New and More Dangerous Cholesterol Found In Your Blood (Lipoprotein(a)

New and More Dangerous Cholesterol Found In Your Blood (Lipoprotein(a) - LPa)

Рет қаралды 129,594

7 ай бұрын

Lipoprotein(a) or Lp(a) is a type of lipoprotein that consists of a cholesterol-rich LDL (low-density lipoprotein) particle linked to a unique protein called apolipoprotein(a). Elevated levels of Lp(a) are associated with an increased risk of cardiovascular diseases, as it may contribute to the development of atherosclerosis.
Lp(a) appears to have a role in the early stages of blood clotting and may interfere with the breakdown of blood clots. High levels of Lp(a) are considered a risk factor for coronary artery disease and other cardiovascular problems. However, the exact mechanisms by which Lp(a) contributes to these issues are not fully understood.
It's worth noting that while Lp(a) is a risk factor, managing overall cardiovascular health involves a combination of factors, including lifestyle changes, diet, and, in some cases, medication.
Linktree: linktr.ee/talkingwithdocs
Donate To Oakville Hospital: donate.oakvillehospitalfounda...
Tiktok: vm.tiktok.com/ZMFtY2JQ7/
Instagram: talkingwithdocs...
Facebook: profile.php?...
Twitter: talkingwithdocs?s...
Please see the complete user agreement at talkingwithdocs.com
Medical emergency
Do NOT use the Video for medical emergencies. If you have a medical emergency, call a physician or qualified healthcare provider, or CALL 911 immediately. Under no circumstances should you attempt self-treatment based on anything you have seen or read on the Video.
General information is not medical advice
The general information provided on the Video is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practice medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Video and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Video. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Video is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.
#cholesterol #diabetes #health #healthylifestyle #nutrition #hearthealth #healthy #heartdisease #bloodpressure #weightloss #fitness #healthyliving #highbloodpressure #wellness #healthyfood #kolesterol #diet #heart #hypertension #cholesterolfree #bloodsugar #heartattack #obesity #inflammation #detox #over #type #hearthealthy #healthyeating #stroke

Пікірлер: 997

@danteburritar2822 7 ай бұрын

LDL and LP(a) are not cholesterol - they are containers that carry cholesterol inside them (just as HDL does). Our bodies re-use normal LDL (re-fill them with cholesterol) but cannot re-use LP(a). LP(a) can’t go back into the liver to be re-used as it won’t fit the receptors due to the extra protein. Hence LP(a) builds up and only reduces by being destroyed. Hence how one treatment for some people, in parts of europe for example, is filtering LP(a) out of the blood but that’s something that has to be done in a hospital and often so not practical for most people. It seems likely that LP(a) and the fact that atherosclerosis and plaque problems resulting in heart attacks requires arterial damage via inflammation (from smoking and too high blood sugar for decades - think high carb diets). This goes some way to explain some people who have heart attacks but don’t have high LDL and some people who have high “cholesterol” values that don’t have heart attacks. It’s worth noting that there is no LP(a) in dietary foods that contain cholesterol. Ergo, dietary cholesterol is pretty safe, and for many - people with LP(a) - it is preferable to the cholesterol that our liver makes. Remember that we would die without cholesterol, our bodies make more if it is needed, so if you eat plenty of dietary cholesterol then your body won’t feel as great a need to make as many cholesterol containers (lipoproteins) including the LP(a) type. Large fluffy LDL is actually healthy and good like HDL, it is small lipoproteins like some oxidised LDL and LP(a) particles that cause a problem : but only when the open door of arterial damage is already present. Cholesterol itself that lives inside the HDL, LDL and LP(a) is not the bad guy, things that cause inflammation are the bad guys that open the door. The main benefit of statins in this scenario is that they will reduce arterial inflammation - so they are of use if you have damaged arteries and high LP(a) - in fact that is likely the biggest benefit of statins to most people, not the cholesterol reduction. I had a WidowMaker heart attack 4 years and have made it my business to research this subject best I can - I recommend the videos with Thomas Dayspring and Ford Brewer here on youtube.

@LVQ-so5th 7 ай бұрын

If you haven't done so, consider reading Malcom Kendrick's excellent book, The Clot Thickens. He has a good section on Lp(a), its purpose as a clotting factor, and why humans have it (a defense against vitamin C deficiency). Once people understand that injury to blood vessels is the cause of heart disease, then everything makes sense. Things that cause injury to arteries (sugar, metals from smoking, stress, diseases such as sickle cell, drugs such as avastin), or which disrupt repair processes of damaged arteries, lead to cardiovascular disease. Kendrick's clot theory unifies seemingly disparate risk factors. Interestingly, back in the 1980s, research on Lp(a) was going strong, but since it is genetically determined, there was no money to be made. Once statins were introduced, the medical profession switched it's focus to LDL (possibly misidentifying Lp(a) in plaques as LDL).

@petertownsend252 7 ай бұрын

My Lp(a) is non-detect,

@pecosgroup 7 ай бұрын

As long as LDL is not oxidized, it is no harm

@08turboSS 7 ай бұрын

Well done indeed. Statins have worse side affects.

@08turboSS 7 ай бұрын

Inflamation, insulin and sugar, and weight are the big ones. Its like these days more people have liver issues that dont drink.

@squeekytoys5911 7 ай бұрын

Cut out sugar and processed food. Take control of your health.

@johnlibonati7807 7 ай бұрын

Just dropped in to say my grandmother had high cholesterol her whole life. Never took meds for it. Lived to 100.

@bgt993 7 ай бұрын

Do you know her numbers?

@Total_Body_Fitness_USA 7 ай бұрын

Because there is much more to it than just cholesterol. As long as your HDL/Triglycerides is a 1:1 ratio you are good. Better than good! Even an HDL of 50 and triglycerides of 100 is still good. The problems occur when your triglycerides are very high like over 300 and your HDL is below 30. Lp(a) is sticky and causes a lot of inflammation and it is 100% genetic. People with that gene will not live to 100 since most start experiencing heart attacks at around age 40 or even before.

@narenmenon6906 7 ай бұрын

I have read that one of the French Paradoxes is that they have higher LDL, and yet they live longer than other Europeans who live in industrialized countries. Then again, your grandma probably didn't not have high levels of Lp(a).

