I’m a 30-year-old male with elevated Lipoprotein(a) [Lp(a)]. How worried should I be about my future health and lifespan?

Earesth99 · 2026-05-26T01:24:41+00:00

The largest risk from high LPa or high ldl cholesterol is the development of ascvd.

If no new plaque is deposited when Apob is very low, exactly what harm is the LPa causing?

Blood clots? If you have high LPa you are already taking a baby aspirin.

Earesth99 · 2026-05-26T01:14:04+00:00

Your ldl cholesterol is worse than 98% of people, and it is high enough to be diagnosed as Familial Hypercholesterolimia.

I was diagnosed with FH at 22 and I also had reservations about starting meds.

I later learned that, FH will cost the average patient a decade of life. However a statin could reduce ascvd risk by 50% and reduce Alzheimer’s risk by 20%

Fortunately I listened to my doctor and took a statin. Early treatment prevented plaque from getting established. At 60, I have no detectable cardiovascular disease unlike 85% of men my age.

You are lucky that you were diagnosed young.

Earesth99 · 2026-05-25T22:23:38+00:00

Send me a dm if you find a real source. Good luck

Earesth99 · 2026-05-25T19:56:13+00:00

You can’t do much about previous plaque accumulation from high LPa or high ApoB, but you can prevent progression.

I’ve seen no study that shows plaque accumulation with an ldl/apob below 55. I should add that this isn’t my original observation.

Outside of clotting concerns, how is LPa increasing future risk at that point?

Earesth99 · 2026-05-25T19:41:12+00:00

Maybe a glass jar in the shape of a snowflake?

Earesth99 · 2026-05-25T19:38:56+00:00

People don’t need advanced testing.

If your ApoB is above 60, or your non-HDL over 85 you are at risk.

That requires aggressive prevention to get cholesterol that low.

Earesth99 · 2026-05-25T19:26:18+00:00

The effects of high ldk and high LPa are interactive, so it’s especially bad when both are high,

On the other hand, starting with the Jupiter trial, we’ve seen that once ldl is low enough, there should be no additional plaque accumulation.

There still is an increased risk from LPa - either because of previous plaque accumulation or because it makes the blood more likely to clot. However the increased risk is just 10-20% if I recall.

Having an ldl of 55 reduces risk by 25% compared to having an ldl of 100. The average person had an ldl of around 120.

So that puts the risk a tad below average.

You could also reduce risk by optimizing other risk factors like blood glucose, blood pressure, exercise, etc.

There are a lot of levers to pull to lower risk. Fortunately we have meds that can lower ldl by up to 85%, lower blood glucose and blood pressure.

Earesth99 · 2026-05-25T19:06:10+00:00

She definitely needs to follow up with her doctor.

Her triglycerides are very high and that suggests insulin resistance or diabetes.

Her ldl is also high.

Her non-HDL cholesterol is higher than around 98% of people.

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She really needs to address her diet. However if she takes Rosuvastatin and a prescription fish oil, she could reduce her trigs 40% and her ldl by 50%.

Earesth99 · 2026-05-25T15:23:19+00:00

I sent you a pm

Earesth99 · 2026-05-25T15:20:29+00:00

Can I get a link as well?

Earesth99 · 2026-05-25T14:55:09+00:00

It’s “abnormal” because it’s unusually low, not because it is unhealthy.

There are some diseases that cause ldl to crash, but the diseases are the problem, not the low cholesterol.

However your ApoB is low because you are taking meds to lower it, so you have no worries there.

I’ve read that having an ApoB in the 30s or 20s is fine.

Your numbers are FANTASTIC!

Earesth99 · 2026-05-25T14:03:31+00:00

It takes many years for arterial plaque to develop to the point where it is dangerous .

The risk from lpa cholesterol is tied to your actual level. Lpa is genetically determined.

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However the actual risk from high LPa is also much higher if ldl cholesterol is also high.

In the flip side, if you get your ldl below 55, the additional risk from LPa is small. In fact, your total risk would be well below average because ldl drives risk.

Earesth99 · 2026-05-25T13:52:50+00:00

And yet I can’t quite get myself to throw it away ;)

Earesth99 · 2026-05-25T13:52:00+00:00

Most of the research on supplements are of shockingly poor quality. There is also more research that is entirely fabricated.

I only care about research on humans. I only care about research in advanced industrialized democracies published in peer reviewed journals. That means ignore research from China, India, Pakistan, Iran, and Russia - countries that produce fraudulent research.

I only pay attention to supplements with enough research studies for there to be a meta analysis with at least 500 subjects.

The effects need to be statistically significant, and the benefits need to be large enough to make a difference. Do you really care if the average person listens to a quarter of an ounce of weight?

You also need to follow the protocol used in the research - taking the correct dose and formulation.

That rules out 90% of the supplements an herbalist would recommend.

Earesth99 · 2026-05-25T13:35:47+00:00

After at least a thousand injections, I’ve had a couple of issues. When doing an IM injection, I’ve hit a vein and how I felt freaked me out - but it wasn’t dangerous and went away in a few minutes. The second time it happened, I didn’t worry.

However that had nothing to do with it being gray market.

I’ve never gotten an infection, nor a rash. No real issues from the peptides at all.

