A 180 On Fats For Healthy Weight and Heart After decades of bad data on cholesterol and good fats, Americans are waking up to a profound new reality about their health benefits.

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For over fifty years, fats have been targeted by mainstream outlets as the enemy as a prime contributor to heart disease. There has been particular emphasis on reducing cholesterol by eliminating saturated fats. In response, butter was replaced with margarine, skim or low-fat milk was recommended over whole milk, canola oil was glorified, and eggs were practically viewed as evil. Many Americans complied with these recommendations…so why, all these decades later, is cardiovascular disease still the number one cause of death in America (aside from Covid)?

Several scientists took on this question, and in January 2021, their research was published in The American Journal of Clinical Nutrition. Their work delved deeper into uncovering the cause of heart disease, pushing beyond the standard focus of what causes cardiovascular disease and asking the question “why”: considering the fact that saturated fat is naturally occurring in many foods (including breast milk) that are important to maintaining good health, why does saturated fat raise blood cholesterol, and why should cholesterol be regarded as dangerous?

With all the years of constant, convincing hype regarding the dangers of saturated fats in the diet—set within an ever-present controversy over what constitutes a healthy diet—you may well be thinking the answer is obvious—saturated fats raise cholesterol, and cholesterol leads to cardiovascular disease, right? Not so fast. The research results suggest the answers are not so cut-and-dried.

Healthy Cell

Researchers analyzed this “diet-heart hypothesis” and found an alternative explanation to the concept that saturated fats lead to high cholesterol, which in turn leads to heart disease. Their model is about what know as the “phospholipid bi-layer” [See Fig.1]. Cells, to thrive, must incorporate the necessary amounts of cholesterol molecules needed in order to prevent their outer membranes from becoming overly fluid or overly stiff. These cells change their cholesterol requirements based on a theory of homeostasis. That is, the needs of the cell will vary according to the amount of saturated or polyunsaturated fats in a person’s diet. Thus, when a diet consists of more saturated fats, cells need to absorb less cholesterol in their membranes because their surrounding environment already contains it.

Conversely, when there are mainly polyunsaturated fats (PUFAs) in a diet and the cells’ environment is more cholesterol-deprived, their membranes need to incorporate more cholesterol from their surroundings. This results in a lower blood cholesterol count in a standard fasting blood test. This provides a logical explanation as to why blood cholesterol levels can change, sometimes dramatically, particularly when there is a sharp change in fat intake.

The researchers concluded that this may be an indication as to why levels of LDL cholesterol may change even without pathology. IncreasingLDL cholesterol could be a normal cell response and is, in fact, a secondary result of insulin resistance, imbalances in the gut microbiome, endotoxemia and chronic inflammation.

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Health Benefits of Good Fats

Outdated recommendations that people should eliminate fats, particularly saturated fats, from their diets caused a dangerous dietary move to include more added sugars, PUFAs, carbs, and processed foods. This led to a worldwide epidemic of overweight and obesity as well as a multitude of illnesses. For years, no differentiation was made between healthy fats and bad fats—all fats were considered equally bad and were thought to lead to high cholesterol and heart disease. Processed industrial vegetable oils such as canola, sunflower, safflower, and soybean became the recommended choices for cooking, dressings, etc.—these oils are high in omega-6 fats, which increase inflammation, the true underlying cause of serious health conditions including diabetes, cardiovascular disease, cancer, autoimmune diseases, arthritis and more. High levels of omega-6s also counteract the health benefits derived from omega-3s.

Healthy fats such as grass-fed butter and yes, even beef tallow, as well as coconut and avocado oils not only offer a wide range of health benefits, they also stand up well to cooking with high heat levels because they are not prone to oxidative damage the way other oils are. The proven benefits derived from healthy fats are actually directly opposed to the arguments against saturated fats. These benefits, among others, include:

  • lowering bad cholesterol while increasing the good cholesterol
  • lowering blood pressure
  • lowering triglycerides
  • lessening the risk of stroke and heart attack
  • protection against arrhythmia
  • aid in preventing and regulating mood disorders
  • contribute to good mental health
  • contribute to skin, hair, and eye health
  • blood sugar regulation
  • help with vitamin absorption

Healthy fats also allow you to feel full so you’re not craving sugars and carbs after a meal. Keep in mind that when it comes to animal fats like beef, butter, beef tallow, and other dairy, there is a big difference between products derived from grain-fed animals and grass-fed animals. Some of the benefits of nutrient-rich grass-fed animal products include:

  • five times more omega-3s
  • twice as much conjugated linoleic acid (CLA)
  • higher carotenoid levels (precursors to vitamin A including beta carotene)
  • higher levels of antioxidants including vitamin E

In addition, products derived from grain-fed animals have lower levels of natural trans fats (keep reading to understand why natural trans fats are important to good health); a diet of grains is unnatural for animals and therefore creates unhealthy changes not only for the animals but for consumers as well. Grass-fed animals are healthier in general and are typically antibiotic- and hormone-free.

Not All Trans Fats Are Equal

Trans fats as a whole are typically lumped into a single category of “unhealthy”, but there are two kinds of trans fats: natural and artificial. Moderate amounts of trans fats—CLAs—occur naturally in grass-fed animals, but less so in grain-fed animals. These natural trans fats have been shown to lower the risk of cancer and are associated with the management and prevention of diabetes through the improvement of insulin resistance and glucose tolerance as well as lowering the risk of heart disease.

On the other hand, artificial trans fats, which are found in products such as margarine, microwave popcorn, frozen pizzas, fried foods, nondairy creamers, prepared bakery goods and more, have altered chemical structures and can cause significant harm to the human body. The effects of artificial trans fats include increased inflammation and increased risk of serious health conditions including diabetes, heart disease, and others. These altered chemical structures also increase bad cholesterol while lowering good cholesterol; they also damage the lining of blood vessels.

Choosing to include healthy fats provides a wide range of foods to choose from, many of which are found in the Mediterranean diet. These choices allow for healthy trade-outs to increase nutrient density; for example, instead of coating salmon in breadcrumbs, make nut-crusted herbed salmon instead. Thinking through these substitutions, any good home cook is likely to discover some new healthier favorites!

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

For more information, call 201-261-5430 or visit GetWell-Now.com

Inflammation—At the Root of Cardiovascular Disease Heart attack and stroke caused by inflammation, not atherosclerosis, is key to research findings and prevention.

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Many patients have heard me say “inflammation is the precipice of all disease”, and that’s true for everything, including cardiovascular disease (CVD). Functional medicine practitioners have known this for years, and now conventional medicine is finally realizing it too.

The shift away from atherosclerosis (the accumulation of fatty deposits on the inner walls of arteries and the dominant cause of heart attack and stroke) being considered “an exclusively lipid-driven disease” is relatively recent and clearly shown in a study published in the New England Journal of Medicine as well as the journal Current Opinions in Cardiology. This study shows compelling data, compiled over the past few decades, that the belief of lipids as the cause of atherosclerosis “has been gradually replaced by the concept of a chronic low-grade inflammatory process of the arterial wall.”