@keithbronson9777 7 ай бұрын

🤣🤣🤣@@Total_Body_Fitness_USA

@TalkingWithDocs 7 ай бұрын

Yes. There are also people who smoked 2 packs of cigarettes a day for 50 years and didn't get lung cancer or got in car accidents and survived despite not wearing seatbelts.

@robinjones6999 7 ай бұрын

Perhaps one of your most interesting and fascinating vlogs yet - keep up the good work guys - many thanks from London

@hg2614 7 ай бұрын

Great information thank you drs for sharing!!

@matthewgraham2546 7 ай бұрын

Docs and guest, thanks for this one. Appreciate the time you put in to make these videos.

@TalkingWithDocs 7 ай бұрын

Glad you like them!

@constantinedimopoulos1110 7 ай бұрын

Great videos. Very informative!

@aliaaabdulhakeem7081 7 ай бұрын

Great videos, thank you so much

@jmarti03261 7 ай бұрын

Super informative as always, got my physical with my Dr tomorrow, I will request the LPa test to be part of my blood work.

@user-ys1vg6cj9u 7 ай бұрын

Thank you Docs, your video's are always informative and are helping the masses better understand what goes on in our bodies.

@kimcollard4001 7 ай бұрын

Thanks Gentleman You really are Helping us to understand the Hows and Whys

@d.e.b.5910 7 ай бұрын

Thanks for posting this vid

@boopsbucket 7 ай бұрын

Found out I have very high Lp(a) recently. I've been extremely depressed. Luckily my cardiologist is with the Cleveland Clinic. I'm thinking of asking her if there's a trial I can enter. Thank you so much for this video, it's kind of amazing that you just happened to drop it, considering I just learned this about myself. I've had a difficult time understanding it, and this has helped a lot.

@TalkingWithDocs 7 ай бұрын

Glad we could help and best of luck to you.

@boopsbucket 7 ай бұрын

@@TalkingWithDocs Thank you! I actually just found an incredibly promising article that was posted to the Cleveland Clinic's website this month about a drug called lipodisiran! "Findings from a phase 1 trial reported by a Cleveland Clinic physician show that a single dose of an experimental therapy produced greater than 94% reductions in blood levels of lipoprotein(a), a key driver of heart disease risk, with the results lasting for nearly a year." I think it's safe to say that I'm feeling significantly less depressed!!

@tedreid1035 7 ай бұрын

That's not fun but when given lemons make lemonade. Diet and exericse and moderate any other risk factors as best you can. Good luck

@doletawood5061 7 ай бұрын

Love Dr Esselstyn❤ he's on you tube

@plants_and_wellness1574 7 ай бұрын

Mine is 380 nmol/L. The best we can do is get our LDL-C/ApoB and particle count as low as we can. I’ve been able to drastically decrease those by following a mostly plant based diet.

@davidotness6199 7 ай бұрын

Thanks, guys. I'll be 73 in a month (if my lucky stars remain aligned) and am paying attention. I appreciate your willingness to communicate on this level. As mentioned in a reply below, I am a newbie convert to natto kinnaise and N-AC w/ glycine daily. Remarkable results from Japanese studies.on the natto. Again, your efforts here are much appreciated.

@beverlyperry663 7 ай бұрын

Thank you so much for your really important information.

@TomDOLAN-cb9th 7 ай бұрын

Both of you with your guests do a very important job...information...Thanks...

@jsstar76 7 ай бұрын

Hi Docs! Great video as usual! Almost 600K! So happy for you! 🎉🎉

@hexhex7220 7 ай бұрын

The more informed we are, the better choices we can make. Thanks Docs

@TalkingWithDocs 7 ай бұрын

We agree. Welcome

@katherenewedic8076 7 ай бұрын

if you got the money to play the life extension game

@Jeffs60 7 ай бұрын

You should be informed about this which they hid from you. The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. This finding was preliminary and should be investigated further in larger studies and in additional settings. 2012 article title, CIMT thickness in asymptomatic subjects with low Lipoprotein(a) levels.

@hexhex7220 7 ай бұрын

@@Jeffs60 thank you, I'll investigate further and discuss with my GP :)

@Jeffs60 7 ай бұрын

@@hexhex7220 Ask your doc why people with higher levels of Lp(a) live to 100 and are they just lucky to have it in their genetics for a reason or would we lower it so we can make money to create a drug someday to destroy their health?

@southerncomfort971 7 ай бұрын

Thank you. What a absolutely great video and explanation.

@chiroxeyhealth 7 ай бұрын

❤

@vj8002 6 ай бұрын

brilliant explanation!

@wendyveith 7 ай бұрын

This is so interesting. Both my parents had heart problems and had open heart surgery. My LPa is 152.5 and dr said it should be less than 75. I had 3 stents placed recently and also have mild aortic stenosis. Also high cardiac C-reactive protein, low total protein, and high A/G ratio. I don’t know what any of that means, but am happy to know about LPa now. Thank you.

@studentaccount4354 7 ай бұрын

Thank you so much!! I need to look at my lab work. I think I saw that and did not know what it was. There were no flags next to it. I had good HDL level and low VLDL. Dr. Lustig a author just wrote a book and was saying the ratio of Triglyceride to HDL was important. I would love to hear more on this. TY again!

@TalkingWithDocs 7 ай бұрын

We will add it to the list. Welcome.

@ruffloverescue2617 4 ай бұрын

Thank you! Excellent explanation!

@rukhsanachaudhry2 7 ай бұрын

Good information.Thankyou.

@aradpd3722 7 ай бұрын

My father died at 32yrs old of heart attack in 1970. My brother and I both have high levels of lp(a) . Mine is 265 nmol/L (normal levels

@stevent5571 7 ай бұрын

Statins deplete CoQ10 in our bodies and if you take a statin, you really need to take coQ10 supplements so your muscles can work properly

@robertusga 7 ай бұрын

@stevent5571 no, you don't. You are just wasting your money. pubmed.ncbi.nlm.nih.gov/35297269/

@Fearzero 7 ай бұрын

Whole plant diet. Only diet shown to reduce arterial plaques.

@robertusga 7 ай бұрын

Do you have outcome data from human studies to support your comment? @@Fearzero

@Fearzero 7 ай бұрын

@@robertusga Dean Ornish and Dr Esselstyn do. Also the longest ever diet study called the 7 countries study showed a high correlation between animal protein and shorter lifespan. 50 year study on 12,000 people.

