Skip to main content
Your session has expired. Reloading...
Cardiovascular

Lp(a): what this inherited lipid particle in your blood does and when to measure it

Cholesterol travels in your blood in particles, and Lp(a) is one of them: an LDL particle with an extra protein attached, apolipoprotein(a). According to the European Atherosclerosis Society (EAS), Lp(a) can set off inflammation in the arterial wall.

The higher your Lp(a), the greater the risk of cardiovascular disease according to the EAS, with no sharp cut-off, and that level is more than 90% set in your genes. Only a blood test shows how much Lp(a) you have.

Unilabs expresses Lp(a) in nanomoles per litre (nmol/l) and divides the result for cardiovascular disease into three: below 75 nmol/l rule out, 75 to 125 nmol/l a grey zone, and above 125 nmol/l rule in.

Doctor's Assessment Included

Lp(a) is a fat particle whose level is largely inherited. Laboratories report it in nmol/l or mg/l, so a result can only be compared with the limit of the laboratory that measured it.

  • Star-SHL and Diagnostiek voor U use < 75 nmol/l, Unilabs < 60 nmol/l and Certe < 500 mg/l.
  • Lifestyle has little effect on the Lp(a) level.
  • A measurement can be useful with heart or vascular disease at a young age, or with heart or vascular disease in the family.

When is this value abnormal?

Decision limits per result, in g/l
Result Value (g/l)
Normal < 0,3
Borderline 0,3–0,5
Elevated ≥ 0,5

Lp(a) is largely inherited and stays almost constant throughout life. The risk rises gradually with the value; the EAS stresses that there is no biological threshold. The NHG guideline CVRM uses > 50 mg/dl (0.50 g/l, 80th percentile) as the cut-off and advises against screening the general population. Some laboratories apply a stricter upper limit (0.3 g/l), which matches the lower end of the EAS grey zone.

Source: Nederlands Huisartsen Genootschap Reference population: Adults (NHG guideline CVRM; EAS 2022)

Source: European Atherosclerosis Society Reference population: Adults (NHG guideline CVRM; EAS 2022)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Lipoprotein(a): what Dutch laboratories use

The upper limit runs from 60 nmol/l at Unilabs to 75 nmol/l at Star-shl.

Reference ranges by group, in nmol/l
Star-shl · Everyone · a limit, not a range < 75 nmol/l
75
Unilabs · Everyone · a limit, not a range < 60 nmol/l
60
Unilabs · Everyone · grey zone for cardiovascular disease 75–125 nmol/l
75 125
Unilabs · Everyone · a limit, not a range · raised risk of cardiovascular disease > 125 nmol/l
125
Certe · Everyone · 18 years and older · a limit, not a range < 500 mg/L
Certe · Everyone · grey zone 300–500 mg/L
Certe · Everyone · a limit, not a range · high risk > 500 mg/L
Diagnostiek voor U · Everyone · a limit, not a range < 75 nmol/L
75
0 137.5 nmol/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

Lipoprotein(a): what this test measures

Star-SHL and Unilabs report the concentration of Lp(a) in your serum in nanomoles per litre (nmol/l). Star-SHL measures with immunoturbidimetry and gives < 75 nmol/l as the reference value, Unilabs < 60 nmol/l.

Lipoprotein(a): why this value matters

The EAS describes Lp(a) as a cause of cardiovascular disease whose risk is continuous, with a rising risk already below the usual limits. The EAS advises reading the result within your total risk of cardiovascular disease.

Lipoprotein(a): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
on its own €36,- Whoop · €499,- · Whoop Heart Health · €629,- · Whoop Men's Health · €659,- · Whoop Performance Health · €689,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Lipoprotein(a): when is testing worthwhile?

The guidelines differ on measuring Lp(a): the 2022 EAS consensus says at least once in every adult, preferably with the first lipid profile, while the Dutch guideline on inherited dyslipidaemia sees no justification for screening the whole population. That Dutch guideline does call a measurement worth considering with unexplained cardiovascular disease at a young age, in yourself or in the family.

Lipoprotein(a): symptoms of a high or low value

Low Levels

A low Lp(a) falls within the reference values of Star-SHL (< 75 nmol/l) and Unilabs (< 60 nmol/l); neither laboratory gives a lower limit.

High Levels

A high Lp(a) raises your risk of cardiovascular disease according to the EAS, and that risk increases gradually as the value rises. According to the EAS, a causal link with thrombosis in the veins has not been shown.

Lipoprotein(a): causes of a low or high value

What lowers the value

  • Reduced liver function

    Lp(a) is made in the liver, so a poorly working liver can lower the level.

  • Overactive thyroid

    An overactive thyroid can lower Lp(a); after treatment the level rises by 20 to 25 percent.

  • Hormone therapy after menopause

    Hormone replacement therapy after menopause lowers Lp(a) by about 25 percent.

  • Severe acute illness

    In life-threatening conditions such as sepsis or severe burns, Lp(a) is lower.

What raises the value

  • Inherited level

    The Lp(a) level is thought to be mainly set by the genes and to barely change from adulthood.

  • Kidney disease

    Reduced kidney function can raise Lp(a), and in nephrotic syndrome the level is 3 to 5 times higher.

  • Pregnancy

    Lp(a) can double during pregnancy.

  • Underactive thyroid

    An underactive thyroid can raise Lp(a); treatment lowers it by 5 to 20 percent.

