Apolipoprotein A-I
Lipids marker
Apolipoprotein A1
Apolipoprotein A-I
The primary structural protein of HDL particles. Superior predictor of cardiovascular risk compared to HDL-C because it directly quantifies functional HDL particles.
PED Notes
Oral 17-alpha-alkylated AAS devastate ApoA-1. Stanozolol reduced ApoA-1 by 40% in clinical studies — it upregulates hepatic triglyceride lipase (HTGL) by 230% within 3 days, accelerating HDL catabolism. Injectable testosterone at TRT doses has minimal effect. Nandrolone showed no significant change. Compounds ranked worst to least: Stanozolol > Oxandrolone > Oxymetholone > Trenbolone > Boldenone > Testosterone > Nandrolone. Recovery is slow — ApoA-1 had not returned to baseline 6 weeks after a 14-week cycle.
When low
When low (<1.10 g/L):
Supplements:
- Niacin (Extended-Release) -- 1500-2000mg/day (titrate up by 500mg every 4 weeks). Increases ApoA-1 by ~8%. Take at bedtime with aspirin 81mg 30 min prior to reduce flushing
- Omega-3 (EPA/DHA) -- 3-4g/day. Improves HDL-ApoA-1 exchange and cholesterol efflux capacity
- Citrus Bergamot -- 500mg 2x/day. Increases HDL-C and modestly improves ApoA-1
Lifestyle:
- Aerobic exercise -- 30-45 min, 3-5x/week. Meta-analysis of 57 RCTs shows aerobic training significantly increases ApoA-1
- Eliminate or reduce oral AAS — this is the single most impactful intervention. If ApoA-1 is below 0.90 g/L, oral AAS should be discontinued immediately
- Increase monounsaturated fats — olive oil, avocados, macadamia nuts
- Allow 8-12 weeks minimum between cycles for ApoA-1 recovery. Do not begin a new cycle until ApoA-1 is above 1.00 g/L
Pharmacological options:
- Pemafibrate -- 0.2mg 2x/day where available; selective PPAR-alpha modulator, raises HDL/ApoA-1 with minimal LDL impact and a cleaner hepatic profile than fenofibrate
- Cabergoline -- 0.25mg 2x/week has shown modest HDL elevation via prolactin-mediated mechanisms; useful when prolactin is concurrently elevated
- See the HDL marker for full niacin protocol; see ApoB and LDL markers for the statin/ezetimibe/bempedoic acid/PCSK9i options that reduce cardiovascular risk even when HDL/ApoA-1 remains suppressed
- All prescription items require physician oversight
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Frequently Asked Questions
Reference Ranges
Standard Range
VitalMetrics Range