Do you go to a cardiologist once you have a problem? Do you go to a cardiologist Is that one of the doctors in your rotation? It should be. We talk about the fact that we're probably reaching people way too late. So, we're seeing them when they're in their 40s and 50s, and they already have cardiovascular disease.And so, we need to be starting much, much earlier. And when you look at women, for example, we talk about the arc of a woman's life and all the risk factors and signs that might present at different stages. So, for example, getting early periods before the age of 11 is a risk factor for women for future cardiovascular disease, which not many women know about. No. When you're in your 20s and 30s, we think about things like polycystic ovarian syndrome or migraines or inflammatory bowel disease or autoimmune conditions like lupus and rheumatoid arthritis.Breast cancer, if you've been treated for breast cancer with chemotherapy and radiation, all these things can predict the fact that you may be at increased risk. And then in pregnancy, pregnancy is a real big window into your risk. So, women who've had preeclampsia, eclampsia, gestational diabetes, early babies, small babies for gestational age or miscarriage, all those things are markers of increased risk. And unfortunately, so many women leave the hospital after delivering and are never told you should see a cardiologist. And then we think about the after period or postmenopause, which we know postmenopausal women or over the age of 55, that is the time of increased risk for women.We start to see cholesterol levels rise. I have women tell me all the time, "My cholesterol levels were fine and now all of a sudden they're going up." Or blood pressure go up. So, we really need to think about the stages of a woman's life and to answer your question, it's never too early to start getting screened or seeing a cardiologist cuz they're going to look at things in a very different way than your primary doctor might or your OBGYN might. Well, it's so interesting because you say having an early period. So, at what age would that be?Oh, younger than 11. Younger than 11? Yeah. I've been asked so many times, "When did your period start?" But then there's never, "Oh my gosh, it started at whatever age it was, maybe you should go see a cardiologist if it's that young." That's That's mind-boggling to me. So, we have some signs starting very, very early.
And we see heart disease on autopsies in people as young as 18, 17. You see fatty streaks in the arteries. So, again, this process is starting at such a young age. I can imagine food makes a difference nowadays. We've got stress that makes a difference nowadays.
We have people that are not as mobile as we used to be. So, I guess I was going to say what do you want every woman listening to know, but I think every woman listening should know to go make an appointment with a cardiologist because, you know, I have to imagine everybody's probably over the age of 20 that's listening to this. Exactly. And, you know, family history is another one, right? So, lots of times you can be the perfect picture of health, but just having as you have, a family history of someone, a parent who had an early heart attack or stroke, that can be enough.
And it increases your risk is whether it's your dad or your mom? Either one. So, if a female had a heart attack or stroke before the age of 65 or male before the age of 55, that is a check in the box of a genetic predisposition to early cardiac to cardiovascular disease. So, that's something that people they don't ask their family, you know, what happened to you or did you have high blood pressure? We need to be asking our family members cuz cuz that's predictive.
But, I think the biggest thing is that we have a lot of tools these days that we can use to pick up an underlying cardiovascular disease that women or men may not know they have. Yeah, let's talk about some of those. So, I do want to address symptoms first of all because I know symptoms in a man and symptoms in a woman are very, very different. They present differently if there's any kind of issue. Can you go over those?
What a woman should possibly be looking for? What a man should possibly be looking for? By and large, the most common symptom both for men and women it will be chest discomfort. And when we say that, it's kind of this big bucket term, but a lot of people will describe it as a pressure, tightness, squeezing, heaviness, burning. Women will sometimes say, "My bra feels too tight, like I want to take it off." So, it doesn't have to be this sort of sharp chest pain that makes you really fall to the ground, but it can be that more subtle like, "Oh, I just feel this sort of knot here." women can also get and men, but jaw pain, shoulder pain on the left side, a feeling of nausea or shortness of breath.
