Author: ogreenspan

What Two Decades As A Cardiac Nurse Taught Me About Women’s Health

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When I started my nursing career more than two decades ago, I felt nothing but excitement.
I chose nursing because I wanted to help people heal — to make a meaningful impact on their lives, their health, and their futures. I imagined a system where I’d have the time, space, and support to truly care for patients in the way they deserved.

But it didn’t take long to realize that the healthcare system wasn’t built for the kind of care I wanted to give.
And for women especially, that gap came with serious consequences.

The Reality I Saw at the Bedside

During my years in cardiac care, one pattern showed up again and again: women weren’t being taken seriously.

Their symptoms were vague.
Their tests looked “normal.”
Or they were told it was stress, anxiety, aging, or hormones.

But here’s what no one talks about:
Women often second-guess themselves long before a doctor does.
They don’t want to be dramatic.
They don’t want to inconvenience anyone.
They don’t want to be a burden.

So they explain away symptoms.
They push through warning signs.
They put everyone else first — until their body forces them to stop.

I cared for countless women who arrived in the cardiac unit terrified, confused, and wondering how things escalated so quickly.
And the heartbreaking truth? Many of these events were preventable.

What Two Decades in Cardiac Nursing Taught Me

Working at the bedside gave me a front-row seat to the realities of women’s health — not the textbook version, but the real, lived experience.

Here’s what I learned:

  • Women’s symptoms are often subtle. They don’t always present with the “classic” chest pain.
  • Their concerns are frequently minimized or dismissed. Sometimes by providers, but often by the women themselves.
  • Our healthcare system is built for emergencies — not prevention. It reacts; it rarely anticipates.
  • Hormones, stress, sleep, metabolism, and cardiovascular risk are deeply connected. But the system treats them as separate issues.
  • By the time testing catches up, disease has often been brewing for years.

I started my career wanting to help people heal.
But at the bedside, I realized I was often meeting women far too late.

Why I Became a Naturopathic Doctor

After 21 years in acute cardiac care, I knew I needed to shift into a role where I could make a different kind of impact — one that focused on prevention, connection, and comprehensive care.

Becoming a naturopathic doctor allowed me to:

  • Spend the time women deserve
  • Connect the dots between hormones, metabolism, inflammation, and heart health
  • Take concerns seriously before they escalate
  • Work proactively during the menopause transition, when risk begins to rise
  • Help women understand what their bodies are saying, rather than dismissing symptoms as “normal”

It gave me the ability to actually practice the kind of medicine I believed in when I first stepped onto the hospital floor as a new nurse.

What Women Deserve — and Why My Mission Is So Bold

Women deserve to be heard.
They deserve symptoms that are taken seriously.
They deserve care that looks at the whole picture, not isolated parts.

My mission is bold:
Not only to help remove heart disease from the top of the list of what kills women —
but to help women feel vital, confident, supported, and deeply connected to their health again.

I want women to feel empowered instead of overwhelmed.
Prepared instead of fearful.
In control instead of confused.

Because when women have the right knowledge and the right care, everything changes.

A New Chapter for Women’s Health

Looking back, those 21 years at the bedside shaped everything I do today.
They taught me what’s missing in women’s healthcare — and what’s possible when women finally get the care they deserve.

Today, my work is about rewriting the story:
Helping women stay heart strong, hormonally balanced, and confident in their bodies through every chapter of midlife and beyond.

Because women’s health deserves better.
And I’m here to make sure they get it.

 

Women who achieve the most benefit and feel their best through perimenopause and beyond are those that have support and a plan that is evidence-based and tailored to their goals and values. If you are looking for support you can trust reach out to book a free consult today!

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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Understanding Hot Flashes in Menopause and How to Get Relief

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Menopause can feel like your body’s having its own spontaneous combustion party, and guess what? You’re the guest of honor! Yes, I’m talking about those delightful hot flashes that can turn a perfectly normal day into a sweltering sauna session.

Why do hot flashes happen?

Hot flashes and night sweats are what are often referred to as vasomotor symptoms, because it impacts the blood vessels. Your hypothalamus located in the centre of your brain is in charge of regulating your body temperature. When estrogen levels decline during perimenopause and are not activating the hypothalamus normally, the brain has a difficult time regulating body temperature correctly. Women feel a sudden surge of heat like your internal thermostat is set to inferno, blood vessels dilate, you feel flushed, you might experience racing heart, and then followed up with drenching perspiration. All of this is your body’s attempt to cool you down. And of course, this often happens at the most inconvenient times: Standing in line at the grocery store, at work as you give a presentation to your team, or in the middle of the night causing you to thrash and tear off your clothes and open up all the windows even in the dead of winter.

