Biomarker / Cardiovascular
Lp(a)
Also called lipoprotein(a), "lipoprotein little a"
A cholesterol particle whose level is set mostly by your genes. About one in five people have a level high enough to raise heart risk, and a standard cholesterol test won't show it.
- Sample
- Blood
- Fasting
- Not required
- Day to day
- Largely stable
- Retest
- Usually once is enough
What it is
Lp(a) is an LDL particle with an extra protein, apolipoprotein(a), attached to it. Like LDL, each Lp(a) particle carries one ApoB, so it is already counted in your ApoB result. The extra protein is what sets it apart.
On the highway from the ApoB guide, an LDL particle is a car. Lp(a) is the same car towing a trailer. The trailer carries inflammatory oxidized fats into the artery wall, and apo(a) can interfere with the body's clot-dissolving system.
You can't unhitch the trailer with diet.
Your Lp(a) level is mostly inherited. Levels vary about a thousandfold between people but stay largely stable within one person over a lifetime.3 Diet and exercise do little to move it.
Why it matters
High Lp(a) raises the risk of heart attack and stroke on its own, even when LDL cholesterol looks fine. Because it's genetic, it can explain heart disease in people who seem to be doing everything right, and it runs in families.
The 2026 ACC/AHA dyslipidemia guideline says everyone should have Lp(a) measured at least once.1 Most people never have: it isn't part of a standard lipid panel, so you usually have to ask for it.
For women, studies show levels rise roughly 20 to 30% after menopause, though part of that rise is age.3 If your only result is from before menopause, ask your clinician whether a second test makes sense.
Reading your result
Check the unit first. Labs report Lp(a) in either nmol/L (particle count) or mg/dL (mass). The two can't be converted precisely, so compare results only in the same unit.
The 2026 guideline treats 125 nmol/L (50 mg/dL) or higher as a risk-enhancing factor, about 1.4 times the risk of heart disease. At 250 nmol/L (100 mg/dL) or higher, risk is about doubled.2 Some labs flag results from 75 nmol/L as a possible risk factor.5
A high result doesn't have its own fix yet. The guideline's answer is to lower LDL cholesterol more aggressively and tighten control of other risk factors.2 That makes Lp(a) worth knowing even though you can't change it directly.
No drug that targets Lp(a) is approved yet. In September 2026, the first large outcome trial of one, pelacarsen, lowered Lp(a) but missed its main goal of reducing heart attacks and strokes. Several others are still in trials.4
Where to test it
| Test | Sample | Cost | MYM review |
|---|---|---|---|
| GoodlabsSingle test, includes $12 lab fee | Lab draw (Labcorp) | $28 | Not yet reviewed |
| DrSaysSingle test, includes $9.99 collection fee; not in NY, NJ, RI | Lab draw (Labcorp) | $31.98 | Not yet reviewed |
| Own Your LabsSingle test, no membership | Lab draw (Labcorp) | $35.20 | Read review |
| Labcorp OnDemandSingle test, reports nmol/L | Lab draw (Labcorp) | $49 | Not yet reviewed |
| Quest HealthSingle test, includes $6 physician fee | Lab draw (Quest) | $51 | Not yet reviewed |
| Walk-In LabSingle test, includes $6 physician fee | Lab draw | $55 | Not yet reviewed |
| WHOOP Advanced Labs1 test per year, includes ApoB | Lab draw (Quest) | $199/yr | Read review |
| Quest Health Advanced Heart Health PanelOne-time, includes ApoB | Lab draw (Quest) | $221 | Not yet reviewed |
| Function HealthAnnual membership, 100+ markers | Lab draw (Quest) | $365/yr | Read review |
| Marek DiagnosticsComprehensive Panel, one-time, ~80 markers | Lab draw (Labcorp) | $495 | Read review |
| Hims & Hers LabsAnnual plans, tiers vary | Lab draw (Quest) | Varies by plan | Not yet reviewed |
Prices as of October 2026, before promotions; NY and NJ often cost more.6 Tests without a review are listed from company information, not first-hand testing. Because you usually need Lp(a) only once, a single test is the cheapest route; a panel makes sense if you want ApoB and other markers at the same draw. InsideTracker's Ultimate panel doesn't include Lp(a). Your doctor can also order it; ask for it by name.
Last reviewed October 10, 2026. Report an error.
For education only, not medical advice. Talk with a clinician about your results and any treatment decisions.
- 2026 ACC/AHA Multisociety Guideline on the Management of Dyslipidemia, JACC.
- Top Things to Know: 2026 Guideline on the Management of Dyslipidemia, American Heart Association.
- Current understanding of the contribution of lipoprotein(a) to ASCVD risk in women, National Lipid Association.
- Lp(a)HORIZON: top-line results dash hopes for pelacarsen, TCTMD, September 2026.
- Lipoprotein(a) test, Labcorp OnDemand.
- Pricing: Goodlabs (lab fee), DrSays, Own Your Labs, Labcorp OnDemand, Quest Health, Walk-In Lab, WHOOP, Quest Health panel, Function, Hims & Hers, InsideTracker Ultimate panel.