That can be a big one that sometimes is missed. So, if you're short of breath when you're walking fast or walking up hills or walking upstairs or even at rest, that can be a sign. Lightheadedness, fatigue. I ask my patients, "Are you unusually fatigued or exhausted more than you would expect? Have you not been able to exercise as much?" All of those can be signs of cardiovascular disease that people need to pay attention to.
And I know when it comes to women, there are certain other indicators. We talk a lot about menopause or perimenopause. Hot flashes are an indicator there could be something going on. Is that correct? Well, hot flashes we think of as this vasomotor dysfunction.
And it does seem like lots of times women who have hot flashes may then go on to be predisposed to some sort of cardiovascular disease. So, there's something again about the way the vessels are responding. So, the same way that we talked about pregnancy as this time where we're predicting what might happen, certainly that vasomotor dysfunction may also be predictive as well. So, let's talk about some of the things that we have for preventative. First of all, you want everyone to go see a cardiologist.
You have You have 17 patients today, so I'm not sure if you have any room. I have room I have room in my in total. I have room for one more. Have one more, so you know what? Good news, we can you know, get somebody in there.
What are some of the things and some of the tools that you have right now that maybe we didn't have before? Yeah, so we have something called a calcium score, which I love. So, this is a very quick CAT scan of the heart. It takes 5 minutes. It is no contrast.
It is very low radiation, about the same as a chest X-ray. It generally costs about $100. And what it does is it looks for spots of calcified or hardened plaque in the heart arteries. And you get a number. If your score is zero, that's great.
You're considered low risk. Anything zero to 10 is sort of low, 10 to 100 is moderate, above 100 is a high-risk person. So, this helps us risk stratify people. We also have blood tests. So, there are newer blood tests in addition to lipid panels, which a lot of people know about.
We have something called lipoprotein A, Lipoprotein A. LP little A. This is a genetically inherited bad cholesterol, not controlled by diet or exercise. One in five people worldwide have a high LPA. That is associated with an elevated risk of heart attack and stroke and aortic valve disease.
We have other markers like apoprotein B and CRP, which is a marker of inflammation. And then we have what we call risk calculators. So, the most common one in cardiology we use is called Prevent. You can go online today and Google the Prevent Risk Calculator and easily put in your age, some of your numbers, even your zip code in some cases and some other factors, and it will give you a 10-year and a 30-year risk of having a cardiovascular disease event. So, these are some of the things we use to really look at someone, take their history, take their numbers, and give them a sense of what their risk is.
Tell me the name of that last one cuz that's Prevent. Prevent. For 10 and 30-year risk. Yes. That's amazing.
Yes, so it's really helpful because for a lot of people they want to know those numbers. They want to advocate for themselves, and maybe that pushes them to think about things like blood pressure medicine or statins or aspirin when maybe they wouldn't have in certain cases. All right, we'll put that in the show notes to make sure that, you know, people can jump on there and see, you know, fill it out and see what You You have more than one You need more than one slot available. Let's talk about some of the preventative things. I mean, we know some of the things that are out there that we talk about in terms of lifestyle.
Can we go over those and maybe any changes that you're seeing, any new information that you're seeing these days? Yes, so the only things we talk about in cardiology that you can't control are your age and your family history. 80% of cardiovascular disease is preventable by lifestyle. So, what do we mean by that? We mean making sure that you're exercising. And then general recommendations are about 150 minutes a week of moderate cardio that's intensity or 75 minutes of vigorous cardio.
We talk about a heart-healthy diet, the Mediterranean diet, the more vegetarian or vegan or plant-based diets, and then the DASH diet. It's called the Dietary Approaches to Stop Hypertension. These are all very heart-healthy diets. Sleep. Getting about 7 to 9 hours of sleep is really critical.
