Therapy
L-carnitine and coenzyme Q10 emerge as the most promising Lp(a)-lowering supplements, a review of 152 articles (Clin Ther 2019)
Original title: Lipoprotein(a): Current Evidence for a Physiologic Role and the Effects of Nutraceutical Strategies
This literature review by Santos, Kones, Rumana, Earnest, Izidoro and Macedo examined 1932 articles on dietetic interventions and nutraceutical agents for lowering Lp(a), narrowing to 740 English-language abstracts and ultimately 152 full-text articles. Reducing saturated fat and ethanol intake, especially red wine, may lower Lp(a), and coffee and tea intake may also decrease Lp(a) levels, though further study is needed before these are considered potent Lp(a)-lowering strategies. Among supplements, only l-carnitine and coenzyme Q10 emerged as promising clinical candidates for lowering Lp(a), while current evidence does not justify vitamin C, soy isoflavones, garlic, or omega-3 for this purpose despite their other cardiovascular benefits. The authors call for definitive long-term clinical trials to confirm whether these dietetic and nutraceutical strategies improve cardiovascular outcomes via Lp(a) lowering.
Original abstract
Purpose: Cardiovascular (CV) diseases account for most worldwide mortality, and a higher level of lipoprotein (Lp)-(a) is recognized as a prevalent contributing risk factor. However, there is no consensus regarding nutritional strategies for lowering Lp(a) concentration. Thus, the purposes of this literature review were to: (1) critically examine data concerning the effects of dietetic interventions and nutraceutical agents on Lp(a) level; and (2) review the feasibility and utility of their clinical use.
Methods: A literature search was conducted for studies published between August 2018 and March 2019. The search was performed using the Cochrane, Medline, and Web of Science databases. In order to expand the research, there were no delimitations on the type or year of the studies. A total of 1932 articles were identified using this search procedure. After duplicates were eliminated, 740 abstracts of articles written in English were screened to identify those of highest relevance. In the final tally, a total of 152 full-text articles were included in this review.
Findings: Several foods and decreases in saturated fat and ethanol intake, especially red wine intake, may lower Lp(a) concentration, but limits are necessary. Coffee and tea intake may decrease Lp(a) level; further investigation is crucial before they can be considered potent Lp(a)-lowering agents. Among supplementation strategies, only l-carnitine and coenzyme Q10 are promising clinical candidates to lower Lp(a) level. Since both l-carnitine and coenzyme Q10 supplementation are commonly used for CV support, they deserve further exploration regarding clinical applicability. In contrast, despite potential CV benefits, current research fails to justify use of higher intakes of vitamin C, soy isoflavones, garlic, and ω-3 for decreasing Lp(a) concentration.
Implications: Definitive long-term clinical trials are needed to confirm the effects of dietetic interventions and nutraceutical agents on Lp(a) concentration when anticipating improved CV outcomes.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.