About 75% of women experience these vasomotor symptoms, and for some they may only be a little bothersome or annoying, and for others they can be debilitating. If menopause symptoms have you feeling like you're trapped in a sauna you didn't sign up for, don't go it alone. Click here to book a consultation and get the support you deserve!

Many women will experience hot flashes for 6 months or up to 2 years but some will last a long time, as long as 10 years! Some women experience them even over 70 from time to time. We can’t predict exactly when they’ll show up or decide to pack up and leave.

Treatment options

If these hot flashes (and other menopausal symptoms) are crashing your life party, it's time to chat with a menopause-informed health care provider. There are plenty of ways to manage the symptoms and get back to feeling more like yourself:

  1. Diet. Women who eat a Mediterrananean diet have less frequent and less intense vasomotor symptoms. This pattern of eating also helps to protect your heart and brain which need extra love post-menopause. There are also certain types of foods that are high in plant estrogens (phytoestrogens) that can be helpful to alleviate hot flashes, such as those found in soy and flax seeds.
  2. Exercise. Exercise can also help to reduce frequency of hot flashes by possibly impacting the body’s thermoregulatory response (ability to control body temperature and be less sensitive to temperature swings). Not only that, exercise slows down brain aging, supports bone health, body composition and protects the heart.
  3. Stress reduction. Stress is like pouring gasoline on your internal fire. High cortisol can mess with your estrogen and can worsen vasomotor symptoms. When we are in a highly stressed state, we are often not prioritizing nutrition and movement further worsening hot flashes, and damaging our health.
  4. Herbal remedies. While there is less evidence for using herbal supplements for hot flashes (and other symptoms of menopause), it can still be a viable option for many women, especially if MHT is not a suitable option or for those who value supporting their health more naturally. It is important to note that this route does require some perseverance as it can take up to 12 weeks to see an impact.
  5. Menopause hormone therapy (MHT). This is the heavyweight champion when it comes to evidence-based solutions for hot flashes. For most women this is a very safe and effective option, but it is important to note that there are some risks you need to be informed of and that there is a window of opportunity when women will glean the most benefit with the least amount of risk.
  6. Antidepressants. For women who prefer not to take hormones or cannot take hormones safely, a particular type of anti-depressant called selective serotonin-reuptake inhibitors (SSRIs), have been found to be effective in treating hot flashes in women who don’t have depression.

It is important to get expert guidance on a menopause treatment plan to ensure safety and prevent potential interactions with your medications or any existing medical conditions.

Women who achieve the most benefit and feel their best through perimenopause and beyond are those that have support and a plan that is evidence-based and tailored to their goals and values. If you are looking for support you can trust reach out to book a free consult today!

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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Navigating the 10-Year Window for Menopause Hormone Therapy: What Women Need to Know

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Menopause is a significant phase in a woman's life, marking the end of her reproductive years and bringing about a range of physical and emotional changes. Women can experience a vast array of symptoms that begin before the cessation of her period, while others may have only a few, these include: hot flashes and night sweats, depression, anxiety, irritability and rage, low libido, vaginal dryness and atrophy, new onset or increasing frequency of headaches, brain fog, mid-section weight gain, joint pain, and insomnia. One common approach to managing the symptoms of menopause, such as hot flashes, night sweats, and mood swings, is hormone therapy (HT). However, the decision to use hormone therapy is nuanced, and research has highlighted the importance of a "10-year window" for initiating this treatment.

Understanding Menopause and Hormone Therapy

Menopause is reached once a women reaches 12 months without a period, and typically occurs between the ages of 45 and 55, although it can happen earlier or later (Read my blog on what women need to know about early menopause). However, symptoms can begin up to 10 years prior to this. During this time, the ovaries reduce their production of estrogen and progesterone, leading to the cessation of menstrual periods. These hormonal changes can cause a variety of symptoms, ranging from mild to severe, that can significantly impact a woman's quality of life.

Hormone therapy, which involves the administration of estrogen or a combination of estrogen and progesterone, can alleviate many of these symptoms. It can also help prevent bone loss and reduce the risk of fractures and cardiovascular disease. However, hormone therapy is not without risks, and its use has been the subject of extensive research and debate.

The 10-Year Window

The "10-year window" refers to the period within ten years of the onset of menopause during which initiating hormone therapy is considered most beneficial and carries fewer risks. This concept emerged from studies indicating that starting hormone therapy closer to the time of menopause onset might offer cardiovascular benefits and lower the risk of certain adverse effects compared to starting it later. Unfortunately, many women are uninformed of this window of opportunity, and by the time they are ready to explore hormone therapy, it can be too late for many women.

