October 15, 2025 • 37 mins
Your heart and brain are in constant conversation, and when that connection falters, everything from memory to mood to energy pays the price.
In this episode of Your Health Toolkit: The Neurology Sessions, Dr. Lauren Young and Dr. Ashley Burkman sit down with cardiologist Dr. Jeffrey Thompson and physician assistant Shawn Brady to explore how your heart and brain work in sync, and what happens when that balance is lost.
They unpack how blood flow, inflammation, and autonomic control shape your memory, mood, and energy—and why “normal” checkups can overlook early warning signs.
You’ll learn:
- How the autonomic nervous system connects heart rhythm and brain clarity.
- Why fatigue, brain fog, and poor sleep can signal cardiovascular imbalance.
- What sleep apnea and microvascular dysfunction reveal about hidden stress on the brain and heart.
- The early role of endothelial health and oxygen delivery in long-term resilience.
- Key labs and tests that catch issues before they become crises.
- The daily habits—nutrition, movement, and stress recovery—that protect both systems.
If you’ve ever been told your heart looks “fine” but you still feel worn down, this conversation is your next step toward understanding why and what you can do about it.
Resources & Links:
- Learn more about Cardiologist Dr. Jeffrey Thompsen and Shawn Brady, PA-C, from Center for the Healthy Heart
- Explore articles and resources from Collaborative Natural Health Partners
Your Health Toolkit is a podcast created by the physicians from Collaborative Natural Health Partners (CNHP) – your go-to hub for holistic and integrated family healthcare in Connecticut and New York. At CNHP, we’ve crafted a special blend of expertise, bringing together naturopathic physicians (NPs), osteopathic medicine physicians (DOs), and Advanced Practice Registered Nurses (APRNs) to offer you a warm, integrative, patient-centered approach to health and wellness. If you’re interested in learning more, head over to our website or follow us on Facebook or Instagram for information, articles, and resources to take the guesswork out of your health.
Your Health Toolkit is a podcast presented for general information and educational purposes only. The discussions presented by Dr. Lauren Young and the show’s guests should not be considered medical advice but rather a conversation starter with your doctor. Everyone’s body is unique, and we recommend having a discussion with your personal healthcare team before trying anything discussed on the show.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Lauren Young (00:01):
Hi there, welcome to your health toolkit.
I'm Dr.
Lauren Young.
And I'm Dr.
Ashley Berkman.
Dr.
Berkman and I have been workingtogether for over a decade at
Collaborative Natural HealthPartners.
We have decided to put togethera brand new series all around
neurology.
Dr. Ashley Burkman (00:15):
Yes, thanks so much for inviting me to be
part of this series.
Brain and nervous system healthis something I care deeply
about, both in my work and mypersonal life.
I see many patients whonavigate through tough diagnoses
like Parkinson's, MS,Alzheimer's, either for
themselves or for someone theylove, and it can feel like a
lot.
Dr. Lauren Young (00:31):
So over this series of episodes, we're going
to be bringing you guysspecialists from around the
country on functional neurologyand integrative medicine to
explore what's really going onwith nervous systems and brains
and what we can actually doabout it.
Dr. Ashley Burkman (00:43):
These conversations with these experts
have been eye-opening, veryinspiring, and we can't wait to
share them with all of you.
So let's dive in.
Dr. Lauren Young (00:51):
Now when we talk about brain health, one
thing that really goes hand inhand with it is heart health
because our hearts and ourbrains are so strongly
connected.
So that's what we're going toexplore today.
Joining Dr.
Berkman and myself is aboard-certified cardiologist,
Dr.
Jeffrey Thompson, and physicianassistant Sean Brady from the
Center of Healthy Heart inConnecticut.
They're experts in theconnection between
cardiovascular and neurologicalhealth, and we are thrilled to
(01:14):
have them with us today.
Dr.
Thompson, Sean, welcome to theshow.
Shawn Brady, PA-C (01:18):
Thank you.
Thanks for having us.
Dr. Lauren Young (01:19):
Great to have you here.
So we're doing this neurologyseries, and we decided to kick
it off with cardiologists.
I really just wanted to hearabout you guys first, what you
do and your role in healthcareand how neurology is an
important thing to you ascardiologists.
Dr. Jeffrey Thompsen (01:35):
Well, thank you.
Um yeah, we're we um run theCenter for the Healthy Heart uh
Northern Connecticut, and uhwe've been in the preventative
specialty of cardiovascularwellness for about 13 years now.
Um yes, neurology is completelylinked, especially the
autonomic nervous system and howthat affects uh affects the
(01:56):
heart.
Uh we we study that as well.
Uh so you know we can go intosome of our lines of service
that we do.
Uh we are an integrativecardiology practice, so we tend
to use the best science whereverthat takes us.
Shawn Brady, PA-C (02:12):
Yeah, and then it's really a
cardiovascular, right?
The cardiology is the heart,but the cardiovascular system is
connecting everything.
And so we see sometimes a lotof patients with uh brain
issues, and we wonder what'sgoing on, lots of strokes and
TIAs, and then sometimes justcognitive decline.
We wonder, you know, thatconnection.
We see it sometimes with a lotof the cardiovascular issues.
(02:33):
So um we treat the wholepatient, and so sometimes we see
the heart, people come here forthe heart, but they get a
little extra, so to speak.
Dr. Lauren Young (02:42):
Yeah, for sure.
I think you know, it's very inline with our kind of thinking
of treating the whole person,and you certainly can't just
treat a heart without looking atthe nervous system, and you
can't treat a brain withoutlooking at the heart and the
rest of the body as well, right?
You touched on a term, and Iwant to make sure we make it um
like the autonomic nervoussystem.
I think that's something wewant to just have a little
(03:03):
primer on for listeners so thatthey understand what that is.
Dr. Jeffrey Thompsen (03:07):
Well, essentially it's it's all the
nervous function that we don'tdo consciously.
The parasympathetic and thesympathetic nervous system is
probably part of the autonomicnervous system.
Uh, so we wonder, well, whydoes the heart change its heart
rate?
Why do we change ourrespiratory effort and rate?
Uh, all of those are controlledbeyond our ability.
(03:28):
The disease process affectsthose nerves, which will affect
uh cardiovascular system.
Uh it's it's so interesting.
Um, when I trained uh inmedical school, we didn't
discuss uh the connection of thenervous system and the
cardiovascular system, we didn'tdiscuss the GI system uh with
(03:49):
with the heart, but uh all threeof those systems are linked
together.
It's just fascinating.
Uh and for those who areinterested in the microbiome and
and what kind of bacteria existin our uh in our GI systems, uh
that affects the heart as well.
So it's fascinating.
Dr. Lauren Young (04:07):
Yeah, and then the link between GI and
neurology as well.
Like they're all sointertwined.
Um, you know, you just werespeaking our language because we
are complete microbiome nerds.
Um yeah, yeah.
Um Yeah, and I would love tohear how you kind of explore all
that.
So yeah, we were just talkingabout like there's this Venn
diagram of cardiovascular andneurological conditions, and
(04:31):
there's a lot of overlap insymptoms, but also in etiology
and pathology associated withconditions.
Um what kind of symptoms put onyour radar that you should be
looking at neurologicalcomponents to um people's
illnesses?
Dr. Jeffrey Thompsen (04:46):
Well, I would say fatigue is is one of
the biggest.
Uh it turns out that our uh thefatigue that uh people
experience is is is largelyrelated to uh heart rate uh
variables, uh as far as cardiaccontractility uh and uh cardiac
output when we need it.
(05:08):
Uh fatigue, dizziness, uhlightheadedness, uh just a
feeling of being unwell.
If you've seen a if you've seena patient with advanced uh
congestive heart failure, heartdisease, they have an ashen
appearance about them.
And a lot of that is just poorcardiac contractility, poor uh
cardiac output.
(05:29):
Uh and and those are thosefeatures of the heart are
largely related to our uh ourautonomic nervous system.
Dr. Lauren Young (05:37):
Yeah, that fight or flight response and how
that gets impacted.
And you know, it's one of thethings we kind of have to
reiterate with patients all thetime is you're not supposed to
feel tired.
You know, that's not thatshouldn't be normal.
Dr. Jeffrey Thompsen (05:48):
It is normal for so many people, but
and we know we know this becausewhen we Sean can attest that
there is there is no morerewarding procedure in
cardiology than a standardpacemaker.
As people age, uh their abilityto raise their heart rate with
activity goes down dramatically.
We call it chronotropicinsufficiency.
(06:10):
And uh when you if they'redizzy, if they're passing out,
if they're extremely fatigued,and we see electrical
disturbance in their workup, uha simple pacemaker, uh getting
them up to an adequate heartrate will change their entire
life.
Sean, your thoughts?
Shawn Brady, PA-C (06:29):
Oh, absolutely.
I've seen uh patients actuallywith Lyme disease uh that had
some heart conduction issues,um, and that actually affected
the heart as far as having tooslow of a heart rate, passing
out dizziness, and you know, thepacemaker was the ultimate uh
savior as far as that.