I will tell you in New York City when I ask people about all these things, you know, 80% of people say that their sleep is off. That is a big, big problem in this country that people are not getting enough sleep. Is it a big risk factor for heart disease? It is because a lot of things happen when you sleep at night that you just think it's this dead zone quiet time, but actually a lot of processes happening in your body. And so, sleep is critical for a lot of these functions of our hormones, of our brain, of our cardiovascular system.
Other things to think about would be stress and mental health. This is a big one that I talk about. So, mental health conditions like anxiety, depression, PTSD, we really want to have those nicely well managed cuz that affects your cardiovascular risk. Stress is a big one. So, making sure that you're finding ways to dial down the stress response is important.
And then really knowing your numbers and taking control of them. So, for example, blood pressure, making sure your blood pressure is in a normal range, which is generally 120 over 80. Your cholesterol numbers look good. Your body mass index, your height-weight ratio, and your sugar. You want to make sure you don't have pre-diabetes or diabetes.
Are you seeing changes to people's numbers now? I know that GLP-1s is a big conversation. We've had a couple of different episodes on it. Those are some of the very popular episodes because a lot of new questions are coming in. Are you seeing that impact numbers in a in a positive way or what are we looking at right now?
I will say this is really revolutionized how we've been able to care for our patients and it's been incredible as a doctor who's been practicing to kind of see this come out and see the impact it has not only on people's mental well-being and how they feel and they're able to exercise more and they just feel generally better self-esteem wise but actually on reducing their cardiovascular risk and we do see the GLP-1s in addition to weight loss the research shows that they actually have separate cardiovascular benefits that we are learning about in terms of lowering blood pressure, lowering cholesterol and potentially having almost like an anti-inflammatory effect and helping the blood vessels. So eventually Tamsen there may come a time where these are not just weight loss drugs, they are cardiac drugs in the same way that we use cholesterol medicine for example. So it's really been a wonderful tool for us to have to help reduce people's risk. You know Wegovy has FDA indication for reducing heart attack and stroke in people who are at higher risk. So it's nice to have this option for people and I have patients on GLP-1s who are 30 years old, I have patients who are 80 years old and they have lost sometimes up to 60 70 pounds on GLP-1s.
People who struggled their whole life with weight. And that's impacting their numbers. It has to be in a very serious way, right? Of course and we know you know and I often tell people it's not just the obesity and how it affects your heart and your joints but also the cancer risk. You know there are seven or eight cancers associated with obesity.
So when you talk about breast cancer and gastrointestinal cancers and reducing the risk of those getting weight in a better place is going to help with that too. I want to also ask about hormone therapy and the protective sides of that. I know there's a lot of women that are scared of hormone therapy. There's a lot of women that have come around and said, "Hey, I'm I'm not scared of it at all." And we're seeing an uptick in the number of people that are starting at at least talk about it if not use it. Is hormone therapy protective for your heart and for cardiovascular health?
This is a great question and I do think that there is still a lot of confusion around this. So, when women get sent to me and they do from their GYN saying, "Can I take hormone replacement therapy?" We talk about the fact that at this point in time, we don't prescribe them for prevention. They are not given to prevent heart disease. However, they are given to women who are low risk, who may be suffering without needing to suffer, who are within 10 years of menopause and under the age of 60. So, there's a whole population of women who may have been afraid to take hormones, may have not been given the option, who now are really able to start using them and feeling better.
So, really getting an evaluation with a cardiologist is a great thing because if you have cardiovascular disease, you have a very high calcium score, or a lot of risk factors, then hormone replacement therapy may not be good for you. On the other hand, if your cardiovascular risk is really low, then this is something that we want women to be able to get. I I really hope that this conversation, I feel like it has been, comes front and center about cardiovascular health and heart health. And I I agree with you, Go Red has done an incredible job talking about that for women, and I feel like we've got to elevate it to that next level because even though we talk about the fact that it is the number one killer, I don't know that we hear it. We don't.