Benefits of Early Initiation

  1. Symptom Relief: When women struggle with symptoms, it makes it difficult to do the things you need to in order to reduce the risk of disease later in life such as good nutrition and exercise habits. Starting hormone therapy within the first ten years of menopause can provide effective relief from vasomotor symptoms (such as hot flashes and night sweats) and genitourinary symptoms, and improve overall quality of life so you can continue to engage in those health promoting habits.
  2. Bone Health: Early initiation of hormone therapy can help maintain bone density, reducing the risk of osteoporosis and fractures, which are more common in postmenopausal women. Hip fractures are a leading of cause of disability for women, causing them to depend on others.
  3. Cardiovascular Health: Initiating hormone therapy closer to menopause has a protective effect on the heart and blood vessels, potentially lowering the risk of heart disease.

Risks and Considerations

While the 10-year window offers potential benefits, hormone therapy is not suitable for everyone. It's important to consider the following risks:

  1. Breast Cancer: Long-term use of combined estrogen-progestogen therapy has been linked to an increased risk of breast cancer. But this risk is small and tends to be after 5 years of use. The risk appears to be lower with estrogen-only therapy. And it’s important to note that a family history of breast cancer is NOT a contraindication for hormone therapy
  2. Blood Clots and Stroke: Hormone therapy, particularly when taken orally, can increase the risk of blood clots and stroke. The risk is generally lower for younger women and those who start therapy closer to the onset of menopause. Remember, there are alternative routes of administration such as a gel or patch that pose less risk and may be a great option for you.
  3. Individual Health Factors: Personal and family medical history, including a history of cardiovascular disease, cancer, or liver disease, can influence the decision to use hormone therapy.

Making an Informed Decision

The decision to start hormone therapy should be made on an individual basis. This is a nuanced discussion with your healthcare provider. Factors to consider include the severity of menopausal symptoms, personal health risks, and the timing relative to menopause onset.

The 10-year window for menopause hormone therapy offers a strategic timeframe during which the benefits of symptom relief and potential cardiovascular protection may outweigh the risks for many women. By working closely with a menopause-informed healthcare provider, you can be empowered to make the choices that best support your health, values and well-being during the menopausal transition and beyond. Not every woman is a candidate for hormone therapy, but EVERY WOMAN deserves a discussion and to be aware of alternative treatment options.

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

Click the link below to discover the key lab tests and assessments for menopausal women, or book your FREE Discovery Call Now.

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Empower Yourself: Unveiling 8 Essential Questions To Ask Your Doctor That Will Revolutionize Your Treatment Journey

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In my work as a naturopathic doctor and as a registered nurse, I encounter many patients that do not understand not only the medications they are on, but also supplements they have been prescribed.

If you want the best care for yourself, and I know you do, you need to have agency over your health and treatment plan. You need to ask questions.

Here are the top 8 questions you need to ask when prescribed any treatment plan:

1. What is the purpose of the proposed treatment?

You need to know WHY you are being recommend something. This can help you to understand your current state of health and how to monitor progress. For example, if we are treating your high cholesterol with a supplement or medication, you need to know the impact that elevated cholesterol has on your health, otherwise why even treat it?

It’s also important to feel that your treatment plan is aligned with your health goals and values. We play a very important role in your health care, providing you with the necessary information required for you to make an informed decision. Afterall, you get to choose how you want to be treated. When patients don’t understand why they are taking something, they are less likely to stick with the plan.

As practitioners we see the bigger picture and what WE would like to see for your health, sometimes causing us to recommend treatments that have a cost to you. If your treatment is not aligned with your health goals than you need to speak with your doctor about this.

2. What are the risks and benefits of treatment?

Most treatments will have some level of risk to them along with benefit, and this is key in helping you decide on a treatment approach. If the benefit outweighs the risk and it is aligned with your goals and values then this may be the treatment for you. But excessively avoiding risk can cause you more harm and reduce your quality of life. For example, because of the results of a large study on hormone replacement therapy for women that reported a risk of breast cancer, many women were pulled off treatment and denied further treatment for their hot flashes and night sweats due to it's misinterpretation. In actual fact the risk for breast cancer for many women was quite small and being prescribed hormone replacement therapy at the appropriate time (before the age of 60) provided significant relief, not only for hot flashes and night sweats, but also bone and cardiovascular protection.

3. How does it work?

It isn’t necessary that you know all the biochemistry and pharmacology of a treatment, but having a basic understanding of how something works to address your concern, or condition can also help you to understand possible side effects and monitoring you may need. For example, it is important for patients who are on a certain type of blood thinner called coumadin, to know that it blocks vitamin K dependent clotting factors. This is why patients on this medication need to maintain a consistent diet of green vegetables or avoid them due to their high vitamin K content.