But on top of you know whatyou're talking about, fatigue,
you know, in cardiology, one ofthe big things that can cause
(06:52):
fatigue is a rhythm calledatrial fibrillation or AFib.
Um that rhythm sometimes goesundetected because sometimes
people don't have any feelingsof it.
Sometimes you do getpalpitations or racing heart,
but fatigue can be the onlysymptom.
So in our practice, we're kindof uh AFib detectives.
We do a lot of heart monitoringbecause it's such uh a
low-hanging fruit to find beforesomebody comes.
(07:14):
I work in the ER too, sosometimes we see people come in
with strokes, and lo and behold,the reason they had the stroke
is because they had AFib, butthey had no idea.
Dr. Lauren Young (07:21):
And and it could present as like brain fog,
fatigue, other things that aregoing on, you know, that
dizziness, that fatigue,absolutely.
Dr. Jeffrey Thompsen (07:28):
Sean's right, because if you take uh a
patient that has no atrialcontribution to their cardiac
output, they're losing right offthe bat 30% of their blood
flow, uh just because the top ofthe heart, the atrium, is not
is not contracting in asynchronous fashion.
So uh it is it is devastatingto people.
(07:50):
And and like Sean said, theydon't really have the
palpitations.
Uh they just feel overallunwell and fatigued.
Dr. Lauren Young (07:57):
And I feel like nerve cells are so
sensitive, right?
Like they they don't like notgetting enough oxygen and blood.
Like, and so symptoms offatigue, but also like brain fog
and those type of things hitreally quickly for those
patients.
We just don't have the um, youknow, bandwidth for those
things.
Like those nerve cells are areour little canaries in the coal
mind, you know, they're gonnalet us know right away that
(08:19):
they're not happy, you know.
Shawn Brady, PA-C (08:20):
Yeah, fatigue just opens up this barrel.
So we see fatigue and we startlooking for sleep apnea as well.
Such a such a huge factor onthe heart and the brain, right?
You just said the the neuronsare so dependent on oxygen, so
is the heart.
So the two big organs that getaffected when somebody has sleep
apnea because of the hypoxiathat's happening and the
inflammation that it causes, thefree radicals, it damages the
(08:42):
heart, it damages the brain.
So we start seeing brain fogand fatigue because of sleep
apnea as well.
Dr. Jeffrey Thompsen (08:47):
We go after aggressively sleep apnea.
It affects every single diseaseprocess in the heart.
I tell patients it's anine-hour scary movie that
you're watching uh when you'resleeping.
It's the heart doesn't know thedifference between fight or
flight and uh and suffocatingduring sleep apnea.
So it's it can be devastating.
Dr. Ashley Burkman (09:08):
Yeah, sleep sleep apnea was something we
were just discussing thismorning, is such a component for
everything from heart health toneurologic health.
And patients present not onlytired, but they also can have
anxiety.
They just are in that fight orflight response.
It's palpable.
You can kind of experience itwhen you're just not even
talking to someone, likesomething must be going on with
them.
So I think it's such a hugecomponent of overall neurologic
(09:30):
health and cardiovascularhealth.
Yeah.
Dr. Lauren Young (09:32):
So we've got this Venn diagram looking at
like neurology and cardiology,and um, certainly sleep apnea is
right in the middle of that.
Inflammation is a big piece ofit as well, right?
I imagine you guys areassessing that and looking that
at that a lot.
Um insulin resistance would beanother one, right?
I imagine you're seeing a lotof that as well.
Dr. Jeffrey Thompsen (09:52):
And the insulin resistance is linked is
linked to autonomic nervousdysfunction.
Uh it it all is is intertwined.
Dr. Lauren Young (10:01):
Yeah, gumming up the works with a little too
much sugar is definitely uhdoesn't help anything.
You know, do you guys look andthink about like microvascular
disease, mitochondria, otherthings like that at all?
Shawn Brady, PA-C (10:13):
Yeah, that was thinking of another symptom,
you know, when we talk aboutmicrovascular, certainly
endothelial dysfunction, we werehuge on the blood vessel
function.
And like in males, we seesomebody with uh erectile
dysfunction, that equalsendothelial dysfunction.
We say ED equals ED.
So we actually use a devicecalled endopat, and it looks at
(10:34):
the function of the bloodvessels because that's where it
all happens, right?
It's the foundation of yourheart, it's the foundation of
your vessels.
So if you damage that, ifthere's this dysfunction in the
endothelium, there's going to beproblems downstream.
You know, the heart is a prettystrong muscle.
Uh, and we think the heartpumps to our fingers, it pumps
(10:54):
to the organs.
Well, it's not that strong.
We depend on that microvascularcirculation, the our arterioles
and the muscles that are inthose small vessels to get the
blood actually to those organs.
So if you're havingmicrovascular issues,
endothelial dysfunction, you'regoing to have brain fog,
cognitive decline.
Dr. Jeffrey Thompsen (11:12):
We started our endothelial function
analysis in 2010, and it's it'sbeen proven at Mayo Clinic to be
linked uh to in in actuallyhand blood flow is linked 80%
linked to all forms of coronaryartery disease, from the most
mild to the most severe.
(11:33):
It's an 80% correlation.
The arteries of the hand arebehaving exactly like the ones
of the heart.
Dr. Ashley Burkman (11:39):
I was just going to mention Rhanods disease
and just that Rheynodsphenomenon.
Like when patients tell meabout experiencing that, that's
a clue that their autonomicnervous system may be a bit out
of balance, not justcardiovascular disease, but of
course we want perfusion toperipheral uh hands and feet.
Um and talking about ED, that'sone of my best ways to get
people to get a sleep studydone.
(12:00):
It might help that way.
It's you gotta figure out a wayto get someone to want to do
that and then talk about what itmeans to actually treat it.
But um it is a very uh goodsymptom to think about when
you're thinking about neurologichealth and how it overlaps
cardiovascular disease.
Dr. Lauren Young (12:14):
Yeah, for sure.
And I think when you're lookingfor sleep apnea, you know to
like it, it doesn't, you know,people be like, well, I don't
snore.
And you're like, okay, but thenI don't I don't not interested
in like, well, I'm a healthyBMI.
Yep, not interested in thateither.
You know, like we're justseeing so much of it.
Dr. Jeffrey Thompsen (12:28):
So thank you for that that point, because
people are under themisconception that uh if they're
uh if they're you know low, lowbody weight, that they can't
have sleep apnea.
It turns out it's just relatedto the pharyngeal anatomy.
Uh and uh we've had uhgentlemen with neck size of 14
(12:50):
and a half come in uh withmassive heart failure plus sleep
with sleep apnea.
Shawn Brady, PA-C (12:56):
And once that sleep apnea was addressed, it
was corrected.
Dr. Jeffrey Thompsen (12:58):
Heart failure was corrected.
Yes, we can get the heartfunctioning back to normal once
we we treat this uh this gravecondition at sleep.
Dr. Ashley Burkman (13:08):
I think it's also important.
I think a lot of patients thatI see or that I'm starting to
see more of are compromisedneurodegenerative conditions
that are going to increase theirrisk of sleep apnea and things
like that.
And I think helping peopleunderstand that not only is this
going to protect yourcardiovascular health
downstream, it's also gonnaprotect your neurologic
function, your memory, yourfocus.
When people talk about wantingto prevent like cognitive
(13:30):
decline and things like that,it's so super important that
they really look at the basics,which is of course their diet
and lifestyle, but how you sleepand if that's affecting you.
So so super important.
Dr. Lauren Young (13:40):
That's a good point.
That like I think, you know, umDr.
Berkman and I come from a worldwhere we're seeing a lot of uh
uh neurology and you know,people have multiple sclerosis,
for example, and then orParkinson's disease, and they
don't think to really focus ontheir cardiovascular system.
And I do you guys see peoplewith those conditions and want
to do a deeper dive just giventhe fact that we know that
(14:02):
there's already some pathologyhappening in their bodies?
Shawn Brady, PA-C (14:06):
Yeah, absolutely.
Sometimes a patient will comein just because they they passed
out, they had syncope, and theyhave this underlying condition
like multiple sclerosis ordementia, and we always look at
the heart because they'reconnected.
And usually you find you knoweither a rhythm issue or carotid
artery disease.
Sometimes, you know, sometimesgeneral cardiology, we just
(14:28):
think of the heart.
Uh again, we talk about thewhole patient.
So we look at carotid arteries,we look at intimal thickening,
can be the very first sign thatsomebody has uh atherosclerosis.
But sometimes I find theseterrible pathologies um in the
neck, you know, 70%, 80%stenosis, and people feel fine.
So absolutely, when we havesome patient, we evaluate the
(14:49):
whole system.
Dr. Lauren Young (14:50):
I want to circle back too and and um just
talk about labs real quick andwhat you like to look at,
because you've kind of mentionedsome testing and those type of
things.
Um what are some tests that youfeel like are not on the
conventional docs radar that aresome of your favorites to kind
of assess people'scardiovascular and neurological
(15:10):
health?
