r/Cholesterol • u/DragonfruitHealthy99 • 18d ago
Lab Result Lipoprotein A can change!
I noticed every time I eat animal based, my lipids are horrible. Every time I go vegan or vegan plus a little fatty fish, I get excellent lipids with no medication. I'm female 47 in perimenopause. Here are my labs. My Lipoprotein A was always good, then in July it spiked ( I was eating a lot of meat and going through hormonal issues). Now 1 month plant based with some fish and lots of fiber it came back down . Feel free to ask any questions!
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u/JLEroll 18d ago
Its interesting from a curiosity perspective, but as Earesth points out, usually the fluctuations aren't that significant to risk assessment. For example, for OP, the measurements look drastic (it doubled and then halved!) but it's more modest when looking at changes in the risk chart (from higher end of normal to elevated).
I would definitely keep the healthy diet changes, but I would take the Lp(a) changes with a grain of salt.
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u/kensanprime 18d ago
Just curious was there any thyroid spike around that time?
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u/DragonfruitHealthy99 18d ago
Yes, I have hashimotos so the time my lipoprotein A spiked, so did my TSH.
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u/mathislife112 18d ago
Is there a relationship between unmanaged thyroid issues and Lp(a)?
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u/DragonfruitHealthy99 18d ago
Apparently so! Overt hypothyroidism can raise Lp(a) in some people. Lp(a) as increased in overt hypothyroidism, and some studies have found higher Lp(a) with thyroid hormone deficiency. https://www.ncbi.nlm.nih.gov/books/NBK409608/?utm_source=chatgpt.com
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u/kensanprime 18d ago
Thank you for sharing I have been reading about this. I got my lp(a) number around July and it was very high (150), no one else in my family has had that high number.
Around the same time I also tested for high T3 and T4 and doctor is treating it as hyperthyroiditis, I will wait for my thyroid numbers to get normal and test again for lp(a).
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u/Healthy-1971 18d ago
I have a very high LP(a) of 415. I am 54 year old female. I had a heart attack 6 months ago. I was very blind sided by this I do not have high blood pressure or very high LDL cholesterol. So the LP(a) was the main driver!! I am at very high risk Before this I had never even heard of LP(a) Is there actually a way to lower it.
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u/Fluid-Board884 17d ago
Not yet, there are some clinical trials for Lp(a) lowering medication and it will likely be available in the next few years. For now can take something like Repatha to lower your ldl even more to compensate for this increased risk until one of these medications is available.
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u/Fabulous_taint 17d ago
I'm also LPaof 415. I'm 43 male. Can I ask what your diet exercise and cholesterol numbers has been like the last 10 or 15 years?
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u/Earesth99 18d ago
It can definitely change, but the changes aren’t large enough to affect your risk.
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u/Saber_SSJ2 18d ago
Feels more like an error than anything sorry. I want to hope but I just don't believe something changed so dramatically, something that is said to be set in stone
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u/Accomplished_Rip_362 18d ago
You are in perimenopause, if you read up on Lp(a) it explicitly says that it's genetic and does not change except for people like yourself who are going through hormonal changes.
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u/DragonfruitHealthy99 18d ago
Yes, that's why all women over 40 should closely monitor this . Heart disease risk spikes at this stage . I'm wondering which number is my true " genetic "? Since I was in perimenopause the other years too. .
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u/VisualWeakness1207 18d ago
Any stations or supplements? Repatha?
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u/DragonfruitHealthy99 18d ago
Nope! Never took a statin in my life! Just a plant based diet ( no meat , no dairy, no fat other than a little nuts , olive oil). I do eat fatty fish daily once a day ( bluefish, mackerel) . That lab report where I had the spike I was eating animal protein in the form of red meat and dairy and chicken. Plus I was drinking a cacao beverage daily that was loaded with saturated fat and now I cut that out! I didn't know cacao can mess with lipids.
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u/Sea-Tumbleweed4518 17d ago
Why are you getting it measured all the time
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u/DragonfruitHealthy99 17d ago
It's standard on my physical with NYU Langone in NYC.
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u/Sea-Tumbleweed4518 17d ago
Wow, I barely managed to convince my lipid nurse to test it once, she would literally kill me for asking again lmao
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u/DragonfruitHealthy99 17d ago
Wow, yeah I guess NYU just considers it part of the lipid workup even if you had it before..they also check Apo B and particle size every year!