The study reveals the important role of inflammation in atherosclerosis and “examines selected anti-inflammatory interventions that have been tested in clinical trials designed to prevent adverse cardiovascular disease events and excess heart health risk.” In plain English, this means that arterial plaquing, once thought to be the cause of heart attack and stroke, is actually a result of inflammation and is instead cardio protective. In other words, the plaque is the bandaid, not the culprit.

It’s interesting to also note that the study review stated that “the recurrence of CVD events remains unacceptably high” with traditional treatments such as statins, bypass surgery, and kexin type 9 inhibitors. Cardiologists involved in the study now believe that an anti-inflammatory therapy can reduce the chances of patients experiencing a repeat event. Inflammation is commonly present in heart attack and stroke patients, according to the American Heart Association, and further research into the role of inflammation in cardiovascular events is ongoing.

The How and Why of Chronic Inflammation

It’s chronic inflammation, as opposed to acute injury, which is pivotal in the development of atherosclerosis. Chronic inflammation can occur as a result of:

  • environmental toxins
  • smoking
  • diets high in sugars
  • trans fats
  • refined carbohydrates
  • certain medications

White blood cells interpret even low levels of systemic chronic inflammation as a threat, which triggers a response by our immune system. When it finds no actual illness, elevated white blood cells can instead attack internal organs, cells, and healthy tissues, which can lead to many health problems from cancer to stroke and heart disease. Cardiovascular disease can be the outcome when inflammatory cells cause a buildup of arterial plaque after staying in blood vessels too long.

While conventional medicine typically believes there are no outright symptoms that serve as warning signs of chronic inflammation, functional medicine practitioners know to look for certain signs which, in conjunction with a comprehensive blood test, may point to the possibility of an inflammatory condition. These include joint or muscle pain, seasonal allergies, gastro-intestinal problems, skin conditions or rashes, moodiness, cognitive issues including brain fog, and others.

Routine blood tests should check for the presence of high levels of the inflammatory marker C-reactive protein (CRP), which is a potential indicator of inflammation in the blood. Elevated levels of CRP are associated with a number of health issues ranging from higher risks of heart disease and lupus to infections and rheumatoid arthritis. Until recently, most doctors did not routinely include testing for CRP levels with regular blood work, even though patients with normal cholesterol but high levels of CRP have a risk factor of heart disease that is several times higher than those with lower CRP levels.

Prevention and Reversal, Naturally

The good news is that there are ways to bring inflammation levels down without using either prescription or over-the-counter medications, both of which can lead to additional health problems and damage internal organs. The answer lies in lifestyle and dietary modifications, as stated in a Harvard Medical School article published by Harvard Health:

“Doctors are learning that one of the best ways to reduce inflammation lies not in the medicine cabinet, but in the refrigerator. By following an anti-inflammatory diet you can fight off inflammation for good.”

This is the same philosophy and approach that functional medicine has used for many years. Diets rich in whole foods and healthy fats, like the Mediterranean diet, include food choices that carry a wide range of beneficial nutrients including high antioxidants, protective polyphenol compounds, vitamins, minerals, and so on that can improve not only inflammation, but also overall health and quality of life.

A few of the foods included in an anti-inflammatory diet are fresh fruits and vegetables, wild-caught fish (particularly fatty fish high in Omega-3s like salmon, sardines, anchovies, and others), certain nuts, and many others. Some seasonings, herbs, teas and spices can also help reduce chronic inflammation while adding even more flavor to meals; these include turmeric, cinnamon, green tea, rosemary, black pepper, ginger and more.

Keep in mind that the quality of food eaten matters as well—it’s always best to buy organic as much as possible, and choose wild-caught fish and pastured eggs and meat instead of farm raised.

But just as important as eating anti-inflammatory foods is kicking the pro-inflammatory foods habit. Foods known to cause inflammation include sugar-sweetened drinks, refined carbs, added sugars, processed and fast foods, fried foods, and foods containing trans fats such as non dairy creamers, margarine, snack foods like microwave popcorn, many prepared baked desserts, foods containing partially hydrogenated oils (most take-out and “junk” foods), and more.

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

For more information, call 201-261-5430 or visit GetWell-Now.com

Heart Disease Risk: The Latest On Cholesterol Learn the flawed methodology used to increasingly prescribe statin drugs and why the true culprit (or culprits) often remains undiagnosed.

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Cholesterol has been vilified for years as the top contributor to cardiovascular disease (CVD) and chronic heart disease (CHD), to the point where lowering that number has practically become a national obsession. The medical community’s answer to this is to prescribe statin medications, like Lipitor, which have dangerous, sometimes permanent side effects.

This obsession comes at a high cost: First, the number of people being prescribed statins for the wrong reason increases every year as pharmaceutical companies press laboratories (and doctors) to further tighten the acceptable range for cholesterol. Even children as young as eight years old are being indoctrinated to The Cholesterol Myth and are being prescribed statins instead of really taking into consideration what would have better long term health benefit for these young lives.

And sweeping recommendations that everyone over fifty should automatically be put on statins “as life-savers” to prevent cardiovascular disease is frightening and not supported in the research. What most patients don’t realize is that cholesterol itself is cardioprotective. When the arterial walls are plaquing it is not because cholesterol manufacture has run amok; in fact, arterial plaquing is a result of thinning and fragility, a weakness in the arterial walls themselves that need shoring. Think of cholesterol as a patch; the same kind of patch used to repair a leaky, punctured tire.

Not only that, cholesterol aids in hormone production as it sits atop the cascade of hormones beneath it, at the very apex of all hormones that are essential to reproduction and survival. It is also a structural component of cells (it is the lipid membrane that constitutes the cell wall), and plays a role in digestion. In fact, cholesterol is so essential that approximately 80 percent of it is manufactured in the liver while only a minor percentage comes from the foods we eat. Think about why that is? When our diet doesn’t contain enough cholesterol, our body will try to make up for the shortage by manufacturing more of it in the liver. Indeed, a very low cholesterol count is associated with a number of serious health problems including cancer, depression, anxiety and more.

A Better Way

Fortunately, today there is great division within the medical community, with a number of highly respected medical professionals questioning the risk-benefit ratio of statins and pointing out the “flawed methodology”, “industry sponsorship” and “statistical deception” used to evaluate the effectiveness and safety of statins. It’s about time!

In approaching the body’s hormone and heart chemistry from a functional medicine perspective, cholesterol is not only necessary, it is essential. It is the precursor to all other hormones, including the steroid hormones such as cortisol and the reproductive hormones like estrogen, progesterone and testosterone.

