Speaker 1:
Welcome to the Dr. Gundry podcast where Dr. Steven Gundry shares his groundbreaking research from over 25 years of treating patients with diet and lifestyle changes alone. Dr. Gundry and other wellness experts offer inspiring stories, the latest scientific advancements, and practical tips to empower you to take control of your health and live a long, happy life.
Dr. Gundry:
Based on your questions about symptoms and possible causes, I’m launching a brand new series to help clarify what you might find on the internet. I’ll be reporting the typical textbook symptoms and then the ones that get overlooked, dismissed, or often misdiagnosed. So I’m going to start with my own line of expertise looking at hearts and arteries and fixing them as a cardiothoracic surgeon and cardiologist practicing for over 40 years. So let’s get started with the typical symptoms you might have of cardiovascular disease and then we’ll discuss what tests I use in my practice with my own patients to help determine if someone has heart issues or it’s something else. First, classic story of heart disease or even a heart attack is jaw or neck pain, particularly left jaw, left neck pain and left shoulder and arm pain. Chest pain doesn’t always center in the heart, and everybody’s pretty convinced their heart’s right here in the middle of the chest.
Many, many times people with heart disease, with narrowing of coronary arteries, or even having a heart attack don’t present with a typical elephant sitting on their chest. Many women never get the typical signs of heart disease like neck or arm or shoulder pain. Interestingly, many women in my practice, their presentation of angina, which is chest pain, is nausea or even vomiting. Many of my women never get the chest tightness, chest heaviness, but nausea is frequently one of their biggest complaints. On the other hand, heaviness with exertion is usually very useful if you are having trouble climbing that second set of stairs and you get short of breath, the word heaviness is very good because my patients use it all the time, or tightness in the chest. Or if you’re out doing your usual walking routine and you notice that your chest gets tight or that you feel more short of breath and then you stop and it goes away and then you start going again and then it starts again. That’s a typical sign that something is amiss.
My own father used to be a fairly decent runner in his mid-70s. And he noticed on the hills in San Diego at about mile two, he had this funny heaviness in his chest that he’d never had before. And he’d stop and it would go away and he’d start again and son of a gun, it would appear again. And to me that was a tip-off. And guess what? We got a cardiac catheterization, and sure enough, he had a narrowing in a coronary artery and he got a stent and went about his business. But it was that story, he didn’t get short of breath, he didn’t have chest pain. It was this heaviness that he reported that tipped me off. Overall fatigue. Now, there are innumerable causes of fatigue and tiredness, but quite frankly, if your heart is having problems pumping because of lack of blood flow, then less blood flow flows to your lungs and your muscles and everyday fatigue in doing everyday activities that you used to be able to do is a red flag and needs to be investigated.
Now, there’s many causes of this. There can be leaks in heart valves, there can be narrowing in heart valves, but this is all part of the heart and it needs to be investigated. Over the last 20 years, I’ve been seeing, as other people have been seeing, a huge increase in pulmonary hypertension and pulmonary hyperplasia. This in my practice is an autoimmune disease, but this can frequently present with shortness of breath, and fatigue, and tiredness when going about doing the things you want to do. Now, Google MD says sleep apnea is a sign of heart disease. Wrong. But sleep apnea is a really good cause of heart disease. So heart disease does not produce sleep apnea, there’s nothing in it that will produce sleep apnea, but it absolutely can cause heart disease.
Now here’s one that I get all the time, trouble achieving or maintaining an erection. Now, I know guys, you don’t connect bedroom problems with problems of the heart, but erectile dysfunction is a very early sign of arterial damage to blood vessels. And what goes on in the lower parts, goes on in your coronary arteries. I won’t give a man a prescription for any of the erection drugs without having them pass a stress test in my office or somebody else’s office. It’s that important. So the word of warning is if you have erectile dysfunction and you need one of these vasodilating drugs to achieve an erection, that should be the biggest red flag that you have narrowing in other parts of your body. And the one you want to worry about most, of course, is your heart. Please, please, please take care and don’t use these things without working up the rest of you.