Dr. Jeffrey Thompsen (15:11):
If you look at a standard cholesterol
profile, uh we're getting about10 to 20 percent of the
information that's truly neededuh to assess cardiovascular
pathology and risk.
Uh, we start with theinflammatory process.
So there are uh lab assessmentsthat look at uh coronary artery
(15:32):
inflammation specifically, thatuh those if abnormal are linked
to cardiac events, stroke, etc.
Uh, then we look at uh thelarge family of lipid uh
particles that might beabnormal, even though the nor
the standard um we'll call itprimary care uh uh lipid
(15:55):
analysis is really unremarkable.
So it it turns out we'll takegood we'll take quote unquote
good cholesterol, uh with whichis HDL.
Uh HDL is a family, andeverybody can say in their
family, you have some that carrytheir weight and some that
don't.
And there are HDL particlesthat are either not beneficial
(16:20):
or harmful.
Uh so really the goodcholesterol moniker of HDL needs
to be done away with.
It's very heterogeneous, and uhwe study the particle size, we
start study the function, andactually we we can have what's
called dysfunctional HDL, whichis even more harmful than quote
(16:45):
unquote bad cholesterol.
So it's it's a very complexanalysis.
Uh preventive cardiology is notreally a handshake, pat on the
back, and say exercise and eatwell.
It's a very sophisticatedanalysis, right down to the
molecular and genetic level, andthen corresponding or
(17:06):
correlating that with thephysiologic data that Sean had
mentioned.
Shawn Brady, PA-C (17:11):
Yeah.
Yeah, the uh the other markerstoo.
I I we we look at those markersthat Dr.
Thompson just mentioned, uhspecifically.
Uh homocysteine is anothermarker we look at when that's
elevated.
We know there's higher risk ofvascular inflammation
inflammation.
We know there's higher risk foraneurysms when that's there.
And sometimes, you know, thatbecause we're not eating well,
(17:32):
we're kind of chronicallystressed, but there's also some
genetics involved, like MTHFR.
Uh, so we can look at that.
Um, insulin is one that's oftenmissed.
And I look at it all the timebecause, like Dr.
Berkman said earlier, it's it'sit's huge.
A lot of people have insulinresistance.
And if you're just measuringthe hemoglobin A1C or a fasting
blood sugar, you miss that.
(17:54):
So we can look at improvementswith looking at insulin and see
peptides.
Dr. Jeffrey Thompsen (17:59):
And gut gut health as well.
We we study uh we studybacterial composition in terms
of what what bacteria are linkedto that that are linked to
cardiovascular disease.
Uh it there it is a lot thatthat we can study on the on the
gut health in the heart.
Shawn Brady, PA-C (18:19):
Like T the TMAO is one that we look at
that's a byproduct of thebacteria that live in the gut.
And it actually blocks reversecholesterol transport.
So if we see that, we seepeople with higher cholesterol
and more cardiovascular risk.
Um, so those are those are someof the ones we look at.
Um often missed too on atraditional panel is magnesium.
Uh it's such an easy target tolook at that's never looked at
(18:43):
because it's not usual if youhave to order it separately.
And a lot of people, it's neverchecked and it's a lot of times
low from our diet.
Dr. Lauren Young (18:52):
This is such a breath of fresh air.
I know, isn't it?
I will say, like one of ourfirst projects together, Dr.
Burke and I wrote this likeextensive uh article on TMAO,
like probably over 10 years agonow, right?
Steve.
Yeah, yeah.
So it's awesome to hear youguys talk about all of this, and
it's so exciting to reallyacknowledge that like a standard
lab panel can look normal whenthey go to their primary care or
(19:14):
they go to a even a someonewho's not looking at functional
medicine, and yet there isunderlying pathology that's
driving both neurological andcardiovascular disease that we
should really make sure we'readdressing.
Dr. Jeffrey Thompsen (19:25):
Yeah, there's a few red alert labs we
look for.
Uh one is TMAL, one is LPlittle A, uh, which is gaining
more uh gaining more traction inin uh in our knowledge to as
far as valvular heart disease,accelerate coronary artery
disease, and those sort ofthings.
Dr. Lauren Young (19:46):
Yeah, for sure.
I think um, you know, reallyrealizing that you have to do a
deep dive into this stuff and umand you know, some of them are
more modulo um modulating thanothers.
Like we can shift, I mean LPA,I know there's some stuff, but
it is a persnickety littlebugger.
Um so I think it's nice to knowwhen you have that, then you
know you have to go even harderon all the other lifestyle
(20:06):
things and make sure everythingelse is in order, sure.
Um we're gonna take a quickbreak and then we will be coming
right back to start talkingabout solutions and um and all
the great stuff that you guysare doing at your clinic to
empower patients.
If you're a fan of this show,you'll know we talk a lot about
conventional and naturopathicmedicine and how they can play a
(20:28):
role in your overall health.
We call this collaborativemedicine.
And through the work we do atCollaborative Natural Health
Partners, we're able to givepeople the knowledge and tools
they need to feel great everysingle day.
If you're interested inlearning more, head over to our
website, ctnaturalhealth.com,where you'll find articles,
courses, and a bunch ofresources to take the guesswork
out of your health.
(20:48):
Don't wait for your nextcheckup.
The doctor will see you now.
Hi there, welcome back to yourhealth toolkit.
We're here today with Dr.
Jeffrey Thompson and Sean Bradyfrom the Center for Healthy
Heart in Connecticut.
We're talking all things brainand heart health.
Um we were just kind ofdiscussing a lot of the
symptoms, lab tests, red flags.
(21:09):
Um, but I really want to diveinto, you know, how are we
addressing this in our clinics?
You sound like you guys havesome really awesome stuff going
on that I want to hear about.
So we get a, you know, they gettheir normal blood work from
their um doctor, they go for adeeper dive with you guys, and
we find some underlying issuesof inflammation, insulin
resistance, uh microvasculardisease.
(21:30):
What are our next steps?
Dr. Jeffrey Thompsen (21:32):
Well, if I'm seeing inflammation, I start
thinking, okay, what's thelow-hanging fruit?
What does everyone do everyday?
Eat.
So we have to look at diet,right?
That's the first thing.
Uh, if we're putting somethingin our mouth, it's either
helping us or it's hurting us.
It could be neutral, but that'show you have to think of food.
So, what can be causinginflammation in our diets?
(21:53):
So I always look at patientsand have them start a
Mediterranean diet where we'rehaving um really high amounts of
uh colorful vegetables, uh,getting rid of the white foods,
the sweet foods.
You try to get 10 to 12servings of organic, fresh uh
vegetables and fruits, kind ofan eight to four ratio of
(22:15):
vegetable to fruit, get rid ofthe high fructose corn syrup if
they're eating it, and sugars.
Those are huge forinflammation.
Um, trans fats.
So we look at the diet firstoff.
And of course, you know, theother pillars we look at, you
know, exercise, sleep, andstress management.
Um, the world in the last fiveyears has become so stressful
(22:37):
with the way everything's had tochange.
We're doing tons of zooms, uh,we're starting to people are
still not working in the office,we're not getting exercise.
We saw that huge decrease inexercise and movement um during
COVID, uh, social isolation.
So all these things are thingsthat we can work on for
lifestyle.
(22:57):
Um, exercise, I try to getpatients moving uh about an hour
a day uh for four times a week,doing resistance training and
uh aerobic training, um, andsleeping.
I try to get sleep, eight hoursof sleep, at least seven, um,
but uninterrupted sleep, like wetalked about before, if there's
um sleep apnea, that's gonnatotally throw that off.
(23:18):
If uh sleep hygiene, somepeople are doing work on their
computers, get that blue light,they can't sleep, they're waking
up a lot, throwing off insulinat night and blood sugars.
So certainly trying to work onsleep hygiene and then stress
management, right?
Uh, everyone's uh prettystressful or busy with kids,
families, multiple jobs, um, andthen you can't sleep, and so
(23:39):
your mind is uh confused duringthe day.
So doing yoga, meditations,balancing out that sympathetic
and parasympathetic nervoussystem.
Let's talk about duration ofeating, uh, Sean.
Uh often, you know, people getup at six in the morning and
then they spike their insulinwith you know some donuts and
(24:00):
then they late night snacks.
So their battle with insulinspikes is going on 14 hours a
day, where if they were toshrink that window to where uh
the glycemia is moreregularized.
Sean, your thoughts on that?
Shawn Brady, PA-C (24:16):
Oh, absolutely.
The uh intermittent fasting andtime restricted eating, you
know, getting your food intothat six to eleven, six seems
pretty tough to start with.
I usually challenge people atleast 12 hours to start with,
eat during this 12-hour periodand slowly move it back so they
get comfortable.
It's really hard to do, youknow, you hear about six hours.
That's a tough time.
But if you can do an eight-houruh time timed eating in that
(24:39):
window, that helps a lot.
Dr. Ashley Burkman (24:41):
I love the thought of intermittent fasting
and just fasting in general.