By obsessing over cholesterol, patients are missing three important facts:

  • True risk of heart disease requires a number of markers to properly evaluate (before taking statins), including epigenetic and inflammatory markers, not just cholesterol, and is generally a function of other co-morbidity factors like high blood pressure and a history of diabetes.
  • 50 to 75% of patients hospitalized with an acute myocardial infarction (heart attack) have normal cholesterol levels as defined by traditional medical standards (lipid measurements).
  • A significant number of heart disease cases are autoimmune and a result of systemic inflammation unrelated to cholesterol.

So what’s the real culprit?

New studies reported by the Royal Pharmaceutical Society Journal show strong evidence that it is insulin resistance, and not cholesterol, that is at the root of cardiovascular disease. This is true for Type 2 diabetes and obesity, as well. In fact, populations in the US and around the world were studied and it was found that body mass index, weight and cholesterol were “ineffective”, “inconsistent” or “misguided” as risk markers for heart disease, obesity and Type 2 diabetes.

Trouble is, there is no medication to reverse insulin resistance. Medications prescribed to improve insulin sensitivity have been only mildly successful, and one type of drug is reported to have actually increased mortality in patients with Type 2 diabetes.

Likewise, it was also discovered that instead of focusing solely on caloric intake, which is commonly the case for anyone overweight or diabetic, or suffering with chronic hypertension, the important factor was whether the calories were coming from processed foods or whole foods. In other words, nutrient dense calories and junk calories are not equal; it’s the metabolic changes that result from eating healthy food that matters.

One such study, the Lyon Diet Heart Study, looked at the effects of different types of food on insulin resistance and found that the Mediterranean diet, which is filled with healthy fats and fresh vegetables, was one of the best for heart health. The conclusion was heart disease risks need to be redefined, and that “lifestyle interventions” were by far more successful than drug interventions.

Be Smarter

Viruses are here to stay; they’ve always been around us, but Covid-19 has made us more aware of their potential severity and the corrosive effect it has on patients with underlying blood vessel diseases. Aside from wearing a mask and social distancing, one of the best strategies to focus on right now for all of us is strengthening our immune systems and our health.

For patients with underlying autoimmune disease, heart disease, chronic illness, or who want to focus on performance, we also recommend testing for specific areas of weakness, including genetic weaknesses, to help identify and restore improvements for future-proofing against viruses that arrive on our doorsteps.

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

For more information, call 201-261-5430 or visit GetWell-Now.com

Depressed and At Risk For Heart Disease? The Hand-In-Glove Relationship Between Mental Health and Heart Disease

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It’s been known for a number of years that depression and cardiovascular disease (CVD) have a close relationship—in fact, it’s a two-way street: at least 25 percent of patients with heart disease experience depression, and adults who suffer from depression frequently develop some form of heart disease. According to a report by the National Institutes of Health, “adults with a depressive disorder or symptoms have a 64 percent greater risk of developing coronary artery disease”, which supports evidence collected over a thirty-year period indicating that depression can be a highly significant predictor of heart disease. The report goes on to state that “depressed patients with coronary artery disease are 59 percent more likely to have a future adverse event, such as a heart attack or cardiac death.”

The association between depression and an increased risk for heart disease appears to be independent of whether a person has any other factors that are traditionally considered to be high risk for heart disease, including high cholesterol, hypertension, obesity, diabetes, etc. In fact, researchers have gone so far as to say they are “confident” that depression is an “independent risk factor” for heart disease.

Depression has been determined to be the strongest predictor for death, particularly if it occurs within the first ten years of a heart disease diagnosis; in such cases, the risk of death from depression is double. The findings of an investigation published in JAMA Psychiatry found that “Adults with depressive symptoms experience poor physical health outcomes and increased risk of mortality across the world and in different settings, especially in urban areas.” Research shows that this increased risk of death due to depression transcends age, gender, when depression began, and whether or not the patient had an actual heart attack.

A separate JAMA Psychiatry article reports on several studies showing that “depression and its associated symptoms” are major risk factors for “development of CVD and death” following myocardial infarction. The article goes on to state that when patients with CVD are treated for depression, their longevity, quality of life, and anxiety improve.

Adolescents, Depression, and Heart Disease

But the problem isn’t just limited to adults—in 2015, the American Heart Association issued a statement that “teens with depression and bipolar disorder stand at increased risk for developing cardiovascular disease earlier in life.” The European Society of Cardiology reports that adolescents suffering from depression or anxiety have a 20 percent higher chance of experiencing a mid-life heart attack than those who do not.

It has been noted that mental well-being in young people from childhood up through age 19 is generally declining, making it extremely important that parents and guardians remain vigilant for any signs of depression or anxiety. These can include:

  • withdrawal from typical social activities or family
  • sulking
  • negative thinking
  • eating more or less than normal
  • sudden bursts of anger
  • unusual irritability
  • trouble sleeping or unusual sleep patterns
  • headaches and other unexplained pains
  • drop in grades
  • letting schoolwork slip
  • engaging in high-risk behaviors
  • fatigue
  • excessive worrying

Early diagnosis of depression at any age, along with intervention, is imperative to prevent an escalation to resulting heart disease. Behaviors and lifestyle choices that accompany depression are also linked to the development of heart disease; these include increased use of alcohol, increased smoking, poor dietary choices, lack of exercise, and lack of interest in overall health maintenance.

Chronic mental stress and depression have been shown to negatively impact heart health in multiple studies. Some of the effects include:

  • weakened immune system
  • arterial damage
  • hypertension (high blood pressure)
  • irregular heartbeat
  • increased post-cardio-surgical pain
  • fatigue
  • increase in proinflammatory markers
  • increased risk of heart attack, blood clots, and CAD
  • increased mortality risk

Functional Medicine Takes Aim at the Root Cause

The cycle of chronic depression leading to cardiovascular disease, and, in turn, CVD causing depression, is quite clear. Obviously, the best way to avoid this vicious cycle is prevention; however, once depression has become a recognizable pattern, or heart disease has been diagnosed, a whole person approach aimed at getting to the root cause rather than just treating symptoms is crucial.

For example, conventional medicine doctors typically identify depression using a scoring method and then begin to medicate with antidepressants; there is no test. If sleep has also become a problem for the patient (a common problem associated with depression), sleep medications will most likely be added, and so on. While this mind-numbing and merry-go-round works for some—with varying degrees of success, if any, it is likely to ignore the correctible and reversible symptoms like leaky gut. Plus, the strong possibility of side effects from too many medications can be severe or lead to additional health concerns. This approach doesn’t serve to alleviate the root cause of the problem. In fact, some medications in and of themselves can create higher risk factors for heart disease, autoimmune disease, and many other health issues.

