Do you ever fell frustrated by the complacency of people you care about?

I’ve always been one to fight for my health and for almost anything really. I question everything, especially narratives that come from the mainstream. I could have been complacent, and probably would be if it were not for my thyroid causing me to lose my child witnessing how the way I lived my life affected my kids.

After a family member came home from surgery all they wanted was fast food so someone brought it to them.  I have other family members who are sick. One has a major issue with their foot- no feeling in their feet and has a huge sore- they are not diabetic but have a rare condition and they just can’t seem to make any diet and lifestyle changes to try to help their condition.

I was telling my brother that I have small dense lipoproteins and he may as well if he wants to get it checked out. He just shrugged his shoulders.

I don’t want to change them. I do WISH they would change, but I’m not out to force my beliefs and lifestyle on them- I tried that, even before I was a nutritionist and believe me it never works. All I am saying is it hard to watch people you care about care so little about fixing their own health problems. As the saying goes, you can lead a horse to water, but you can’t make them drink.

It makes me sad, but I know that all I can do is lead by example and live my best life. So that is what I am doing.

I am very proactive when it comes to my health and since my last labs, I have gotten pretty serious about making sure I don’t have some sort of coronary event if I can help it.

I had basic labs done, a complete metabolic panel, complete blood count, thyroid panel, iron panel, and an advanced lipid panel called the CardioIQ through Quest Diagnostics which looks at lipoproteins in more depth.

I’ll kind of summarize what my nurse practitioner said in the visit summary about the labs and then I’ll talk a bit more about them.

She says my iron markers look fine but ferritin is slightly low. She didn’t think this was related to my fatigue which waxes and wanes. I have to agree because my fatigue is always better if I eat a ton of veggies.

My thyroid labs were stable so I am continuing on my current dose of medications. I have been taking Ashwagandha and Maca and it lowered by TSH and Free T4 but kept my Free T3 in the normal range. Reverse T3 is at 10 with a range of 8-25 through Quest Diagnostics.

My insulin resistance had improved quite a bit. This is looking at insulin, C-peptide and a calculation called insulin resistance score. This is good news because insulin resistance is one thing that will cause you to hold on to and create fat tissue which gets worse as we age. It looks like it is exercise for the win here!

My basic lipid panel or cholesterol panel had improved from the last one but I think it was off because I had a matcha latte on the way to the lab draw without even thinking and these are supposed to be fasted lab draws. The  one thing she noted was the low HDL at 43 and should be between 65-85 for a woman my age and physical activity. In the last 2 years there has not been much time I have missed a workout lifting a minimum of 2 days a week but for much of the last 2 years, it was 3 days a week plus some other kind of activity 2 other days in the week. Prior to my foot problem, I was walking almost daily and swimming laps here and there and doing things like elliptical and sprints or high intensity intervals. Exercise should help raise HDL so given mine is staying low she thinks there might be a genetic component to it. The Cardio IQ panel reveals a high Lp (a) [Lp little a] but my vascular specific marker is in normal range. The lipoprotein fractionation is all abnormal with a pattern B overall.

I will explain what these markers are and what they mean as best I can for the layperson to better understand.

Let’s first understand what cholesterol is.

Every cell in your body makes cholesterol because cells need it - it’s part of their make up. Cholesterol is the reason why your cells are fluid meaning things are allowed to cross the cell membrane both in and out. That is how sugar gets in to your cells as well as hormones and other things. It’s also how things that are no longer needed leave the cell.

Your body needs cholesterol to make all the hormones from vitamin D to sex hormones to thyroid hormone.

We need it to make bile. Bile helps break down fats and it helps remove toxins from the body. Bile is what makes your stool dark brown.

Not every part of the body makes all the cholesterol it needs so we need lipoproteins to carry it through the blood. This is where HDL and LDL come in.

HDL is made of apolipoprotein(a) or apo(a). LDL is an apoB. According to Peter Attia MD there is no difference between HDL and LDL cholesterol so calling one good and one bad is not correct. The reason LDL is called bad is because it is the one that infiltrates the wall of an artery and becomes oxidized or damaged. This oxidized cholesterol molecule enters the tissue of the artery which activates your immune system and other things to help with that inflammation and this is what leads to ‘hardening of the arteries’ or atherosclerosis.