There's so much research onneuror regeneration, uh,
reduction of inflammation,rebalancing insulin, things like
that.
So I'm glad you brought thatup.
It's a very powerful tool.
Dr. Jeffrey Thompsen (24:52):
And it helps the cleanup through for
the nerve the nervous system interms of cells that uh need to
be uh need to be cleaned up, uhsenescent or dead cells, and the
the regeneration uh that ispossible with that.
Shawn Brady, PA-C (25:08):
Yeah, and sugar, sugar is such a uh a huge
endemic problem.
I mean, I'm a recoveringsugarholic myself.
I couldn't stop, I'd have a bagof MMs and that it would have
to be uh it would be gone by theend of the day.
So um I know what it's like,but it's amazing how those
cravings are gone once you stopit.
Dr. Lauren Young (25:27):
Um yeah, and I mean, and realistically, our
cardiovascular system doesn'tlove being like becoming a
caramel apple, and our braincertainly does either, like
becoming a crouch potato.
I thought it was reallyinteresting to bring it back to
the autonomic nervous system,too, right?
The like fight or flight, restand digest.
And really the way to help allof this is to, you know,
addressing the fight or flightand the rest and like get us
(25:50):
back into that parasympatheticum chill mode by nurturing our
sleep, our stress management,our food, all these basic
things.
As far as uh other therapeuticsyou're looking at, are you guys
prescribing any specificsupplements?
Or do you not that we want toobviously give anything
particular for people, but justin general, things that you guys
(26:11):
are looking at.
I know we talked about umhomocysteine, for example, and
so there's things like that thatum may be on people's radar to
like talk about.
Dr. Jeffrey Thompsen (26:20):
We believe uh that nitric oxide is where
we start and anything, dietlifestyle uh supplementation
that can get us to nitric oxide,uh, which is the benefit of
these lifestyle modificationsand diet modifications.
(26:43):
Turns out nitric oxide is themost potent uh uh substance that
is that is going to improveendothelial function.
So we start really there.
If you look at beet beet root,it it's it in terms of
supplementation, it is theclosest uh benefit of nitric
(27:04):
oxide.
Your thoughts on that, Sean?
Shawn Brady, PA-C (27:07):
Absolutely.
The beets are really great forthat.
Nitric oxide is super importantfor the for the dilation of the
arteries to keep vascular tonerelaxed.
You know, when we have uhelevated homocysteine, just
since we started talking aboutthat, um the B vitamins are
super important as well uh tohelp with blood vessel function
and regulating that.
(27:28):
Um, certain things likeomega-3s, we always try to get
patients to eat their way tohealth, right?
Because I'd rather have themget nutrients because they have
to eat anyway versus takingpills and pills and pills.
Sometimes it's their bestattempts, it doesn't work.
So we do need supplementation,but trying to get omega-3s uh
from the smash fish, thesardines, the macaron anchovies,
(27:49):
salmon, and herring, since theyhave low mercury, that's a good
way.
But if somebody doesn't eatfish, you can get some omega-3s
from the flax seeds and chiaseeds, even spinach and brussels
sprouts.
So getting those omega-3s up,but if not using a high-quality
supplement that has a a good uhbalance of omega-6 and threes
and a uh GLA and some of thestore brand ones are suspect
(28:13):
sometimes because of the amountof chemicals that might be in
there.
So we usually use a highquality product.
Dr. Jeffrey Thompsen (28:18):
Um and we uh we we also Sean, you can
discuss uh some of the benefitsof niacin uh therapy.
It is a vitamin.
Uh we tend to uh use uh thehigher higher doses of niacin,
uh but the benefits of niacin onlipids is is tremendous.
(28:40):
Uh I mentioned the HDL familyof particles.
Uh you we we have seen betterfunctioning HDL, uh better
quality HDL with three months ofniacin therapy.
Uh and uh and uh you can'tthat's something that pharma
(29:01):
just has never been able tosucceed with.
Shawn Brady, PA-C (29:05):
Right, yeah.
Dr.
Young mentioned LPA, and that'sone of the treatments we
usually um see working prettygood, certain types of niacin,
not the inositol or theflush-free niacin, uh, but
nicotinamide and uh niacin,nicotinic acid, uh, those are
the ones that usually help.
Um, NAC can sometimes helplower that as well.
Um another nutrient we'retalking about is coQ10.
(29:26):
As we age, uh coQ10 levels godown and it affects the heart
because ATP is vital in themitochondrial.
It's important to make ATP,which is our our body's energy
source.
So the brain and the heart arethe two organs that need the
most of it.
So as we age, we don't getenough coQ10.
So meats and fish have it.
Um, if not, then we can use asupplement as well.
Dr. Lauren Young (29:48):
I think, yeah, coQ10 is definitely, we were
talking about that Venn diagramof neurology and cardiology.
CoQ10 is definitely like smackin the middle as far as things
we want to think about and canbe a nutrient.
depleted from certainmedications um or inhibited from
being produced in our bodies,right?
Um and certainly is is found infoods, but um, you know, is
(30:09):
definitely one that I like tolean on a uh a higher dose.
Right.
Shawn Brady, PA-C (30:12):
It's in our population patients, the
patients that have had heartattacks and bypass surgeries,
you know, their statinmedications are standard for
that.
And statins, unfortunately, theway they block the cholesterol
production in the liver, theyalso block the production of
cochi 10.
So you can't eat your way outof that.
So we always have to supplementCoke 10.
Dr. Jeffrey Thompsen (30:29):
And we mentioned the microbiome in
terms of dietary effects onthat.
It turns out that the high thehigh sugary foods promote the
bacteria we don't want.
The high fiber diet forfermentation uh and production
of short chain fatty acids arereally what we're after.
(30:50):
So sugary, high fiber diet andthings like that are so
beneficial.
Dr. Lauren Young (30:55):
Yeah, I I love the idea of food as medicine.
I mean that's like all whatwe're into for sure.
Dr.
Berkman, can you think of anyother supplements or things that
you like or dietary picks forum that cardiovascular neurology
picture?
Dr. Ashley Burkman (31:09):
Yeah I think anything that supports the
mitochondrial function.
So cocutent is the probablymost popular one but all the B
vitamins which are going tooverlap with homocysteine levels
and just mitochondrial functionand mitochondria being the
powerhouses of our cells thatregenerate and so if we've had
you know a heart attack orsomething you know of that
nature, like Sean said, wereally want to revive those
(31:29):
cells and and really you knowsupport in that way.
And of course low sugar.
Dr. Jeffrey Thompsen (31:35):
Your thoughts on L-carnitine in terms
of mitochondrial function, Ithink that's also a benefit.
Dr. Ashley Burkman (31:42):
Carnitine, yeah I love carnitine.
So I think about it a lot in mypatients who are vegan and
vegetarian I mean same coQ10 andthings like that.
So there is a subset ofpatients that I'm more concerned
about maybe supplementing thesethings a little bit heavier
just because they're not goingto get it dietarily.
But yeah carnitine, deribose,things of that nature certainly
we can pull out the whole kitand caboodle depending on what's
(32:03):
happened and how much we wantto invest with that.
Shawn Brady, PA-C (32:06):
For the heart patients that heart failure
patients we have L carnitine andderibose is a must coq10 for
sure PQQ can sometimes help withthat and taurine actually
sometimes helps as well.
Dr. Ashley Burkman (32:18):
You guys are just like not normal
cardiologists I know I'm lovingthis.
Dr. Jeffrey Thompsen (32:21):
We don't normally have conversations like
this with cardiac yeahproviders this is pretty awesome
we're either in the ICU orwe're we're in the in the office
discussing prevention.
Shawn Brady, PA-C (32:32):
Yeah it's hard when I see patients in the
hospital how I can try totransition to help them but I
can't do it there.
You know that they're there foran acute phase right so for
sure traditional medicine in ahospital in a in a general
setting works right we have thisacute care model emergency
medicine it's amazing.
But if we try to this is what Ilearned after years of doing
(32:53):
practice where I wasn't seeingpatients get better.
I was like what is missing sowe're using the same model to
fix something acute to fix achronic problem and it wasn't
working.
Dr. Jeffrey Thompsen (33:03):
And then I think I think the most drastic
example of that is uh when I wasin fellowship uh we had uh
performed a code on a agentleman in a on the tennis
court 55 just succumbed to asudden cardiac death event uh we
could not resuscitate him uhbut there was uh someone who
(33:27):
astutely got a limpid panel andsure enough that HDL was you
know 34 uh so it was that linkthat first made me so interested
in how the genetic uh and andmetabolic profile could put
(33:47):
somebody in that in that riskand here the gentleman was uh
still with the tennis gear andeverybody thought uh uh he was
in complete excellent health butthere was way more to the story
and since I uh since I learnedabout the the slipidemia and the
(34:08):
metabolic component to how thataffected that man's risk it
it's that that's what got methinking about it.
And Sean deals that with that alot in the ER.
