There can be some real dangerous things that happen. And of course, just the heart rate can go up. And over time, if you put your foot on your accelerator in your car and you've always got it pedal to the metal, you might do yourself some damage.
If we talk about cars anymore, I'm going to embarrass myself, you know, from Detroit, because I can't tell a carburetor from a flux capacitor. But anyways, there's no carburetors anymore.
I do know that, they're just pedal to the metal. If your thyroid is overactive and your heart rate's 90, 95, 9800 and 204. Hi, it's doctor Jen. Welcome back to the Integrative Health podcast with Doctor Jen I'm doctor Jen and today we'll be uncovering a surprising connection how your thyroid could be the key to a healthier heart.
Joining us is America's healthy heart doc, Doctor Joel Klein, one of the top cardiologists and a passionate advocate for plant based nutrition. While we disagree on some of the nutrition aspects, Doctor Con after decades of treating acute heart attacks, he transformed his approach, focusing on prevention through holistic cardiology, from groundbreaking diagnostic tools to the transformative power of nutrition.
He's on a mission to help your heart thrive. Could your thyroid be holding the secret weapon for better heart health? Let's dive into the discussion. Hello!
Welcome back, everyone, to the Heal Your Thyroid and reversing Hashimoto's Summit. I'm your host, Doctor Jen back here. And today we have Doctor Joel Kohn.
He is an expert in all things cardiology. He has been on Doctor Phil, the doctor show, Doctor Oz, Larry King, Joe Rogan, so many things because. Because he knows what he's doing.
So of course we would have him here to talk about the heart and the thyroid. What you need to know. So, Doctor Khan, welcome. We're so excited to have you here.
Tell us a little bit about yourself and how you got to be so amazing with cardiology. I am so kind, but I'm excited to. It's a great topic. Gear summit is great information.
And, I'm in suburban Detroit and people might say, why don't you live in San Diego, Costa Rica like everybody else? But I love it here. My family's here, and I trained at the University of Michigan.
And, at age 18, I adopted a plant based diet at University of Michigan. You might call that vegan. So I had a strong interest in nutrition for now, over 45, 46 years.
I'm in my, approaching mid 60s. Amazing to say that, but I got my first, email, letter from Medicare recently. Too soon, too soon. Don't want to. But anyways, and as I did standard cardiology, I want your heart attack.
I want to put a stent in your artery. I would talk to people about nutrition. And out of that, after many years of, really hard core cardiology in suburban Detroit, in Ann Arbor, I went back and did my full integrative medicine training, functional medicine training.
And about eight years ago said, you know what? That's it's exciting and scary. It's frightening to make changes, but I'm going to completely turn my life upside down. And it's been a delightful path.
So we spend a lot of time with people at the root cause, the functional medicine cause from, you know, sleep to nutrition to fitness to dental health.
So I just had a talk to a patient literally five minutes ago as the dentist in ten years. Oh my God, oh my God. His wife had set me up to make sure I knew to ask him about it, but I ask every day about it.
And we spend a lot of time on the thyroid, because it's so critical in metabolism in general and cardiac health, particularly. Yeah. That's awesome. And I'm so glad that you did something scary.
And and now you're helping tons of people. I know I can refer patients to you, which is nice, because you're just like an hour away from where my office is.
So I'm so great that I have you as an option. So let's talk about the thyroid and our heart health. So how does the thyroid hormone impact our heart health?
Some people might think they're separate because they go to a cardiologist and they go to an under chronologies. But as we know with integrative and functional medicine, they're all connected.
Yeah. Oh, actually, no, there are actually thyroid receptors on the heart and on the heart muscle cells and, blood vessels that supply the heart. The clearest connection, you know, and when you have a healthy thyroid, we call that you thyroid.
There's the pronoun for the thyroid. You, you, that's, you know, full evaluation, and your thyroid is making just the right balance of thyroid hormone, the free T3 and the free to for us.
You have a wonderful symphony going on, but there is that potential to have overactive thyroid, the hypothyroid. And that's pretty uncommon in your practice.
