Authored by Dr. Cassie Wilder

There is a lot of talk about high cholesterol being the ultimate risk factor for cardiovascular disease. While I think that having high amounts of cholesterol is not beneficial to your heart, I also want to talk about a different perspective.

What if it’s not the amount but the status of your cholesterol that is the most harmful?
 
An underutilized blood biomarker can potentially predict just how risky your cholesterol is and it’s called oxidized LDL. You may recognize LDL as the ‘bad cholesterol’ as its sent out by the liver to do all sorts of anti-inflammatory, hormone building tasks, while its counterpart HDL ‘good cholesterol’ is the scavenger that brings all those LDL’s home, removing them from the blood stream. Researchers are finding that LDL may not be inherently bad, meaning that if well taken care of, they can actually do their job correctly without contributing to heart disease. So how do you know if yours aren’t being well taken care of?
 
That's where OX-LDL comes in. When your LDL become oxidized (sort of like salmon becoming rancid and foul if you left it sitting on the counter all night) it makes your LDL become stickier and prone to plugging up your arteries. What types of things increase free radicals and cause your LDL to become oxidized?

1. Cigarette smoking
2. Consumption of sugars or having blood sugar dysfunction, like type 2 diabetes
3. Immune system activation (autoimmunity, chronic infections)
4. Inflammation (i.e. from chronic pain, gut dysbiosis, ‘leaky gut’ and autoimmunity, amongst others)
5. Stress (from cortisol excess)

 
You’re probably wondering how you would know if you have high levels of oxidized LDL. Well, some assumptions can be made based on how many diet and lifestyle risk factors you have that contribute to oxidation. However, the best way to know is to do blood testing. Once we have a numerical value on your OX-LDL, we can make a personalized plan just for you that takes into account all of your health history, family history, genetics, and lifestyle needs.
 
There are many ways that you can naturally deal with oxidative stress and you would guess, antioxidants are generally the treatment of choice. A few treatments that have been studied to decrease the number of OxLDL include vitamin C1, vitamin E2, and the Mediterranean Diet3! As a Naturopathic Doctor with a passion for heart health, I’ve found that it’s not always about just treating the oxidation status – a well designed treatment plan takes into account the whole person and helps you eliminate the cause of your free radicals. Whether that be help with smoking cessation, nutrition counseling, or correcting autoimmunity, you have to treat the whole person to achieve optimal heart health.
 
 
References

1. Pancorbo D, Vazquez C, Fletcher M. Vitamin C-lipid metabolites: uptake and retention and effect on plasma C-reactive protein and oxidized LDL levels in healthy volunteers. Medical Science Monitor: International Medical Journal Of Experimental And Clinical Research [serial online]. November 2008;14(11):CR547-CR551. Available from: MEDLINE Complete, Ipswich, MA.
2. Huang Z, Liang C, Han S, Wu Z. Vitamin E ameliorates ox-LDL-induced foam cells formation through modulating the activities of oxidative stress-induced NF-κB pathway. Molecular And Cellular Biochemistry [serial online]. April 2012;363(1-2):11-19. Available from: MEDLINE Complete, Ipswich, MA.
3. Fito M, Guxens M, Corella D, et al. Effect of a traditional Mediterranean diet on lipoprotein oxidation. Arch Intern Med. 2007;167:1195-1203.

Authored by Dr. Wilder

Magnesium has been a favorite mineral in the Naturopathic community for quite some time now. It has been studied for numerous different reasons ranging from regulating bowel movements, treating insomnia, to lowering your blood pressure – all with powerful, positive results.
 
If you are looking for additional support to your high blood pressure medications, you can look to the research studies on magnesium to find some pretty neat outcomes.
 
Magnesium has been shown to act similar to a calcium channel blocker (aka Verapamil or Amlodipine if you’re checking your medicine cabinet now), as well as a potent smooth muscle relaxant that can allow your arteries to open up wider and allow more blood to flow through. With your arteries open wide, your heart doesn't have to pump as hard to get the blood out to your body! 
 
Some studies have shown magnesium can lower blood pressure as much as 5 points (mmHg) on the top number and 3 points (mmHg) on the bottom number1. Considering that a reduction in blood pressure by 5mmHg can reduce stroke deaths by 14% and heart disease deaths by 9%2, I would say magnesium could be a very safe and effective additive therapy to existing blood pressure lowering medication.
 
