February is American Heart Month. Learn about heart disease in women and what you can do to keep a healthy heart.
Get Informed: Facts on Women and Heart Disease
- Heart disease is the leading cause of death for women in the United States.
- Although heart disease is sometimes thought of as a “man’s disease,” around the same number of women and men die each year of heart disease in the United States.
- Some conditions and lifestyle choices increase a person’s chance for heart disease, including diabetes, overweight and obesity, poor diet, physical inactivity, and excessive alcohol use.
- High blood pressure, high LDL (low-density lipoprotein) cholesterol, and smoking are key risk factors for heart disease. LDL is considered the “bad” cholesterol because having high levels can lead to buildup in your arteries and result in heart disease and stroke. Lowering your blood pressure and cholesterol and not smoking will reduce your chances for heart disease.
While some women have no symptoms of heart disease, others may experience heavy sharp chest pain or discomfort, pain in the neck/jaw/throat, or pain in the upper abdomen or back. Sometimes heart disease may be silent and not diagnosed until a woman has signs or symptoms including:
- Heart Attack: Chest pain or discomfort, upper back pain, indigestion, heartburn, nausea/vomiting, extreme fatigue, upper body discomfort, and shortness of breath.
- Arrhythmia: Fluttering feelings in the chest.
- Heart Failure: Shortness of breath, fatigue, swelling of the feet/ankles/legs/abdomen.
- Stroke: Sudden weakness, paralysis (inability to move) or numbness of the face/arms/legs, especially on one side of the body. Other symptoms may include confusion, trouble speaking or understanding speech, difficulty seeing in one or both eyes, shortness of breath, dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache.
Heart disease is largely preventable.
Listen to CDC’s Dr. Bowman discuss ways to prevent heart problems.
What You Can Do for Heart Health
You can lower your chance of heart disease and a heart attack by taking simple steps.
- Eat a healthy diet with fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products. Choose foods low in saturated fats, cholesterol, salt (sodium), and added sugars.
- Exercise regularly. Adults needs 2 hours and 30 minutes (or 150 minutes total) of exercise each week. You can spread your activity out during the week, and can break it up into smaller chunks of time during the day.
- Be smokefree. If you are ready to quit, call 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers) for free resources, including free quit coaching, a free quit plan, free educational materials, and referrals to other resources where you live.
- Limit alcohol use, which can lead to long-term health problems, including heart disease and cancer. If you do choose to drink, do so in moderation, which is no more than one drink a day for women. Do not drink at all if you are pregnant.
- Know your family history. There may be factors that could increase your risk for heart disease and stroke.
- Manage any medical condition you might have. Learn the ABCS of heart health. Keep them in mind every day and especially when you talk to your health provider:
- Appropriate aspirin therapy for those who need it
- Blood pressure control
- Cholesterol management
- Smoking cessation
Have you recently experienced a major stress in your life, be it illness, job, death, children, etc? After this stress, have you felt as though you just cannot seem to get yourself together, or at least back to where you used to be? Are you usually tired when you wake up, but still “too wired” to fall asleep at night? Is it hard for you to relax or to get exercise? Do you find that you get sick more often and take a long time to get well? If so, then you, like many other Americans may be experiencing symptoms of Adrenal Fatigue.
Adrenal fatigue is not a new condition. People have been experiencing this condition for years. Although there is increasing physician awareness, many are not familiar with adrenal fatigue as a distinct syndrome. Because of this lack of knowledge, patients suffer because they are not properly diagnosed or treated.
Adrenal fatigue is a condition in which the adrenal glands function at a sub-optimal level when patients are at rest, under stress, or in response to consistent, intermittent, or sporadic demands. The adrenal glands are two small glands that sit over the kidneys and are responsible for secreting over 50 different hormones—including epinephrine, cortisol, progesterone, DHEA, estrogen, and testosterone. Over the past century, adrenal fatigue has been recognized as Non-Addison’s hypoadrenia, subclinical hypoadrenia, neurasthenia, adrenal neurasthenia, and adrenal apathy.
Generally patients who present with adrenal fatigue can often be heard saying, “After______, I was never the same.” The onset of adrenal fatigue often occurs because of financial pressures, infections, emotional stress, smoking, drugs, poor eating habits, sugar and white flour products, unemployment and several other stressors. After experiencing many of these events over a long period of time, the adrenal glands tend to produce less cortisol, the body’s master stress hormone. Cortisol’s main role in the body is to enable us to handle stress and maintain our immune systems. The adrenal gland’s struggle to meet the high demands of cortisol production eventually leads to adrenal fatigue.