In my practice. Usually requires some referral out to an endocrinologist or a thyroid allergist, but an overactive thyroid just whips on that poor heart.
You know, most people with an overactive thyroid, their energy is low. They may have some tremor. They may have a progressively higher heart rate because of all that excess thyroid hormone, they may start to lose some weight and sweat a little.
Their eyes may start to bug out a little bit. Called graves. Eye disease can be quite serious if it's autoimmune hypothyroidism, graves disease, grave apostrophe.
And interestingly, when you're hypothyroid, your cholesterol falls. So maybe transiently, temporarily, your risk of heart attack may drop a little bit, but that can create a whole spectrum of heart diseases in and of itself.
Because really, we're whipping. Just think of, you know, giving yourself adrenaline day after day after day. Maybe you have an EpiPen and you eat some nuts accidentally, and you bad guy, take an EpiPen and you feel better, but for a little while, your heart's racing and you're all jazzed up.
Think about, you know, 24 hours a day. You've got a thyroid nodule or the entire gland making too much thyroid hormone and really whipping. Not just cardiac, but specifically because it can stimulate cardiac muscle cells, and all.
There can be some real dangerous things that happen. Of course, just the heart rate can go up. And over time, if you put your foot on your accelerator in your car and you've always got a pedal to the metal, you might do yourself some damage.
If we talk about cars anymore, I'm going to embarrass myself, even though I'm from Detroit, because I can't tell a carburetor from a flux capacitor. But anyways, there's no carburetors anymore.
I do know that, you know, just, pedal to the metal. If your thyroid is overactive and your heart rate's 99, 95, 98, 102, 104, that's why one of the mainstays of the early therapy of overactive hypothyroidism is, a beta blocker.
Temporary way to, protect the heart from excessive, adrenaline and high heart rate at all. There's a really interesting and unusual, but well known, syndrome.
Syndrome means we understand some of it. Not all of it, but some people present in congestive heart failure. They're short of breath. Their ankles are swollen.
They've gained some water weight. They're breathless just walking to the bathroom and taking a shower. Of course, these are pretty marked symptoms. And in the evaluation, maybe as an outpatient, maybe as an inpatient, we find out that their thyroid hormones are out of whack.
They're hypothyroid. And if we do that simple test that we do in anybody that's short of breath called an ultrasound of the heart, also known as an echocardiogram, we sometimes find a weak heart.
So there is a and that's a fancy word, but that's called a cardiomyopathy a weak heart. And there is a cardiomyopathy of hypothyroidism. And it can be quite serious.
You can have rather marked congestive heart failure and develop hypothyroidism. And the good news is, I mean, there's going to take weeks to months of instituting a variety of therapies, focus that the thyroid, from the beta blocker to other drugs that block the production of the thyroid hormones, maybe ultimately a, radiation ablation or, surgery to correct the nodule in the thyroid or the diffusely disease gland.
But generally when you have a weak heart, you really worry about the long run, and you don't generally expect the heart to recover completely. In hypothyroid, cardiomyopathy, hypothyroid, floppy, weak heart, it can recover fully, completely, and entirely.
So we always will be checking, even though it's unusual. But thyroid hormone for thyroid excess in, hypothyroidism, you know, even we we create, hypothyroidism in our cardiology practice on occasion probably everybody knows and I'm sure from the other excellent segments on the summit, that iodine has a lot to do with thyroid hormone production.
And there is a particular cardiac drug we used a lot 20 years ago. We use less, but my mom is on it. So we still use it sometimes. And I'm careful with my mama at age 90, but she's on a very low dose.
It's called amiodarone and am then I od. What's the I od I within the structure of this heart rhythm? Medication used for atrial fibrillation is built on an iodine molecule.
And it can be a problem because in the process of even at low doses using amiodarone or it used to have a name brand Corinna Rhone. And it's been around for 40 years at least.
