Lipoprotein(a) Overview and Genetics

Broadcast from KSQD, Santa Cruz on 1-22-2026:

• An emailer from Canada asks about long-term Remicade (infliximab) use for her 16-year-old daughter's ulcerative colitis. Dr. Dawn explains the drug blocks tumor necrosis factor, which stops autoimmune attacks but also weakens infection defense—increasing risk of fungal infections, tuberculosis, and after about 10 years, slightly elevated blood cancer risk. She recommends the daughter practice good hygiene and mask in high-risk settings. For achieving full remission, she suggests vitamin D levels around 75-80, DHEA supplementation, strict gluten avoidance due to its pro-inflammatory effects, and working with a certified functional medicine practitioner to heal the gut and potentially withdraw medication.
• Dr. Dawn presents a case study of a 27-year-old woman with progressive weakness, pins-and-needles sensations, and impaired balance. Despite normal B12 blood levels, elevated homocysteine and methylmalonic acid revealed functional B12 deficiency from using 20-30 nitrous oxide whippets daily. Nitrous oxide oxidizes the cobalt atom in methylcobalamin, permanently inactivating the enzyme needed for myelin sheath maintenance. Treatment requires months of daily B12 injections with recovery taking up to 84 weeks. She warns that nitrous oxide also interacts dangerously with Viagra-type drugs (causing dangerous blood pressure drops), methotrexate, stimulants, hallucinogens, and respiratory depressants.
• She describes Canadian researchers developing a miniaturized 3D printer for vocal cord repair. After removing nodules that cause hoarseness, the device prints hydrogel along the wound to create a flat surface preventing keloid-like regrowth, rather like spackling a wall before healing occurs underneath.
• Dr. Dawn discusses lipoprotein(a), written as Lap(a), a genetic cardiovascular risk factor discovered in the 1960s. This relative of LDL carries a protein that promotes blood clots, thus raising heart attack and stroke risks. In a recent large survey, only about 14% of people have been screened despite its significance. New drugs like pelicarsin can reduce Lp(a) levels up to 80%,trials underway to confirm a benefit of reduced cardiac events. She notes tennis star Arthur Ashe had high Lp(a) contributing to his coagulopathy. A natural option is already available. She recommends lumbrokinase, derived from earthworms and used in traditional Chinese medicine, as an existing treatment that combats high Lp(a) and counteracts its procoagulant effects. The product Boluoke is commercially available, offering an alternative to high-dose niacin which causes intolerable flushing and diarrhea.
• Dr. Dawn reports research finding people with anxiety disorders have 8% lower choline levels in brain regions regulating emotion. Increasing choline could help. Choline sources include eggs (two eggs provide 300mg of the 500mg daily choline need), organ meats, salmon, soybeans, and lecithin supplements.