And you know, we see the pink we see the pink ribbons, we see, you know, the the football players every season with the pink. There's just there's not enough out there about heart disease. And it's one in three women. I talk about one in three of our sisters, our best friends, our mothers are dying from cardiovascular disease. You wrote a book, The Healing Power of Resilience.
So, I want to talk a little bit about it. It came out in January, right? What what made you write this book at this time? I've always had a fascination with resilience. You know, what is it that separates people when they face a challenge and one person sort of thrives and the other person really isn't able to.
What is that intangible quality of resilience? And I've seen it happen to me my whole life in every aspect of my life, in friends, in my family members, as a journalist covering stories of people who've demonstrated resilience, and in my patients. And so when Simon & Schuster approached me and said they wanted to write a diet COVID book, what did I think about that? I said, "I mean, I could write that." But they said, "What do you want to write about?" I said, "I really want to write about resilience." And I had already started down this road of exploring this topic when I was at CBS News. And I had done two stories on resilience and understanding the science of it.
So, this was really the natural evolution of my love and passion for this topic and really getting it out there. And as I started to write it and I really I realized, you know, this isn't just important for everyone, but I really recognized the gap in really educating people about how to build resilience in the medical field. That we just don't do a great job connecting the dots between psychology and physical health. And, you know, too often patients are given a diagnosis and sent out the door. And that is a form of trauma when you're told you have heart failure, you've had a stroke, or you have breast cancer, the reaction in the body and in people is the same as if they've suffered a collapse of their business or they've lost their home in a fire.
It is completely paralyzing for people. And so my hope is that, you know, women and men are able to take this concept and hopefully hospitals and institutions hear it and they build resilience training programs. It would be fascinating because that's not part of the prescription. No. You know, you're making it part of the prescription right now.
But how do you define resilience? Because we do look at that and we're that's what we're enamored by, I think, with people, right? We look at their strength, how they deal with certain things, how they wake up the next day and are positive about it or move forward despite all odds. How do you how do you define it? It's a great question and I think there are a lot of different definitions out there.
When I was writing the book and researching all the different psychology definitions of it. I really wanted to kind of come up with my belief of what resilience really is. And it is not this concept of going back to what you were. And I think, you know, that is really what a lot of people think resilience is. Well, I just have to go back to where I was before whatever the traumatic event happened.
That means I'm resilient. And what resilience to me is is not moving backwards. It's what I call bouncing forward. So, it's taking what happened to you and creating a new normal, a new vision, a new future that can be just as wonderful and beautiful and where you can derive just as much meaning, but it just looks different. You might be a little bit different, but that doesn't mean that you can't pull every little morsel of joy out of life.
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Correct? My father's a cardiologist. My mother's a nurse. Oh, okay. Yeah.
Well, you got some medical there. A lot of medical. Did you grow up? Did you Did you grow up with just that was the norm all around you? Yeah, I mean, I you know, my father was like this larger-than-life figure.
He's from India. He came here as an immigrant, you know, with no money and built his whole career and actually ended up being really one of the leaders in the field of cardiac electrophysiology. And so, I would watch him go and lecture around the world. And when I was a little girl, I would actually go to the hospital with him and make rounds. And I loved being in the hospital and seeing him and seeing the patients.
And I loved science so much. I was actually telling my daughter last night about one, you know, dissecting earthworms and crayfish in science class and how much I loved it. Went to science camp and I volunteered in the department of cardiac surgery when I was in high school and I got to see a heart transplant at the age of like 17. And so, I just was like all in to science and medical. And so, I really I knew I loved science.
I knew I loved the idea of helping people. But then I went a little bit off course when I went to college. Okay. I actually majored in economics in part because my father said, you know, medicine's a really tough life. If you want to have a family, maybe you should think about something else.
And so, I did. And I mean, at 17 you already seen a heart transplant. So, you were kind of already way advanced. Exactly. And then when I was at Stanford, I studied economics.