And the process of getting control of medium or serious heart rhythm problems like atrial fibrillation or ventricular tachycardia, you're flooding the patient with gobs of iodine and their thyroid on occasion will become overactive.
So we can we're treating one problem the heart rhythm problem, maybe atrial fibrillation. And we have the potential for creating a completely different and serious heart problem.
Hypothyroid state and maybe even with the cardiomyopathy. So we gotta, you know, always when we use medication, be so careful that we're not, you know, paying Peter.
Rob Paul, I think is the statement or paying Paul to rob Peter, but, getting one gain and offsetting another, and that's just, you know, a brief overview of the overactive thyroid syndrome, the hyper, thyroid syndrome, the graves disease, the toxic nodule.
It's just putting out hormone. Putting hormone, put it on hormone. That's why certainly in my clinic, I'm sure in your clinic and most functional medicine clinics, thorough thyroid panel is pretty much, a basic just like a blood sodium and potassium level.
You're going to get a pretty thorough thyroid panel. And, you know, I do find a lot of thyroid disease that others don't find. And, you know, some of it is the fancy word in medicine.
If we cause disease, we call it atra genic. Sometimes we're doing it. We're giving so much iodine drops, iodine supplements or medications that we trigger hypothyroidism.
But the good news is the outcome is usually pretty damn good. Yeah. And it's interesting because with iodine, it's like there's a sweet spot. It's kind of like Goldilocks.
And it's hard to test for too. So with iodine. Yet you don't want to give too much. You don't want to get too little. You need that sweet spot. But definitely when medications like amiodarone, you have to know if you have a loved one on that.
They need to have their thyroid be monitored during their treatment on that, right. We have a few, really competent functional medicine doctors around the Detroit area, but a few of them just love iodine for a variety, thyroid says possesses some cardiac conditions.
You know, that's a alternative approach. You're not going to find most conventional doctors treating anything with iodine. And some of them are using really big doses.
And when I want to know and I don't level, I do a urinary iodine. You can do it just on a spot urine. You could do a 24 hour urine. But I'm told that the spot urine is pretty accurate.
And these people come back with, you know, levels that are 500 times the reported upper limit. And I give a call to my colleagues and they tell me not to worry about it.
But, you know, I'm sure once in a while it's got to trigger hypothyroidism. Just like this medication built around an 18 mile kill can trigger hypothyroidism.
So we don't want to do harm. We want balance. I agree, and the balance can be tricky. Yeah. And with that balance, like you said, sometimes we cause things as doctors even though we don't mean to.
So with with patients, if they go on thyroid meds. One thing I do tell them, especially if I'm starting, t3 medication that watch out if you have palpitations or anything going on like that, you know, we got to recheck your levels, come down on the dose because medications affect everyone differently.
So yeah, I don't know. You see that from time to time. Yeah. And I left a little piece of the story out. But it's too important not to just double back.
While we're talking about overactive thyroid, hyper thyroid is that, there's this insanely common heart rhythm that dominates standard cardiology and also dominates a lot of integrative cardiology practice, and that is atrial fibrillation.
I said that word when I was referencing my sweet mama. And if you overdose a thyroid supplement, whether it's a pharmacy or a natural compound one, you can, really, because of this, finding that there is thyroid receptor, receptors on the heart muscle throughout the heart, top of the heart bottom.
There you can promote, somebody flipping into a rapid, irregular or uncomfortable, arrhythmia or rhythm problem called atrial fibrillation. And, you know, very often that requires emergency room visits and evaluation or just makes them very anxious and upset.
Well, it's happening and you find out, oh my, my DSH is so low I can't measure it. And my free T3 is sky high or reverse T3 sky high. So you're right, sweet spot is obviously the goal is not so easy, but, to precipitate atrial fibrillation is messing up a patient's, you know, homeostasis.
So we want to try and avoid that practitioners for sure. Yeah, absolutely. The other cases of hypothyroid that I find is interesting is when they get the subacute thyroid, thyroiditis from a virus.