Lipoprotein(a): lifestyle and this value

If a parent, brother or sister has a markedly raised Lp(a), the EAS considers it reasonable to measure your Lp(a) too. The EAS recommends family testing for high Lp(a) with familial hypercholesterolaemia (inherited high cholesterol), with a (very) high Lp(a) in the family, and with cardiovascular disease in yourself or in the family.

Lipoprotein(a): frequently asked questions

How often should you have Lp(a) measured?

According to the EAS, Lp(a) should be measured at least once in adults, and the Dutch guideline on inherited dyslipidaemia assumes that the value hardly changes from adulthood.

Can you lower Lp(a)?

According to the EAS, Lp(a) falls by 15 to 30% with PCSK9 inhibitors, which are not registered for that, and new medicines against the production of apo(a) are being studied. Whether lowering Lp(a) specifically leads to less cardiovascular disease has not yet been examined in any randomised study, according to the Dutch guideline on inherited dyslipidaemia.

What does an Lp(a) of 75 to 125 nmol/l mean?

Unilabs calls an Lp(a) of 75 to 125 nmol/l a grey zone for cardiovascular disease: below 75 nmol/l Unilabs counts the risk as ruled out, above 125 nmol/l as ruled in.

Lipoprotein(a): sources

  1. Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J 2022;43(39):3925-3946. Grijs gebied 30-50 mg/dl, per de FAQ in Atherosclerosis 2023. (retrieved 2026) doi.org
  2. NHG-Standaard Cardiovasculair risicomanagement (M84). Gepubliceerd juni 2019, laatste aanpassing september 2024. Tabel 22, Overzicht van afkapwaarden bij niet-nuchter afgenomen bloed (80e percentiel): "Lp(a) > 50 mg/dl". Geraadpleegd 14 juli 2026. (retrieved 2026) richtlijnen.nhg.org
  3. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  4. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  5. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  6. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  7. Kronenberg F, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J 2022;43(39):3925-3946, Table 1. (retrieved 2026) pmc.ncbi.nlm.nih.gov
  8. Federatie Medisch Specialisten, Richtlijn Erfelijke dyslipidemie in de 2e en 3e lijn, module Behandeling patiënten met verhoogd Lp(a), richtlijnendatabase.nl, geraadpleegd 2026-10-03 (retrieved 2026) richtlijnendatabase.nl

Test Products

This marker is included in the following test panels.

Athletes

Whoop

A 45-biomarker comprehensive health panel inspired by WHOOP Advanced Labs — a deep look at metabolism, cardiovascular risk, hormones, liver, kidney and inflammation.

SHBG (Sex Hormone Binding Globulin) TSH (Thyroid Stimulating Hormone) ALT (Alanine Aminotransferase) LDL Cholesterol Cortisol DHEA-S Estradiol (E2) Free Testosterone FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) Total Testosterone Bicarbonate Calcium Chloride Ferritin Iron (Serum) Magnesium Potassium Sodium Transferrin CRP (C-Reactive Protein) Homocysteine Glucose (Fasting) HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) HDL Cholesterol Total Cholesterol Albumin HOMA-IR ALP (Alkaline Phosphatase) AST (Aspartate Aminotransferase) Bilirubin (Total) Total Protein Urea (BUN) Creatinine Vitamin D (25-OH) eGFR (Estimated Glomerular Filtration Rate) Insulin (Fasting) Leukocyte Differential Transferrin Saturation Lipoprotein(a) Triglycerides Basic Blood Count Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€499,-
Athletes

Whoop Heart Health

A 46-biomarker heart health panel inspired by the WHOOP Heart Health Panel — an advanced look at cholesterol, lipoproteins, inflammation and kidney function.

Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) Cystatin C Uric Acid Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€629,-
Athletes

Whoop Men's Health

A 49-biomarker men's health panel inspired by the WHOOP Men's Health Panel — testosterone, PSA and prostate health plus a complete metabolic and hormone base.

Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) PSA (Prostate-Specific Antigen) Prolactin Leptin Uric Acid Zinc Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€659,-
Athletes

Whoop Performance Health

A 51-biomarker performance panel inspired by the WHOOP Performance Health Panel — recovery, blood production, thyroid, hormones, iron and nutrient status for people who train.

Complete Blood Count (CBC) ALP (Alkaline Phosphatase) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) Albumin Total Protein Bilirubin (Total) ApoB (Apolipoprotein B) Total Cholesterol LDL Cholesterol HDL Cholesterol Triglycerides Lipoprotein(a) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Calcium Bicarbonate Chloride Sodium Potassium Magnesium Cortisol DHEA-S Estradiol (E2) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) SHBG (Sex Hormone Binding Globulin) Total Testosterone Free Testosterone TSH (Thyroid Stimulating Hormone) Glucose (Fasting) HbA1c (Glycated Hemoglobin) Insulin (Fasting) HOMA-IR CRP (C-Reactive Protein) Homocysteine Ferritin Iron (Serum) Transferrin Transferrin Saturation Vitamin D (25-OH) IGF-1 (Insulin-like Growth Factor) Creatine Kinase (CK) Reticulocytes Free T3 (Triiodothyronine) Free T4 (Thyroxine) Vitamin B12 Folate (Folic Acid) Bilirubin (Direct) Bilirubin (Indirect) Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€689,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab

Lipoprotein(a)

€36,-