A functional medicine practitioner will look into a wide spectrum of possible causes, from inflammation (gut, body and brain) to toxicity and many others. Changes in lifestyle, dietary habits, stressors and more are all taken into consideration in combination with comprehensive lab tests to uncover the underlying cause of depression, heart disease and other possible previously undiscovered health issues that could be contributing to the patient’s health problems.

Functional medicine will not only look at a patient’s depression and heart disease for their shared trigger, such as blood sugar dysregulation, the practitioner will also look at them in combination–systemically as having the same inflammatory cause. Digging even deeper, the practitioner will search to discover the reason for these elevated inflammation-producing proteins (or other factors) in order to correct the problem at its root. Through these medical investigations, other health issues—either undiagnosed or thus far undetected—can be prevented before they’re able to surface.

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

For more information, call 201-261-5430 or visit GetWell-Now.com

Skin Rashes and Cardiovascular Disease: Is There a Link? Having one autoimmune disease leads to another, and another... and new cases are on the rise

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Autoimmune disease is an etiology—a root cause—of many common diseases, including some that are rare, in which the body’s immune system malfunctions and attacks healthy organs, cells and tissues, including the heart. According to the American Autoimmune Related Diseases Association, there are now over 100 identified autoimmune diseases, including:

  • psoriasis/psoriatic arthritis
  • lupus
  • type 1 diabetes
  • multiple sclerosis (MS)
  • rheumatoid arthritis (RA)
  • inflammatory bowel disease
  • celiac disease
  • Hashimoto’s thyroiditis
  • Graves’ disease
  • myasthenia gravis
  • chronic Lyme disease
  • Addison’s disease
  • fibromyalgia

The prevalence of autoimmune diseases is increasing at an estimated rate of between 3% and 9% every year; currently more than 24 million Americans have been diagnosed with some form of autoimmune disease. What’s most alarming is that a study published in the journal Arthritis & Rheumatology in April 2020 showed that adolescents 12-19 years old were among those that showed a significant increase—the largest increase of all groups in the study of over 14,200 people—in the presence of antinuclear antibodies (ANA), a common biomarker for autoimmunity. Researchers considered this “concerning” and believe it may be indicative of a possible increase of autoimmune disorders in the future.

While conventional medicine treats autoimmune diseases with symptom management, it doesn’t cure their root causes, which means that even if symptoms are minimized, the core problem of the disease still remains. Because the root of the autoimmune disease itself is not being reversed or controlled, it can lead to other health problems including cardiovascular disease (CVD).

The Link Between Autoimmune Diseases and CVD

Since different autoimmune diseases affect different areas of the body—psoriasis impacts the skin, RA attacks the joints, Hashimoto’s targets the thyroid, and so on—is there a commonality between autoimmune diseases in general and cardiovascular disease? The answer is yes—it’s inflammation, a common factor in most health conditions and disorders. In addition, although individual autoimmune diseases impact different areas of the body, they can be systemic disorders. For example, psoriasis shows up on the skin and is thought of as a skin disorder, but it’s actually an inflammatory and immune-mediated problem, which are the actual underlying causes that increase the risk of CVD. This is why simply treating the skin lesions with medications and moisturizers to lessen discomfort and appearance won’t cure the actual cause of the problem.

Cardiovascular disease is considered a secondary, or downstream, effect of autoimmune disease, meaning that whatever primary effect each specific autoimmune disease exhibits (i.e., psoriasis causing thick, scaly skin patches or rheumatoid arthritis causing joint swelling and deformity), an increased risk of heart disease can be yet another effect that is secondary but potentially life-threatening.

Atherosclerosis, one type of coronary artery disease and a main cause of CVD, was for many decades considered a degenerative disease that was an inevitable part of aging. However, research has shown that it is neither inevitable nor degenerative. Rather, it is an autoimmune-inflammatory disease with factors that lead to immune system activation, a consequence of which is the narrowing of arteries, deterioration of artery walls due to an accumulation of scar tissue and fatty deposits, and a proliferation of smooth-muscle cells.

A recent meta-analysis by the National Institutes of Health found that “many reports have been focused on the immunologic background of [atherosclerosis], and it is no longer in doubt that it shares several autoimmune pathways. It is not surprising to find an accelerated [atherosclerosis] in quite a lot of [autoimmune diseases].” In addition, an article in the American Heart Association Journals definitively states, “The risk of CVD is very high in a prototypic autoimmune disease, systemic lupus erythematosus (SLE), and is also raised in other autoimmune diseases such as rheumatoid arthritis.”

The Functional Medicine Perspective

Many conventional medicine doctors agree with their functional medicine counterparts that a healthy lifestyle and diet low in sodium, sugars, processed foods, etc. coupled with regular exercise can help lower the risk of autoimmune and cardiovascular diseases. After that, the two generally part ways:

Conventional medicine treats symptoms and manages dietary considerations on a macro level; it manages the disease progression using pharmaceuticals, and waits for new disease pathways, potentially more acute, to present that are more actionable
Functional medicine searches for root causes that are systemic, that can be targeted using small dietary, lifestyle and nutraceutical interventions, in order to reverse or minimize disease. The goal is to halt the progression and eliminate new pathways, using more natural means and giving the body what it needs to help itself.

While prescription medications are certainly necessary in emergency situations and may need to continue being taken for certain health issues, health problems including autoimmune disease and cardiovascular disease do not occur in isolation or suddenly appear for no reason—there was one or more triggers or a buildup over time that created the problems. Health issues are the result of something going awry in the body—this is the root cause that must be uncovered and addressed in order for optimal health to be achieved and to avoid further complications. Sometimes health problems like diabetes may not be completely reversible (although functional medicine practitioners have achieved reversal in some cases), but they can be improved so that medications can be eliminated and/or their levels reduced to a less risky level through an integrative approach.

One of the problems with long-term medication use is that it can cause a myriad of other problems—just one example is that there are more than 35 medications known to cause “drug-induced lupus”. Conditions that are treated with immunosuppressants (many times used post-transplant and to control inflammatory diseases), which literally suppress the immune system, leave patients open to more easily contracting viruses and other infectious diseases.

Many medications cause even more inflammation in the body, which leads to more disease and/or the addition of new prescriptions. Since inflammation is one of the commonalities between autoimmune disease and CVD, it’s easy to see how this vicious cycle of inflammation and increased disease can occur.

Oxidative stress is another factor that causes both autoimmune diseases and CVD; oxidative stress is an imbalance between the production of free radicals (unstable and highly reactive molecules) and antioxidants—this imbalance can cause disease and damage cells. Research published in the peer-reviewed journal Oxidative Medicine and Cellular Longevity states that oxidative stress and inflammation can lead to hypertension, arteriosclerosis, mitral valve prolapse, and other conditions that, in turn, lead to stroke and other heart disease. Oxidative stress and inflammation are also associated with such metabolic disorders as diabetes, obesity, and hypertension, which can bring about heart failure, diastolic dysfunction, and left ventricular hypertrophy (when the heart’s main chamber has thickened and isn’t pumping efficiently). In short, oxidative stress is a major contributor to vascular disease.