So I had a patient that she went to the ER and they just ran a TSH. They didn't check a free T4 and a free T3 and her, her cheap free T3 was like close to ten.
And she had had, you know, Covid and she, she got that subacute thyroiditis kind of kicked in and she leveled out and she was fine. But it was crazy hurt her neck just hurt her and her back hurt her.
And then she was dropping weight and she you know, she didn't really have palpitations, though. But if it would have went on and we wouldn't have intervened, she might of.
So it's really important to make sure that you do get a full picture, because just the it might be more subtle. And I know you see probably that a lot in your office because you're looking for the optimal ranges and not just the standard ranges for sure, for sure, for sure.
Now those are good points. And, you know, we just spent ten, 15 minutes talking about a relatively uncommon medical condition hypothyroidism. Yeah, I'll flip over okay. With you.
You know, much more common and much more involved in the standard practice of medicine and the integrated practice function practice is hypo or underactive thyroid, where your receptors in your heart are not getting stimulated, to the normal amount.
And of course, there's a whole variety of reasons. You know, I have a practice that doesn't require patients to be vegan. Also know this whole food plant based.
But because I am, many of them are, and they come to me partly for that and guidance. I want to be the healthy, wholefood, plant based vegan eater. I don't want to be a train wreck like I once in a while.
See you on Twitter or Instagram or, documentaries and all. And you know, one potential deficiency. This is not a startling statement. I don't think there's a perfect diet out there because they all could induce some nutritional, weak spots.
But one of the weak spots in 100% all plant based diet is that iodine intake can be low. And we just talked about I didn't take too high. And we talked about sweet spots in the middle, but iodine intake can be too low.
There's scientific literature in that, in somebody that is eating whole foods plant based. There are some, you know, easy fixes without supplements. People that put kelp flakes on food.
I'm one of them I find beautiful, you know, mixed spice mixes, organic ones that you can buy at spice stores or online that are built on kelp flakes. And kelp is a pretty tasty.
It doesn't taste seaweed fishy. And, it has a lot of iodine in it. And then you can check that urine test to see if you're in the sweet spot. Some people like to eat seaweed at sushi restaurants.
I go to sushi restaurants. I have the pickled radish roll or the, natto roll, or the organic tofu roll or, cucumber roll or something. But I'll often have a nice seaweed salad.
That's a good way to get a little iodine. More and more, multivitamins. And there are multiple sites geared for the whole food plant based community have identified iodine as, worth putting in a multivitamin.
It's not in all motivates, but, just to give a shout out, there's a Doctor Furman multivitamin that has iodine. I use one called complement Essentials that has eight components.
I use it for myself for my patients, but I think there's eight milligrams of iodine a day, which is just enough to make sure you're not missing out on that important nutrient and, starve your thyroid and make the hypothyroid potentially, you know, there's a the rumor.
I don't know how you feel about this, that the cruciferous vegetables, particularly the awful kale. I don't think kale is awful, but some people paint it as an awful, awful green vegetable.
I mean, if you massage it enough and cook it properly, it can be delicious. It's not so attractive as raw. I'll eat spinach now and then and arugula raw all the time.
I don't know much raw kale. I know it. Last time I looked in the medical literature, there was very few actually documented case reports that cruciferous vegetables can be, going Trojans can, produce hypothyroidism or thyroid nodules by interfering with thyroid metabolism.
It may happen subtly, but to actually produce disease. The case report I remember was a Oriental lady eating like 5 pounds of bok choy a day. And not too many of us are eating 5 pounds of any green vegetable a day.
Chris Hemsworth said. Chris Hemsworth is eating 5 pounds of spinach a day, and he got kidney stones from all the oxalates. So anybody listening at, you know, plant based diets are super healthy.
But rotate, eat arugula, eat some, actually eat some spinach, eat some romaine. Even now rare iceberg I don't eat much iceberg. Yeah, I agree with you, doctor con with the cruciferous vegetables that that's kind of blown out of proportion.