Patients with adrenal fatigue have a distinct energy pattern. They are usually very fatigued in the morning, not really waking up until 10 AM, and will not usually feel fully awake until after a noon meal. They experience a diurnal lull in their cortisol (the stress hormone produced by the adrenal gland) and as a result, they feel low during the afternoon, generally around 2-4 PM. Patients generally begin to feel better after 6 PM; however, they are usually tired after 9 and in bed by 11 PM These patients find that they work best late at night or early in the morning.
Some key signs and symptoms of adrenal fatigue include salt cravings, increased blood sugar under stress, increased PMS, perimenopausal, or menopausal symptoms under stress, mild depression, lack of energy, decreased ability to handle stress, muscle weakness, absent mindedness, decreased sex drive, mild constipation alternating with diarrhea, as well as many others.
Although there no specific tests that will provide a true diagnosis of adrenal fatigue there are tests that may contribute to an assessment, such as a postural hypotension test, an AM cortisol test, or an ACTH stimulation test. It is customary for a physician to assess the adrenals together with thyroid tests to rule out insufficiency, which sometimes occurs in long-standing hypothyroidism.
A single determination of plasma cortisol or 24-hour urinary free cortisol excretion is not useful and may be misleading in diagnosing adrenal insufficiency. However, if the patient is severely stressed or in shock, a single depressed plasma cortisol determination is highly suggestive. An elevated plasma ACTH level in association with a low plasma cortisol level is diagnostic.
Treatment for adrenal fatigue is relatively simple. Lifestyle modifications can be initiated to treat this condition. Simple changes such as more laughter (increases the parasympathetic supply to the adrenals), small breaks to lie down, increased relaxation, regular meals, exercise (avoiding any highly competitive events), early bedtimes and sleeping until at least 9 AM whenever possible can all benefit those experiencing adrenal fatigue.
A diet that would be conducive to treating adrenal fatigue includes one that combines unrefined carbohydrates (whole grains) with protein and oils (nuts and seeds) at most meals—olive, walnut, fiber, flax and high-quality fish oil. It is also important for patients to eat regular meals, chew food well, and eat by 10 AM and again for lunch. Patients should look to avoid any hydrogenated fats, caffeine, chocolate, white carbohydrates, and junk foods. Diets should have a heavy emphasis on vegetables. It may be of additional benefit that patients add salt to their diet, especially upon rising and at least a half-hour before their lowest energy point of the day. (Preferably, 1/8 to 1/2 teaspoonful of sea salt, Celtic salt, or sea salt w/kelp powder added to an 8 oz glass of water). In adrenal fatigue, one should not follow the USDA’s Food Guide Pyramid, as these patients tolerate fewer carbohydrates and need more protein.
The addition of nutritional supplements may also offer additional benefits to patients experiencing adrenal fatigue. They should consider the addition of:
- Vitamin C 2,000-4,000 mg/day Sustained Release
- Vitamin E w/mixed tocopherols 800 IU/day
- Vitamin B complex
- Niacin (125-150 mg/day) – as inositol hexaniacinate
- B-6 (150 mg/day)
- Pantothenic acid (1200-1500 mg/day)
- Magnesium citrate (400-1200 mg)
- Liquid trace minerals (zinc, manganese, selenium, chromium, molybdenum, copper, iodine)– calming effect
- If depression is present – Add SAM.e 200 mg bid; DL-Phenylalanine (DLPA) 500 mg bid
Some herbal remedies that have been noted as possible therapies include Licorice, Ashwagandha, Maca, Siberian Ginseng, Korean Ginseng. Note: Licorice can and, if taken over time, does have a propensity to elevate blood pressure. It should not be used in persons with a history of hypertension, renal failure, or who currently use digitalis preparations such as digoxin.
Under the supervision of a physician hormone supplementation with DHEA, Pregnenolone, and Progesterone may also offer some benefits. There are several glandular extracts on the market that contain adrenal, hypothalamus, pituitary, thyroid, and gonadal that are also often recommended.