@haidersyed6554 7 ай бұрын

Please talk about Nattokinase, its ability to burst blood clots and shrink plaque

@NancyEvansUSA 7 ай бұрын

pubmed.ncbi.nlm.nih.gov/33843667/

@narenmenon6906 6 ай бұрын

Natto is even better. Organic frozen Natto, Made in Japan, is sold in many Korean Supermarkets. I had no problem with its taste or texture.

@KPDancin 5 ай бұрын

Thank you! This was very helpful & easy to understand all about APOb and LPa - I can now have a better informed conversation with my Dr.

@marieholzwasser9224 7 ай бұрын

Fascinating VLOG!!!! We are always learning something about our bodies.

@TalkingWithDocs 7 ай бұрын

Awesome!

@carolalbert2254 7 ай бұрын

You guys are wonderful! Thank you so much!

@x7j4 7 ай бұрын

My doctor gave me a requisition for this blood test about six months ago, but I didn’t bother to get it done. After watching your video I’m making an appointment tomorrow morning.

@keithbronson9777 7 ай бұрын

Why go to the doctor if you don't follow up.

@x7j4 7 ай бұрын

@@keithbronson9777 Kind of obvious why I didn’t bother!!’ Watch the video again, there is absolutely nothing they can do with the test results. The only reason I’m going now is curiosity.

@patriotone755 5 ай бұрын

Great info! Thank you!

@TalkingWithDocs 5 ай бұрын

Glad it was helpful!

@vickiepatterson1748 7 ай бұрын

Now we have the Good, the Bad and the Ugly! I have heard nothing about LPa! And I don't know if this is something on my lab work. My LDL and HDL are both good and I would think my doctor would let me know if there was any concern with my LPa. But I see her in January and can ask her then (if I remember LPa). I love the great information you always provide for us! You're so good at keeping us informed about things we should know! You go out of your way to bring in specialists on different subjects so we can be better informed and make better choices I can't say I ever wanted to know about a third cholesterol so try to come up with a second good cholesterol!(wouldn't that be nice!)😉 Thanks for sharing another great video!

@jmcenterprises9591 7 ай бұрын

Thanks Docs-I have high LPa and I have had heart attacks. Going by feel alone (chest pressure/pain), diet and lifestyle affects everything. When I eat clean-very low fat, almost vegan, I feel like I am 30 years old again. L-arginine and balsamic vinegar on leafy greens supposedly increases nitric oxide, protecting the arteries. I believe that the clean diet and exercise makes the arteries LPa-proof. Caldwell Esselstyn also states this (well known heart surgeon-recommend his book and diet). Your videos are the best! Thanks again.

@TalkingWithDocs 7 ай бұрын

Glad you are ok and we agree - eat clean!!

@suzanne296 7 ай бұрын

Thankyou for your story

@jmcenterprises9591 7 ай бұрын

You're welcome@@suzanne296

@markwiener1091 7 ай бұрын

Dr.Esselstyn suggests 100% vegan with plenty and frequently eating high nitrate leafy greens and abstaining from nuts and oils... Supplement at least with B-12. Get protein from beans and oats.

@haidersyed6554 7 ай бұрын

You need nattokinase

@terribrooks9041 5 ай бұрын

Just found out I have extremely high Lp(a). Trying hard to not get seriously depressed. Educating myself on this and cant believe that so many doctors and professionals in all matters of the heart no so little about this terrible genetic lipoprotein. After talking with a certified lipidologist, I have a heart xray scheduled to show what my coronary calcium score shows. To say least it is very concerning. I am reading that i should also make other family members (siblings, children) aware of this terrible news which just adds another layer of terribleness to this bc dialysis and MAYBE this injectable inhibitor you mentioned (that you can't get without going through what sounds like impossible hoops) . Since I've learned of my situation it's like a surreal experience and situation I don't even want to share with anyone. People think if you just lower your LDL it will all just be fine - that's not the case. LDL and this genetic risk factor are two different things . I could go into more elaborate explanations of this but it's too exhausting.

@elizabethfletcher1487 2 ай бұрын

Judging by your photo, you are quite a bit younger than me. I am 73 and have Apo-B of 1800 with Lp(a) of 574. I am still doing fine as far as being able to hold 85% of my max heart rate for one minute during an hour on a treadmill at 4% incline. Have first doctor visit after discovering my Lp(a) [I did my own blood work for years and learned enough this year to check for particle number and Lp(a). Hope all is well with you now and you are a bit calmer. My siblings took the news about this genetic problem with their usual slap in the forehead and their irritation. You can lead them to water....

@theag5895 Ай бұрын

I had a NSTEMI at 57…premature for a women. So doc tested for Lp(a)…over 300 nmol. I got on a clinical trial for high Lp(a)…there are a few still recruiting. They are in stage III, so the meds have been tested on humans and dosages settled on. I am in the Horizon trial…results expected next year. I had a heart cath last month…plaque levels went from 50% to 30% in LAD and LCX. Lpa is really the culprit…not LDL. Relax…and if you want, find a clinical trial. It gave me hope for the future. 🙏❤️🕊️

@elizabethfletcher1487 17 күн бұрын

My ultrasounds of carotid, leg, and aortic arteries came up clean as a whistle. Echocardiogram was fine too, so don't fret til you get the data...

@jcampbell100 7 ай бұрын

Great info. Thanks

@TalkingWithDocs 7 ай бұрын

Glad it was helpful!

@richardmonson8657 7 ай бұрын

Great video guys. Please never stop saying “you are in charge of your own health.”

@chiroxeyhealth 7 ай бұрын

❤

@pamelabyars3983 7 ай бұрын

What about particle size and how it affects what cholesterol numbers would be bad for you personally.

@zanereese4796 7 ай бұрын

I quit alcohol (cheap beer mostly), I eat a little ground whole flaxseed everyday, and my LDL crashed, from way high and fell way below that good-bad line. My other numbers improved, I'm now about 9% cardiovascular risk number. I'm borderline my doctor wanting to prescribe a statin.

@paulmaxwell8851 7 ай бұрын

If your doctor is attempting to lower appropriate lipid numbers, you need to find a new doctor. It sounds as if you already know what to do, with regards to lifestyle.