And unless you're eating breakfast, lunch and dinner and snacks and going out of your way, and also, yes, I Popeye, he had kidney stones. I mean, Popeye from all the oxalates from the spinach, like, oh, but I didn't know that about Chris Hemsworth.
So yeah, it was pretty big deal in the news. The company, he was plant based, vegan, and he left the movement. Hey, you know, whenever a, media person, leaves anything, it makes news like he has his PhD in nutrition that anybody of reasonable value would have said.
But when you're making those morning smoothies, just rotate around a little bit, you know, put some chlorella in there, but so it's very lean in there, but, you know, just don't focus on mono foods.
You know, like variety, like variety of color and even within a color variety of sources of that color, without making it too tedious. I mean, it doesn't have to be, you know, painting by the brush with 30 different colors every day.
But, you know, next week, go to the grocery store and try new and tried dandelion greens, for God's sakes, or, kale, kohlrabi or, broccolini or something a little different, good stuff.
So I also a little bit so vegans, iodine, multivitamins or seaweed or nori rolls or, a little kelp flakes. But in general, just talk about the importance hypothyroidism from everyday causes slows down the metabolism.
People are tired, people skin is dry. Their hair is brittle and dry. Maybe falling out, temperature may drop a bit. They tend to have a lower heart rate if it's really profound.
Opposite, of course, of the hypothyroidism. Not particularly prone to the atrial fibrillation. But just like the real severe hypothyroidism could trigger rarely this congestive heart failure, cardiomyopathy, weak heart, a really severe case of hypothyroidism.
Somebody with they've had their thyroid out. They've had a thyroidectomy or a thyroid ablation. And they stopped their meds, sick and tired or I forgot to pick it up for six months and they get severely hypothyroid.
It can impact cardiac function, even to the point of congestive heart failure. Again, good news. Largely reversible. They may get some fluid around their heart.
Fluid around their lungs. That's called a pericardial effusion and a pleural effusion. A heart rate may be in the 40s. If you do an ultrasound again, an echo test, the heart function may be at the low end to normal, even below normal.
And an interesting thing and important. That's why you want this sweet spot you mentioned. And I'm going to use that word again is cholesterol. Is very much tied to thyroid metabolism.
And in, hypothyroidism when we talked about beginning, cholesterol tends to fall to you bring them back to normal thyroid and that not necessarily a bad thing, but the worrisome thing is in hypothyroidism, cholesterol can skyrocket up and you can see cholesterol as of 300 plus, which for a week or two.
It may not be dangerous, but, you know, month after month, you might be, you know, promoting your already somewhat disease tired arteries if you've not had the healthiest of genetics and lifestyle.
So, you know, again, just like, anybody with atrial fibrillation is going to get a full thyroid panel or, and all, but anybody with, a high cholesterol should get a full thyroid panel because the treatment may not have to be dietary tweaks and, cholesterol medication or cholesterol supplements.
It may just be, replacing their iodine, supplementing their thyroid with natural compounded supplements. And you just see the cholesterol fall dramatically.
I've seen some big old cases of that. For sure. And I think that's a really important point to make is if your LDL is high, your cholesterol, the bad cholesterol, if something's off before you get thrown on a statin, you know, if someone's out there and they just have a primary care doctor, for right now, make sure they get a full thyroid panel.
Make sure you ask for it. And not just a TSH. You know, at bare minimum, a free T4, free T3. And so that way you're not chasing this cholesterol number when you're not finding out the root cause, which, you know, could be your thyroid.
And since since you might have an audience for your wonderful summit that has a female predominance, because when we talk about thyroid disease, that is just the demographic that it concentrates.
And I just want to run with what you said for a minute, even though it's not directly thyroid, but it's so much what I do in my clinic, you know, Mrs., Mrs. Cole, you're going to need to start this low dose cholesterol medicine called Lipitor, because your cholesterol is 265, and, you know it's going to put you at risk.
Well, step one, you just mentioned, you know, doesn't matter if you're seeing function. Medicine practitioner, gynecologist, endocrinologist, internist.