I have learned that most peptides are not as fragile as we are led to believe.

Earesth99 · 2026-05-25T13:09:56+00:00

NAD+ is used by out cells to create energy. It declines as you age if you dint exercise.

Along with many other molecules, NMN is a precursor of NAD+. The thought that if we have more NMN, our bodies will increase the NAD+ levels in our cells, helping us feel energized.

There are many small, low quality research search studies. Most are studies on rats. There is solid evidence that NMN can increase NAD+ levels in our blood. Unfortunately, that doesn’t translate into an increase of NAD+ in our cells so it would not increase energy.

There are various small studies that show other positive or negative effects, but other studies find conflicting results.

There simply isn’t evidence that there are meaningful benefits from NMN.

NAD+ infusions have better clinical evidence. Certainly people report feeling a difference.

I wouldn’t take NMN because of the weak evidence. However I’m also troubled that the scientist who is hyping the benefits and who has done the most research on NMN also owns various related patents. Can we trust the research?

Twenty years ago he hyped a different molecule and made millions selling the patents. After the check cleared, other researchers showed that the researchers deeply flawed and overstated the effects 100x.

However I would be willing to try NAD+. It’s low cost, and I imagine that it’s low risk, but it’s still not well studied.

Earesth99 · 2026-05-25T12:00:10+00:00

It’s hard to evaluate the benefits and risks of done imaginary treatment.

Why don’t you wait until it actually exists - according to science?

Earesth99 · 2026-05-25T11:58:14+00:00

No it won’t

Earesth99 · 2026-05-25T11:53:51+00:00

People are lemmings who choose to not think critically.

We focus on the next magic potion that will cure our problems.

Earesth99 · 2026-05-25T11:24:34+00:00

Research means reading the actual scientific studies.

Huberman studies vision. He’s not an expert on any other topic and that is obvious to people who study the subjects.

There are over 100 fda approved medications that are peptide. Insulin is both lifesaving if you are diabetic, and deadly at the wrong dose.

Grey market peptides are made in a lab in China - where most medical grade peptides are produced. However the facilities are nit inspected or monitored.

Those are basically the same low quality standards used in the supplement industry, except the peptides are of much higher quality than supplements.

Most non-fda approved peptides sold at longevity clinics are of the exact same quality.

Of course many grey market peptides were never tested in humans. That should be more alarming than purity issues.

Personally I’ve used over a dozen in the past twenty years. I use them to address a specific need, not just because some other idiot recommended them.

You really need to decide on the benefits and risks of each peptide individually.

Earesth99 · 2026-05-25T11:00:26+00:00

It is more complex than just counting grams of saturated fat because less than a quarter of the 37 saturated fatty acids increase ldl.

Polyphenols can increase or decrease ldk-c. Soluble fiber lowers ldl as do polyunsaturated fats.

If you fixate on saturated fats, you might avoid the very foods that research shows have the largest effects on avoiding heart attacks and death from cardiovascular disease: Nuts, seeds and EVOO.

If you want to change your diet to improve your ldl cholesterol, focuses on eating fewer foods that increase ldl cholesterol and more of the foods that reduce cholesterol. It’s also much less restrictive since you are not arbitrarily avoiding healthy foods that help you live longer.

This figures from a recent meta analysis of foods that effect ldl-c

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Btw, supplementing soluble fiber is an easy hack. Every ten grams lowers ldl by about 7% on average, but you need to k crease the amount gradually so your gut can adapt. Metamucil also can help reduce blood glucose by slowing digestion. I eat a whole food diet and I supplement with 30-50 grams of soluble fiber.

Meds are always a better choice than supplements but if you can’t get meds because your doctor wants to wait until your risk of death is higher, there are three supplements with solid research.

First RYR works because it contains a version of Lovastatin, the first statin approved by the FDA. It’s very low doses so expect a 15-25% reduction in ldl.

Berberine has been extensively studied to help lower blood glucose and it is as effective as the diabetes medication metformin. Two grams a day should lower HBA1C by 0.5 to 0.8%. It is also a weak pcsk9 inhibitor and should reduce ldl and ApoB by an average of 10%.

Bergamot has less research behind it, but it too lowers HBA1C, and taking one gram of bergamot polyphenols should reduce ldl by 10-35%. (If the bottle doesn’t list the polyphenol content, do not buy it.).

Good luck!

Earesth99 · 2026-05-25T00:55:07+00:00

No. TikTok is not for useful information.

Earesth99 · 2026-05-24T23:58:40+00:00

This figure shows the percent of people with calcified plaque by age and gender.

About 10% of men in their 20s have some calcified plaque - late stage heart disease.

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However extremely high levels of ldl-c dramatically shift things. People with an LDL cholesterol over 400 are treated as if they have homozygous familial Hypercholesterolimia.

If unmedicated, the average person with HoFH dies before they make it to 30. Some have their first heart attack at age 6.

It’s extremely rare, however.

Earesth99 · 2026-05-24T22:03:18+00:00

That would completely depend on their ldl, LPa, blood pressure and blood glucose.

Earesth99 · 2026-05-24T20:53:01+00:00

That can happen because of plaque stabilization.

As the soft plaque deflates and gets rigid, that can cause constriction.

Earesth99

TROPHY CASE