4. When should I expect results?

This is one of the most important factors in supporting patients to stick with a treatment plan. You need to know a timeline to expect results. Drugs tend to work fast, supplements may take longer, could be months. Are you willing to stay the course? If you don't know when to expect results, you may give up on an effective plan prematurely. There are no quick fixes and there are always costs to treatment.

5. How will I know the treatment is working?

This may be determined by how you feel, changes in blood work, or both. You also need to know the magnitude of benefit. Some treatments may help minimize symptoms to a level you are comfortable with, but knowing that a treatment may or may not completely resolve your symptoms or condition is critical to keeping a realistic perspective on what is possible.

 6. What is the cost of treatment?

Costs could be financial. Supplements may be required long term and can be expensive. If you are not able to stick with it then perhaps a medication covered by a drug plan may be a better option for you to reach your health goals. Taking something multiple times a day may or may not be a burden to you. If it is and that is required to achieve results then this is not the treatment for you.

7. What if it doesn't work?

It is important to know that you have options, and knowing that there is a plan B and C can help you stay positive and motivated about your health situation.  There is no one-size-fits-all approach with medicine. There are treatments that will be gold standard to treat certain symptoms or conditions, but sometimes medicine requires a little trial and error as well.

8. What if I do nothing?

This may be a viable option for you. You need to know the benefits and risks of delaying treatment. In the short term, this may be okay but waiting too long to take action may cause collateral damage in the future that may or may not be reversible. If you want to feel better and improve the state of your health and prevent disease, this is likely not aligned with your goals. You need to have a strategy and understand the tactics to employ. Reach out for support.

Be curious. Ask questions.

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

Click the link below to learn 5 critical ways to reduce your risk of a heart attack in just 5 days. And it's FREE! or book your FREE Discovery Call Now.

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Early Menopause: What You Need To Know Now To Protect Your Future Heart Health

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Early menopause occurs before the age of 45, and can be due to a decline in ovarian function or medically induced from a hysterectomy. One of the most significant but less talked about concerns of menopause is the heightened risk of cardiovascular disease women experience. If you have or are experiencing early menopause, this risk starts earlier. While this might feel scary for you, understanding this phase of life, changes you experience and how to protect your cardiovascular system will help allay the fear and help you to feel empowered during this time in your life.

Understandably, women are most concerned with the symptoms of menopause: hot flashes, night sweats, mood and cognitive changes, and weight gain which prompt women to see their health care provider. Unfortunately, the silent changes get ignored resulting in a missed opportunity to educate and empower women to take a proactive approach to their heart health.

After menopause, women experience a significant increase in their risk of developing cardiovascular disease. Prior to this stage, women are generally better shielded against cardiovascular disease compared to men, thanks to the protective effects of estrogen. However, with the onset of menopause, the once-advantageous influence of estrogen diminishes, leaving women more vulnerable to cardiovascular health issues.

Estrogen, a hormone that declines during menopause, plays a protective role in cardiovascular health. The decline in estrogen after menopause causes a heightened risk for cardiovascular disease in a number of ways:

  1. Reduced estrogen levels can lead to unfavorable changes in lipid profiles, including increased levels of total cholesterol, low-density lipoprotein (LDL), triglycerides, and Lp(a), and decreased levels of high-density lipoprotein (HDL) cholesterol. These changes can contribute to the development of plaque build up in the artery walls and increase the risk of heart attack or stroke.
  2. Endothelial dysfunction: Estrogen helps maintain the health and function of the endothelium, the inner lining of blood vessels. Endothelial dysfunction, characterized by impaired dilation and increased inflammation, is an early event in the development of atherosclerosis. Decreased estrogen levels can contribute to endothelial dysfunction, thereby increasing the risk of CVD.
  3. Weight gain and abdominal fat: Hormonal changes during menopause can lead to an increase in body fat, particularly around the waistline and organs (called visceral fat). Abdominal fat is strongly associated with a higher risk of heart disease, type 2 diabetes, and other metabolic disorders.
  4. Elevated blood pressure: Menopause may cause an increase in blood pressure levels, further straining the cardiovascular system.
  5. Reduced insulin sensitivity: Menopausal hormonal changes can affect insulin sensitivity, potentially leading to insulin resistance and an increased risk of developing diabetes, which is a significant risk factor for heart disease.

Given the increased risk of heart disease associated with menopause, it's important for women who experience early menopause to be proactive about cardiovascular health. This includes adopting a heart-healthy lifestyle and Mediterranean eating pattern, engaging in regular physical activity, not smoking, managing stress, and monitoring blood pressure and cholesterol levels. For many women, hormone replacement therapy is an important part a treatment plan and should also be included in the discussion for management of early menopause. Early screening is paramount for women in early menopause to prevent future cardiac events.

