Welcome to episode #155 with Dr. Kathryn Retzler.
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04:37 Advanced Biomarkers for Cardiovascular Disease: AMDA (asymmetric dimethylarginine) is one of many biomarkers linked with cellular ageing, endothelial dysfunction and cardiovascular disease. What is good for the heart and the blood vessels is good for the brain and good for cancer prevention.
05:59 Cholesterol: LDL particle numbers show how many bad cholesterol particles are being produced. The size of these particles is important. If they are big and fluffy, they are rolling off the artery wall rather than getting through. If you have endothelial dysfunction, it would mean that you have leaky arteries, open to LDL entry and the beginning of the plaque cascade. We can measure the oxidation (inflammatory) levels of LDLs. We can measure myeloperoxidase, an enzyme made by white blood cells that contribute to unstable plaque. CRP is non-specific. However, if it is high, it tells us that there is inflammation somewhere. This inflammation could come from the gut, excess fat tissue from obesity or periodontal disease.
07:00 Imaging for Risk Evaluation: Dr. Retzler’s patients who have high lipids/high risk receive a CT to check their calcium score. A score of 0 reflects nearly a 0 likelihood of heart attack within the next 15 years. A low score means that therapies do not need to be aggressive. In addition, one could look at an IMT and carotid ultrasound too view the vessels to see if the disease process has begun.
08:02 Extending Healthspan: It is rare to have a vibrant and optimally healthy 40 year old patient. In the concept of functional reserve, our organs are only meant to last a certain amount of time.
10:28 Lifestyle and Hormones: Testosterone levels and sperm counts in men are declining at younger ages. Lifestyle factors play a role in whether we can make optimal hormones. It is difficult to age well without hormones. It is difficult to be in your 60s without supplemental hormones with energy as well as optimal brain, bone and cardiovascular health.
16:21 Hormone Delivery: Bioidentical means that it is the same molecule that is made in the human body. Dr. Retzler believes that it is important to use the same molecule that the human body makes. For estrogen replacement therapy, Dr. Retzler mainly uses estrodiol. She uses the twice a week patch and for estrogen replacement. Vaginal is used most often, especially for women with vaginal atrophy.
22:11 Advanced Cardiovascular Assessment Tools: Start with a lipid panel, including LDL particle size and Apo A-I, HDL particles. She uses Boston Heart for their HDL map, which provides alpha 1 and alpha 2 particles. This allows you to see HDL particle size and allows you to infer HDL functionality. She runs CRP, fibrinogen, MPO, myeloperoxidase, and sometimes lipoprotein phospholipase a2, TNF alpha or il-6. She mainly uses True Health in Boston. Biomarkers indicate risk factors, not disease.
28:17 Assessing Cognitive Function: The mindset is that there is nothing you can do for dementia or Alzhiemer’s and it is not true. Research shows that changes in cognition appear 30 to 40 years before dementia is diagnosed. Fall in love with your brain. There are things that you can do to prevent dementia.
33:34 Preventing Dementia/Alzheimer’s: Trauma increases dementia risk. Your brain is the consistency of soft tofu or butter at room temperature. The skull is hard and has lots of pokey ridges. If you let your kid do things where their head can get hit, they can end up with brain injuries.
37:26 Brain Assessment: Dr. Retzler uses CNS Vital Signs for cognitive testing. It is validated, easy for the patient to do and she can track them.
43:34 Dr. Retzler’s Morning Routine: She is not a morning person. Two mornings a week she goes to spin class. She checks patient messages, reviews notes, listens to podcasts or reads something science based. She does HeartMath before she sees patients.
46:38 Dr. Retzler’s Favorite Supplement/Nutrient: Resveratrol, quercetin, antioxidants and she eats an antioxidant rich diet. Her supplement of choice is CoQ10, the rate limiting enzyme in ATP production. If you want ATP, you need CoQ10.
50:03 Dr. Retzler’s Elevator Pitch: The American people need to be taught about prevention and that they have control over their health destiny.