Knowing your apoB separately from your LDL will give you a better idea what kind of cardiovascular disease risk you have. ApoB actually causes damage to your arteries years before you would even notice. ApoB actually rises in menopause too.

My  Cardio IQ test showed apoB was in the normal range at 82 with optimal being below 90. Others believe a healthy range is around 60 mg/dL so if I follow that, then mine is high.

The test also went over particle size such as VLDL or very low density cholesterol. The VLDL is the type that causes atherosclerosis so you want to know what that is. These particles are what infiltrate the wall of your artery or vessel. This is not good.

The Lp(a) is part of apolipoprotein(a) which is bound to apo(B). Lp(a) plays a role in repairing things, rises in inflammation, scavenging. When high it gives an increased risk of cardiovascular events. This is as deep as I am going with this explanation because it is very very complicated to explain and if you want a deep dive follow Peter Attia MD’s podcast The Drive.

What can you do to help improve your cardiovascular health?

First of all, it has been said that hypothyroid patients tend to have higher cholesterol. I could be completely wrong about this but I think it is because T4 only medications are keeping many patients at suboptimal health.

Getting your thyroid in it’s sweet spot will be good. You also want to avoid smoking. It is one of the biggest risk factors for cardiovascular disease and it’s just gross. I’m married to a smoker and grew up with smokers.

There are pharmaceutical drugs you can take such as statins but I’m not a fan of pharmaceuticals unless absolutely necessary.

Avoiding type 2 diabetes is preventative. You can take my Nutrition and LIfestyle for PreDiabetes course on my website to get a start on simple diet and lifestyle changes you can make to prevent yourself from becoming a type 2 diabetic.

Keep your blood pressure in check.

Know your calcium score if you are over 50 so you know your risk for CVD.

Get your weight in check. Easier said than done with hypothyroidism and even with inflammation. But things like diet changes, knowing what is causing the inflammation and even exercise are very helpful in getting your weight down if you need to.

The quality of the food you eat is important as well. I’ve talked about this a lot so if this is your first episode, you will learn more about this as you listen to other episodes.

Get your sex hormones balanced. Know that your cholesterol levels are different depending on what phase of your cycle you are in. HDL is highest at ovulation, Total and LDL cholesterol both rise after your period starts and peak in the follicular phase. Getting your cholesterol checked during your period is the most ideal time to do it.

Know if you have PCOS.

Focus on healthy fats such as olive oil, coconut oil, grass fed butter. Fiber consumption through vegetables and fruits should be around 30g per day. Most people don’t get half that. It’s okay to include whole grains such as brown rice and quionoa. Avoid processed foods as much as possible. Don’t over eat.

Exercise as I said before. The more fit you are the better off you are. It will lower your CVD risk.

Manage both physical and psychological stressors.

Niacin can reduce Lp(a) in the amount of 1-3grams of niacin- the kind that causes flushing. I took 500mg my first round and I had terrible flushing in my face for a few hours. It wasn’t uncomfortable but my face was really hot!

Hormone therapy for menopausal women can help as well but if you are more than 5 years post menopause, I don't recommend that. Also, Lp(a) doesn’t go up significantly so likely not anything to worry about.

Consume more monounsaturated fatty acids like avocados, olive oil, almonds, pecans, cashews, and peanuts. In general, consume a Mediterranean style diet as it is the most well studied in cardiovascular disease prevention. Be sure you are getting a minimum of 30g of fiber per day. This has been shown in the research to improve cardiovascular risk factors.

I’ll keep you posted on the results of my supplement and diet regimen and whether or not they are helping. I am taking fish oil, time released niacin, pantethinic acid, and curcumin.

If you need supplements, this is a friendly reminder that you can get them 10% off from my dispensary at https://us.fullscript.com/welcome/hfh

You can sign up for my newsletter on my website and when you do you get the definitive guide to Hashimotos  https://mailchi.mp/0e5555d60258/the-definitive-guide-to-hashimotos

Please leave a review on the apple podcasts so other people can find the show, if you don’t like something let me know so I can fix it.

Thanks for listening. Bye everybody.