Women’s Heart Health, Stress & Immunity: A Naturopathic Guide to Cardiovascular Prevention
How I Approach Heart Disease Screening, Holiday Burnout, and Whole-Person Wellness
Greetings!
I hope you had a lovely Thanksgiving :)
A few things we will cover in this newsletter - a focus on cardiovascular health, an exercise to address holiday burnout, a few quick and inexpensive approaches to immune health and a somewhat vulnerable ask (for - gulp - google reviews) ...
First things first:
Cardiovascular diseases such as heart attacks and strokes are the number one cause of death in women. And because risk usually doesn't go up until over age 60 - most women are unaware of what they can be doing in their 30s, 40s and 50s to prevent heart disease later in life. It is infuriating to me how little folks focus on heart disease in women and I can't help but think a part of that is because it only impacts older women - a demographic often overlooked in both health research and media coverage.
The screening done at your annual exam is a good first step - looking at a basic cholesterol panel, taking blood pressure, etc. However, there is a lot more that can and should be done. Screening guidelines - the set of tests like PAPs, mammograms and annual cholesterol testing - tend to lag about 10-15 years behind the research. You need lots of organizations to review the data, do a cost/benefit analysis and then get the government on board in order to add tests to the list of things that will be routinely recommended and covered by insurance for every patient. There have been a lot of advances in cardiovascular testing over the last decade, but they have not yet made it into standard of care for most patients. And, in my opinion, they are often offered too late and only after folks have already started to form plaques in their arteries - a process which really accelerates in the 5-10 years after menopause.
The ideal time to start screening with in-depth blood work is mid-thirties. Earlier for some, possibly later for others. This includes basic cholesterol panel - but also lipoprotein(a), Apolipoprotein B, fasting insulin, omega levels and markers of vascular inflammation. Once folks hit their mid-40s/50s - imaging tests are helpful as well. Coronary Calcium Screening and Carotid ultrasound are both important . It lets us get a baseline of plaque formation in the vessels of the heart and insight into the health of the carotid arteries, the vessels that send blood to your brain.
I'm sure you have heard this phrase before in relation to different activities - I most recently heard it in a jujitsu class.
When is the best time to start training jujitsu? 10 years ago. When is the next best time to start? Today!
The same is true for cardiovascular screening :)
Does insurance cover this screening - sometimes, but not always. But the good news is with cash prices the blood work is typically $250 or less. Imaging ranges from $100-300 depending on location. We also don't have to do everything at once and many are not repeated yearly. Unfortunately, our current health care system is not focused on preventing cardiovascular disease. It is pretty good at treating things once they have gotten symptomatic and dangerous. For example - bypass surgery once someone has had their first heart attack, but there just is not the time or inclination to get into the details of prevention in primary care.
Once we have all the data, we can stratify individual risk and create a plan. Yes, nutrition and movement are the cornerstones, but also sleep and stress management and blood sugar and the gut microbiome - it all plays a roll. There are some supplements that can be helpful - and also some medications as well. The key is to match the plan to the person - their values, their goals and their life experiences all influence what a plan might look like. That is the joy of naturopathic medicine - to use the diagnostic tools of modern medicine to create an individualized treatment plan that incorporates the right interventions at the right time - so fun :)
If you have been pondering your own healthspan, have a family or personal history of cardiovascular disease or have been concerned about recent lab results and want to know more - schedule an appointment and we can dig in!
On a somewhat related note:
- see: stress management as a key mediator of heart health
How are you feeling this holiday season? With Thanksgiving behind us many are gearing up for the next month of activities. Even for folks who love the holidays, it can be a time of overwhelm and overcommitment. One thing I ask patients to do is create an intentional plan for the season. To start, consider what the holidays mean to you and what you really value. Maybe pick 2-3 words or phrases. Then chat with the people that you spend holidays with - kids, spouses, friends, family - what are 2-3 things that are important to them. It can be feelings - like "cozy" or "connected." Or traditions like "making cookies with grandma" or a spiritual/religious service like "mass on Christmas Eve." Whatever makes the list is a priority - make a plan and put it on the calendar. But also pay attention to what is not on the list! Resist the urge to do things just because you think you should, or because the pictures will be cute or it is something you have done every year but no-one truly enjoys. Make your season intentional, sustainable and focused on your values. What can we prioritize that also allows your sleep, your stress, your budget and your nerves to all survive the holiday seasons as well :) Resist the urge to crash and burn into the new year. Instead, think about cultivating peace, meaning and connection - the true reason for the season.
A funny story - I had this conversation with my kiddos last night as I was thinking about plans for the next month. My 12 year old requested "fancy hot chocolate" - I thought he meant going out for hot chocolate together - but upon further questioning, he is requesting his own stash of the good stuff - specifically he asked for Swiss Miss! Not the "off-brand" (as he described it) stuff we have at home. Ahhh, to be the child of a naturopathic doc, being forced to drink adaptogenic RASA Dream Cocoa while pining for Swiss Miss.
Quick tips:
Germ season is upon us! Please wash your hands, spray your nose, gargle your water, drink green tea and exercise- all very accessible options that make a real difference when it comes to immunity and decreasing your likelihood of viral infection!
Finally:
I am updating my website and my designer noted that I should probably focus on google reviews. I don't actually love the review-industrial complex that dominates small business ownership and it feels strange as a healthcare provider to solicit reviews from patients. However, I also realize that reviews help folks figure out if providers might be a good fit and I certainly have found them helpful as a consumer. So if you feel inclined, please leave a review here.
In Health,
Dr C.