Dr. Lauren Young (34:19):
Yeah I think one of the takeaways I take from
today is that there's a falsesense of security with a lipid
panel and a calcium score maybeeven you know that we want to
make sure we're doing a deeperdive and really looking at the
tissue down from like either abattery pack to the cells, the
mitochondria or looking down tolike the the lining of our blood
vessels that endothelialdysfunctions that we're looking
(34:40):
at that piece of things tostart, right?
And then really making surethat we're good there so that we
can build off of that.
And knowing that like thenervous system and the
cardiovascular system work sointerconnected and so um
dependent on each other that youreally can't treat one without
looking at the other.
They're really that connectedso any other final thoughts as
(35:06):
we kind of tell people, youknow, there are a lot of things
we can do we have a lot oftools.
I thought that was reallyinteresting to hear from you
guys as well that you know youcan reverse things, you can
address things, you can gethearts working better, you can
get people their brains workingbetter if we address their sleep
apnea and underlyingconditions.
Dr. Ashley Burkman (35:22):
I was thinking you know for people who
are listening who don't have aprovider they can talk about
this stuff with I just wanted toleave them with some tangible
things that they could startlooking at today.
And really for me I think likeSean said we're just in this
overstressed environment so ifwe can chill out that probably
is one of the best things youcould do.
So creating a gratitude listdecluttering your space and
(35:45):
really connecting the researchand science behind connection
and lack of it during thepandemic was huge on
cardiovascular health, onneurologic health, you know,
just mental health in general soI feel like connection is is
key.
So connecting with peersconnecting with friends.
Dr. Jeffrey Thompsen (36:00):
And let's go back to books and not the
phone maybe not people peoplecome to me you know on their
phones and like we're talkingthe heart here and you could
almost see they're they'rethey're on overdrive from from
the events that they're lookinglooking at on a second by second
(36:22):
basis on these problems.
Dr. Lauren Young (36:24):
I'm guilty as charged but uh you know it's
something that we need to goback to to the basics uh in
terms of you know our ouroverall wellness that's probably
all the time with a patientthat I'm questioning about so
sorry I've been I've been buyingmagazines for that same reason
of like magazines in the housephones get tucked away you know
(36:47):
read a fun article in NationalGeographics or something you
know I love it.
I love it.
Well Dr.
Thompson uh Sean thank you somuch for your time Dr.
Berkman for your time todayguys I feel like we've given
people some some great umthinking points and some tools
to kind of bring to theirphysicians and to their lives um
and to all our listeners thankyou for tuning in to your health
(37:09):
toolkit um we absolutely lovetalking about health and
wellness so if you have aquestion or a topic idea please
find us online atctnaturalhealth.com or on social
media.
Until next time it's me Dr.
Lauren Young wishing you thebest in health happiness and
longevity
Hi there, welcome to your health toolkit.
I'm Dr.
Lauren Young.
And I'm Dr.
Ashley Berkman.
Dr.
Berkman and I have been workingtogether for over a decade at
Collaborative Natural HealthPartners.
We have decided to put togethera brand new series all around
neurology.
Dr. Ashley Burkman (00:15):
Yes, thanks so much for inviting me to be
part of this series.
Brain and nervous system healthis something I care deeply
about, both in my work and mypersonal life.
I see many patients whonavigate through tough diagnoses
like Parkinson's, MS,Alzheimer's, either for
themselves or for someone theylove, and it can feel like a
lot.
Dr. Lauren Young (00:31):
So over this series of episodes, we're going
to be bringing you guysspecialists from around the
country on functional neurologyand integrative medicine to
explore what's really going onwith nervous systems and brains
and what we can actually doabout it.
Dr. Ashley Burkman (00:43):
These conversations with these experts
have been eye-opening, veryinspiring, and we can't wait to
share them with all of you.
So let's dive in.
Dr. Lauren Young (00:51):
Now when we talk about brain health, one
thing that really goes hand inhand with it is heart health
because our hearts and ourbrains are so strongly
connected.
So that's what we're going toexplore today.
Joining Dr.
Berkman and myself is aboard-certified cardiologist,
Dr.
Jeffrey Thompson, and physicianassistant Sean Brady from the
Center of Healthy Heart inConnecticut.
They're experts in theconnection between
cardiovascular and neurologicalhealth, and we are thrilled to
(01:14):
have them with us today.
Dr.
Thompson, Sean, welcome to theshow.
Shawn Brady, PA-C (01:18):
Thank you.
Thanks for having us.
Dr. Lauren Young (01:19):
Great to have you here.
So we're doing this neurologyseries, and we decided to kick
it off with cardiologists.
I really just wanted to hearabout you guys first, what you
do and your role in healthcareand how neurology is an
important thing to you ascardiologists.
Dr. Jeffrey Thompsen (01:35):
Well, thank you.
Um yeah, we're we um run theCenter for the Healthy Heart uh
Northern Connecticut, and uhwe've been in the preventative
specialty of cardiovascularwellness for about 13 years now.
Um yes, neurology is completelylinked, especially the
autonomic nervous system and howthat affects uh affects the
(01:56):
heart.
Uh we we study that as well.
Uh so you know we can go intosome of our lines of service
that we do.
Uh we are an integrativecardiology practice, so we tend
to use the best science whereverthat takes us.
Shawn Brady, PA-C (02:12):
Yeah, and then it's really a
cardiovascular, right?
The cardiology is the heart,but the cardiovascular system is
connecting everything.
And so we see sometimes a lotof patients with uh brain
issues, and we wonder what'sgoing on, lots of strokes and
TIAs, and then sometimes justcognitive decline.
We wonder, you know, thatconnection.
We see it sometimes with a lotof the cardiovascular issues.
(02:33):
So um we treat the wholepatient, and so sometimes we see
the heart, people come here forthe heart, but they get a
little extra, so to speak.
Dr. Lauren Young (02:42):
Yeah, for sure.
I think you know, it's very inline with our kind of thinking
of treating the whole person,and you certainly can't just
treat a heart without looking atthe nervous system, and you
can't treat a brain withoutlooking at the heart and the
rest of the body as well, right?
You touched on a term, and Iwant to make sure we make it um
like the autonomic nervoussystem.
I think that's something wewant to just have a little
(03:03):
primer on for listeners so thatthey understand what that is.
Dr. Jeffrey Thompsen (03:07):
Well, essentially it's it's all the
nervous function that we don'tdo consciously.
The parasympathetic and thesympathetic nervous system is
probably part of the autonomicnervous system.
Uh, so we wonder, well, whydoes the heart change its heart
rate?
Why do we change ourrespiratory effort and rate?
Uh, all of those are controlledbeyond our ability.
(03:28):
The disease process affectsthose nerves, which will affect
uh cardiovascular system.
Uh it's it's so interesting.
Um, when I trained uh inmedical school, we didn't
discuss uh the connection of thenervous system and the
cardiovascular system, we didn'tdiscuss the GI system uh with
(03:49):
with the heart, but uh all threeof those systems are linked
together.
It's just fascinating.
Uh and for those who areinterested in the microbiome and
and what kind of bacteria existin our uh in our GI systems, uh
that affects the heart as well.
So it's fascinating.
Dr. Lauren Young (04:07):
Yeah, and then the link between GI and
neurology as well.
Like they're all sointertwined.
Um, you know, you just werespeaking our language because we
are complete microbiome nerds.
Um yeah, yeah.
Um Yeah, and I would love tohear how you kind of explore all
that.
So yeah, we were just talkingabout like there's this Venn
diagram of cardiovascular andneurological conditions, and
(04:31):
there's a lot of overlap insymptoms, but also in etiology
and pathology associated withconditions.
Um what kind of symptoms put onyour radar that you should be
looking at neurologicalcomponents to um people's
illnesses?
Dr. Jeffrey Thompsen (04:46):
Well, I would say fatigue is is one of
the biggest.
Uh it turns out that our uh thefatigue that uh people
experience is is is largelyrelated to uh heart rate uh
variables, uh as far as cardiaccontractility uh and uh cardiac
output when we need it.
(05:08):
Uh fatigue, dizziness, uhlightheadedness, uh just a
feeling of being unwell.
If you've seen a if you've seena patient with advanced uh
congestive heart failure, heartdisease, they have an ashen
appearance about them.
And a lot of that is just poorcardiac contractility, poor uh
cardiac output.
(05:29):
Uh and and those are thosefeatures of the heart are
largely related to our uh ourautonomic nervous system.
Dr. Lauren Young (05:37):
Yeah, that fight or flight response and how
that gets impacted.
And you know, it's one of thethings we kind of have to
reiterate with patients all thetime is you're not supposed to
feel tired.
You know, that's not thatshouldn't be normal.
Dr. Jeffrey Thompsen (05:48):
It is normal for so many people, but
and we know we know this becausewhen we Sean can attest that
there is there is no morerewarding procedure in
cardiology than a standardpacemaker.
As people age, uh their abilityto raise their heart rate with
activity goes down dramatically.
We call it chronotropicinsufficiency.