Sometimes the initiation of hydrocortisone (Cortef®) may be necessary as a replacement hormone when cortisol is not being produced by the adrenals. While the initiation of corticosteroids, such as hydrocortisone may have quick and dramatic results, they can sometimes make the adrenals weaker rather than stronger. As a result, the initiation of hydrocortisone is usually a last resort. It is important to note that patients may have to undergo treatment for 6 months to 2 years.
While a cortisol measurement may be helpful to confirm any thoughts or ideas that a patient may have decreased adrenal function, typically blood cortisol levels would be tested along with blood levels of potassium, and sodium. If the pituitary gland is the cause of adrenal failure electrolyte levels are usually normal. Practitioners usually pay attention to extremely low cortisol levels, which generally diagnoses Addison’s disease—a condition in which the adrenal glands are completely depleted, also considered a medical emergency.
As a society, we are acutely exposed to daily stresses, be they emotional, physical, or mental. Work situations, family changes and obligations, changes in our bodies and in our health–all of these can contribute to the stress demands on our bodies. Our bodies respond to these stresses in a similar fashion despite the source. Physiologically, each time we are exposed to stresses, our adrenal glands respond by producing certain hormones. One part of the adrenal gland, the adrenal cortex, responds to long and short-term stresses, while the adrenal medulla responds to sudden or alarm situations, producing our “fight or flight” response. With the amount of stress we are exposed to each day, you’d think our adrenal glands were of considerable size, but that isn’t the case. Our adrenals weigh about 5 grams each and reside in our bodies just above our kidneys in the low back area. For small glands, they play an enormous role in our health. Their function also tends to decline over a person’s lifetime, leading some researchers to coin a new term “adrenapause” to define this loss. As such, we need to have ways in which we can keep our adrenal glands healthy.
From a preventive standpoint, we can reduce our exposure to certain stresses, as well as change the degree to which we allow stresses to affect us. This involves making choices about what we subject ourselves to, as well as how we respond to situations we can’t avoid or change. The amounts of hormones, specifically glucocorticoids and catecholamines, that are released by the adrenal glands are directly related to the amount of stress the body endures, and these hormones can affect nearly all the tissues in our bodies. Individuals exposed to long-term stress have higher circulating glucocorticoids than a person who is unstressed does. Certain lifestyle changes, such as exercise, meditation, breathing exercises, and yoga, have all been demonstrated to ease our response to stress. Those who incorporate one or more of these into their days are noticeably more resilient to daily stresses.
We can also address adrenal health through nutritional support and herbs. Vitamin C and the B-complex vitamins are crucial to adrenal health. Being water-soluble vitamins, they are easily depleted and may need regular supplementation, especially in times of stress. Vitamin C is stored in high concentrations in the adrenal glands, which is evidence of its need for this important vitamin. It has been shown that a person’s need for vitamin C varies, depending on what their body is going through at the time. Infection, for an example, can increase the body’s need for vitamin C considerably. Herbs which address adrenal health are referred to as adaptogens, because they help the body adapt to changes, or stresses. Some of the most notable herbs utilized for adrenal support are licorice, ginseng, and astragalus. Astragalus has long been used in Chinese medicine as a tonic. Research has demonstrated its value in enhancing immunity through multiple mechanisms. Ginsengs are commonly prescribed to increase energy and support adrenal function. Research has demonstrated improved functioning under stress as well as increased working capacity following ginseng use. For women, Siberian ginseng appears to be the most appropriate of the ginsengs, as from a Chinese medicine perspective, it is more cooling (less likely to induce hot flashes) and can be used on a regular basis. Borage leaf also provides specific support to the adrenal cortex and can be used daily to support adrenal health.
Diet is another factor that plays a strong role, as it can supply the body with nutrients as well as deplete the adrenals, depending on what choices are made. For example, sugar and caffeine tend to draw energy from the adrenal glands, so stay away from them during times of stress or if you are working at improving adrenal health. In contrast, nutrients that are found in fresh fruits and vegetables supply healthy support for the body. Nutrient-rich foods, like kelp and other seaweed, are good sources of key vitamins and minerals important to glandular health.
A balanced program for supporting adrenal health includes scheduling time to exercise and taking some time for you to be mindful of your stress level and facilitate adjustments when necessary. Remember that treating health holistically means addressing mental, physical, and spiritual aspects of one’s life, for they all affect one another and can contribute to health as well as disease.
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