Expert Answer
Do you only need one Lp(a) test in your life?
Quick Answer
Most adults need at least one Lp(a) test. Attia's guest Benoit Arsenault describes Lp(a) as inherited, stable from about age five, and common in roughly 1 in 5 people. A standard cholesterol panel often omits it. Your clinical situation determines whether you need to repeat the test.
Strong Consensus
on ApoB overall
What the Panel Says
In his Lp(a) episode with researcher Benoit Arsenault, makes the case that everyone should have Lp(a) measured at least once, because it is genetically determined, stable over a lifetime, and a strong, common driver of cardiovascular risk that standard panels miss.
Recommends advanced lipid testing that includes Lp(a), noting a standard cholesterol panel does not capture it.
Frames ApoB as counting all atherogenic particles including Lp(a), reinforcing that Lp(a) is part of a complete risk picture, without a separate testing protocol of her own in the analyzed videos.
Surfaces Lp(a) via the ApoB conversation with Attia as one of the particles that matter, without an independent testing stance in the analyzed videos.
No direct Lp(a) coverage in the analyzed videos.
Detailed Answer
Most blood markers are worth re-checking because they move - LDL, ApoB, blood sugar and blood pressure all respond to diet, exercise and medication. Lp(a) is different. It is largely genetic and remarkably stable across your life; in Attia's Lp(a) episode, the point is made that its level is essentially locked in early (gene expression is described as stable by around age five).
Because it does not drift much, most people only need to measure it once.
That stability is exactly why the experts covering it argue everyone should get at least one Lp(a) test. It is common - roughly one in five people carries an elevated level, with meaningful variation by ancestry - and it is a strong, independent cardiovascular risk factor. Yet it is usually left off a standard cholesterol panel, so many people never learn their number unless they specifically ask.
A single measurement can flag lifelong risk and has implications for family members, since it is inherited (though the pattern is heterogeneous enough that you cannot reliably predict your level from a parent's).
A couple of honest caveats. Assays report Lp(a) in different units (nmol/L is generally preferred over mg/dL), so results are not always directly comparable - worth noting when you get tested. And while "measure once" is the general rule, whether you need repeat testing depends on your clinical context, which is a conversation for your doctor.
This page is educational synthesis of what these experts said on video, not medical advice.
Related Questions
Why does Lp(a) only need to be measured once?
Because it is largely genetic and stable over a lifetime - essentially set early in life - it does not move much, so a single measurement usually captures your lifelong level. Repeat testing depends on your clinical context.
Is Lp(a) on a standard cholesterol panel?
Usually not. Lp(a) is typically left off a standard lipid panel, so you may have to request it specifically. Hyman and Attia both point to advanced lipid testing to capture it.
How common is high Lp(a)?
In Attia's Lp(a) episode it is described as affecting roughly one in five people, with levels varying significantly by ethnicity - making it one of the more common inherited cardiovascular risk factors.
If my Lp(a) is high, what can I do?
Lp(a) does not respond much to the diet and lifestyle changes that lower LDL. Knowing your number lets you and your doctor manage overall cardiovascular risk more aggressively through the factors that are modifiable.
More Questions About ApoB
Precis Pro
Get the exact protocol for ApoB
The answer above is the whole answer — every expert's position, where they disagree, and the timecode behind each one. Nothing on this page is held back.
Pro adds
- The dose each expert actually names, and the form they name with it
- Timing and what they say to take it with, or keep it away from
- The interactions they flag by name
- Chat across 3,700+ expert videos, with a timecode behind every answer
$9/mo · Cancel anytime
Full ApoB Consensus Report
See what all the experts agree and disagree on