Family doc. Yeah. Check the thyroid. Complete. Check the liver health check your blood sugar. I mean, if you're pre-diabetic, you want to focus on that and see if you, you know, change your diet, lose the weight, start to exercise, take some berberine or bergamot or some natural supplement bitter melon and get your blood sugar down.
You know, your cholesterol will typically fall and you don't need the medicine. So those are called secondary causes of cholesterol. And before you take a med for life, you know, with rare exception, you want to go through that list.
And certainly thyroid is a big part of it. But it's not the only one, you know, excessive alcohol intake. Excessive, you know, dietary discretion, indiscretion.
And of course, you're just addicted to Frappuccinos and Mountain Dews and Tim Horton donuts. I mean, take Lipitor, take, all those beautiful fruits and vegetables we mentioned.
But the, the new, really endorsed approach to this big subset of women. And I'd say that because I see it in women, more women that I seemingly and low risk for heart attack and stroke.
But their numbers on the paper are a little bit worrisome is there's a simple test called a heart calcium CD scan, not talking to the 32 year old, but the 48 year old, the 51 year old, the 46 year old that's been told you need to start cholesterol medicine.
I'm really uncomfortable with your cholesterol numbers. Your mother had a stroke at age 79. I'm worried about you. The current approach is that there's a CT scan you can get at almost any hospital in the United States, and even outside the United States takes about 10s.
You just lie down, hold your breath. Go home. No IV, no injection. The radiation exposure can be less than a mammogram. So that's considered low. And the newer, better of a CT scan, or you're having it done at the lower the radiation will be. But nothing injected.
And there's something called a heart calcium score. And if it comes back to zero, it was suggested way back in the 2000 that people with a heart CT scan of zero don't need, don't benefit from, have more risk from than benefit from Lipitor, Crestor and the stat and cholesterol medicine.
So of course you might. Your doctor might start just super low. But the data was we don't think we need this at all. And as the science progressed and I adopted that philosophy, I take women off of statins.
If they go get the CT scan, typically cost about 75 to 100 and $125 to get the CT scan. And you do it once. And if you're a good zero perfect card result, big celebration.
Do it again in about seven eight years, something like that. So the radiation is very low and the cost is very low and I take one off stands. But in 2019, the American Heart Association looked at all the data and said, we actually agree.
If you've been told you need cholesterol medicine in your heart, calcium CT scan is done and it's zero. We can't find any evidence you really benefit from Lipitor.
Crestor, the Canadian Heart Association came on board, and just in the past couple of weeks in Denmark, they did a massive study and they segregated out 24,000 people.
I think it was 10,000 that had a calcium score of zero, but big numbers, and they looked over up to four years and then another subset 16 years if you were zero, even if your cholesterol was really high, you did not have a risk identified of strokes and heart attack.
So, I think cholesterol is always important. But what's more important is our arteries, clean or not. And if your arteries are clean, you got time to work on your diet, get your thyroid balanced, get your eye level balance, get your, you know, gym membership to Orange theory and plays, get the weight under control.
Do the fasting mimicking diet do something. But you don't need to take a prescription for life. So so many of the women listening to this may well have been told, you know, if your cholesterol doesn't come down, you need cholesterol.
Medicine for life. First question is, can I get my thyroid checked and my liver checked, or my blood sugar checked and and my iodine level checked. And can I work on my diet and I'll.
But can I get a prescription and I'll go pay $100 at the hospital to get a heart calcium CT scan. If it's like Vegas, baby, if you come back at zero, you scream and shout in joy and you do that again about 5 to 7 years.
I love that you went on that tangent because it is so, so important because these statins, they have side effects. Many people are not told they deplete CoQ10, so then they're taking a stand in their code Q10 is getting depleted.
So I think that this is really important information that you share because like you said, it's quick and easy. Not a lot of radiation. I know when I need to get to that age where I want to look at my coronary calcium score.
I will get one. So very great preventative medicine, which, you know, we want to stop people before they have a heart attack. And for sure you haven't. Yeah.
