Comments by TomD
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    First and most important, comments here shouldn’t replace medical advice. Given that, some people take niacin to lower Lp(a) levels modestly. High does niacin (2-3 gm/day) does have a tendency to increase insulin resistance, and thus might not be a good option for everyone. Some of the people taking the extended-release niacin vs. immediate release niacin (to limit flushing effect) notice increases in liver function enzymes (ALT in particular I think). PCKS9 inhibitors provide a much more potent Lp(a) lowering effect, but from what I have heard most insurance plans won’t cover it. There is an Lp(a) inhibitor being tested now that is looking promising, but it will be another 6+ years likely before that study is finalized and published. So there is hope on the horizon, you just need to hang in there and try to manage what you can for your health. The publicly quoted cost of Repatha was significantly reduced recently, but it is still quite expensive.

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      Thank you! And yes absolutely not looking for medical advice, rather information. :) I hadn’t heard there was anything new in development as far as Lp(a) inhibitors, but was aware niacin had some positive effect. It seems the side effects for anything we have now outweigh the benefit if you’re otherwise healthy. Good news at least that Lp(a) is being looked at. Thanks again!