Why isn't Lp(a) included in standard lipid panels?

Standard lipid panels measure total cholesterol, LDL, HDL, and triglycerides. Lp(a) requires a separate test. Guidelines now recommend everyone get tested once, but it's not yet routine practice everywhere. Many people with elevated Lp(a) don't know it.

Can I lower my Lp(a)?

Unlike LDL, Lp(a) is largely genetic and doesn't respond much to diet, exercise, or statins. Niacin can modestly reduce Lp(a). New therapies targeting Lp(a) specifically are in development. If your Lp(a) is high, focus on optimizing other risk factors.

If Lp(a) is genetic, why test it?

Knowing your Lp(a) helps determine your true cardiovascular risk. If Lp(a) is high, you may need more aggressive treatment of other risk factors (LDL, blood pressure). It also explains why some people have heart disease despite "normal" cholesterol.

How does Lp(a) compare to ApoB?

Both are advanced cardiovascular markers. ApoB counts all atherogenic particles (including LDL and Lp(a)). Lp(a) specifically measures this genetically determined, high-risk particle. Testing both gives the most complete picture.

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❤️ Heart Health

Lipoprotein(a) [Lp(a)] Blood Test

Lp(a)

Lipoprotein(a) is a genetically determined cardiovascular risk factor. Elevated Lp(a) increases your risk of heart disease, stroke, and aortic valve disease independent of LDL cholesterol.

Lipoprotein(a), or Lp(a), is a cholesterol-carrying particle similar to LDL but with an additional protein called apolipoprotein(a) attached. Your Lp(a) level is largely determined by your genetics and remains stable throughout your life.

What makes Lp(a) important:

It's an independent risk factor for heart disease, stroke, and aortic stenosis
20-30% of people have elevated Lp(a), often without knowing
It's not included in standard lipid panels, so it requires specific testing
High Lp(a) can explain heart disease even when LDL appears controlled
It has both atherogenic (plaque-building) and thrombotic (clot-promoting) effects

The European Atherosclerosis Society and American Heart Association recommend that everyone get their Lp(a) tested at least once in their lifetime, as it's a valuable piece of your cardiovascular risk puzzle that standard cholesterol testing misses.

Price

$21

All-in

$39

incl. $18 lab & physician fee

Results

2-3 business days

Fasting

Not Required

What's Measured

Lipoprotein(a)

What This Test Measures

This test measures the concentration of Lp(a) in your blood, typically reported in mg/dL or nmol/L. Desirable: <30 mg/dL (<75 nmol/L). Borderline: 30-50 mg/dL (75-125 nmol/L). Elevated: >50 mg/dL (>125 nmol/L). Very high Lp(a) can exceed 100 mg/dL (250 nmol/L).

Who Should Consider This Test

Everyone should test Lp(a) at least once (per current guidelines). Especially important for people with family history of early heart disease, those with heart disease despite normal LDL, individuals with familial hypercholesterolemia, and anyone wanting a complete cardiovascular risk assessment.

Health Insights

Conditions Screened

Cardiovascular disease riskFamilial elevated Lp(a)Aortic valve stenosis riskStroke riskPeripheral artery disease riskFamilial hypercholesterolemia evaluation

Related Symptoms

No symptoms (screening test)Family history of early heart diseasePersonal history of heart disease or strokeUnexplained cardiovascular eventsHigh LDL despite lifestyle changes

When to Get Tested

No fasting required. Since Lp(a) is genetically determined and stable throughout life, you typically only need to test once. Repeat testing is only needed if your first result was borderline or if you start Lp(a)-lowering therapy (currently limited options).

No fasting needed. How to prepare for your blood test →

Full guide: what annual blood work should include →

Understanding Your Results

Lp(a) <30 mg/dL (<75 nmol/L) is considered desirable. Levels >50 mg/dL (>125 nmol/L) significantly increase cardiovascular risk. Very high levels (>100 mg/dL) may warrant aggressive management of other risk factors. Unlike LDL, lifestyle changes have minimal effect on Lp(a).

What to Expect

After placing your order, we send it straight to Quest Diagnostics — there is no consent form to sign and no partner email to wait for. Your requisition is usually ready to download from your dashboard within about an hour, and you can book your blood draw at any Quest Diagnostics location.

The blood draw typically takes just a few minutes. Results are usually available within 2-3 business days and will appear in your secure JustLabs dashboard.

Our results include reference ranges and easy-to-understand indicators showing whether your values are within normal limits.

How much does the Lp(a) test cost?

The Lp(a) test costs $21 at JustLabs — $39 all-in, since the $18 lab & physician order fee is charged once per order, however many tests you add. The price is fixed before your blood draw; no insurance or doctor visit needed.