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

Click the link below to learn 5 critical ways to reduce your risk of a heart attack in just 5 days. And it's FREE! or book your FREE Discovery Call Now.

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5 Changes In Menopause That Impact Your Heart Health

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Many women dread the transition to menopause. Hearing the discontented experiences of friends, mothers and other women before them, it is assumed that menopause will be this dreadful rollercoaster ride that could last 5, 8 or up to 12 years! Due to the decline in protective estrogen, heart disease risk begins to climb during this time. Post menopause, women’s risk catches up with that of men’s risk. Because of this, there is a lot of messaging encouraging menopausal women to adopt a heart disease prevention program. But I’m here to tell you not to wait that long.

We do know that the earlier women start a heart disease prevention plan, the better they will fair post menopause in reducing their risk of heart disease. And if you have officially celebrated the end of your menstrual cycle, there is no time like the present to take deliberate action to prevent your risk of a heart attack.

If you’re approaching perimenopause the timing couldn’t be more crucial to take strategic action. Here’s why…

Body Composition

Estrogen causes fat distribution pattern in breasts, buttocks and thighs. The decline in estrogen during menopause causes more weight gain around the middle instead of the hips and buttocks. Central obesity can lead to low grade chronic inflammation, insulin resistance and type II diabetes

Blood Pressure

Estrogen, along with collagen and elastin, help support normal distensibility of blood vessels and protects the delicate lining of arteries called the endothelium. A decrease in estrogen, along with decline in collagen and elastin production can affect blood vessel health, contributing to arterial stiffness, reduced arterial dilation, and high blood pressure.

Cholesterol

Estrogen plays a role in upregulating LDL receptors in the liver to take up circulating cholesterol. A proposed mechanism contributing to changes in lipids is the down regulation of LDL receptors in the liver causing less uptake from the blood stream.  Central adiposity associated with menopause may also contribute to the dyslipidemia as well.

Post menopausal women compared to pre-menopausal women tend to experience changes in their lipid profiles including higher total cholesterol, LDL, apolipoprotein B, and a decrease in HDL function. [1]

Sleep Apnea

Menopause is a significant risk factor for sleep apnea. In fact, your risk may even double post menopause. Untreated sleep apnea can lead to high blood pressure, poor glucose regulation, disturbances in heart rhythm and overall cardiovascular disease risk.[2]

If you are having ongoing unrefreshing sleep despite 7-9 hours, waking with headaches, snore, having significant daytime fatigues, it is worth a conversation with your doctor about testing. A quick quiz you can do to help determine your potential risk is the SLEEP BANG quiz. Click here to take the quiz.

Vasomotor Symptoms

Women who have more severe vasomotor symptoms (hot flashes, night sweats) are at a higher risk for coronary heart disease compared to those with less severe symptoms. VMS have been associated with a less favorable cardiovascular risk profile and surrogate CVD endpoints such as higher cholesterol, triglycerides, LDL-C, BMI, systolic blood pressure, diastolic blood pressure, and insulin resistance, have been found in women with VMS compared to asymptomatic women.[3]

What can be empowering to know is that even though you may be postmenopausal there are many evidence-based strategies you can implement that can reduce your risk.

So, ladies, what do you say we put prevention—and ourselves—first? Approach menopause with confidence.

If you’re with me, start having a discussion with your health care provider about what strategies you can implement now so you can enjoy the next decades without fear of a heart attack. It’s simpler than you might think. Also know that if you struggle with the symptoms of hormonal changes - night sweats, hot flashes, headaches, cramping, heavy periods, mood changes...there is help for you, you don't need to suffer.

References

[1] Sharma, J., McAlister, J., Aggarwal, N., et al. Evaluation and management of blood lipids through a woman's life cycle. American Journal of Preventive Cardiology, 10 (2022). https://doi.org/10.1016/j.ajpc.2022.100333.

[2] Thompson, C., Legault, J., Moullec, G. et al. A portrait of obstructive sleep apnea risk factors in 27,210 middle-aged and older adults in the Canadian Longitudinal Study on Aging. Sci Rep 12, 5127 (2022). https://doi.org/10.1038/s41598-022-08164-6

[3] https://www.imsociety.org/2021/05/12/vasomotor-menopausal-symptoms-and-cardiovascular-disease-risk/

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

Click the link below to learn 5 critical ways to reduce your risk of a heart attack in just 5 days. And it's FREE! or book your FREE Discovery Call Now.