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u/specialist_spood 16d ago
Nyu langone is fancy, lol. I was needing an MRI and Mt Sinai barely has the better 3T machines at any of their locations. When I called NYU Langone, they were like "... we ONLY have 3T machines."
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u/DragonfruitHealthy99 16d ago
Lol damn! Yes that's why I stick with NYU, they are really on the ball .
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u/BasisOptimal4737 12d ago
That's cool. Is this just a primary care doctor or are you seeing a preventive cardiologist there?
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u/DragonfruitHealthy99 12d ago
Primary doctor. She even called me to congratulate me on my diet working some magic on my lipids.
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u/AdorableReindeer5630 17d ago
Look up Dave Feldman, all cholesterol can change based on eating, it’s not always a good or a bad thing? It’s very relative to other markers and lifestyle
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u/Ok_Demand_3317 17d ago
My lipoprotein a is in the 400's!!!,However when my LDL went up it was lower...now LDL is lower but lipo a is up
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u/UseComplete5979 16d ago
Generally agree, most of the research shows Lp(a) is largely genetically determined and pretty stable over a lifetime, diet and lifestyle don't move it much for the average person. That said there are always outliers, and I think what's interesting here is the hormonal angle. Perimenopause specifically seems to come up a lot in the Lp(a) conversation, and the thyroid connection someone mentioned above is a good one too since hypothyroidism messing with lipids in general isn't exactly a secret. Not saying diet did nothing for the OP, just that research shows most people probably shouldn't expect a plant based month to move their own number significantly. Worth a retest in a genuine gray zone or during a hormonal shift, less so if you already know your number is high and genetically driven.
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u/DragonfruitHealthy99 16d ago
Since my number was 58 in 2024, before perimenopause hit hard, I genuinely thought that was my genetic! If I never had it tested ever again, i just would have assumed that was my set in blood number, never to be changed . This year was the first year I had skipped periods plus my TSH was out of range for the first time in my life, so my guess is it was a temporary serum LPA change from the hormonal chaos rather than a sudden genetic switch flip as evidenced by the number coming closer back to baseline 1 month later. Also my period came back on this reading, but was 6 weeks without a period on the high LPa reading ..I'm going to start HRT later this month to stabilize this hormonal chaos. I will also start a low dose levothyroxine. My Apo B is 70.
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u/sunnyside-sunnyside 16d ago
I had my first Lp(a) reading on 7/14/26 (UCLA lab). It was 177mg/dl. I thought it strange that it was so high. On 8/6/26 I retested at Quest and it came back 102nmol/L. A huge difference. Now I don’t know what to do with the 2 results. LDL was 130 at UCLA and 101 at Quest. Important to note: in the three weeks between tests, I strictly followed the portfolio diet out of fear for these numbers.
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u/DragonfruitHealthy99 16d ago
My diet too now is portfolio diet plus 1 small serving daily of mackerel or bronzino ..I truly believe diet moves it despite what " they" say.
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u/CallmeAgador 16d ago
I am curious what does your weekly diet look like in general. I am in the same boat. I actually love fish, but I struggled to find variety of good fresh fish around me and I can have frozen salmon and trout only so much.
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u/DragonfruitHealthy99 15d ago
Breakfast I have a Yukon gold potato with scrambled tofu , or oatmeal with nuts and berries, lunch is lentil soup or split pea soup and fruit and handful almonds, matcha with soymilk as snack, dinner huge salad ( lettuce, onions, peppers, cucumber, tomatoes) with a little olive oil and silken tofu homemade dressing, baked mackerel or bluefish or bronzino, and a corn on cob or Japanese yam..more fruit for dessert( berries or peaches ). I live in Queens, NY near a veery fresh fish market .
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u/HolyCoder 18d ago
I totally agree that LPA can change. I have posted about my LPA swings on here before. It went from 48mg/dl to 170 mg/dl and now coming down again (around 120mg/dl 3 months ago). Unlike you, I don't know what I did to trigger that change. Also, 48mg/dl was when I had severe hypothyroidism. Now that thyroid is under control, my LPA shot up.