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.
http://www.neptunebiotech.com/clinicalstudies.html
If this is true, I wonder if Lp(a) might be improved by this stuff?

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.

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.

http://www.saveyourheart.com/ingredients_heartsupplementingredients.html

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?

Thanks.

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.

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.

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.

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.

Thanks, kindly, Midlife Male!

I would like to say the way you keep expressing your system is excellent.This is something that is really very great.Keep sharing articles like these.Very informative post.Thanks for sharing the information.

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.

Just wanted to stop by and say that I think you are very talented and I am so happy for you that things are falling into place. Your blog are soooo fun. Thanks for sharing.

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?

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.

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!

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

Dee

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.

Hi, Alex--

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

I think your are on to something, Dr. David. Every winter I get sad and depressed. After starting my omega-3 supplements, I noticed that I started feeling "better". I know that's very subjective. We set our clocks backwards 1 hour in a few days. I guess I will get a chance to test the "happy factor" of fish oil soon!

FYI, Laval is in Quebec, but Guelph is in Ontario (albeit both Canada). Perhaps you'd edit the post.
  --  Rob McVey, Markham, Ont.

Just to make it clear, the Univesity of Guelph is located in Ontario.

I live in a high-rise apartment building where many of the residents are grouchy old ladies.

Should I sneak fish oil into their food?

Or should I move into a building with lots of happy old Inuits?

I always enjoy and learn so much from you blog. Thank you.
I have tried taking omega 3 fish oil capsules but they give me acid stomach and fish burps. Any solution to these problems? I have tried the enteric coated ones too.

I am not surprised at this data.  When I began taking adequate fish oil (7gm EPA+DHA) I noticed an improved mood, memory, and ability to organize my activities.

Rob and Haggus--

Thanks for the correction.

Hi, Jim--

Perhaps throw a fish oil party for the ladies!

Of course, then you read of a new study discounting fish oil benefits for heart failure and you're left scratching your head:

http://www.sciencedaily.com/releases/2009/09/090929203024.htm

Deb,

You are experiencing the effects of "cheap" fish oil that has a lot of other stuff in it besides Omega-3. I tried Walmart's Nature Made stuff and it made me feel sick. Now I am take Omapure 4x a day (one capsule each time) and I do not feel the same "fishy" burps.

Deb-

Try lemon-flavored liquid form of EPA/DHA. Go with a high quality brand like Carlson, which a lot of us use.

One tsp gives you 800EPA+500DHA (1300 total), and it actually tastes pretty good (it's not cod-liver oil).

Buy it online, such as from i-Herb as an example:

http://www.iherb.com/The-Very-Finest-Fish-Oil-Lemon-Flavor-16-8-fl-oz-500-ml/2796?at=0

You won't have to swallow all those softgels, which used to bother me.  Also, a good quality distilled fish oil should not cause gastro distress, etc.

Rich

They have done Omega 3 depression studies. I believe they found EPA more important than DHA for improving depression scores. A lot of the 'mood' fish oil supplements tend to be EPA heavy too.

I think they theorize that EPA helps the brain function, while DHA is primarily for structure (hence why it's important for children/babies).

I think this is an important study, but I have to wonder if low omega-3 might also indicate difficult in fiding adequate food, which would clearly be stressful.  It's a chicken and egg argument so to speak.  Without verying that total nutrition other than omega-3 was adequate, I'm no sure a real conclusion can be made.

The question would be is it the Omega 3's or the fact that those who eat carbs get more depressed?

I've battled depression on and off for most of my life.  Meds help.  Fish oil and lots of vitamin D help even more.  I increase my intake of both whenever my exposure to sunlight is limited (including when the summer heat keeps me indoors a lot.)

So what would be the typical EPA+DHA daily dose (not the oil) to reach these heights of happiness...or plasma levels?

Another recent report from Laval University suggests that highly purified ethyl-eicosapentaenoic acid (E-EPA) may relieve psychological distress in middle-aged women.
The daily dosage was about 1gram.
http://www.ajcn.org/cgi/content/abstract/89/2/641
E-EPA is a very popular omega-3 supplement in Europe and Japan.

In response to several comments--

Taken in the context of other studies, this study simply adds to the notion that omega-3 intake is associated with mood status.

While omega-3 plasma levels may also serve as a surrogate for other phenomena, such as vitamin D intake (also rich in fish, though not fish oil), the experience as a whole do indeed show a strong relationship between omega-3 levels and depression/mood/"psychological distress."

I'm skeptical of this study.  Look, I expect that, eventually, research will show a strong relationship between mood and LC ω-3.  But this study ain't it.

First off, this is an observational study.  When observational studies turn up order-of-magnitude differences, they point to cause-and-effect relationships.  But when they turn up relationships that barely pass the statistical significance test (p ~ .05) they are more likely measuring the shared influence of some other cause.

And what might this cause be?  Well, the authors point out (a) seafood consumption varies upwards with wealth and income.  (b) Happiness varies upwards with wealth and income. (c) They really would have liked to have controlled for wealth and income but they couldn't because the Inuits wouldn't fill out the wealth and income portion of the questionnaire.  

So their study was underpowered to measure one of the most obvious non-physiological explanations of the (weak) correlation they found.

This study would have us believe (a) Inuits have much higher ω-3 levels that other Quebec citizens.  (b) The suicide rate among Inuit in 1987–1994 was 6.5 times higher than in the rest of Québec, and the rate in the younger age group (15–
24 years) was 20 times higher. (!!) (c) ω-3 is associated with better mood.

Something is pretty discordant there.

I'll wait for an intervention study.

Hi, Red-

That's right.

This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

Hi, Red-

That's right.

This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

Fish oil makes me depressed and nauseous and tired . I do not  know what all the fuss is about.

I use a supposedly good type too, Carlson's.

A group from Laval University and University of Guelph, both in Canada, examined the relationship of plasma EPA + DHA levels and measures of psychological distress. This group had previously shown that Inuits older than 50 years had twice the plasma omega-3 levels (11.5%) compared to those younger than 50 years (6.5%), reflecting the shift away from the traditional diet.

Omega-3 is geally great. Improves memory , I'm loosing pounds and I don't feel hungry or depressed (and when I'm depressed I eat soooo much!).  I prefer flax oil of flax seed as a sourse of omega-3.  My body seems to reject fish oil and I think it's not for nothing. The mercury pollution won't do any good.

Unlike heart disease that can creep up on a person without external symptoms, everyone (excluding a very, very small percent of anomalies) gets direct feedback from their diet. Blaming the government, or subsidies, or corn, or companies, or advertising, or genetics or whatever other rationalizations, indulges delusion.

Blame could be placed on lack of education, however most everyone (including children) knows that there is a nutritional difference between a cookie and a carrot.

Control of your body (and your children’s body) and what you choose to put in it begins with you, not from the executive branch of government on down.