Posted 4/16/2018 2:48 AM (GMT -6)
I have a strong family history of heart disease, and discovered about 7 years ago that my Lp(a) cholesterol is very high. This most likely is the cause of heart disease in my family, as none of my family members is overweight or diabetic, and all have good diets and get plenty of exercise.
To lower my Lp(a), I began taking high-dose niacin several years ago ( 4000 mg immediate release niacin ), which I tolerate well. I take it on a full stomach and gradually built up the dose so I have no flushing, itching, etc.
However, my homocysteine has been rising and is now 20 ! 11 or below is considered ok, 15 is high. The niacin has cut my Lp(a) in half but it is still to high. But the niacin is also a likely culprit in my rising homocysteine.
So I apparently have a dilemma / catch 22 situation. If I stop the niacin, hopefully my homocysteine will go back down, but my Lp(a) will probably skyrocket. But even with the niacin, my Lp(a) is still double what is considered a healthy range ( below 30 mg/dl ). And I have read that the combination of high homocysteine and high Lp(a) is very dangerous and increases heart attack risk by 10-fold.
So, what to do ? Any thoughts or suggestions are appreciated. Thanks !