@Ahmedkhan8802 7 ай бұрын

Very informative, and sobering, as always. Thank you, docs.

@cookiemomma123 7 ай бұрын

Congratulations on almost having 600000 subscribers

@whobdis77 7 ай бұрын

Mine was tested maybe 8 years ago. It was around 250. Lowered it with Niacin to 219..though maybe it was just pure chance. My cardiologist (who also has high LPa) thought it was not a cause..though that was 3 years ago. I've had 3 stents. It will be interesting to see what the outcome of current trials reveal.

@AngloFrancoDane 7 ай бұрын

I had a heart attack 6years ago. This year my cardiologist ordered the LP(a) test and I was very high, very high risk. He put me on Praulent (on top of my statin). I have always done a lot of exercise, never smoked, never been overweight. Sometimes you just can't win.

@skipbanks4fun1 5 ай бұрын

Did the Praulent help you ? I hope so. Skip

@AngloFrancoDane 5 ай бұрын

Certainly lowered my LDL further, but my cardiologist says the LP(a) will not change, so no subsequent tests.@@skipbanks4fun1

@mjg5628 22 күн бұрын

Thanks very much in- deed for this valuable info.

@TalkingWithDocs 22 күн бұрын

Glad it was helpful!

@dwtubeyou 7 ай бұрын

Great video. Does Dr Heffernan sometimes prescribe higher statin dosage levels when lp(a) numbers are high, simply to lower the ApoB or LDL-C levels even further down than statin patients without this high lp(a) issue typically take?

@stevemc2626 7 ай бұрын

I had 256 mmol. I started 500mg niacin . 3 months later I tested and the new number was 186. I then went to 1000mg/day and after 3 months I tested again - 156. I’m now on 1500/day and I’ve been on it for 3 months. Getting tested again today.🤞 So from my experience you can lower it. I also take the equivalent amount of TMG (as per advice from Chris Masterjon) , Nattokinase twice daily to reduce clotting factors and berberine because there are some reports that it can have a slight PCSK9 inhibition. Plenty of fish oil too for blood viscosity. I also give blood every 3 months, again to reduce viscosity. Oh and make sure your niacin is the flushing type. Non flushing won’t work. I hope this helps someone because I put many many hours into researching this.

@jmcenterprises9591 7 ай бұрын

thank you for this information!

@stevemc2626 7 ай бұрын

Just a follow up. My latest result - 45!!! Yes that is correct, 45. But now for the downside, along with this unbelievable result came a huge raising of my liver enzymes. I have been checking them each time and after the 500mg niacin and 1000mg things were all good. But it looks like the 1500 is too much for me to handle. Although I do take a few other supplements so maybe’s there is a cross reaction. So more trial and error to go but this confirms without doubt that at least for some people, high dose niacin can be extremely effective in lowering Lp(a). And let’s not forget that advice like ‘ you can’t change it so do everything you can for other markers like LDL (which is short for ‘take a statin’) will on average increase your Lp(a) by 11%.

@narenmenon6906 6 ай бұрын

How is the flush at 1500 mg of Niacin?

@e8a284 6 ай бұрын

Have you done a CAC to check any calcium build up in arteries?

@alexmp3821 6 ай бұрын

can you let us know the brand of niacin you are taking

@katherinekinnaird4408 7 ай бұрын

This is interesting . Understandably there will be people who feel this is a negative. As a senior in years I am accustom to less than positive medical reports. I can say that for myself I would want to know especially if I am on the fence when it comes to Lifestyle Changes concerning LDL heart conditions Etc. Proactive seems to be a weapon in this case.

@vkarabin 7 ай бұрын

Guys are great!!!.. keep it up!!

@horcents 5 ай бұрын

You guys are awesome. Love your approach to informing the masses. Hope you can cover STEMLESS shoulder replacement technology sometime soon. Thanks.

@barbhelle5481 7 ай бұрын

You Docs are so funny. Thank you 😊

@harrytrevenen2310 7 ай бұрын

Is this the same thing that has in the past been described as an LDL protein that has oxidized, or something totally different?

@immasher2139 7 ай бұрын

Good question!

@editaatteck9587 6 ай бұрын

Thanks for the video. Unfortunately many GPs in Ontario have no idea about lp(a) or apoB. It took a lot of self-advocacy to convince a cardiologist to measure these markers a year ago and even today.

@elizabethfletcher1487 7 ай бұрын

Nice. I just ordered Apo-B and got a surprise Lp-a result as well and I am loaded with both. Been trying to learn what to do about both. Thank you. It was helpful.

@tesos2866 2 ай бұрын

Determine if you are a hyperabsorber of hyper producer of Apob. One way is to try Zedia as a monotherapy, if it substantially drops ApoB Then you know you are a hyperabsorber of cholesterol. If that's the case 10mg zedia and a low dose of statin will drop it further with no rebound effect.

@elizabethfletcher1487 2 ай бұрын

@@tesos2866 Thank you.

@flowersinherhair 7 ай бұрын

Is there an active clinical trial for this?

@davidh5309 7 ай бұрын

Yes, there are 4 drugs in the pipe. Amgen is in Phase 3 with OLPASSIRAN and Eli Lilly is testing LY3819469. 2026 is probably the earliest you might see the first hit the market. The Amgen preliminary findings has found OLPASSIRAN, in heavy dose, capable of lowering your Lpa to 0?

@beepbeepnj2658 7 ай бұрын

Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.

@chiroxeyhealth 7 ай бұрын

❤

@beepbeepnj2658 7 ай бұрын

@@chiroxeyhealth High Lp(a) is good and low is bad. 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

@robertusga 7 ай бұрын

You know that association does not equal causation, right? Reverse causation and confounders need to be considered. They did that. High Lp(a) is causal.

@tesos2866 2 ай бұрын

If someone has high LP(a) But a zero CAC they are deemed to be low risk, the reason is that LP(a) really cranks up calcification. So if you are older and have zero calcification the version of LP(a) you have (crinkles/number of duplications of KIV2.more seem to be better) may not be a threat to you. studies are being done to allow of stratification of patients. LP(a) is also raised in cases of hypothyroidism, and does lower when treated. Seems not everyone with high LP(a) is at risk, we just need to be able to determine who is or is not. It looks like LP(a) evolved in humans to increase survivability when wounded, and heal quickly. A great benefit when humans only lived for 30 or 40years.