And you know the statins don't really they don't really do it. But yes, lifestyle is so important. And even for the thyroid making sure your blood sugar levels are balanced and, you know, checking the liver enzymes like you said to make sure there isn't fatty liver, which is another early indication of blood sugar issues.
So it's it's just the whole body. And that's why this is so cool. It's it's all connected. So I love that you educate your patients, you know, on nutrition and you were like the the OG of eating vegan.
It seems like almost because you said in med school you started that age 18, 45, 46 years ago. So, have literally been completely committed to that and have benefited from it.
But I've seen patients not do well with it, and I've got to coach them. And, you know, and I don't apologize for taking a multivitamin with some key supplements in it.
Usually I take Algae Omega three versus fish oil based omega three, but I don't want my brain rotting. I don't want my thyroid rotting. And, you know, I, I'm not going to call a vegan diet a natural diet, but it's a point of decision to make in 2023 if it may not be the best thing for you.
So it worked out pretty well for me and a whole lot of my patients. Certainly a heart friendly diet. Yeah, and definitely not every diet is going to fit every person perfectly.
But like you said, the diet has to be done correctly, so anything could be taken extreme. Like, I remember reading an article about a guy that just ate bacon for 30 days straight and he lost weight and all this stuff.
And so, you know, that's too extreme. So I think during chemotherapy every day and lose weight and all right, I'll tip you take before a meal. You eat a little apple.
There's there's certain foods out there that give you a negative calorie deficit. You need a 100 calorie apple and a half an hour for dinner. On average, people eat 200 calories less at dinner because they've got a feeling of satiety.
So yeah, it's a the other one I just happened to post on social media. You take a glass of water with a teaspoon of chia seeds, stir it up and wait a couple of minutes and drink it.
I'm going to a party, and I just know I'm not going to have self-control. I'm going to overeat. You know that, it really fills your stomach up with great, nutrition because, chia seeds are great in omega three and fiber, but it gives you a nice feeling of satiety.
I mean, everybody's injecting themselves now with these, you know, genuine indication or somewhat shady indications for the weight loss drugs. There are some natural foods you can do it with, too.
And, and get yourself well to a healthier weight without any weight shaming going on here. No weight check. Yes. And I just have that hard conversation with a patient today, and she's like, I'm just so desperate to lose weight.
But we we weren't there yet. I'm like, you know, if you need a GLP one agonist, you know, if we're at the end of the road and you need it for three months, then we can talk about it.
But, you know, it's not an easy fix. You know, it's better to have habits. You know, a lot of these patients that are really desperate to lose the weight, which is good because less weight, less inflammation, you know, less inflammation, less cardiac disease.
But I usually put a continuous glucose monitor on them. And we watch and we do the work and I give them tips. I love that tip. I might actually start telling my patients about the chia seed tip, because that's going to fill your stomach with fiber and hold a little bit of water there.
So yes, you you're not going to jump right for the desserts right when you get there. So it's going to give a little more need to follow. You know, you gotta be a little mindful.
And you might actually say I don't really feel like getting it. Yeah I do want to give a shout out. I'm sure you've covered one of the basic labs I do in my clinic is some sort of a selenium test.
And, truly, I don't see too many people. Selenium, an important mineral, and Bluetooth iron production, but very important in thyroid function. I actually see more people with, according to the blood tests, a bit of an excess selenium.
Level in their blood. But, I am I pay attention to that. I pay attention to it in my, plant based eaters. Yeah. A lot of them eat a couple Brazil nuts a week.
Brazil nuts from a natural source are super high in selenium. The multivitamin I take again has not just iodine, but has. I think it's 200 micrograms a day of selenium, which is pretty typical.
The vitamin based dose. You don't want to overdo it, but you know, if you're suffering some thyroid condition, if you're on a plant based diet, you might just ask your doctor, can we get a blood selenium se Lee and I, level, and might benefit you to, you know, supplement a little bit, either with foods rich in selenium or a multivitamin that has a small amount in it.