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5 Osteoporosis Myths You Need To Know About

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Osteoporosis affects 2.3 million Canadians and is characterized by low bone mass and deterioration of bone tissue over time. It is known as the “silent thief” because it occurs over decades with no associated symptoms.[1] By the time a fracture occurs, the disease is advanced and the best option is medication to prevent future fracture risk. Unfortunately, while many of my patients fear medication and prefer natural options, the reality is supplements are not as effective as medication to reduce fracture risk.

Osteoporosis reduces quality of life, contributes to reduced or loss of mobility and lack of independence, and in some cases death. 22% of women and 33% of men who suffer a hip fracture will die within the following year. [1]

You have decades to prevent this, are you doing it right?

Who should be screened?

  • Women 65 years and over, and men 70 years and older should be screened for osteoporosis
  • Younger post-menopausal women, women in the menopausal transition, and men aged 50-69 years with clinical risk factors
  • Adults who have a fracture at age 50 years and older
  • Adults with conditions such as rheumatoid arthritis or organ transplant, or taking a medication (glucocorticoids, aromatase inhibitors, androgen deprivation therapy) that is associated with low bone mass or bone loss. [2]

Many people are falling through the cracks and are not getting timely screening. That is one way I help patients. Diving deep into your history and asking the right questions can help to identify those who are higher risk and need advocacy for appropriate, sometimes early, screening and an effective prevention plan. Many patients are misinformed about the best prevention plan and too many women don’t realize that menopause is their biggest risk for osteoporosis.

Let's crack open some common myths about osteoporosis (pun intended).

Myth #1: Walking is the best exercise for bone health and reducing fractures.

If you are sedentary and currently don’t get much exercise, than brisk walking can definitely help to build bones. But if you are currently active than you need to ensure you are getting in strength training at least 2 times a week. 3 times a week is best. And the best outcomes are achieved with supervised fitness sessions. This is important to make sure you are lifting weights properly to avoid injury and that you are using the right weight to build muscle. Preventing fractures also means preventing falls in the first place. Balance exercises should also be included in your osteoporosis prevention plan on a daily basis.

Myth #2: Supplements can reverse osteoporosis.

Some supplements can help prevent osteoporosis if you are deficient, such as adequate calcium and vitamin D. However, once osteoporosis sets in, the best treatment to reduce fractures according to the best available evidence is medications. The best prevention plan includes a comprehensive approach that includes quitting smoking, limited alcohol, adequate protein, calcium, and vitamin D, the right type of exercise, and identifying risks for falls such as vision and gait problems, low blood pressure, sedating medications, and loose rugs in the home and other tripping hazards.

Myth #3: You don’t have to worry about osteoporosis until menopause.

The biggest risk for women is menopause. Women will lose 10-12% of their bone during the menopausal transition. However, bone loss occurs throughout adulthood at a rate of 1-2% per year.

Myth #4: Only women get osteoporosis.

While women may be at a higher risk for osteoporosis, it still impacts men and many are not screened appropriately.

Myth #5: If you have osteoporosis you can’t build bone.

If you have an evidenced based intervention plan, you can build bone but you need to start now. Bone changes occur very slowly over time but small improvements in bone density can significantly reduce fracture risk.

Here’s a simple, validated tool to assess your risk for osteoporosis using your weight and age, without a bone mineral density test.

https://qxmd.com/calculate/calculator_708/osteoporosis-self-assessment-tool-for-women

Click here to get an estimate of your daily calcium intake.

I want you to live the life you want to. Reach out to find out how we can work together.

 

[1] Osteoporosis Canada. https://osteoporosis.ca/what-is-osteoporosis/

[2] LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician's guide to prevention and treatment of osteoporosis [published correction appears in Osteoporos Int. 2022 Jul 28. Osteoporos Int. 2022;33(10):2049-2102.

[3] Kanis, J., Cooper, C., Rizzoli, R. et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30, 3–44 (2019).

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

Click the link below to learn 5 critical ways to reduce your risk of a heart attack in just 5 days. And it's FREE! or book your FREE Discovery Call Now.

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6 Key Strategies for the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease

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Non-Alcoholic Fatty Liver Disease (NAFLD) is becoming increasingly common but yet remains underdiagnosed, and is the most common liver disease in Canada. It is diagnosed in women who consume less than 20g/day of alcohol and in men who consume less than 30g/day of alcohol, and other causes for liver disease are ruled out. NAFLD is on a spectrum from mild fat (triglyceride) accumulation to inflammation and scarring (non-alcoholic steatohepatitis or NASH), and eventually liver cirrhosis or even cancer (hepatocellular carcinoma)[1].

NAFLD is commonly an incidental finding on ultrasound or suspected when an elevated ALT is noted on routine lab work.