@chrisbradford1027 4 ай бұрын

Thank you for the information. I have only recently started getting more intrusive with my cholesterol levels at 52. I requested my Lp(a) test with my doctor, and it came back at 199. I am trying to fully understand what I am facing and how to tackle it. This video has helped me understand it better!

@misskitty4296 7 ай бұрын

In my mid sixties with some family history. My doc checked it and mine is high! Very high! So of course I researched and found nothing can really be done about it. I try to be healthy, but I am overweight with HBP and a somewhat high cholesterol markers, kept in check with medication and diet. At first I stressed! What good does it do me to have this info with nothing to do about it! So I finally relaxed and am just living my life as best I can. Love your videos, and esp your sense of humor! It was nice to hear someone talking about it, and to see others in the comments with the same issue!

@catejordan7244 7 ай бұрын

My mom lowered hers with Niacin. Look into that. Not many studies because big pharma doesn’t make money with it

@immasher2139 7 ай бұрын

Now that it interesting! I will have it tested. I have had genetically high LDL for decades (thanks, Dad). No statins per my choice. Thanks Doc's, I love your channels and your specialist guests!

@robertusga 7 ай бұрын

No statins per your choice? Why? I hope you are taking alternative medical interventions to lower your ApoB. Many other options than statins these days. Most of the fear mongering on statins is proven to be completely unfounded an nocebo effect. Also, using combo of very low dose statin and ezetimibe eliviates most if not all potential side effects.

@immasher2139 7 ай бұрын

@@robertusga I have seen how the side effects affected many of my own patients. I didn't want any part of the pharmaceutical interventions with what I witnessed.

@robertusga 7 ай бұрын

@@immasher2139 yeah lots of docs starting statins at crazy high doses and then being shocked patients get side effects. How about brushing up on the latest outcome data and actually treat your patients properly? Super low dose rosuvastatin and ezetimibe could be a start. You also realize statins are not the only option nowadays right?

@LuwanaWard1974 7 ай бұрын

I have high cholesterol and triglycerides and have been on several statins but none of them have helped lower my numbers. My Dr. is trying to get Repatha pre-approved. I’m 66 years old and weigh 118 and my numbers have been high for 20+ years it must be hereditary because my Mom also had the same problems. I sure hope the repatha ( If approved) brings my numbers down. Thanks for the informative video 😊

@circa1890 7 ай бұрын

Try 2 tsp of psyllium husk in 1 c water/daily with your large meal of the day and see if that works for you.

@LuwanaWard1974 7 ай бұрын

@@circa1890 Thanks, I’ll try that and hopefully you’ll get my numbers down without more statins😊

@keithpomeroy3654 7 ай бұрын

I was a patient of Dr Heffernan 22 years ago and he did an excellent job of reassuring me when a genetic defect (bicuspid) aortic valve needed to be replaced. (I have had a second operation since). Your Talking With Docs presentations are very informative! Thanks

@stujm8376 7 ай бұрын

You guys may have terrible jokes, but your vids really have helped me understand some issues I had. Now I try to put what you guys say into practice. You really are lifesavers.

@JW02828 7 ай бұрын

I have a question from your other video. How does tachycardia effect high blood pressure? What is an alternative medicine to slow down the heart rate with less side-effect then Metoprolol?

@tedreid1035 7 ай бұрын

I don't know that tachycardia has direct effect on blood pressure. When you say tachycardia how fast is it going? Is it a sinus tachycardia or someother form? Beta blockers have been the mainstay of treatment for years but there are a couple other classificatins of meds tha work depending on the type of tachycardia.

@JW02828 7 ай бұрын

@@tedreid1035 For me heart rate stays around 82 to 95. What other classifications of medicines to slow down the heart?

@wread1982 7 ай бұрын

To get rid of tachycardia, buy a redundant bike and ride it 30-40 minutes a day and increase the tension and time each time and get your heart in really good shape, it will also make your vessels more flexible with endothelial function improvements. Got rid of all my skipped beats, flutters and raising heart and it lowered my BP, a sauna will do the same thing, it works the heart while you sit there

@billwilliams44 7 ай бұрын

@@wread1982 if you’re fat, out of shape and have tachycardia, that could work. Or even if you’re not fat, it could work. But it doesn’t work for everybody. I have a history of Atrial fibrillation and of frequent PVCs (like so many that my perfusing pulse at times had been 32 to 38 beats a minute) I’ve been riding bicycles all my life. Despite four vigorous bicycle rides a week I had these problems. But, again, a regular exercise habit can certainly help reduce cardiac problems.

@plants_and_wellness1574 7 ай бұрын

I’m curious to hear what any of you would do personally if you had really high Lp(a) and no one in your family lived past 67. What diet and lifestyle would you follow? My Lp(a) was 243 nmol/L last year and in April it was 380 nmol/L. I’m almost 40 but I’ve been a health freak for ten years. I have zero health problems but my high lp(a) concerns me. I’m 5’6 and 122 pounds. My A1C is 5.0. My last LDL reading was 132 even though I cut out saturated fat. But my LDL WAS 194 before I went almost 100% plant based. I thought I had a really healthy diet but my particles were almost 1900 and my LDL small particles were over 500. My Lp-Pla2 was over 225. Since I changed to an almost exclusive plant based diet my particles are under 1200 and my small particles are under 400. My last Lp-Pla2 was 118. My LDL was 112 in April and I recently added back eggs, I wonder if that’s the reason my LDL is now 132?