Yes, absolutely. So, Doctor Khan, when someone goes to their cardiologist, let's kind of wrap up the they should be getting a thyroid test right of some sort or what what do they say when they, when they go in like I, you know, how how can we help them out here to get what they need?
The reality is, in standard practice, drawing blood is a pain. There's no income in it. I hate to say that. It takes time. When you get the labs back, it takes more time.
You know that. You see that? I spend, you know, a 10th of my life doing nothing but looking at labs and emailing patients and giving them feedback, sending them their results, sending the results to their other docs to be a team player.
So they probably aren't going to get any labs, but would it be a good idea? And more likely, their primary care provider is going to be more open minded?
I mean, fortunately, there are some labs out there, like old timers like a and life extension where unfortunately you may have to pay for them. They try and make it reasonably priced.
You can pick up pretty comprehensive panel labs on your own if you're struggling. Maybe your doctor doesn't want to do your iodine level or your selenium level or, various other things that I talk about, you talk about.
So people that are proactive, you know, without completely blowing the mortgage, can pick their own labs and get them. But, you know, from a cardiology standpoint, you are obviously at a minimum of fasting cholesterol panel.
There is a more advanced version, but at least get that. I want everybody to get a blood test called light bulb protein A, a inherited cholesterol that can destroy your arteries.
And you have no clue. And it's 20 to 25% of the population. So it's extremely common. I like to see your high sensitivity C-reactive protein. It's always for 20 years plus been an important measure of inflammation.
But some brand new data says it's even more important than we thought. Like to see Omega three blood test. That's nothing. A primary care that gives you draws.
But if you don't have adequate omega three from your diet or supplements, your thyroid, your brain, your heart, your cholesterol, your joints, your eyes are all suffering and particularly your brain.
Oh, I don't mind a homocysteine level and a vitamin D level and some form of blood sugar, insulin, hemoglobin A1, C. But now a lot of these labs you can get there's a new one out there.
Now, I hate to, give a a name, but I don't have any financial ties called life force.com, and Tony Robbins is behind it. So, you know, it's got to be medically sound.
No worries. It's got some great advisors and like $399, you get 40 blood tests. And it's a pretty damn good panel for $399. I've never had I've never referred anybody there yet.
So I don't know where you go to get your blood drawn. They probably send you the tubes, and you got to figure it out. But with these kind of options, even if your medical team is resisting, you can work around them.
Then you just got to find somebody that understands them. Like you. Yeah. And I think that's important is if your doctor's not ordering it for you, then find a doctor that will or go out and do it yourself, because these are life changing labs that we're talking about that you need to know.
Like you said, lipoprotein little a I know when I got mine back and I was like, yeah, I'm good because because it's genetic, like you said it, that's a tough one.
The LDL, triglycerides, those, those you can really make a big impact with your lifestyle diet. And if you had an underlying hypothyroidism problem going on, you can really turn those around or, Yeah.
So, Doctor Khan, thank you so much for your time and your expertise today. I would love for you to share with how everyone could find you. They can visit you in Detroit.
Where else do you hang out with? I love your Instagram. I chuckle a lot. I'm licensed in about 20 states, so I do a lot of telemedicine Florida, Georgia, New York, Texas, Ohio, Illinois, Missouri, Maryland and Wisconsin.
I don't know, Doctor Joel con.com Dr. Joey Kay hsn.com take you to my podcast, taken to my blogs, taken in my clinic, take you to the six books that I've written and have a lot of fun and, you know, more excited about practicing medicine and cardiology than ever because it's just breakthrough after breakthrough after breakthrough.
And it's so much fun being in a small, hands on, high touch clinic where I can really implement new technology and new testing, new therapies and see the results.
So it's good to be free. Free bird. Well, you're doing amazing things, so we appreciate it so much. Thank you for being here today. Thank you so much.
That was such an insightful conversation with Doctor Khan. I proof that understanding the connections in your body can lead to big changes in your health.
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See you next time and stay well.