There is a strong relationship between cardiovascular diseases (CVD), particularly coronary artery disease (CAD, disease of the arteries of the heart) and NAFLD. CVD is the most common cause of death in those with this disease. Insulin resistance, diabetes, endothelial dysfunction, hypertension and hyperlipidemia are commonly found in those with NAFLD[2]. Excess caloric intake, obesity, and sedentary lifestyle create the perfect storm to develop NAFLD.

First line treatment for NAFLD includes lifestyle interventions with an emphasis on exercise and weight loss. The following are key strategies to reduce liver fat and prevent the progression of NAFLD1 [1,3]:

  1. Weight loss. 5-10% weight loss goal depending on severity, achieved by a loss of 0.5-1kg/week. Severe caloric restriction and rapid weight loss can have a detrimental impact on liver health. An activity goal of 150 minutes/week of moderate intensity aerobic activity should be achieved.
  2. Mediterranean diet. A plant-based dietary pattern provides antioxidants and helps to reduce oxidative stress and inflammation. It also helps to manage insulin resistance, and elevated cholesterol reducing risk of NAFLD as well as cvd and diabetes. Choose plant-based proteins such as beans, lentils, a variety of vegetables, healthy fats found in nuts, flax seed, and olive oil and choose more poultry and fish.
  3. Low saturated fat, no trans fats with an emphasis on polyunsaturated and monounsaturated fats. Diets high in saturated fats and trans fats increase oxidative stress, inflammation and accumulation of fat in the liver, also increasing risk for cardiovascular diseases. While healthy fats, such as those found in fish and extra-virgin olive oil, can help to reduce triglycerides, LDL, and cholesterol, reduce inflammation and fat accumulation in the liver.
  4. High fibre, whole grains. Choosing more whole grains instead of starchy and high glycemic foods will help to balance blood sugar, keep you feeling full longer and helps to reduce cholesterol. Not only that, it also helps to maintain healthy gut bacteria which is important for liver health
  5. Avoid processed foods, and foods high in fructose. Process foods are often high in saturated and trans-fat and excess sugar contributing to excess calories and accumulation of liver fat. By eliminating highly processed and sweetened foods and beverages can help you achieve your weight loss goals.
  6. Reduction/elimination of alcohol.

 

 

[1] Jeznach-Steinhagen, A., Ostrowska, J., Czerwonogrodzka-Senczyna, A., Boniecka, I., Shahnazaryan, U., & Kuryłowicz, A. (2019). Dietary and Pharmacological Treatment of Nonalcoholic Fatty Liver Disease. Medicina (Kaunas, Lithuania), 55(5). https://doi.org/10.3390/medicina55050166

[2] Arslan, U., & Yenerçağ, M. (2020). Relationship between non-alcoholic fatty liver disease and coronary heart disease. World journal of clinical cases, 8(20), 4688–4699. https://doi.org/10.12998/wjcc.v8.i20.4688

[3] Elena S George, Adrienne Forsyth, Catherine Itsiopoulos, Amanda J Nicoll, Marno Ryan, Siddharth Sood, Stuart K Roberts, Audrey C Tierney, Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults, Advances in Nutrition, Volume 9, Issue 1, January 2018, Pages 30–40, https://doi.org/10.1093/advances/nmx007

 

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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Two Tests You Need to Ask For if You Are Prescribed a Statin

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Like any drug treatment (and even natural treatments) there are risks, but there are also benefits. Naturally our human brains tend to focus more on the negative - we are wired this way - but you can't look at one side without consideration for the other. The class of medication called statins which include the commonly known Lipitor/atorvastatin, or Crestor/rosuvastatin are one of the most prescribed classes of medications. I see patients all the time on these medication. We know those who benefit the most are those who have had a heart attack or who are at high risk for one. The benefits of statins go beyond total cholesterol and LDL reduction - they support the health of the artery lining (endothelium), support nitric oxide important for the relaxation of the arteries, act as an antioxidant and help to reduce inflammation. Not bad eh?

For those who have no known cardiovascular disease and are at a low risk for a heart attack, I like to use a more natural approach to reducing cholesterol where possible however, sometimes the best approach is a cholesterol lowering drug. Part of my role in working with patients is discussing all treatment options and advocating for the best approach for them. Not all cholesterol lowering medications or statins are the same and may pose different risk profiles. Sometimes it’s necessary to look at each person’s unique risk profile and chose an approach that will have the most benefit with the least amount of harm. What’s more is that if you need to be on a drug, we can create a strategy to reduce your risk of side effects. Two tests that help in assessing a patient’s potential for statin-related side-effects are vitamin D and insulin.

