Lipoprotein (a) Blood Test

No, you don't need to be fasting before you take your Lp(a) Blood Test. However, if you are adding on a test for your other lipids and cholesterol then it's best not to eat in the 6 hours before testing. Fasting before checking your cholesterol isn't absolutely essential but it can make the results more consistent and easier to track over time.

Your Lp(a) level is mainly determined by your genes rather than your lifestyle (e.g. diet and exercise). This means that your L(a) level doesn't significantly change over time. Most people only need to measure their Lp(a) level once. If your level is low then that's all you need to know. It's not going to change.

However, if your Lp(a) level is high, there are some drugs that can lower the level a little. In these cases, you might measure your Lp(a) to see the effects of these medications.

Because your Lp(a) levels is largely set by your genes, there's not a lot you can do to change the actual Lp(a) level itself. However, it's still important to know if your Lp(a) level is high because you can affect lots of the other factors impacting your heart disease risk such as your regular cholesterol levels and your sugar-handling.

So, the first thing to do if you have high Lp(a) levels is to assess your other risk factors for heart disease. This means checking a few other biomarkers such as those included in our Metabolic Health Blood Test. Once we have the complete picture you can take action to optimise your other risk factors. For example, this might involve lowering your cholesterol levels or improving your sugar-handling. In general, it's best to do this with the help of a healthcare professional such as one of our metabolic health experts or your GP.

There are no medications that you can take to have to significantly lower your Lp(a) level. For example, statins work very well to lower your regular cholesterol levels but they don't lower Lp(a) and can actually slightly increase the Lp(a) level.

However, there are some medications that can lower Lp(a) levels a little. PCSK9 inhibitors (e.g. inclisiran) can lower Lp(a) by 15-30% but this is generally not enough to make a significant difference to those with high levels. PCSK9 inhibitors are very good at lowering regular cholsterol levels though so they're still very useful medications in people with high Lp(a) to lower overall heart disease risk.

There are some drugs specifically designed to lower Lp(a) that are undergoing clinical trials. Hopefully, we'll see these become available to patients with high Lp(a) in the next few years.

Lp(a) levels can be measured in either "mg/ml" (mass units) or in "nmol/L" (molar units). Molar units are the most accurate measure of Lp(a) and heart disease risk and are recommended in major guidelines. Therefore, we measure Lp(a) in molar units and your level will be given in "nmol/L".