Similarly, an article published by the National Institutes of Health states that oxidative stress also plays an important role in leading to autoimmune disease “by enhancing the inflammation, inducing apoptotic cell death [known as “cellular suicide”], and breaking down the immunological tolerance. When the state of oxidative stress was investigated in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren’s syndrome (SS)…most subjects were in excessive oxidative stress or in defective antioxidant potentials.”

Rather than targeting the symptoms and diseases caused by oxidative stress, functional medicine will work with patients to reverse oxidative stress itself in order to correct the actual cause of the resulting autoimmune diseases and CVD. By doing this as well as discovering any other lifestyle or medical issues that may be contributing to inflammation, autoimmune issues and CVD, additional diseases and furthering of symptoms can be prevented, and existing conditions may even be reversed.

Heart Disease Made Worse By Having Diabetes Ongoing high blood sugar levels create an inflammatory cascade of health concerns

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Let’s get straight to the point about this—there is no question that diabetes greatly increases the risk of heart disease. According to the American Heart Association (AHA), at least 68 percent of diabetic adults who are 65 and older die from heart disease, and about 16 percent die from stroke. In addition, adults with diabetes are up to four times more likely to die of heart disease; the AHA considers diabetes to be one of the top seven major risk factors for cardiovascular disease.

The latest diabetes statistics from the Centers for Disease Control (CDC) are rather alarming: 34.2 million Americans—1 in every 10—have diabetes, and 88.8 million adults—1 in every 3—have prediabetes, though many aren’t aware of their condition. And for the ten-year period between 2008 and 2018, the number of young Americans under age 20 who have been diagnosed with type 1 and type 2 diabetes has “significantly increased”.

The CDC goes on to state that diabetes and heart disease “go hand in hand”. Having diabetes doubles a person’s risk of having a stroke or heart attack at a younger age, and that risk increases the longer a person has diabetes. Conditions such as high blood pressure and high cholesterol are also common in diabetics—both of these can be precursors to cardiovascular disease (CVD).

How Does Diabetes Lead to CVD?

Diabetes creates risk factors for a number of other conditions that can lead to heart disease. High glucose levels associated with diabetes damage blood vessels by lowering the levels of nitric oxide in blood vessels; nitric oxide molecules (vasodilators) serve the extremely important function of relaxing inner blood vessel muscles, allowing them to widen, thereby increasing blood circulation. When nitric oxide levels decrease, muscles in veins and arteries tighten and narrow, restricting blood flow.

Ongoing high blood sugar levels can also weaken capillaries that supply nerves with nutrients and oxygen. This leads to autonomic neuropathy, a condition that interferes with brain-organ-nerve messaging and damages the nerves that control involuntary bodily functions and internal organs, including those that control the heart itself. Blood vessels that supply nourishment to the nerves are also damaged, and problems with blood pressure and heart rate, as well as other organs and vital functions, can also develop.

Some of the symptoms of autonomic neuropathy, a frequent indicator of diabetes, include:

  • lightheadedness, dizziness or fainting upon standing or when physically active
  • rapid heartbeat
  • sudden increase or decrease in heart rate
  • inability to feel chest pain during a heart attack or when the heart is oxygen-deprived
  • change in breathing patterns
  • change in sleep patterns
  • slower stress reactions
  • digestive problems
  • bladder function
  • sweating too much or too little, causing body temperature irregularities

Lifestyle Risk Factors for Developing CVD

Certain lifestyle risk factors are known to lead to cardiovascular disease, and these risks are increased in those with diabetes.

It’s common knowledge that smoking leads to a myriad of health problems; besides the increased risk of causing heart disease in general, both smoking and diabetes cause blood vessels to narrow, restricting blood flow to the heart and creating an elevated potential for heart disease and damage to blood vessels. When blood flow to the heart, organs and muscles is impacted, it becomes more difficult to exercise or engage in normal physical activities, which is another contributing factor to diabetes-related CVD.

High blood pressure, a common health condition in diabetics, forces the heart to work harder, which damages blood vessels and puts a strain on the heart. Both of these resulting issues can lead to CVD, including heart attack and stroke; having both hypertension and diabetes doubles the risk of developing cardiovascular disease.

Insulin resistance, typically not tested for by conventional medicine prior to a diagnosis of diabetes, can be associated with a lipid disorder. Obesity is not only a major risk factor for developing CVD, it can also cause insulin resistance and is a cause of high blood pressure. The American Heart Association states that “insulin resistance or diabetes in combination with one or more” other risk factors mentioned here put individuals at “even greater risk of heart disease or stroke.”

Not getting enough regular physical activity, which has become a common problem today, can lead to becoming overweight or obese, especially if a sedentary lifestyle is coupled with poor dietary choices such as processed or fast foods and diets high in sodium and/or sugars. Lack of physical activity can also lead to insulin resistance and high blood pressure.

As you can see, each individual risk factor above contributes to other risk factors, so taking steps to manage or eliminate even one, such as high blood pressure or smoking, can help reduce the chance of developing others. But the good news is that every one of these risk factors can be reversed, managed or improved without the use of medications, which can create new health issues.

Conventional Medicine vs. Functional Medicine Approach

For conventional medicine, a comorbidity scenario (diabetes coupled with CVD) goes something like this:

  • A patient taking one or two medications for diabetes begins experiencing occasional chest pain when he’s exercising or physically active.
  • He is diagnosed with some form of CVD and given a diagnosis-dependent prescription, possibly a beta blocker for arterial plaque, as well as a statin.
  • He’s also told to take one aspirin daily. A recommendation for low-fat, low cholesterol diet modification as well as regular physical activity is given and he’s sent home.
  • Months later, when his blood pressure remains high, a new medication to lower blood pressure is added to the existing medication mix, and when that causes leg swelling, he’s prescribed a water pill.
  • This patient is now on a cocktail of six or seven medications that can cause serious side effects (some of which require hospitalization) or lead to additional health issues like psoriasis, muscle pain and weakness, heart irregularities and more.

Should a heart attack occur anyway, which many times is the case, a surgical procedure is likely performed. However, the patient may be left with a general feeling of tiredness and an inability to engage in normal physical activities without becoming short of breath. This is called congestive heart failure.

  • At this point, the dosage of prescribed diuretic is increased and will likely negatively impact kidney function.
  • Since he’s no longer able to enjoy fulfilling activities and has more health issues than ever, the impact on the patient and his family can take a psychological toll, resulting in depression.

The above scenario may seem extreme, but it’s not out of the ordinary.