@emsea1658 7 ай бұрын

Do you really think your LDL going from 112 to 132 is pathological and not physiological? That's still low. And as you get older there is evidence that higher LDL to an extent has an inverse relationship with mortality. Now of course nutrition science is a war zone nowadays and I dont mean to get into a back and forth arguement. Ive never had my lipo a tested so I really cant answer much of your question. There is a pretty comprehensive all cause study that found the sweet spot for LDL was in the upper 100s anyways and even slightly above 200 the risk change is miniscule. Again like i said, nutrition science is a mess nowadays. Just sharing some thoughts and wishing you good health. One more being an a1c is not always definitive marker for metabolic health, since your insulin status may still remain untested. As in your insulin response to food. ie, the Kraft test. This can drive chronic inflammation behind the scenes for years before an abnormal a1c throws a flag

@plants_and_wellness1574 7 ай бұрын

@@emsea1658 my mom is the only one in our family to make it to 70. Her parents and 4 siblings died early 60’s to late 60’s. All from heart disease. They all ate mostly red meat and veggies covered in butter or lard. Their breakfast of choice was eggs fried in lard and bacon. My mom has high Lp(a) and has smoked for 50 years, yet she doesn’t have ONE heart problem. What did she do differently? Her LDL is 80!! She stayed away from red meat, butter, lard, milk, etc. Her low LDL must be doing something for her because she should have died by now but she’s actually pretty healthy at 70. Even though she smokes. She eats a mostly plant based diet, has chicken a couple times a month and fish 2-3 times a week. I think high Lp(a) isn’t a death sentence if your LDL is low and you live an otherwise healthy lifestyle. She’s proof of it.

@Fearzero 7 ай бұрын

Whole plant diet, well planned, zero processed foods will sort you out. Eat lots of cooked greens for the nitric oxide and 1c blueberries daily as well as steel cut oats and walnuts and pumpkin seeds topped with homemade hemp milk.

@Ansonidak 7 ай бұрын

Continue to work hard on all the other risk factors that you can affect.

@lenakohl2339 7 ай бұрын

@@emsea1658 "And as you get older there is evidence that higher LDL to an extent has an inverse relationship with mortality." This may be a correlation, but not causation. Or even reversed causation. E.g. some types of cancer can lower LDL.

@CarrieV9 7 ай бұрын

My grandpa died at 51 after his 6th heart attack. My mom has had 3 and had quadruple bypass. My LDL was above 200 despite healthy diet and weight. I thank god there are medications and other interventions to help lower my risk.

@jaguilar11009 7 ай бұрын

THANKS 👍 FOR YOUR HELP ❤😊👍👏👏👏😊

@Total_Body_Fitness_USA 7 ай бұрын

As a functional medicine practitioner, I've been teaching about Lp(a) for at least a decade.

@TalkingWithDocs 7 ай бұрын

That's great!

@tedreid1035 7 ай бұрын

What do you teach or say about Lp(a)?

@keithbronson9777 7 ай бұрын

🤣🤣🤣🤣🤣🤣🤣🤣

@petertownsend252 7 ай бұрын

My Lp(a) is non-detect,

@WhereNerdyisCool 7 ай бұрын

My Lp(a) is very high and they put me on a PCSK9 med that should drop it some. A recent study showed statins can raise Lp(a) a great deal! 😢

@immasher2139 7 ай бұрын

So it's a damned if you do and damned if you don't scenario...

@jackspintz5784 7 ай бұрын

the most dangerous situation is a cardiovascular doc putting someone on a statin and not knowing they have elevated Lila. however the docs and FDA make money on statins, so they need to fig how to capitalize on the money. 20% of america has high Lil a and plus they want everyone dead anyway. Niacin 500-1000mg flush will help, dont believe the study that says will still cause events, that is bogus! of course niacin is cheap why wouldn't they say that. I never go to docs about my genera health anymore do all my blood work, only see them for surgery if needed or X-ray etc.

@WhereNerdyisCool 7 ай бұрын

@@immasher2139right? They are testing an mRMA jab that could shut off the mechanism that generates so much Lp(a). Last video I saw on it stated it was being developed and brought it down 90-95% on test subjects. As the docs state, big pharma is working on some stuff. I get retested in January to see how the PCsK9 med is working.

@stevenbrewer8788 7 ай бұрын

Peter Atia, TWD, and Rob Lustig! Bringing the knowledge!

@barbarameuleman389 7 ай бұрын

Very informative. I see a specialist every 3 months re. high cholesterol. Because he said it was genetics, I asked about LPa and he said "We don't even check for that here." (Hospital in Canada.) I can't tolerate the statins he has prescribed so he did mention that injectables are an option. I'm really glad to hear it might be helpful. I hate needles but now I'm willing to try! Thank you!

@my-smalltowns 7 ай бұрын

My Lipoprotein (a) is 279 should be

@petertownsend252 7 ай бұрын

My Lp(a) is non-detect,

@hindnamir6985 5 ай бұрын

Thank you for sharing your age and lpa. Because I’m freaking out. My 13 years old has high lpa. I’m thinking he is going to have heart attack at early age?!!

@StickMan...77 2 ай бұрын

Thank you for sharing,hope God gives you many more years.

@GTLee9 7 ай бұрын

When should you test for lp a? When you’re on statins? Or does it make a difference?

@narenmenon6906 7 ай бұрын

My understanding is that statins do not reduce Lp(a). Niacin does.

@deejayk5939 7 ай бұрын

Love the head wear! 😂Seriously thanks for the info.

@robevans2114 7 ай бұрын

Wow great insights and fact helping be to more healthy Thank you

@lacmeadows4092 7 ай бұрын

Thank you for bringing awareness to LPa. The two drug classes looking at this specifically are PCSK9 and siRNA (Repatha and Leqvio)Let's hope the data reads out soon and is favorable so that there is something that can treat it.

@davidh5309 7 ай бұрын

No, the PCSK 9 inhibitors have little effect on the Lpa, around 20%. Your going to have to wait until one of the four drugs in the pipe that specifically target the Lpa. Hopefully by 2026?

@YogaWithGail 7 ай бұрын

What are the diet and exercise regimens that help lower one's inflammatory LP(a)? Recommended nutritionists?

@Value1lady 7 ай бұрын

I want to know as well

@jackspintz5784 7 ай бұрын

take 500mg flush niacin do the research

@Total_Body_Fitness_USA 7 ай бұрын

Anything that lowers inflammation. Lp(a) is a sticky molecule and eating a high fat oxidized diet is very very very bad. Check all your inflammatory markers along with OxLDL and MPO and do your best to keep your triglycerides below 100 and preferably your HDL above 50. Most people with high Lp(a) have genetically high HDL so that is beneficial. The unfortunate ones with low HDL are the ones that have heart attacks before the age of 40. Research high dose niacin, berberine, and nattokinase along with K2. BTW, I've trained in functional medicine for over a decade. Best of luck.