When taking a Naturopathic approach to lowering blood pressure, it’s not just substituting a pharmaceutical for a ‘natural’ version of the same pill. You have to treat the whole person, which means tackling the blood pressure from many different angles and ultimately reducing your need for the pharmaceutical.
 
When you’re my patient, here are some questions I’ll ask that give us a great place to start:

1. What dietary changes that can be made to lower your blood pressure?
   Eating a diet that is full of colorful vegetables, quality protein sources, and healthy fats help to decrease inflammation. By decreasing inflammation, you decrease the amount of plaque building up and ultimately reduce the pressure necessary to push past those plaques.
   
   
2. What lifestyle changes can be made to lower blood pressure?
   Did you know that high amounts of stress can cause you to pee out your extra storage of magnesium? By adding in stress reduction methods, and encouraging proper stress response through adrenal support, you can improve blood pressures and magnesium storage. Doing your best to incorporate daily movement is also highly beneficial in blood pressure reduction. This doesn't mean just high intensity exercise; taking a 30-minute walk per day can also provide valuable reduction in pressures!
   
   
3. What other personal health history is contributing to your high blood pressure?
   Conditions such as iron deficiency anemia and testosterone deficiency also contribute to high blood pressure. We will take a thorough look at everything from your gut function to your mental-emotional health to start targeting the individualized reasons your blood pressure is elevated.

 
If you’re on the market for a quality magnesium supplement that will help to increase your magnesium stores, and provide valuable heart benefit try magnesium taurate, malate, glycinate or a chelated form (bisglycinate chelate). These forms are well absorbed by the gut, and are highly absorbable by the tissues to increase your magnesium stores.r  
 
References:
1. Houston M. The Role of Magnesium in Hypertension and Cardiovascular Disease. Journal of Clinical Hypertension 2011; 13(11): 843-847.
2. Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, Winston MC, Karimbakas J. Primary pre- vention of hypertension: clinical and public health advisory from the National High Blood Pressure Education Program. JAMA 2002; 288:1882–1888.

Authored by Dr. Wilder

When it comes to searching for the root cause of or factors that contribute to heart disease, it’s imperative that you look outside of the heart.

If you’re one of the 14 million individuals living with Hashimoto’s thyroiditis1, the time is now to start thinking about how to prevent heart disease.

Hashimoto’s thyroiditis is an autoimmune condition where your own body's immune system cells attack your thyroid gland. Over time, the thyroid becomes damaged and its ability to release hormones decreases, giving you symptoms of under-active thyroid (hypothyroid). You receive a diagnosis of Hashimoto’s by measuring specific antibodies (anti-thyroid peroxidase antibody and anti-thyroglobulin antibody) in the blood, and if they come back elevated it's a good indication that you have autoimmunity to your thyroid gland.

Many research studies have shown that hypothyroidism leads to an increase in risk of heart disease5,7, but it’s now being researched how autoimmune thyroid conditions may also be a risk factor for atherosclerosis (build up of plaque on artery walls) and ischemic heart disease (heart not getting enough oxygen).
 
A clinical finding of Hashimoto’s thyroiditis that is not always talked about is the chronic low-grade inflammation that it causes3. The persistent antibodies that are being produced by your immune system orchestrate the recruitment of white blood cells to deal with the antibodies. These white blood cells release chemical messengers that trigger this chronic inflammation4,5.
 
The activation of these inflammatory messengers causes an increase in the amount of oxidative stress that is put on your body, which not only reduces your own body's antioxidant storage, but can lead to damage of your blood vessel lining2. When your blood vessel lining gets damaged, its cholesterol’s job to come in and patch that up causing what is widely known as plaque.
 
You can assess your levels of inflammation and risk of heart disease by having your doctor run a high-sensitivity CRP (hs-CRP) or serum homocysteine lab. An imaging test that can be helpful is a carotid intima media thickness test6. This non-invasive ultrasound could be helpful in determining your heart disease risk in subclinical hypothyroid or Hashimoto’s by seeing how much plaque is built up in your arteries.
 
So what are some things you can you do to reduce your risk of heart disease?

1. Incorporate an anti-inflammatory diet this is high in colorful vegetables, quality protein sources, and good fats. This can help to combat the inflammation that is being caused by the antibodies. It will not only help protect the blood vessel lining, but can protect the thyroid gland from further damage.
2. Balance your immune system.
3. Increase your antioxidant stores by eating dark berries, or supplementing with Hawthorne to quench the free radicals being caused by the antibodies.