A holistic, functional medicine approach

When the same diabetic patient with CVD who is taking the same initial two or three medications visits a functional medicine doctor, that doctor will investigate further. The patient’s health history, current health issues, lifestyle, stress levels, stressors and more are examined during an hour-long initial visit. During this discussion, the doctor will look at the whole timeline, including paperwork, and begin to uncover underlying root causes like high blood pressure, high glucose levels, inactivity, etc. For example, there could be a significant amount of stress for the patient that is taxing his adrenals. Or, workplace pressure that causes significant amounts of stress eating.

A functional medicine doctor would look at how the heart is affected by toxicity (or, the inability to properly detoxify), microbiome imbalances, food allergies and sensitivities and more. Coupled with comprehensive blood work, a functional doctor ferrets out important avenues of inquiry using independent, functional laboratories that examine more than blood chemistry. So, gut microbiome, DNA testing, hormone analysis, organic acids, and so on.

The results of these provide insights that can be dealt with naturally through various dietary corrections and supplementation. Over time, problematic symptoms can disappear or become minimal and manageable; in many cases, medications are no longer necessary or may be significantly reduced. New health problems due to adverse reactions to over-the-counter or prescription medications can be avoided and deteriorating conditions can be reversed.

While the connection between diabetes and cardiovascular disease is undeniable, it is not inevitable if the proper course of action is taken. Further complications due to diabetes-related CVD can be avoided, managed, or reversed without the risks presented by medications.

A Fresh Look at Cardiovascular Health Improves Outlook for Dementia Mounting research suggests that heart disease prevention reduces risk of cognitive impairment and brain decline through early intervention

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One of the largest studies conducted on the effects of cardiovascular disease (CVD) on cognitive function, published in the Journal of the American College of Cardiology (JACC), followed over 7,800 people with no previous or existing cognitive impairment (CI) or heart disease. At the end of a twelve-year period, 5.6 percent of those in the group had experienced heart attack or angina. Over the course of those twelve years, three sets of cognitive tests were administered at different times, and it had been determined that none of the participants had risk factors or were likely candidates for impaired brain health or cognitive function. However, researchers found that those who had suffered a heart attack or angina were at a much higher risk for cognitive decline.

In another study reported in JACC, 1,588 dementia-free patients were followed for 21 years and assessed annually. This study examined the impact of cardiovascular risk on “cognitive decline and structural brain differences”. The conclusion was that cardiovascular risk factors such as diabetes, obesity, hypertension, and smoking may not only predict cognitive decline but are also “associated with neurodegeneration and vascular lesions in the brain.”

Until recently, most of the studies regarding cognitive decline have focused on circulation problems caused by events such as stroke, which affects blood supply to the brain. However, more attention is now being paid to the connection between heart function and brain decline through the lens of vascular health. And with the World Health Organization projecting that by the year 2030, a projected 82 million people are projected to develop dementia (an increase of 32 million since 2017), unless we can develop new tools for identifying risk factors, especially since there is no available cure.

The National Institutes of Health published an Expert Opinion paper stating that “cognitive decline is a prevalent condition…in patients with heart failure.” The research they compiled showed that between 39 percent and 80 percent of patients hospitalized for heart failure experienced CI, with the highest percentage accounting for patients with acute decompensation (a sudden worsening of heart failure typically marked by swelling of the legs or feet, fatigue, or difficulty breathing). Because of the prevalence of CI in these patients, these researchers recommended that cognitive assessments become part of the routine examinations for heart failure patients.

Beyond risk factors for heart disease, cognitive assessments lead to higher early identification of CI

There are a number of factors that contribute to cognitive problems in patients with heart failure, including:

  • stroke
  • atrial fibrillation
  • hypertension
  • impaired blood flow
  • medications
  • poor nutrition
  • metabolic abnormalities
  • co-morbidities including diabetes, anemia, and artherosclerosis

Cognitive impairment due to heart failure, which typically fits the parameters for vascular dementia or vascular cognitive impairment, can range from mild or moderate symptoms to advanced dementia; even mild symptoms can negatively impact independence and self-care. The cognitive areas typically affected include:

  • learning
  • concentration
  • visual-spatial function
  • short-term memory
  • task processing speed (coordination, accuracy, smoothness)
  • executive functions (decision-making, problem solving, planning, social abilities, adaptation)
  • reaction time
  • difficulty recalling personal memories

Interestingly, research has shown that some of the same risk factors for CVD—diabetes, obesity, and high blood pressure—are also associated with impaired cognition. Risk factors for both CVD and CI increase greatly with age, and because cognitive decline is considered a “normal” part of the aging process, CVD is frequently overlooked as the cause of CI in older patients.

Vascular research provides fresh perspective about cholesterol and fats as cardio- and brain protective

According to the American Heart Association, 121.5 million American adults—over 48 percent—have some form of cardiovascular disease. With so much attention paid by conventional medicine to heart disease over the past several decades, why have the numbers increased so much? This is one major area where functional medicine parts ways with certain conventional medicine recommendations:

Conventional medicine advocates for low- to no-fat diets and makes a generally sweeping claim that fats clog arteries and cholesterol is the enemy, while functional medicine has embraced a multitude of studies that continue to prove that healthy fats and cholesterol are necessary for their anti-inflammatory properties and improvements to arterial flexibility, blood and nerve flow and vascularity.

For example, a study published by the National Institutes of Health followed more than 347,700 participants over a span of 5 to 23 years. Of those participants, 11,006 suffered a stroke or coronary heart disease (CHD) during that time period. However, a thorough analysis concluded that saturated fat intake “was not associated with an increased risk of CHD, stroke, or CVD.”

While a number of studies have reached the same conclusion, there are no one-size-fits-all solutions. Every individual’s genetics and lifestyle need to be taken into consideration before recommendations for optimal health and wellness can be made. However, other risk factors (and this is not a conclusive list) are much more concerning, including metabolic syndrome, insulin resistance (which is rarely, if ever, tested for in conventional medicine), sedentary lifestyles, processed and refined foods, and diets high in carbohydrates and sugars.

In general, a good balance can be found in the Mediterranean diet that uses high amounts of olive oil and fish, but as important are sufficient fruits, vegetables, meats and healthy fats for each person’s specific brain and heart health needs. A fast-food hamburger with its heavy sodium content and low-quality meat does not offer the same health benefits as a homemade grass-fed beef hamburger. Frozen vegetables processed with chemical-laden cheese sauces are not the equivalent of fresh vegetables lightly cooked with grass-fed butter or eaten raw. And sweetened fruit juices or juice drinks don’t replace fresh fruits.

If we are to lower our risk of cognitive impairment brought on by cardiovascular disease, we must first understand our own medical risk factors such as history of heart attack, hypertension and stroke and replace outdated therapeutics and “wait and see” approaches with better tools of inquiry such as brain health functional assessments that include cognitive reasoning. There is ample evidence of diet and lifestyle, along with rigorous attention to cardiometabolic activity, can improve vascular health and lower the risk for heart and brain problems.