I graduated, didn't have a job. I was a little bit lost and I thought, well, I'll just start my own business. So, I started a smoothie juice bar at the age of 22 in Miami. And I did that for a few years. And we were successful, but I was just really unhappy.
And I I realized that I didn't want to do business. I really wanted to to go back into medicine. So, I I switched and changed directions. Went to medical school? Went to medical school.
And when I was in medical school, I mean, I was so thrilled to be there. That is actually where I started to think about journalism because I love to communicate and teach and educate. And I really I remember saying to my friends, you know, I want to do what Sanjay Gupta does. And this was back in 2000. And they thought I was crazy, but I knew that there was a real need for someone to kind of take what's happening in the science world and communicate it in a way that is effective, approachable, understandable.
And so, that became my next dream was become a doctor and become a journalist all at the same time. Things. Yes. But, you know, it's an incredible combination in so many different ways because there really is a need to have that kind of communication and that line of communication because I feel like a lot of people go into a doctor's office, whether it's your cardiologist or your OBGYN or your GP or whatever whatever doctor it is and feel intimidated, quite frankly. You know, I've I never I didn't grow up in the world that you could go in and have a conversation with your doctor.
I went in and they looked at you, they touched you, they said, you know, checked out your heart, they looked in your ears, and they or wherever else they're going to look, and that that was it. And you kind of left with everything looks good or you got to come back. And so, I think that you straddling both of those worlds is really helpful in terms of normalizing some of these words and making people feel like there's a, you know, a real human being there. Obviously, social media has helped that in a lot of ways, too, but I think it's really important as a journalist. Yeah, I mean, to me it was so important.
I always tell the story when I was in medical school, I had an attending who talked about making medicine personal when I was She was a pediatrician. She runs a huge program for domestic violence survivors out at USC. And her words really never left me. And so, you know, when I'm sitting in the exam room with someone, it's about making it personal for them. And when I'm sitting on, you know, a set talking about something, it's about how do you connect in a way that people are really going to hear you and want to take action.
And it's about, you know, advocating and helping people advocate for themselves. And I just had a woman actually today in my office tell me, you know, I came to see you because I I heard you talk about, you know, being listened to and heard. And unfortunately, a lot of people go see doctors and they're not heard or they're dismissed. I mean, this woman today told me she had seen several people and her symptoms were dismissed. She was blown off, and and it is a reality in medicine that unfortunately, as the patient, you really do have to sometimes seek out a second opinion and push and really, you know, move the needle yourself because it's not always going to happen the other way.
Those days of the doctor up here and the patient down here, that that's doesn't exist anymore. You need to really come in there as if you're on equal ground with your physician and feel like you're seen and heard as a whole person. I appreciate you saying that cuz I just I was just talking to somebody actually who really just switched entire, you know, systems of you know, to of a hospital just to make sure that they were heard. And I think it's people are getting that message, you know, slowly but surely. When you have somebody that you have to give news to, and if you're if there's somebody out there that's listening that's going through something difficult, what is your advice for resilience in the worlds that you live in because you're seeing all sides of them?
Yeah, I mean, I've had this obviously happen a lot, and this was part of the reason why I again why I wanted to write the book. But I think the idea and we we walk through different tools in the book, but the first one is just about acceptance. And so for a lot of people when they're given a diagnosis, it's really about the acceptance that this has happened to me. And And that was something that I learned in medical school when I had my own health scare. I lost vision in part of my eye, and I was given the Serenity Prayer by my mom, which says, you know, accepting the things we can't change.
And And that's key. So I think really accepting your diagnosis, but then recognizing that time and putting one foot in front of the other and sort of changing your view of where you're going can really be helpful. And so for a lot of people not looking so far ahead in the future. Now I will tell my patients, let's just focus on today and then tomorrow and then the next day and pretty soon you're going to realize, you know, 6 months have passed. And because for a lot of people the fear is there, what if this happens again?