(06:10):
And uh when you if they'redizzy, if they're passing out,
if they're extremely fatigued,and we see electrical
disturbance in their workup, uha simple pacemaker, uh getting
them up to an adequate heartrate will change their entire
life.
Sean, your thoughts?
Shawn Brady, PA-C (06:29):
Oh, absolutely.
I've seen uh patients actuallywith Lyme disease uh that had
some heart conduction issues,um, and that actually affected
the heart as far as having tooslow of a heart rate, passing
out dizziness, and you know, thepacemaker was the ultimate uh
savior as far as that.
But on top of you know whatyou're talking about, fatigue,
you know, in cardiology, one ofthe big things that can cause
(06:52):
fatigue is a rhythm calledatrial fibrillation or AFib.
Um that rhythm sometimes goesundetected because sometimes
people don't have any feelingsof it.
Sometimes you do getpalpitations or racing heart,
but fatigue can be the onlysymptom.
So in our practice, we're kindof uh AFib detectives.
We do a lot of heart monitoringbecause it's such uh a
low-hanging fruit to find beforesomebody comes.
(07:14):
I work in the ER too, sosometimes we see people come in
with strokes, and lo and behold,the reason they had the stroke
is because they had AFib, butthey had no idea.
Dr. Lauren Young (07:21):
And and it could present as like brain fog,
fatigue, other things that aregoing on, you know, that
dizziness, that fatigue,absolutely.
Dr. Jeffrey Thompsen (07:28):
Sean's right, because if you take uh a
patient that has no atrialcontribution to their cardiac
output, they're losing right offthe bat 30% of their blood
flow, uh just because the top ofthe heart, the atrium, is not
is not contracting in asynchronous fashion.
So uh it is it is devastatingto people.
(07:50):
And and like Sean said, theydon't really have the
palpitations.
Uh they just feel overallunwell and fatigued.
Dr. Lauren Young (07:57):
And I feel like nerve cells are so
sensitive, right?
Like they they don't like notgetting enough oxygen and blood.
Like, and so symptoms offatigue, but also like brain fog
and those type of things hitreally quickly for those
patients.
We just don't have the um, youknow, bandwidth for those
things.
Like those nerve cells are areour little canaries in the coal
mind, you know, they're gonnalet us know right away that
(08:19):
they're not happy, you know.
Shawn Brady, PA-C (08:20):
Yeah, fatigue just opens up this barrel.
So we see fatigue and we startlooking for sleep apnea as well.
Such a such a huge factor onthe heart and the brain, right?
You just said the the neuronsare so dependent on oxygen, so
is the heart.
So the two big organs that getaffected when somebody has sleep
apnea because of the hypoxiathat's happening and the
inflammation that it causes, thefree radicals, it damages the
(08:42):
heart, it damages the brain.
So we start seeing brain fogand fatigue because of sleep
apnea as well.
Dr. Jeffrey Thompsen (08:47):
We go after aggressively sleep apnea.
It affects every single diseaseprocess in the heart.
I tell patients it's anine-hour scary movie that
you're watching uh when you'resleeping.
It's the heart doesn't know thedifference between fight or
flight and uh and suffocatingduring sleep apnea.
So it's it can be devastating.
Dr. Ashley Burkman (09:08):
Yeah, sleep sleep apnea was something we
were just discussing thismorning, is such a component for
everything from heart health toneurologic health.
And patients present not onlytired, but they also can have
anxiety.
They just are in that fight orflight response.
It's palpable.
You can kind of experience itwhen you're just not even
talking to someone, likesomething must be going on with
them.
So I think it's such a hugecomponent of overall neurologic
(09:30):
health and cardiovascularhealth.
Yeah.
Dr. Lauren Young (09:32):
So we've got this Venn diagram looking at
like neurology and cardiology,and um, certainly sleep apnea is
right in the middle of that.
Inflammation is a big piece ofit as well, right?
I imagine you guys areassessing that and looking that
at that a lot.
Um insulin resistance would beanother one, right?
I imagine you're seeing a lotof that as well.
Dr. Jeffrey Thompsen (09:52):
And the insulin resistance is linked is
linked to autonomic nervousdysfunction.
Uh it it all is is intertwined.
Dr. Lauren Young (10:01):
Yeah, gumming up the works with a little too
much sugar is definitely uhdoesn't help anything.
You know, do you guys look andthink about like microvascular
disease, mitochondria, otherthings like that at all?
Shawn Brady, PA-C (10:13):
Yeah, that was thinking of another symptom,
you know, when we talk aboutmicrovascular, certainly
endothelial dysfunction, we werehuge on the blood vessel
function.
And like in males, we seesomebody with uh erectile
dysfunction, that equalsendothelial dysfunction.
We say ED equals ED.
So we actually use a devicecalled endopat, and it looks at
(10:34):
the function of the bloodvessels because that's where it
all happens, right?
It's the foundation of yourheart, it's the foundation of
your vessels.
So if you damage that, ifthere's this dysfunction in the
endothelium, there's going to beproblems downstream.
You know, the heart is a prettystrong muscle.
Uh, and we think the heartpumps to our fingers, it pumps
(10:54):
to the organs.
Well, it's not that strong.
We depend on that microvascularcirculation, the our arterioles
and the muscles that are inthose small vessels to get the
blood actually to those organs.
So if you're havingmicrovascular issues,
endothelial dysfunction, you'regoing to have brain fog,
cognitive decline.
Dr. Jeffrey Thompsen (11:12):
We started our endothelial function
analysis in 2010, and it's it'sbeen proven at Mayo Clinic to be
linked uh to in in actuallyhand blood flow is linked 80%
linked to all forms of coronaryartery disease, from the most
mild to the most severe.
(11:33):
It's an 80% correlation.
The arteries of the hand arebehaving exactly like the ones
of the heart.
Dr. Ashley Burkman (11:39):
I was just going to mention Rhanods disease
and just that Rheynodsphenomenon.
Like when patients tell meabout experiencing that, that's
a clue that their autonomicnervous system may be a bit out
of balance, not justcardiovascular disease, but of
course we want perfusion toperipheral uh hands and feet.
Um and talking about ED, that'sone of my best ways to get
people to get a sleep studydone.
(12:00):
It might help that way.
It's you gotta figure out a wayto get someone to want to do
that and then talk about what itmeans to actually treat it.
But um it is a very uh goodsymptom to think about when
you're thinking about neurologichealth and how it overlaps
cardiovascular disease.
Dr. Lauren Young (12:14):
Yeah, for sure.
And I think when you're lookingfor sleep apnea, you know to
like it, it doesn't, you know,people be like, well, I don't
snore.
And you're like, okay, but thenI don't I don't not interested
in like, well, I'm a healthyBMI.
Yep, not interested in thateither.
You know, like we're justseeing so much of it.
Dr. Jeffrey Thompsen (12:28):
So thank you for that that point, because
people are under themisconception that uh if they're
uh if they're you know low, lowbody weight, that they can't
have sleep apnea.
It turns out it's just relatedto the pharyngeal anatomy.
Uh and uh we've had uhgentlemen with neck size of 14
(12:50):
and a half come in uh withmassive heart failure plus sleep
with sleep apnea.
Shawn Brady, PA-C (12:56):
And once that sleep apnea was addressed, it
was corrected.
Dr. Jeffrey Thompsen (12:58):
Heart failure was corrected.
Yes, we can get the heartfunctioning back to normal once
we we treat this uh this gravecondition at sleep.
Dr. Ashley Burkman (13:08):
I think it's also important.
I think a lot of patients thatI see or that I'm starting to
see more of are compromisedneurodegenerative conditions
that are going to increase theirrisk of sleep apnea and things
like that.
And I think helping peopleunderstand that not only is this
going to protect yourcardiovascular health
downstream, it's also gonnaprotect your neurologic
function, your memory, yourfocus.
When people talk about wantingto prevent like cognitive
(13:30):
decline and things like that,it's so super important that
they really look at the basics,which is of course their diet
and lifestyle, but how you sleepand if that's affecting you.
So so super important.
Dr. Lauren Young (13:40):
That's a good point.
That like I think, you know, umDr.
Berkman and I come from a worldwhere we're seeing a lot of uh
uh neurology and you know,people have multiple sclerosis,
for example, and then orParkinson's disease, and they
don't think to really focus ontheir cardiovascular system.
And I do you guys see peoplewith those conditions and want
to do a deeper dive just giventhe fact that we know that
(14:02):
there's already some pathologyhappening in their bodies?
Shawn Brady, PA-C (14:06):
Yeah, absolutely.
Sometimes a patient will comein just because they they passed
out, they had syncope, and theyhave this underlying condition
like multiple sclerosis ordementia, and we always look at
the heart because they'reconnected.
And usually you find you knoweither a rhythm issue or carotid
artery disease.
Sometimes, you know, sometimesgeneral cardiology, we just
(14:28):
think of the heart.
Uh again, we talk about thewhole patient.
So we look at carotid arteries,we look at intimal thickening,
can be the very first sign thatsomebody has uh atherosclerosis.