Beyond Diabetes: Insulin Resistance a Precursor to Cardiovascular Disease Functional medicine imparts new wisdom into how Insulin resistance affects heart health

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Most of what we usually hear regarding insulin deals with medications you can take that lower your risk of developing type 2 diabetes, and less about the deleterious effects of the disease, or what blood sugar really is, and how our bodies use it for fuel. Insulin resistance also has been found to be a “major underlying abnormality driving cardiovascular disease” (National Institutes of Health, August 2000), including heart attack and stroke. Unfortunately, most patients don’t even fully understand the warning signs or the symptoms, as insulin resistance is considered a common health problem in the United States. The predominance of those who have insulin resistance—many times unbeknownst to them—is continually increasing.

What is Insulin Resistance?

Insulin resistance is a metabolic disorder characterized by extreme fatigue after meals, brain fog and similar slowing down of metabolism that leads to weight gain, high blood pressure, and lack of motivation. In a technical sense, the body doesn’t allow insulin into the cell, especially to brain cells, where glucose is the primary fuel. This isn’t something that happens suddenly—it’s a slow process caused by any of the factors listed below (primarily high-sugar and high-carb intake) as more insulin is needed by your body to keep your blood sugar at the right level. That said, it affects children in early, pre-pubescent childhood. Another misconception is that everyone with insulin resistance or elevated blood sugar is heavy or fat.

The inability to regulate blood sugar sets off an inflammatory cascade that leads to cardiovascular disease in a couple of different ways. One way this can happen is when insulin resistance alters a person’s systemic lipid metabolism, which then leads to high levels of triglycerides, small dense low-density lipoproteins, and low levels of high-density lipoprotein; this combination contributes to the formation of plaque in the arteries and vascular damage.

Another contributor to arterial plaque formation caused by insulin resistance is endothelial dysfunction, which is a type of coronary artery disease where the large blood vessels on the surface of the heart narrow instead of opening. Evidence of the fact that insulin resistance can directly lead to the formation of fatty plaque in arteries was borne out in the Insulin Resistance Atherosclerosis Study.

Hyperinsulinemia—when the amount of insulin in the blood is higher than normal—can lead to salt and water retention in the body, which in turn leads to hypertension, a condition that can cause heart failure, coronary artery disease, heart muscle thickening, and other cardiovascular diseases. Insulin resistance can also be at the root of obesity, high blood pressure, and high cholesterol—when all three are present, it’s called metabolic syndrome—which are all known to cause cardiovascular disease. Because insulin resistance can be at the root of these and so many other different types of cardiovascular issues, it’s considered a “multifaceted syndrome that increases significantly the risk for cardiovascular disease” (National Institutes of Health).

Risk Factors for Developing Insulin Resistance

There are a number of factors that can lead to insulin resistance, including:

  • high carbohydrate diet
  • sedentary lifestyle
  • diet high in sugars
  • trans-fats in the diet
  • obesity
  • smoking
  • hormonal disorders
  • poor sleep
  • certain prescription medications
  • out-of-balance gut microbiome
  • diet low in healthy fats
  • chronic stress
  • environmental toxins

These risk factors, among others, cause oxidative stress and damage insulin-making beta cells in the pancreas, as well as triggering insulin resistance. Hyperglycemia occurs when the pancreas can’t manufacture enough insulin, leading to oxidative stress, which then contributes to a number of health issues including vascular damage.

Conventional Approach vs. Functional Medicine Approach

Unfortunately, conventional medicine doesn’t usually monitor insulin resistance or take action until a person’s blood sugar numbers reach dangerous levels or they have a full-blown cardiac or diabetic event. The standard approach is to “watch” rising blood sugar levels, monitoring them periodically through fasting blood tests until a high-risk level is reached. However, insulin levels are not typically taken at all, yet they can rise before blood sugar, serving as an indication to take action. On the other hand, there are cases where blood sugar levels are normal but insulin levels are very high—these risky insulin levels are not usually found by convention medicine because doctors are not testing for them. The resulting cardiac event will then be treated, but attention may not be paid to the underlying cause of insulin resistance.

Standing by and watching a person’s health deteriorate until it reaches a crisis level is not and never has been the approach used in functional medicine. The loss of sensitivity to insulin is progressive and would be spotted by a functional medicine doctor through regular comprehensive lab tests that pick up the problem early in its development. If a patient already has insulin resistance, a case-specific plan can be put in place to pinpoint the areas where corrective action needs to be taken in order to reverse the condition—without dangerous medications.

This Single Ingredient Is Damaging to Heart Health Added sugars—not fats—are behind the high rates of heart disease

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For decades, Americans – and people around the world – were led to believe that fats were the true evil behind cardiovascular disease. Doctors preached that a protein-packed breakfast of eggs and meat should be replaced by whole grain cereals and other carb-based choices. But now JAMA Internal Medicine, the American Heart Association and the British Heart Foundation report that it is actually added sugars, not fats, that contribute to an increased risk of cardiovascular disease.

Many people don’t realize how much sugar they’re ingesting on a daily basis, mainly because they’re used to unhealthy choices being a regular part of their lives. Sometimes consumers don’t realize how much added sugar is actually in the products they’re eating, and other times packaged or processed products contain hidden sugars, which can be labeled with about 60 different terms that can be unrecognizable or have healthy-sounding names.

Sweetened drinks like sodas, sports/energy drinks, bottled iced tea drinks, specialty coffees and others top the list of the most heavily consumed sugar-added products. For perspective, a 12-oz. soda can contain anywhere between 9-1/2 to 12-1/2 teaspoons of sugar – if you drink a 16 oz., 20 oz. or larger container or if you have more than one soda per day, you can see how quickly your sugar intake increases just from soda alone. Then add in even more sugar from these commonly consumed culprits (and many others):

  • Sweetened breakfast cereals and oatmeal mixes
  • Jams, jellies, preserves, honey, spreads, syrups
  • Cakes, candy, cookies, etc.
  • Low-fat yogurts with sweetened fruit at the bottom
  • Pre-made sauces and gravies
  • Other processed foods like packaged meals.
  • Juice drinks, including green drinks, apple juice, orange juice, and so on

There are a few different ways that sugar takes a toll on heart health. First and most obviously, an excess of sugar can lead to becoming overweight or obese, both of which are known to increase the risk of heart disease. But regardless of weight, sugar also raises blood pressure and creates inflammation in the body, which is associated with an increased risk of cardiovascular disease, cancer, and other health problems.

The Conventional Approach Leads to Skyrocketing Cases of Heart Disease and Diabetes

The American Heart Association has revised its recommendation for sugar consumption, stating that women should have less than 6 teaspoons of sugar per day and men should consume less than 9 teaspoons per day. One small 12 oz. soda already exceeds both of those numbers. But does anyone really understand how serious the numbers are or what that recommendation means?