Now, there’s a form of vascular disease where the arteries to the legs are affected, and that’s called peripheral vascular disease, PVD. This is typically felt when you are out walking or doing strenuous activities and you get tightness or literal cramps in your calves or even in your feet, and you stop and it goes away, and then you start up again only to have it start again. So this is the same sort of feeling you get in your heart, and another way of saying it is leg angina, and this is a classic sign of narrowing in the blood vessels to your leg. Now, it doesn’t tell you where the narrowing is. Although traditionally, if you get cramps in your butt or your thigh, the narrowing is usually up in your belly or right at your groin. If the narrowing is farther down, then the narrowing can be farther down as well. But this is a sign that you need to have studies. We can easily do ultrasounds of the arteries of your legs and pinpoint these narrowings.
It’s easy to get a CT angiogram of your legs, a CT NMR angiogram. But if you’re getting this, it’s time to investigate it. Now, one topic that gets dismissed that I think is really important is symptoms of carotid artery disease. Now, one of the classic symptoms that I see all the time is what’s called haemorrhoids fugax. What the heck is that? Well, people get this experience of literally having a shade come down over one eye, it’s almost like somebody pulling the blinds down, and it lasts for a few seconds, maybe a half a minute or a minute, and then the shade goes back up. And people rub their eyes, they think they have something in their eyes. This is actually a sign of a tiny blood clot that hits the retinal artery in your eye, shuts off the flow of blood to your retina, and then it dissolves.
It’s that small. So that’s a classic symptom that many, many, many people ignore that there’s a little plaque breaking off from your carotid arteries. What else can change? There’s actually four big blood vessels that go up to your brain from your chest. Two in the front called the carotid arteries, that’s where you feel your pulse. And two in the back that are smaller called the vertebral arteries. Some people get dizzy with a sudden change of their head position or a quick look to the side, and this can actually be one of these arteries that’s got a narrowing getting more critically lowered, particularly typical of people who have vertebral artery disease. People who have vertebral artery disease are more likely to say they get dizzy when they suddenly change head positions or look up or look down. Now, this is one that I hear quite a bit, and sorry to use the pun.
If you hear a whoosh in one ear, almost like a stream, and not the other, or you hear a whoosh in one ear when you’re laying down on a pillow and not the other when you’re laying down a pillow, this can frequently be a sign that there literally is a narrowing in your carotid artery and it’s not your imagination. Now again, it’s easy to get a carotid artery duplex, there’s nothing invasive about it. Okay, so these are the symptoms that I want you to look for. These are the symptoms that patients tell me about that usually lead me to further investigation. Okay. So what should you ask your doctors to get? Most doctors are going to get a cholesterol profile on you. Quite frankly, it’s really not going to tell you much of anything. Now, cholesterol can be high in my practice, but I use tests to look at whether cholesterol is activated, whether it’s oxidized. And I have and treat a number of patients with very high LDL cholesterols who have absolutely no coronary artery disease by CT coronary angiograms.
What’s far more important is to look for markers of inflammation. I measure markers of inflammation including heart-specific C-reactive protein. I use the PLAC test, the Lp-PLA2 test, which looks at inflammation on blood vessels. I use myeloperoxidase, which is the Cleveland Clinic’s favorite marker of inflammation. And yes, I will perform stress tests. Now, there are multiple forms of stress tests. I like to use a nuclear scan in my office. But stress tests are not perfect, stress tests can miss true coronary artery disease 15 to 20% of the time. And this lecture won’t go into why that happens, but they can miss. In the past, the definitive test was a coronary angiogram in the cath lab. Now CT coronary angiograms, particularly the clearly test, is my test of choice. They’re becoming much more available. They’re becoming much more affordable. The beauty of the clearly test is that it uses artificial intelligence to look underneath calcified areas in blood vessels and to see underneath those calcifications. And CT coronary angiogram is a minimally invasive test that really gives you a 3D picture of what’s going on. And I’ll often, when I hear these symptoms, I see these complaints, I’ll get a CT coronary angiogram for the definitive look at what’s going on.