@Value1lady 7 ай бұрын

@@Total_Body_Fitness_USA my son in law was taking berberine. My hdl is sometimes above 50 seems i cant keep it that way y i dont know and i dont eat a high fat diet bc of my ldl cholesterol that is slightly elevated my total was good so idk how to bring the hdl up tried but can’t succeed. U have any suggestions for that?

@YogaWithGail 7 ай бұрын

@@Total_Body_Fitness_USA Well, my LP (a) was 147, but LDL was 36, Triglycerides 26, and HDL 59. I tend to eat more plant-based with venison, eggs, & lean beef thrown in, to up iron content. I took a nutritionist's course, on how to read one's blood work, and one of the suggestions was to get an LP (a), blood work done.

@marciacoco9549 7 ай бұрын

Great video ‼️. My nephew who is close to 50 years old went in to cardiac arrest last year. He survived thankfully. He has long Covid and asthma. After going to doctor after doctor one found that he had a different type of cholesterol along with the regular HDL and LDL. I’m wondering if this is it, he is in a medical trial in hopes of lowering it.

@kathleenking47 7 ай бұрын

Try nattokinase for long covid

@myhappynest6125 5 ай бұрын

My sister had a heart attack around age 56. She was in excellent fitness. Her HDL number was 40(low). She had her LPa tested and was very elevated.

@user-sy8ri4iz5l 7 ай бұрын

I’m 62. My LPa results were in the upper 500’s. I live in Chicago Illinois with great health insurance and it was VERY difficult to get the test! My mom died at 66 by heart attack. I’ve been on statins since she died (about 25 years) but have become intolerant to the statins. I’m doing everything I can - but this is terrifying!

@BillyBoy66 7 ай бұрын

Carnivore diet will change your life for the better. Do some research on it. It's not to late.

@user-sy8ri4iz5l 7 ай бұрын

Thank you, but I’m a vegetarian 😮

@BillyBoy66 7 ай бұрын

@@user-sy8ri4iz5l Ok, well I'm a carnivore and my cholesterol dropped 50 points in the last 4 months because of it. I'm 57 and feel 30 yrs younger. All of my major health issues have been reversed. I eat NO sugar and very little carbs (less than 20g per day). If you're a vegetarian because you like it, then fine. But if you're a vegetarian because you think it's more healthy, I'd say think again.

@user-fx5df1ur4m 7 ай бұрын

@user-sy8ri4iz5l There are several types of statins; also ezetimibe, also bempedoic acid, PCSK9 inibitors... Meanwhile, look at the Lp(a) Clinical Guidance calculator in order to motivate you about the Lp(a) residual risk. By the way, exactly which is the specific reason for being intolerant to the statins?

@KAT-dg6el 7 ай бұрын

@@BillyBoy66 I tried the carnivore diet, and in two months I lost 4 inches around my waist, (i’m not overweight I just have the belly and I’m positive now it wasn’t all fat but some of it was inflammation) also my knees that ached for years stopped hurting. I went from 17 units of basal insulin down to six units a day. My blood sugar stayed between 80 and 110 all the time. But my LDL did skyrocket up to 315. Doctor told me I was gonna die without statins or vegetables. I did add back in low carb vegetables but said no to the statins. I gained 2 inches back in my waist and had to increase my basal insulin to 10 units. Last month the doctor scared me into taking Crestor. Red yeast rice had decreased my LDL from 315 to 288. I was on Crestor for two weeks and I stopped. Knee pain back, heart fluttering, heart pounding out of my chest, and for some weird reason I’d wake up every morning crying. I don’t know what the hell that was about, and blood sugar skyrocketed. I’ve been off of it for two weeks and I still have knee pain off & on and blood sugar spikes for no reason. Which tells me the statin drug is still in my system! I am so mad that I ever took that drug. I’m going back on the carnivore and going to try to keep my carbs as low as possible. 10 g a day or less. I seem to fit what Dr. Ken Berry says about his body when it comes to getting close to zero carbs as possible. If I die I die because I am sick and tired of listening to Doctor’s and their drugs.

@debbiebatten6021 7 ай бұрын

Thank you docs! I just wanted to comment on the “evil statins”, even though they don’t help with this particular form of cholesterol. I worked with my doctor for two years trying different kinds of diets and exercise programs to lower my cholesterol naturally. While I greatly admire those who are able to make this work for them, it wasn’t meant to be for me. Finally, my doctor came into the exam room with my latest lab results and said, “It isn’t what you eat.” I started on a statin and my cholesterol plummeted in just three weeks. Fortunately, I have had no side effects, and I’m feeling great. I do continue to watch my diet and get regular exercise because I don’t believe statins are magic bullets, but I am grateful for them at this point. I appreciate that you take the time to make these videos. Thank you again!

@roch369 Ай бұрын

Were you on a low fat plant based diet? Thats made many peoples numbers plummet.

@debbiebatten6021 Ай бұрын

@@roch369 Yes, I tried it for 6 months. Whole foods, plant based, and no oils. I was so disappointed when that didn’t help! I think it came down a few points, but not nearly enough to be helpful.

@roch369 Ай бұрын

@@debbiebatten6021 Did you try Dr.Esselstyn or Ornish plan?

@Marc_de_Car 7 ай бұрын

Thank you

@christinadiaz1969 7 ай бұрын

Will you please follow up with a video about normal litle a and elevated b

@keppela1 7 ай бұрын

"New"? I remember reading about lipoprotein (a) 30 years ago. C'mon guys.

@tedreid1035 7 ай бұрын

they ain't the same.

@keppela1 7 ай бұрын

@@tedreid1035 Really? There's more than one lipoprotein (a)? Care to elaborate?

@LVQ-so5th 7 ай бұрын

You are correct. A pubmed search will verify this.

@billoberg3272 7 ай бұрын

Sometime soon, please talk about vitamin E supplement tocotrienols as a supplement. Another channel proports that it can reduce risk of STROKE???

@TalkingWithDocs 7 ай бұрын

Ok bill we will take a good look at it.

@bmills3133 7 ай бұрын

It appears I missed this. What specific blood test should be ordered to identify my LP(a) level.

@somuchtruth2306 7 ай бұрын

I wasn't sure if I understood one point in this video. If a person has extremely low LDL (mine is 45) is it likely that will offset the danger of having a high LP(a)? Unless I can find some numeric goals to shoot for, I don't believe I will take the LP(a) test because it will just frighten and depress me if I score high.