But sometimes I find theseterrible pathologies um in the
neck, you know, 70%, 80%stenosis, and people feel fine.
So absolutely, when we havesome patient, we evaluate the
(14:49):
whole system.
Dr. Lauren Young (14:50):
I want to circle back too and and um just
talk about labs real quick andwhat you like to look at,
because you've kind of mentionedsome testing and those type of
things.
Um what are some tests that youfeel like are not on the
conventional docs radar that aresome of your favorites to kind
of assess people'scardiovascular and neurological
(15:10):
health?
Dr. Jeffrey Thompsen (15:11):
If you look at a standard cholesterol
profile, uh we're getting about10 to 20 percent of the
information that's truly neededuh to assess cardiovascular
pathology and risk.
Uh, we start with theinflammatory process.
So there are uh lab assessmentsthat look at uh coronary artery
(15:32):
inflammation specifically, thatuh those if abnormal are linked
to cardiac events, stroke, etc.
Uh, then we look at uh thelarge family of lipid uh
particles that might beabnormal, even though the nor
the standard um we'll call itprimary care uh uh lipid
(15:55):
analysis is really unremarkable.
So it it turns out we'll takegood we'll take quote unquote
good cholesterol, uh with whichis HDL.
Uh HDL is a family, andeverybody can say in their
family, you have some that carrytheir weight and some that
don't.
And there are HDL particlesthat are either not beneficial
(16:20):
or harmful.
Uh so really the goodcholesterol moniker of HDL needs
to be done away with.
It's very heterogeneous, and uhwe study the particle size, we
start study the function, andactually we we can have what's
called dysfunctional HDL, whichis even more harmful than quote
(16:45):
unquote bad cholesterol.
So it's it's a very complexanalysis.
Uh preventive cardiology is notreally a handshake, pat on the
back, and say exercise and eatwell.
It's a very sophisticatedanalysis, right down to the
molecular and genetic level, andthen corresponding or
(17:06):
correlating that with thephysiologic data that Sean had
mentioned.
Shawn Brady, PA-C (17:11):
Yeah.
Yeah, the uh the other markerstoo.
I I we we look at those markersthat Dr.
Thompson just mentioned, uhspecifically.
Uh homocysteine is anothermarker we look at when that's
elevated.
We know there's higher risk ofvascular inflammation
inflammation.
We know there's higher risk foraneurysms when that's there.
And sometimes, you know, thatbecause we're not eating well,
(17:32):
we're kind of chronicallystressed, but there's also some
genetics involved, like MTHFR.
Uh, so we can look at that.
Um, insulin is one that's oftenmissed.
And I look at it all the timebecause, like Dr.
Berkman said earlier, it's it'sit's huge.
A lot of people have insulinresistance.
And if you're just measuringthe hemoglobin A1C or a fasting
blood sugar, you miss that.
(17:54):
So we can look at improvementswith looking at insulin and see
peptides.
Dr. Jeffrey Thompsen (17:59):
And gut gut health as well.
We we study uh we studybacterial composition in terms
of what what bacteria are linkedto that that are linked to
cardiovascular disease.
Uh it there it is a lot thatthat we can study on the on the
gut health in the heart.
Shawn Brady, PA-C (18:19):
Like T the TMAO is one that we look at
that's a byproduct of thebacteria that live in the gut.
And it actually blocks reversecholesterol transport.
So if we see that, we seepeople with higher cholesterol
and more cardiovascular risk.
Um, so those are those are someof the ones we look at.
Um often missed too on atraditional panel is magnesium.
Uh it's such an easy target tolook at that's never looked at
(18:43):
because it's not usual if youhave to order it separately.
And a lot of people, it's neverchecked and it's a lot of times
low from our diet.
Dr. Lauren Young (18:52):
This is such a breath of fresh air.
I know, isn't it?
I will say, like one of ourfirst projects together, Dr.
Burke and I wrote this likeextensive uh article on TMAO,
like probably over 10 years agonow, right?
Steve.
Yeah, yeah.
So it's awesome to hear youguys talk about all of this, and
it's so exciting to reallyacknowledge that like a standard
lab panel can look normal whenthey go to their primary care or
(19:14):
they go to a even a someonewho's not looking at functional
medicine, and yet there isunderlying pathology that's
driving both neurological andcardiovascular disease that we
should really make sure we'readdressing.
Dr. Jeffrey Thompsen (19:25):
Yeah, there's a few red alert labs we
look for.
Uh one is TMAL, one is LPlittle A, uh, which is gaining
more uh gaining more traction inin uh in our knowledge to as
far as valvular heart disease,accelerate coronary artery
disease, and those sort ofthings.
Dr. Lauren Young (19:46):
Yeah, for sure.
I think um, you know, reallyrealizing that you have to do a
deep dive into this stuff and umand you know, some of them are
more modulo um modulating thanothers.
Like we can shift, I mean LPA,I know there's some stuff, but
it is a persnickety littlebugger.
Um so I think it's nice to knowwhen you have that, then you
know you have to go even harderon all the other lifestyle
(20:06):
things and make sure everythingelse is in order, sure.
Um we're gonna take a quickbreak and then we will be coming
right back to start talkingabout solutions and um and all
the great stuff that you guysare doing at your clinic to
empower patients.
If you're a fan of this show,you'll know we talk a lot about
conventional and naturopathicmedicine and how they can play a
(20:28):
role in your overall health.
We call this collaborativemedicine.
And through the work we do atCollaborative Natural Health
Partners, we're able to givepeople the knowledge and tools
they need to feel great everysingle day.
If you're interested inlearning more, head over to our
website, ctnaturalhealth.com,where you'll find articles,
courses, and a bunch ofresources to take the guesswork
out of your health.
(20:48):
Don't wait for your nextcheckup.
The doctor will see you now.
Hi there, welcome back to yourhealth toolkit.
We're here today with Dr.
Jeffrey Thompson and Sean Bradyfrom the Center for Healthy
Heart in Connecticut.
We're talking all things brainand heart health.
Um we were just kind ofdiscussing a lot of the
symptoms, lab tests, red flags.
(21:09):
Um, but I really want to diveinto, you know, how are we
addressing this in our clinics?
You sound like you guys havesome really awesome stuff going
on that I want to hear about.
So we get a, you know, they gettheir normal blood work from
their um doctor, they go for adeeper dive with you guys, and
we find some underlying issuesof inflammation, insulin
resistance, uh microvasculardisease.
(21:30):
What are our next steps?
Dr. Jeffrey Thompsen (21:32):
Well, if I'm seeing inflammation, I start
thinking, okay, what's thelow-hanging fruit?
What does everyone do everyday?
Eat.
So we have to look at diet,right?
That's the first thing.
Uh, if we're putting somethingin our mouth, it's either
helping us or it's hurting us.
It could be neutral, but that'show you have to think of food.
So, what can be causinginflammation in our diets?
(21:53):
So I always look at patientsand have them start a
Mediterranean diet where we'rehaving um really high amounts of
uh colorful vegetables, uh,getting rid of the white foods,
the sweet foods.
You try to get 10 to 12servings of organic, fresh uh
vegetables and fruits, kind ofan eight to four ratio of
(22:15):
vegetable to fruit, get rid ofthe high fructose corn syrup if
they're eating it, and sugars.
Those are huge forinflammation.
Um, trans fats.
So we look at the diet firstoff.
And of course, you know, theother pillars we look at, you
know, exercise, sleep, andstress management.
Um, the world in the last fiveyears has become so stressful
(22:37):
with the way everything's had tochange.
We're doing tons of zooms, uh,we're starting to people are
still not working in the office,we're not getting exercise.
We saw that huge decrease inexercise and movement um during
COVID, uh, social isolation.
So all these things are thingsthat we can work on for
lifestyle.
(22:57):
Um, exercise, I try to getpatients moving uh about an hour
a day uh for four times a week,doing resistance training and
uh aerobic training, um, andsleeping.
I try to get sleep, eight hoursof sleep, at least seven, um,
but uninterrupted sleep, like wetalked about before, if there's
um sleep apnea, that's gonnatotally throw that off.
(23:18):
If uh sleep hygiene, somepeople are doing work on their
computers, get that blue light,they can't sleep, they're waking
up a lot, throwing off insulinat night and blood sugars.
So certainly trying to work onsleep hygiene and then stress
management, right?
Uh, everyone's uh prettystressful or busy with kids,
families, multiple jobs, um, andthen you can't sleep, and so
(23:39):
your mind is uh confused duringthe day.
So doing yoga, meditations,balancing out that sympathetic
and parasympathetic nervoussystem.
Let's talk about duration ofeating, uh, Sean.
Uh often, you know, people getup at six in the morning and
then they spike their insulinwith you know some donuts and
(24:00):
then they late night snacks.
So their battle with insulinspikes is going on 14 hours a
day, where if they were toshrink that window to where uh
the glycemia is moreregularized.
Sean, your thoughts on that?
Shawn Brady, PA-C (24:16):
Oh, absolutely.