February is American Heart Month, but in my line of work every month is heart month. That said, you’re probably going to see a lot of articles about how to stay heart healthy this month. So I want to set the record straight because chances are you’ll see one of these heart health myths in just about every article you read. I know you want to stay healthy and I’m here to help. So let’s bust these heart health myths once and for all. Myth number one, you need to stop eating fatty foods. Fat is terrible for your heart. The truth, some fats are terrible for your heart. Things like trans fats, hydrogenated vegetable oil, and oils derived from lectin-heavy ingredients like sunflower or peanut oil. But other fats have actually been shown to help boost your heart health, and you should actually try to eat more of them.
I’m talking about fats like olive oil and perilla seed oil, nuts, wild-caught seafood and avocado. The truth is omega-3 fatty acids are actually connected to reducing the risk of heart disease and stroke. That’s one of the reasons I eat an avocado just about every day, and I suggest my patients do the same. Here’s my favorite, myth number two, you need to eat more whole grains for a healthy heart. I’m pretty sure this lie was created by food companies who wanted to sell more whole grain. Because here’s the thing, it’s dead wrong. But whole grain cereals, brown rice, bread, and a whole assortment of unhealthy foods have been marketed using the heart healthy label, even foods loaded in sugar and lectins. And even the American Heart Association has hopped on the heart healthy whole grains bandwagon. But when you look at the diets of people with the lowest instances of heart disease, you’ll see that they have one thing in common.
They actually don’t eat a lot of whole grains. France actually tops the list, and they do eat a lot of bread in France, but most of it is made with refined white flour. And in Japan, white rice is common while brown rice is practically unheard of. The takeaway, eating whole grains won’t keep your heart healthy. But eating a diet rich in omega-three fats, leafy green vegetables, and polyphenols will. So look to the Mediterranean diet or even the Okinawan diet for heart health inspiration and leave the whole grains on the table. Myth number three, eating high cholesterol foods will raise your cholesterol. The truth, when it comes to your cholesterol, you are not what you eat. Sure, doctors used to believe that eating foods like eggs and shellfish would raise your cholesterol to problematic levels. But the truth is moderate intake of cholesterol rich foods, yes even things like egg yolks and shrimp, won’t raise your cholesterol.
Again, take a look at the Japanese diet, one rich in shellfish, eggs, and seafood. The Japanese have some of the lowest instances of heart disease in the world despite eating cholesterol rich foods. That’s because most of the cholesterol in your diet just can’t be absorbed by your gut. And what is absorbed actually plays a role in helping your body run smoothly. So go ahead, eat your omega-3 eggs or your wild caught seafood from time to time. When they’re part of a balanced diet, they’re fine for your health. Myth number four, you need to work out for hours a week to improve heart health. The truth, exercise is good for it, but you don’t need hours of cardio to improve your heart health. In fact, extreme cardio like running marathons, triathlons, or climbing mountains can actually put more strain on your system than is healthy. Studies of triathletes have recently shown that it causes severe fibrosis of your heart, that’s thickening like gristle in your heart.
Doesn’t sound like a good idea to me. Now, this isn’t to say you should be a couch potato. Get active, but remember, 30 to 45 minutes a day is a good start, especially if you’re not used to a long workout routine. And it’s fine to start by walking around the box or swimming laps at a pace that’s comfortable to you. And you don’t have to be in pain for your workouts to work. Myth number five, for a healthy heart, eat fruits and vegetables. Wait, how is that a myth? It’s the fruits part. You absolutely should eat vegetables and some in-season fruit is a treat. But by putting fruit first, you’re putting sugar first, and that’s bad for your heart health, your blood sugar, your kidneys, and your gut. So go ahead and eat plenty of vegetables, especially things like cruciferous vegetables, tubers like sweet potatoes or jicama, and leafy greens.