Mhm. Or, you know, will I be able to do all the things I want to do? So it's really about that focus on the present moment and living in the present and not worrying so much about the future and changing and that's where that step two tool in our book about flexible thinking really shifting your vision of where your life might be heading and that's okay. So you might be going thought you were going down this way, but actually you're going to be going down another road and that road is going to be just as good. I feel like if there's anybody who could write that book from being you know, following your dad around doing rounds to a smoothie bar to medical school to being a journalist on a on a top TV market is really incredible.
It's a you know, it's life is this beautiful organic thing, you know, and I you know, the quote I use in the book about Michelangelo sort of carving the marble and setting the angel free, you know, that's my visualization for resilience. It's that we are all this angel inside of marble and we're going to get chiseled a little bit by the things that happen to us in life, but at the end this beautiful angel sort of emerges. So the chiseling and the events that happen to us, they may be difficult, but they're creating this beautiful new version of us. And the serenity prayer, my mom used to live by that. So yeah, it's a big deal.
Do you mind if we do a little bit of Q&A? Sure. People to send in questions and I'm telling you I'm excited to see the interest in the questions that are coming out about cardiovascular health. More and more. Yeah.
Okay, Sarah at Austin. I keep hearing I need to lift heavy weights, but I've been a good cardio girl my whole life. Do I give up my spin classes or is cardio still good for my heart? I just had this question today from a young woman who wanted to know should I be focusing on cardio or weights? And really you want to focus on both, for sure.
As cardiologists, we definitely talk a lot about the cardio and we give that number of 150 minutes a week of moderate cardio or 75 minutes a week of vigorous cardio, but we also say you should be doing at least two days a week of strength or resistance training. We know in particular for women as we get older, making sure we have muscle for our bones going to be really important. So and for our overall weight management, building muscle is really key. So you really don't want to negate one for the other. You want to really focus on both.
And a lot of people think cardio has to be running and that's a another conversation we have is that it can be anything. It could be walking on the treadmill, elliptical, rowing machine, swimming, biking, dancing, anything where you're really getting your heart rate up. Good. I was going to ask you that talking about rigorous exercise versus more moderate. Yeah, it can be either.
I mean, some people also there's some suggestion too that the high intensity, you know, people like to work that in a little bit. That might be good for the cardiovascular system if it's something that you can do, but not necessary either. All right, Diana's asking, "I walk every single day at least 45 minutes, sometimes more. My younger sister keeps telling me it's not enough. Is walking actually doing something for my heart or do I need to be doing more?" Everyone's walking nowadays, myself included.
I feel like I I ask this question all the time. Yeah, walking's great. So, too. And if you're living in New York, what Yeah. What choice you have Yeah, it's so good and I walk.
I walk on a treadmill on an incline. I find that that's very effective for like short periods of time, you know, 20-30 minutes if that's all you can do. It's a really good workout. So and it's low impact. It's good for your health, your joints.
So yeah, walking's totally adequate. You just want to make sure well, number one, any walking's adequate, but if you are walking, you can try to do it at a pace where, you know, it's a little hard to carry on a conversation with someone. That's a good marker of I'm walking fast enough. How do you feel about weighted vests? They're fine.
That question all the time? Have I have not gotten that question a lot, but yeah, sure. Yeah, I mean, they get it makes you a little more breathless. Think it makes make it harder for you. You're carrying weights around.
Jennifer, I'm 52. I'm a marathon runner. I eat clean. I don't drink. Everyone tells me I look great.
Should I still be worried about my heart? Can fit people really get heart disease? If I told you the number of patients I have who are triathletes or marathoners or extremely active who come into my office thinking they're not going to have any heart disease and then we send them for a calcium score and they do, you would be shocked. And they are shocked because they say exactly that, which is, "I'm doing everything right. I don't look like the picture of heart disease." But that's not the whole story.
