I was seeing.  In fact, the head of the patient cholesterol support center at the large HMO--you'd recognize the name if I mentioned the name--I belong to once even told me that I knew more about these therapies than she did.

    A few years ago, in speaking with my cardiologist, I mentioned some of the scientific abstracts I had read for myself about possible new high LP(a) treatments and he told me that I appeared to know more than he did about them.

    Scary !

    You likely are clear about this, but I'd like to tell you again how much the kind of information you provide is incredibly helpful.

    Your work can be literally life saving for people in need who take the time to address their heart related issues in a serious way!

    Thank you.

  • Dr. Davis

    8/29/2007 2:04:00 PM |

    Thanks, kindly, Midlife Male!

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  • Alex L

    10/4/2011 1:00:19 AM |

    I had a quadruple bypass 2 years ago. I've followed the Pauling/Rath protocol for 6 months with 12 grams ascorbic, 6 grams lysine and 3 grams proline daily. However, I just had blood lab work done and was concerened that my Lp(a) score was 275. I thought that the ascorbic/lysine combination targeted Lp(a). This issue is critical to me because vein graft patency from bypass is a function of Lp(a) levels. Any suggestions on how I can lower Lp(a) and any opinion as to why my Lp(a) score would be so high even after 6 months on ascorbic & lysine?

  • Dr. William Davis

    10/4/2011 2:37:44 AM |

    Hi, Alex--

    Sadly, I have yet to see any effect from this Pauling/Rath protocol.

    In the Track Your Plaque program, our preferred starting regimen is high-dose fish oil, i.e., 6000 mg EPA + DHA per day, but it requires up to 2-3 years to work. There are several other strategies worth considering, all discussed on the site.

  • Alex L

    10/7/2011 1:12:03 AM |

    Dr. Davis,

    I've looked all over the trackyourplaque website, but I can't find what specific advice you are referring to to reduce Lp(a). Can you please be more specific, or furnish the link? I appreciate any advice you might have. Thanks!

  • Dee

    10/7/2011 10:49:50 PM |

    I tried the Pauling/Rath protacol for six months and my LP{a} was much worse.  I take niacin and fish oil.


  • Dr. William Davis

    10/7/2011 11:01:05 PM |

    Hi, Dee--

    I, too, have yet to see any affect from this protocol.

    Perhaps it's telling that Mathias Rath is currently trying to persuade South Africans that the AIDS epidemic there is the invention of the western world.

  • Dr. William Davis

    10/8/2011 2:22:10 AM |

    Hi, Alex--

    It's all in the Library. There are several detailed Special Reports devoted to Lp(a).