The amount of sugar being consumed by most people is staggering. JAMA reports that most adults consume 10% of their calories from added sugar. That added sugar crowds out other nutrient-dense calories and only contributes to our already elevated societal-wide sweet tooth. What’s worse, one out of every 10 adults get a whopping 25% or more of their calories from added sugar. In many cases, not because of personal choice but because they have limited food options. Sugar is cheap. When researchers compared these two groups to people who get less than 10% of their calories from added sugar, there was a significant difference in cardiovascular disease rates and mortality.

Just how serious are these numbers? The study showed that adults who consumed a fifth of their caloric intake from added sugars had more than twice the risk of a heart attack. Even more staggering: those with the highest sugar intake raised their risk of cardiovascular disease by 400%. Those are some pretty serious numbers.

Functional Medicine’s Focus On Food as Nourishment, Not Entertainment

Most children, teens and adults are consuming far more added sugar than is considered safe, but the good news is that it’s easy to find healthy alternatives that will benefit you in multiple ways and begin to reverse the effects of added sugars. For some families, it’s as easy as making better decisions at the grocery store to replace sugary snacks with fresh fruits, seeds, nuts and the like, squeeze citrus fruits into sparkling water or cold still water to replace soda and “enhanced” waters, and use fresh vegetables, rice and meats rather than frozen or prepackaged products. For countless others it’s about knowing what constitutes a healthy option on the go, and how to plan and prepare small snacks for throughout the day that contribute to blood sugar stability. And for too many, it’s about overcoming food scarcity and pushing back on the amount of processed white flour and sugar that is provided at meals.

This is where functional medicine is helping to change the healthcare landscape. Not only is it possible to work with a doctor who can individualize the best approach; but through functional medicine, food (not calories) are seen as an essential strategy to restore health, avoid medications, and recover from illness.. In part, a functional medicine doctor will run comprehensive lab tests that include glucose and insulin, , blood pressure readings, testing for overall carbohydrate and essential fatty acid metabolism, and so on . These tests will not only help guide decision making about food and food timing, but will advocate deeper connections and causes for disease than standard allopathic models do. Together, with your doctor you determine additional risk factors for heart disease and diabetes in order to take a holistic approach to address any underlying factors you may not even be aware of and put you on the path to whole body wellness.

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

For more information, call 201-261-5430 or visit GetWell-Now.com

Is Thyroid at the Root of Anxiety, Panic & High Blood Pressure? New research into the thyroid-heart connection yields results for reversing hypertension

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As people begin letting go of the idea of “hustle culture” and start embracing a simple, slower lifestyle, the topic of “How are you feeling?” has naturally come up. This doesn’t mean something is wrong, but the more often you can connect to it without feeling panicked about the answer, the less stressed and anxious you will feel overall. 

You may not automatically connect thyroid and heart issues, but here are a few of the problems with overactive thyroid.

  • worsening of existing heart issues
  • atrial fibrillation
  • increased risk of stroke
  • congestive heart failure
  • blood pressure irregularities

Your heart is a muscle that requires oxygen to work; it receives oxygen through coronary arteries. For a patient with hyperthyroidism, increased levels of thyroxine released from the thyroid gland further stimulate the heart to beat quicker and harder.

Medical Approach to Thyroid

Mainstream medicine is primarily concerned with overactive thyroid. Is your rapid heart beat caused by overactive thyroid, and a result of a thyroid “storm”?

A thyroid storm is an overrelease of thyroid stimulating hormone.

An initial influx of elevated thyroxine may produce a fast heart rate called tachycardia, in which the heart rate is 100 beats or more per minute. In some patients, prolonged stimulation of the heart may cause palpitations or an irregular heartbeat (atrial fibrillation). This is considered to be the most common and dangerous cardiac risk caused by an overactive thyroid. Functionally speaking, the electrical impulses have formed a short circuit within the atria, causing partial or poorly coordinated atrial contractions.

The autoimmune expression of a thyroid storm is called Grave’s Disease.

Hypertension, Grave’s and Low TSH (Differentials)

Prolonged and irregular stimulation such as this can cause some increase in blood pressure, which is called systolic hypertension. The diastolic blood pressure—the lower of the two blood pressure numbers—is not normally increased. The increased contraction of the heart with increased cardiac output causes a pulse that is easily felt at the wrist and contributes to warm, sweaty hands.

Hyperactive thyroid shows up on a blood test as a pathologically low TSH marker, typically below 0.05 on a blood test.

A cardiologist might run this marker or refer to an endocrinologist to rule out any kind of “thyroid storm”.

For patients with Grave’s Disease, the thyroid will typically be removed and caused to stop releasing hormones.

Low Thyroid Function (Hypothyroidism)

Symptoms and signs of a underactive thyroid gland tend to be the opposite of those mentioned above, and can develop at any age (often in menopause). Common symptoms primarily consist of a slow heart rate and low blood pressure, and include the following:

  • constipation
  • poor blood flow
  • lightheadedness or dizziness upon standing
  • fluid retention
  • low energy and fatigue

Prolonged hypothyroidism causes metabolic changes in the body and can affect heart health.

Hypothyroidism & Heart Health

While a lot of attention over the years has been given to cholesterol as a root cause deteriorating heart health, recent research has been examining vasculature & blood pressure itself.

A functional medicine approach to heart disease is going to look at a common, often overlooked symptom such as hypertension and examine what could be done differently. Like diabetes, patients with hypertension take a daily medication believing that’s all they need to improve their health when in fact, all they are doing is masking a symptom. So a functional doctor might consider reversing elevated blood pressure by examining what we know about the heart’s vasculature and how we might use cellular nutrition, for instance, to nourish and strengthen it.

What we know is that the body uses nitric oxide to stimulate blood vessels to expand and contract, keeping blood pressure in check. Both men and women with poor circulation or a history of thyroid or heart disease (including many common symptoms like high blood pressure and elevated cholesterol) are often deficient in the critical molecule nitric oxide. Precursors for the synthesis of nitric oxide include dietary amino acids such as L-arginine, ornithine, and citrulline. The right balance has been shown to stimulate growth hormones for anti-aging benefits, improve insulin sensitivity to help normalize blood sugar, and increase fertility and pleasure sensation by stimulating oxygenation and blood flow.

By the same token, functional medicine looks beyond the presenting symptoms for thyroid disorders and heart disease to examine what could be done to reverse the course, avoid medications, and even improve performance. In the case of thyroid disorders, comprehensive lab testing goes beyond that of conventional medicine, which typically tests for TSH and T4 only; they are ruling out a hyperactive thyroid problem such as Grave’s Disease when in fact, a majority of patients suffer the opposite. As such, functional medicine testing includes a complete panel with TSH, T4, T3 and reverse T3, along with others. Because health issues don’t exist in isolation and many factors can affect a person’s health, a holistic—or whole person—approach is taken to pinpoint areas of concern.