So yes, you can be doing all those things right and still have cardiovascular disease. More genetic at that point? In some cases it can be, you know, genetic family history of early heart disease or maybe you just have high cholesterol even though you exercise all the time and you're, you know, at a normal healthy weight. I feel like that's discouraging when we're telling people to like [gasps and laughter] But I get it. I've I've heard so many of these kind of things where it's it is, you know, people that say they're doing everything correct and there's still a problem.
We do address this one a little bit, but Maria, I've been hearing a lot about Ozempic and heart health. Is there actually a benefit just beyond weight loss or is that just hype? There is. There is for sure. And as I mentioned, the most recent research really does show that there are just isolated cardiac benefits that have nothing to do with the weight loss.
So we know that the weight loss is obviously going to improve blood pressure and cholesterol just from losing weight. But when we tell people, "Well, wow, it does seem like these drugs are actually having separate effects." That's really where the interesting thing about these drugs. And then we're learning more about these drugs in terms of potentially beneficial for dementias, for addiction, liver disease, sleep apnea, kidney. I mean, it's like the list goes on and on of what they don't Well, that's what I was wondering about. So do each one of those areas are starting to be tested now?
Is that what happens next? They're researching all of those things. I mean, obviously the drugs have some FDA indication for liver disease and sleep apnea already and cardiovascular disease, but they're doing research into some of those other indications. I've had a lot of patients tell me, too, that they they don't want to drink alcohol anymore. So it's cutting back on their cravings for alcohol.
So, there are clearly a lot of effects that we're still learning about. Yeah, it's really fascinating. I remember first hearing about them and I it felt like they were so I don't know. It was something so far away. And that was just a few years ago.
It's really interesting. Tammy from Chicago, I'm taking like six different supplements because a doctor on Instagram told me they're good for my heart, magnesium, CoQ10, fish oil, you name it. Am I wasting money or does any of it work? I love this question because so many people come in with supplements and they think they're really doing themselves a favor and I often tell people that the concern with supplements is that they're not regulated by the FDA. And many of them, some of them have had heavy metals in them, chemicals in them.
They interact with other things you take you are taking. And patients have ended up in the hospital with liver damage. The liver injury is a real, real issue when it comes to supplements. And so, I often tell people there's no data to support that they have benefit and there's only the potential for risk. If you eat a healthy diet and you're not deficient in things like calcium or vitamin D or B, there's no reason that people need to be taking supplements.
I will say the one caveat that does, again, seem to be coming out of the research is Centrum Silver. There's have been some studies that talk about, yes, reducing the risk of cognitive dysfunction or dementia. So, when people say, "What should I take?" I say, "Well, you maybe the Centrum Silver might be the one thing I would recommend." That's fascinating. I'm really shocked. CoQ10 though, do you you don't have to take that with a a blood thinner or a beta blocker?
There's I thought they were something that had to go together. People take it because they think it will reduce the side effects of statins. So, some people are worried about taking cholesterol medicine statins cuz it will have muscle or pain or associated with it. And for some people that is a side effect. And for some people CoQ10 might help relieve that.
But, it is not something that we automatically give people who are taking statins or that they need to take. And fish oil was very big at one time. Is that Was that Is that old-fashioned? Is that like Yeah, again, you know, for people who have really high triglycerides, you know, we will sometimes prescribe fish oil. If you don't eat a diet that has fish, people might take it, but I will say also with fish oil, that can have blood thinning effects.
So, for some people who are on blood thinners and taking fish oil, they have the additional blood thinning effects of the fish oil. And there's some data to say that it might actually also increase your risk of atrial fibrillation or abnormal heart rhythm. So, I often tell people again, you know, no reason for just taking fish oil if you generally eat a well-rounded healthy diet. Silver. Take your Cent Oh my gosh.
Okay, where can people find you? Dr. Tara, thank you. I might come see you in your office. Given your family history, no, you should.
Seriously, you really should. Gosh. You can be the 18th patient. Be the 18th. Thank you so much.
Thank you.