@joemodzelewski3242 7 ай бұрын

I am a practicing Pathologist. In my opinion, the additional lipoprotein on LP(a) should be called 'lipoprotein little a'. You mentioned it once, but hammer it home. That would help a lay person understand the difference in LDL and LP(a) much better, especially as testing for apolipoprotein A and apolipoprotein B becomes more common place.

@robertusga 7 ай бұрын

Sure, as long as you start using LDL-c and not LDL. Not the same. There is no test for LDL, there is for LDL-c.

@nanecky 7 ай бұрын

Thanks Docs!! Just had an Advanced Lipid panel LP(a) 144.2 APOB 132 TC 334, LDL 203, HDL 112. But the predominantly high particle size puts my risk very very low. CT Angiogram shows no plaque no stenosis and a Zero CAC. I do have AFib but at less than 1% A carotid artery ultrasound found some issue so having a CIMT in a couple of weeks so we’ll see. Not planning to take statins.

@jackspintz5784 7 ай бұрын

yep your particles are important and metobolic health, insulin etc.

@nanecky 7 ай бұрын

@@jackspintz5784 my IR was 22 and glucose measured in August was 83

@Total_Body_Fitness_USA 7 ай бұрын

I always go by Triglycerides to HDL ratio even if your Lp(a) is a little high, you can counteract it as long as you keep your triglycerides in balance with your HDL. Preferably a 1:1 ratio, especially if your Lp(a) is over 100. I'm assuming you are under the age of 40. Also, the body compensates. Just look at your HDL is off the charts compared to other people with normal Lp(a). Check your OxLDL and MPO to make sure there is no oxidation going on. Cholesterol is only bad in the presence of oxidation and inflammation.

@DK-pr9ny 7 ай бұрын

Triglycerides? A1C?

@nanecky 7 ай бұрын

@@Total_Body_Fitness_USA I wish I was under 40! I’m 64. 5’4 130lb

@gregoryglen4090 7 ай бұрын

Wow! How interesting Docs. Thanks!!! Of course, I went to get my blood work done today actually, and they lost the Dr. req. Sooo now I'm waiting for my next checkup.

@JMK-vo8pv 7 ай бұрын

Thank you, gentlemen, for the informative video. Could you please direct me to JUST ONE trial, paper, study that proves CAUSATION between Lp(a) and atherosclerosis, NOT just a bunch of associative/correlation studies?

@km-bo3zx 7 ай бұрын

You said that LP(a) is inflammatory. So, wouldn’t taking a low dose statin (like Crestor), which is anti-inflammatory, be recommended?

@TalkingWithDocs 7 ай бұрын

At this point the evidence does not support that

@JMK-vo8pv 7 ай бұрын

Would you agree that cardiologists should ROUTINELY be ordering cardiovascular biomarkers (hsCRP, MPO, Lp-PLA2, Alb/Creat on their CAD patients? Since we know that atherosclerosis is an INFLAMMATORY disease, it seems that following such CV biomarkers would help to "risk stratify" known CAD patients for future MACE. @@TalkingWithDocs

@suzanne296 7 ай бұрын

Ok I am learning something new. Watching now. But how do I get tested?

@TalkingWithDocs 7 ай бұрын

Family doctor

@nancyv4431 7 ай бұрын

Please make a video explaining Lipoproteins fractionation ion mobility testing. What can be done to lower those numbers?

@chrisstepleton4761 7 ай бұрын

I read that a whole food plant based diet can reduce your LPa by 15 % in 4 weeks.

@TheFightingSheep 7 ай бұрын

Drug pushers and medical racketeers, no conscience and no shame.

@TalkingWithDocs 7 ай бұрын

If you watched the video he literally said there are no drugs to lower this. There are trials taking place. Yes what medicine should do is sit back and let the people with elevated Lp(a) just suffer. Our channel is definitely not for you. Best of luck.

@rebeccabowen101 6 ай бұрын

I'm 57 and just learning that I have elevated levels, as well as my 18-year old daughter. My boys have not yet been tested. But, my younger brother recently had a heart attack. Scary stuff!

@thomasconc 7 ай бұрын

That is very interesting. There is no clinical guideline to test for this in Australia. I had a major HA/widowmaker almost 4 years ago, triple bypass at 53 years old. Seemed to have had high LDL cholesterol undiagnosed but had been otherwise non-smoking, good BMI, no diabetes and a lifetime athlete - so this could explain what happened to me. Incidentally I have also been on Evocumulab (Repatha) now for 2 years so that may well have helped - LDL is currently 0.8 mmol/L or 31 mg/dl with statins & repatha. I think I will push to have this test to see if I have this Lp(a) gene as it would make sense.

@T-aka-T 7 ай бұрын

On the offchance, if you're in Sydney or could make the trip, see if you can get an appointment with Dr Paul Mason (honours sports medicine scientist and medical doc as well). He does a lot of specialised testing. At least see his Low Carb Downunder presentations. PS What were your trigs and HDL? And the ratios? Look at his session on understanding your cholesterol readings.

@charlesincharge3404 7 ай бұрын

After knowing everything we now know, they're still talking about freakin' cholesterol, and completely ignoring the true causes of heart disease...argh

@scottmackenzie8499 7 ай бұрын

Which are?

@walkingmckinney 7 ай бұрын

What’s the true cause?

@hmmm..2733 7 ай бұрын

Inflammation? Caused by sugar? Or seed oils? Or?

@TheFightingSheep 7 ай бұрын

Medicine is a racket, backed by quack science, like witch doctors. Nothing new under the sun.

@tylerbird1359 7 ай бұрын

Sugar seed oils and unnecessary chronic inappropriate inflammation from these not from red meat stay away from this channel and do the research

@gener.1253 7 ай бұрын

Instead of hunting for a drug and treating the symptoms forever how about looking for the cause of high LPa. If it's in the body, it's either there because the body needs it or something wrong is going on in the body to create it.

@zealman79 7 ай бұрын

I'm guessing twisting yourself into pretzels of logic is a speciality of yours. The cause of LP(a) is the same cause that you're alive today.... Your mom and your dad

@LVQ-so5th 7 ай бұрын

They'd go out of business if they did that.

@rukhsanachaudhry2 7 ай бұрын

Appt your information regarding high cholesterol