Tag: cholesterol

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.

 

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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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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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5 Mediterranean Grocery Staples To Keep Stocked In Your Kitchen

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The famous Mediterranean diet – although I consider it more of a lifestyle than a diet – is one that is shared by the people living along the Mediterranean Sea. We tend to associate this eating style with those living in Italy, France, and Greece, but it includes many other countries such as Morrocco, Egypt, Spain, and Turkey, just to name a few. It is no surprise to me that this way of eating is one of the healthiest, if not THEEEE healthiest – full of variety, antioxidants, healthy fats, anti-inflammatory ingredients and not to mention packed full of flavour. Not everyone is familiar with the Mediterranean eating style and it is not difficult to start. Here are 5 essentials to get you started and help you reap the benefits of the Mediterranean Way:

  1. Olive Oil. This healthy monounsaturated fat is a key staple of the Mediterranean diet. It’s tremendous health benefits can be attributed to the high polyphenol content and anti-inflammatory action of this oil. Regular intake can help improve lipid parameters, support the function of blood vessels and a healthy blood pressure. Don’t over do it though as like any fat, eating too much olive oil can increase your caloric intake fast if you are trying to lose weight. A good place to start is incorporating 1-2 tbsp daily in the form of salad dressing or adding flavour to meals.

Pro Tip – purchase in dark glass bottle in smaller quantities and look for the symbol of the North American Olive Oil Association to ensure quality

  1. Eat more legumes such as beans, lentils, chickpeas. They are high in fibre and protein and low in fat, making a great meat substitute and helping you feel full longer. They are also a great source of folate, iron, magnesium, and potassium which is essential for healthy blood pressure.

Pro Tip – soaking beans overnight and changing the water once or twice can help make them easier to digest.

  1. Snack on nuts and seeds. They also provide a great source of unsaturated fats as well as a variety of minerals, fibre and a little bit of protein. They can help 1-2 small handfuls daily is all you need. They have a cholesterol-lowering effect as well as helping to reduce inflammation, improve insulin sensitivity and blood vessel health. Walnuts, almonds, pistachios, pecans and macademia nuts are good choices. Also, don’t forget sesame seeds and tahini, as well as flax and chia to boost your fibre intake.

Pro Tip – choose raw, unsalted, and keep stored in the refrigerator or freezer to preserve the healthy fats. Nuts and nut butter (such as almond butter) pair well with a piece of fruit or spread on some celery for a light snack.

  1. Incorporate more fish and seafood at least twice/week. They contain long chain omega fats important for heart and brain health.

Pro Tip – choose small cold water fish and wild caught if possible. Salmon, sardines, herring and mackerel are the best options for their omega 3 content.

  1. Tomatoes! (and of course other Fruits and vegetables) – Tomato sauce and tomato paste are excellent sources of lycopene, a key antioxidant for health, as well as other vitamins and minerals, phytosterols, amino acids, fibre and many other antioxidants. Lycopene is a carotenoid that gives tomatoes their bright red colour. Tomatoes have numerous health benefits such as protection against eye disease, diabetes, cancer and cardiovascular disease to name a few.

Pro Tip – cooked tomatoes with olive oil increases the bioavailability of the lycopene. Be sure to look for low sodium versions. And if you suffer from heart burn, you may want to limit or avoid tomato based products.

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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