 
 
References:

1. Hashimoto's Thyroiditis: Information for Patients page. The American Association of Clinical Endocrinologists (AACE) Web site. Available at: http://www.aace.com/pub/thyroidbrochures/pdfs/Hashimoto.pdf. 2005. Accessed April 27, 2010.
2. Taddei S, et al. Low-Grade Systemic Inflammation Causes Endothelial Dysfunction in Patients with Hashimoto’s Thyroiditis. J of Clin Endocrinology & Metabolism. 2006; 91(12):5076-5082.
3. Libby, Peter. Inflammatory Mechanisms: The Molecular Basis of Inflammation and Disease. Nutrition Reviews. 2007; 65(12):S140-146.
4. Nanda N, Bobby Z, Hamide A. Inflammation and oxidative stress in hypothyroids: additive effects on cardiovascular risk. Indian Journal Of Physiology And Pharmacology [serial online]. October 2011;55(4):351-356.
5. Isgüven P, et al. Effects of Thyroid autoimmunity on Early Atherosclerosis in Euthyroid girls with Hashimoto’s Thryroiditis. J Clin Res Pediatr Endocrinol 2016;8(2):150-156.
6. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta- analysis. Circulation 2007;115:459-467.
7. http://www.ncbi.nlm.nih.gov/pubmed/15249698

 

Q: What made you decide to become a naturopathic doctor?
A: I’ve always wanted to be a doctor (besides the few months I wanted to be an Olympic gold medalist or the few years I wanted to be Elle Woods in Legally Blonde). I realized that my love for puzzles, science, and getting to know and interact with other humans would make me a really great doctor. I did hospital rotations while in undergrad and was not inspired to continue on that career path. Instead of entering that system and attempting to change it, I found a branch of medicine that combined all my love for modern technology and science with the expanded holistic tool box that can target specific biochemistry and make people better. I knew in that moment I was destined to be a Naturopathic Doctor.
 
I chose to go into Cardiology because of my curiosity and fascination with the heart’s physiology (I’m a details person, I couldn't resist!). I chose to stay in the specialty because I found there was a lot of fear-based decision making on the patient’s end to make quick decisions, especially when they are being told there are life-altering consequences on the line. During my internship, I found that if the doctor and the patient were all on the same page about risks, benefits, possibilities of adverse events, set specific guidelines and goals we could all work together to positively benefit their heart health. That's my practice philosophy – to have open lines of communication, collaborate with my patients, and have clear expectations and goals we are working towards. When we all do our part, your heart reaps the rewards.
 
Q: Tell us about a time you really connected with a patient and went above and beyond to meet their needs.
A: I’ll never forget a patient I followed in my internship, Q. He had been seeing my attending physician for quite some time with several heart issues (valve disease, arrhythmias, hypertension and eventually an enlarged heart) and we were working through all the holistic therapies in our tool box to get to the root cause, mitigate risks of adverse events, and ultimately heal his heart. He was getting better, so much better. His blood pressure came down, his arrhythmias were under better control, and his heart was healing.
 
There came a point in his treatment where we had to discuss risks and benefits of getting his valve replaced, and analyze the benefits his valve was getting with our current therapies. We ultimately decided that it would be the best decision to get the valve replaced and we (yes, we!) started interviewing surgeons. We advised him on his surgical options, and picked one we thought would be best for him and sought out to find a surgeon who could do it, and do it well. I followed that patient into the surgical room to observe and then post-surgery put him on a great healing protocol! He recovered quickly and was back to being the best version of Q possible!
 
Q: What is your favorite meal?
A: My favorite meal is chicken jambalaya, extra spicy. My grandma used to make that meal for me all the time as a child and when I came home from college, and it holds a lot of nostalgic memories for me. She spent her last Christmas eve teaching me how to make it the ‘right’ way, the way grandma always made it.
 
Q: How do you spend your free time?
A: I spend as much of my free time outdoors as I can! One of the biggest draws for me to move to Minnesota was the availability of year round outdoor activities! My husband, Sam, and I love to go skiing in the winter, and spend our summers hiking, camping, and hanging out at the lake. There’s just something about being in nature that reenergizes my spirit.