And when it comes to fruit, remember three things. If it has a seed, it’s a fruit. That includes things like peppers, tomatoes, and squash. Eat seasonally. Maybe have a little citrus for dessert this time of year or have some berries in the summer. But remember, fruit is nature’s candy, so treat it like candy. The only fruit you can and should be eating every day is an avocado because it’s all healthy fat, and protein and fiber, and it’s actually good for your heart. Oh, and one other thing, in honor of American Heart Month, go ahead and share this video with your friends and family because your loved ones deserve to know the truth about heart health. I’m Dr. Gundry, and I’m always looking out for you. And this month, for your heart.
Bizarre daily habits that may support heart health. Despite modern advancement, heart disease remains the number one most common disease among Americans. And it’s the case of one in every five deaths. So what’s the big problem? Well, 42% of Americans are officially obese. As I say, fat in your gut, you are out of luck. So belly fat contributes directly to heart health, as I explain in all of my books and I’m going to spend even more time in the upcoming book. But it releases bacteria and bacterial particles into your bloodstream, and that sets up inflammation. Heart disease is not a problem of cholesterol, heart disease is a problem of inflammation in blood vessels. Most people don’t realize that statin drugs don’t work by lowering your cholesterol, statin drugs work by lowering the inflammation in your blood vessels. But there’s lots of other easy ways to do it. So let’s start with number one. Eat walnuts. First of all, fat does not make you fat. Not only does fat not make you fat, but fats in the form of walnuts or an olive oil actually benefit heart health.
Walnuts are also a great source of a funny chemical called polyamines. I’ve written extensively about polyamines. They have been shown to increase your overall health, your health span, and longevity. Now, one of the miracle fats in walnuts is actually a short-chain Omega-3 fat called alpha-linolenic acid, abbreviated ALA, and I promise there won’t be a test. ALA has been shown in numerous studies, including this one, but also in the Lyon heart diet study to dramatically lessen the incidence of coronary artery disease in people who have coronary artery disease. ALA is present in walnuts, it’s present in flax seeds, it’s present in organic canola oil. But it’s present in my favorite oil for ALA, perilla oil. So any way you can get ALA into your diet, including walnuts, that’s what to do. Now, alpha-linolenic acid is an essential fatty acid. What does that mean? It means we don’t manufacture it, but we have to have it to properly function cell membranes and mitochondrial membranes. So get yourself some more alpha-linolenic acid, ALA. And one of the easiest ways to get it is have a handful of walnuts every day.
All right, number two, take a shot of extra virgin olive oil. Now, there are multiple studies showing the benefit of extra virgin olive oil. Extra virgin olive oil is a great way of getting polyphenols into your system. Polyphenols actually interact extremely well with blood vessels. And in fact, I’ve written several papers showing the benefit of polyphenols on arterial health, on stickiness of blood vessels, and in allowing blood vessel flexibility. There’s a saying in longevity that you are only as young as your blood vessels are flexible, and so polyphenols, particularly in olive oil, are one of the great ways to do it. Multiple areas of the blue zones, for instance, in Crete, Italy, in Sardinia, and even in [inaudible 00:23:46] south of Naples, all use about a liter of olive oil per week.
Now they even have olive oil soup in Crete. There’s some fantastic polyphenols in olive oil, one of the best is hydroxytyrosol. It’s a powerful polyphenol that can have huge beneficial heart health benefits. I actually performed a science experiment showing this right here on my YouTube channel. Check it out, it’s incredibly eye-opening. And once again, fat is not your enemy. So I recommend everyone should try to consume about a liter of olive oil per week like they do in Crete. But to make it easy, have a shot of olive oil every day. Bring olive oil to the table. Pour it on your meats, your chicken, your fish, pour it on your vegetables, pour it on your ice cream.
Number three. Now this one sounds like almost a non-starter but bear with me, swallow a whole clove of garlic. Now, there’s a compound in raw garlic called Allicin. Chronic oral administration of allicin lowered blood pressure in hypertensive rats. If you cook garlic, it’s inactivated. Sorry about that. So swallow it whole or used aged garlic extracts. Now, garlic is actually well known as being great for your immune health. Now, since you’re swallowing garlic whole, you won’t get that potent garlic breath. So it’s a win-win. So how do you do it? Just peel the clove of garlic, I personally like to roll it in olive oil, pop it in your mouth and swallow it. The olive oil makes it slippery and it goes right on down. Number four, your microbiome, your gut begins at your mouth. And your oral microbiome and your oral health is really just as important as your gut microbiome in terms of heart health. Heart disease begins in the mouth and gums. Bacteria get through your mouth, through your gums, into your bloodstream, and actually begin to affect the blood vessels in your heart.