Vitamin D

Low serum vitamin levels have been associated with statin related muscle pain, and as a result, low adherence. Low serum vitamin D itself can contribute to muscle pain and so the addition of a stain medication such as atorvastatin (Lipitor) or rosuvastatin (Crestor) may increase the susceptibility of those already at risk, particularly if your serum vitamin D level is under 75nmol/L.[1]

Insulin

It is known that those who use statins are at an increased risk for new-onset diabetes than non-statin users, and seems to have a bigger impact the higher the dose and the longer duration of use. It is an even bigger concern for those who have any of the risk factors for diabetes (metabolic syndrome, obesity, impaired fasting glucose, HbA1C >6 percent).[2] [3] This does not mean that statins should be avoided. Rather an assessment of individualized risk should be done prior to making an informed decision about the use of statin, which statin to use and how to prevent future diabetes risk. It is known that elevated insulin is an early indication of metabolic dysfunction and diabetes risk and can precede changes in fasting glucose and HbA1C by years.

Any treatment plan, whether it includes pharmaceuticals or natural alternatives to drug therapy should be done with consideration of a patient’s unique risk factors. My approach when creating any heart health plan with patients involves not just targeting a few numbers in a lipid panel but involves a look at your totality of risk factors in order to achieve the best outcome for you.

[1] Michalska-Kasiczak, M. et al. Analysis of vitamin D levels in patients with and without statin-associated myalgia — A systematic review and meta-analysis of 7 studies with 2420 patients. International Journal of Cardiology. 2015. 178: 111-116.

[2] Jung Ko, M et al. Time‐ and Dose‐Dependent Association of Statin Use With Risk of Clinically Relevant New‐Onset Diabetes Mellitus in Primary Prevention: A Nationwide Observational Cohort Study. Journal of the American Heart Association. 2019. Vol 8 (8).

[3] Ridker PM, Pradhan A, MacFadyen JG, Libby P, Glynn RJ. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis from the JUPITER trial. Lancet. 2012;380(9841):565-571.

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

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Ignoring Snoring? It’s Not Just A Noisy Nuisance

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Are you feeling that familiar elbow in your back night after night, or your/your partner’s snoring is so disruptive that you now sleep in separate rooms? Snoring can be a nuisance, but it can also represent a red flag that your heart and your health is in danger. Here is why you should not ignore the snore.

There are different types of sleep apnea, but obstructive sleep apnea is the most common and is characterized by pauses in breath throughout the night while you are sleeping, resulting in unrefreshing sleep. It is an underdiagnosed and undertreated condition. Snoring is one of the most obvious signs but other symptoms include:

  • Waking up tired and fatigued through the day, feeling like you can easily fall asleep while driving or talking to someone
  • Difficulty concentrating during the day
  • Morning headaches
  • Waking up gasping or choking
  • Mood changes such as depression or irritability
  • High blood pressure and high blood pressure that isn’t responding to treatment

When sleep apnea goes untreated it can increase your risk for the following:

  • High blood pressure
  • Heart attacks
  • Arrhythmias or irregular heart beats
  • Diabetes
  • Weight gain

The good news is sleep apnea IS treatable. Treatments include:

  • A special face mask that delivers positive airway pressure throughout the night
  • A special mouth piece (called mandibular advancement device) that thrusts your jaw forward to keep your airway open
  • Weight loss

What’s more is that you need to wear your mask for only 4 hours at night to achieve a clinical benefit (although you will feel better if you are wearing it for all your sleep hours).

Not everyone who snores has sleep apnea but snoring shouldn’t be ignored, especially if you also wake gasping or choking in the night or your bed partner reports that you do.

Click here to take this 8 question quiz to quickly assess your likelihood of having sleep apnea. Even if you score low but are suffering with your sleep and feeling unrefreshed in the morning, you should consult your health care provider for support and a proper assessment.

Sleep apnea that goes untreated can wreak havoc on your overall health. Frequent apneic episodes during the night place a significant strain on your heart – it increases sympathetic activation, increases the resistance your heart has to pump against (called afterload), reduces the production of vasodilating substances such as nitric oxide which all contribute to a rise in blood pressure and risk for arrhythmias and cardiac events. Don’t ignore the snore!

 

Hasthi U. Dissanayake,  Juliana T. Colpani, Kate Sutherland,  et al. Obstructive sleep  apnea therapy for cardiovascular risk reduction—Time for a rethink? Clin Cardiol. 2021 Dec; 44(12): 1729–1738.

 

Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.

 

Click the link below to learn 5 critical ways to reduce your risk of a heart attack in just 5 days. And it's FREE! or book your FREE Discovery Call Now.

Join The FREE Mini-Course
Book A Free Discovery Call