In fact, people with gum disease have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event. Believe it or not, when I’m doing surgery, and we’ve actually looked at the plaque that we take out of people when we do bypass surgery, these plaques have been shown to contain oral bacteria. And how they get in there? It came from your mouth. So the benefits of brushing and flossing go way beyond fresh breath. Also, speaking of fresh breath, most commercial mouthwashes destroy your oral microbiome and actually raise your blood pressure. Exactly what you don’t want to do. So instead of mouthwash, use oil pulling and you’ll get great results. In fact, I actually talk about this on episode 221 with Dr. Puneet Nanda, aka Dr. Fresh. It’s great watching and it’s very entertaining to hear his story.
Last but not least, cheese please. Now, recently big news was made with a study out of Norway looking at people with stable angina. Stable angina means that these people had coronary artery disease, and if they did too much activity, if they walked too fast, if they exercised too fast, they got chest pain, angina. When they stopped doing that, the chest pain went away. And it was predictable. This is called stable angina. Now, what they did was they looked at the effect of dairy consumption, butter consumption, and cheese consumption on what happened to these people’s stable angina. Now, what made the news was that dairy and butter dramatically worsened stable angina. In other words, they went on to have heart attacks or needed stents. But was not mentioned was the fact that the more cheese people ate, the better their angina got.
It went away. Huh? Well, I’ve written extensively about this in Unlocking the Keto Code, and I’m going into it even more in the upcoming book. But cheese has fascinating products that improve heart health in multiple areas. Interestingly enough, four out of the five blue zones actually are blue zones because they eat goat and sheep cheeses. The fermentation process of making cheese produces very important compounds that actually protect against heart disease, having nothing to do with cholesterol. Now, no, you can’t eat nachos and cheese sauce or other highly processed cheeses. If you’re going to have cheeses, look for the fact that they’re made out of casein A2. These are most cheeses in France, most cheeses in Italy. All goat and sheep cheeses and water buffalo cheeses are casein A2. So enjoy your cheeses, the right cheeses please. Finally exercise snacking. Now, everyone knows that regular exercise is absolutely essential for heart health, but that doesn’t mean you have to spend hours in the gym every week. Instead, try exercise snacking. It’s super easy, fun, and great for even the of people like me.
So what do you do? Wall sit. Wall sit for up to two minutes several times a day. Now, this is hard to do. This is how I get ready for ski season. So don’t give up. Just sit against a wall for as long as you can before your quadriceps are screaming, and then try to push it a little bit longer every day. Get to two minutes and you’ll be shocked at the benefit of wall sitting. Couch planks. Get off the couch in a commercial and just do a plank against the couch. It’s really easy. It’s effortless. My personal favorite, do deep knee bends when you’re brushing your teeth. Come on folks, you’re not doing anything else Twice a day. Just do deep knee bends while brushing your teeth, time your brushing with your deep knee bending. Walk and talk. Instead of taking a call at your desk, get up, carry the phone with you, and walk around the office, walk down the hall instead of just sitting there talking. It’s also incredible for your overall health, including your heart. It’s really the most underestimated form of exercise. Go out and walk every single day and you’ll notice better health, more energy, and a slimmer waistline. And that’s what I tell all my patients please get a dog. A dog will demand a walk twice a day and it’ll get you out as well.
Speaker 1:
I hope you enjoyed this episode of the Dr. Gundry podcast. If you did, please share this with family and friends. You never know how one of these health tips can completely transform someone’s life when you take the time to share it with them. There’s also the Dr. Gundry Podcast YouTube channel, where we have tens of thousands of free health insights that can help you and your loved ones live a long, vital life. Let’s do this together.