The uh intermittent fasting andtime restricted eating, you
know, getting your food intothat six to eleven, six seems
pretty tough to start with.
I usually challenge people atleast 12 hours to start with,
eat during this 12-hour periodand slowly move it back so they
get comfortable.
It's really hard to do, youknow, you hear about six hours.
That's a tough time.
But if you can do an eight-houruh time timed eating in that
(24:39):
window, that helps a lot.
Dr. Ashley Burkman (24:41):
I love the thought of intermittent fasting
and just fasting in general.
There's so much research onneuror regeneration, uh,
reduction of inflammation,rebalancing insulin, things like
that.
So I'm glad you brought thatup.
It's a very powerful tool.
Dr. Jeffrey Thompsen (24:52):
And it helps the cleanup through for
the nerve the nervous system interms of cells that uh need to
be uh need to be cleaned up, uhsenescent or dead cells, and the
the regeneration uh that ispossible with that.
Shawn Brady, PA-C (25:08):
Yeah, and sugar, sugar is such a uh a huge
endemic problem.
I mean, I'm a recoveringsugarholic myself.
I couldn't stop, I'd have a bagof MMs and that it would have
to be uh it would be gone by theend of the day.
So um I know what it's like,but it's amazing how those
cravings are gone once you stopit.
Dr. Lauren Young (25:27):
Um yeah, and I mean, and realistically, our
cardiovascular system doesn'tlove being like becoming a
caramel apple, and our braincertainly does either, like
becoming a crouch potato.
I thought it was reallyinteresting to bring it back to
the autonomic nervous system,too, right?
The like fight or flight, restand digest.
And really the way to help allof this is to, you know,
addressing the fight or flightand the rest and like get us
(25:50):
back into that parasympatheticum chill mode by nurturing our
sleep, our stress management,our food, all these basic
things.
As far as uh other therapeuticsyou're looking at, are you guys
prescribing any specificsupplements?
Or do you not that we want toobviously give anything
particular for people, but justin general, things that you guys
(26:11):
are looking at.
I know we talked about umhomocysteine, for example, and
so there's things like that thatum may be on people's radar to
like talk about.
Dr. Jeffrey Thompsen (26:20):
We believe uh that nitric oxide is where
we start and anything, dietlifestyle uh supplementation
that can get us to nitric oxide,uh, which is the benefit of
these lifestyle modificationsand diet modifications.
(26:43):
Turns out nitric oxide is themost potent uh uh substance that
is that is going to improveendothelial function.
So we start really there.
If you look at beet beet root,it it's it in terms of
supplementation, it is theclosest uh benefit of nitric
(27:04):
oxide.
Your thoughts on that, Sean?
Shawn Brady, PA-C (27:07):
Absolutely.
The beets are really great forthat.
Nitric oxide is super importantfor the for the dilation of the
arteries to keep vascular tonerelaxed.
You know, when we have uhelevated homocysteine, just
since we started talking aboutthat, um the B vitamins are
super important as well uh tohelp with blood vessel function
and regulating that.
(27:28):
Um, certain things likeomega-3s, we always try to get
patients to eat their way tohealth, right?
Because I'd rather have themget nutrients because they have
to eat anyway versus takingpills and pills and pills.
Sometimes it's their bestattempts, it doesn't work.
So we do need supplementation,but trying to get omega-3s uh
from the smash fish, thesardines, the macaron anchovies,
(27:49):
salmon, and herring, since theyhave low mercury, that's a good
way.
But if somebody doesn't eatfish, you can get some omega-3s
from the flax seeds and chiaseeds, even spinach and brussels
sprouts.
So getting those omega-3s up,but if not using a high-quality
supplement that has a a good uhbalance of omega-6 and threes
and a uh GLA and some of thestore brand ones are suspect
(28:13):
sometimes because of the amountof chemicals that might be in
there.
So we usually use a highquality product.
Dr. Jeffrey Thompsen (28:18):
Um and we uh we we also Sean, you can
discuss uh some of the benefitsof niacin uh therapy.
It is a vitamin.
Uh we tend to uh use uh thehigher higher doses of niacin,
uh but the benefits of niacin onlipids is is tremendous.
(28:40):
Uh I mentioned the HDL familyof particles.
Uh you we we have seen betterfunctioning HDL, uh better
quality HDL with three months ofniacin therapy.
Uh and uh and uh you can'tthat's something that pharma
(29:01):
just has never been able tosucceed with.
Shawn Brady, PA-C (29:05):
Right, yeah.
Dr.
Young mentioned LPA, and that'sone of the treatments we
usually um see working prettygood, certain types of niacin,
not the inositol or theflush-free niacin, uh, but
nicotinamide and uh niacin,nicotinic acid, uh, those are
the ones that usually help.
Um, NAC can sometimes helplower that as well.
Um another nutrient we'retalking about is coQ10.
(29:26):
As we age, uh coQ10 levels godown and it affects the heart
because ATP is vital in themitochondrial.
It's important to make ATP,which is our our body's energy
source.
So the brain and the heart arethe two organs that need the
most of it.
So as we age, we don't getenough coQ10.
So meats and fish have it.
Um, if not, then we can use asupplement as well.
Dr. Lauren Young (29:48):
I think, yeah, coQ10 is definitely, we were
talking about that Venn diagramof neurology and cardiology.
CoQ10 is definitely like smackin the middle as far as things
we want to think about and canbe a nutrient.
depleted from certainmedications um or inhibited from
being produced in our bodies,right?
Um and certainly is is found infoods, but um, you know, is
(30:09):
definitely one that I like tolean on a uh a higher dose.
Right.
Shawn Brady, PA-C (30:12):
It's in our population patients, the
patients that have had heartattacks and bypass surgeries,
you know, their statinmedications are standard for
that.
And statins, unfortunately, theway they block the cholesterol
production in the liver, theyalso block the production of
cochi 10.
So you can't eat your way outof that.
So we always have to supplementCoke 10.
Dr. Jeffrey Thompsen (30:29):
And we mentioned the microbiome in
terms of dietary effects onthat.
It turns out that the high thehigh sugary foods promote the
bacteria we don't want.
The high fiber diet forfermentation uh and production
of short chain fatty acids arereally what we're after.
(30:50):
So sugary, high fiber diet andthings like that are so
beneficial.
Dr. Lauren Young (30:55):
Yeah, I I love the idea of food as medicine.
I mean that's like all whatwe're into for sure.
Dr.
Berkman, can you think of anyother supplements or things that
you like or dietary picks forum that cardiovascular neurology
picture?
Dr. Ashley Burkman (31:09):
Yeah I think anything that supports the
mitochondrial function.
So cocutent is the probablymost popular one but all the B
vitamins which are going tooverlap with homocysteine levels
and just mitochondrial functionand mitochondria being the
powerhouses of our cells thatregenerate and so if we've had
you know a heart attack orsomething you know of that
nature, like Sean said, wereally want to revive those
(31:29):
cells and and really you knowsupport in that way.
And of course low sugar.
Dr. Jeffrey Thompsen (31:35):
Your thoughts on L-carnitine in terms
of mitochondrial function, Ithink that's also a benefit.
Dr. Ashley Burkman (31:42):
Carnitine, yeah I love carnitine.
So I think about it a lot in mypatients who are vegan and
vegetarian I mean same coQ10 andthings like that.
So there is a subset ofpatients that I'm more concerned
about maybe supplementing thesethings a little bit heavier
just because they're not goingto get it dietarily.
But yeah carnitine, deribose,things of that nature certainly
we can pull out the whole kitand caboodle depending on what's
(32:03):
happened and how much we wantto invest with that.
Shawn Brady, PA-C (32:06):
For the heart patients that heart failure
patients we have L carnitine andderibose is a must coq10 for
sure PQQ can sometimes help withthat and taurine actually
sometimes helps as well.
Dr. Ashley Burkman (32:18):
You guys are just like not normal
cardiologists I know I'm lovingthis.
Dr. Jeffrey Thompsen (32:21):
We don't normally have conversations like
this with cardiac yeahproviders this is pretty awesome
we're either in the ICU orwe're we're in the in the office
discussing prevention.
Shawn Brady, PA-C (32:32):
Yeah it's hard when I see patients in the
hospital how I can try totransition to help them but I
can't do it there.
You know that they're there foran acute phase right so for
sure traditional medicine in ahospital in a in a general
setting works right we have thisacute care model emergency
medicine it's amazing.
But if we try to this is what Ilearned after years of doing
(32:53):
practice where I wasn't seeingpatients get better.
I was like what is missing sowe're using the same model to
fix something acute to fix achronic problem and it wasn't
working.
Dr. Jeffrey Thompsen (33:03):
And then I think I think the most drastic
example of that is uh when I wasin fellowship uh we had uh
performed a code on a agentleman in a on the tennis
court 55 just succumbed to asudden cardiac death event uh we
could not resuscitate him uhbut there was uh someone who
(33:27):
astutely got a limpid panel andsure enough that HDL was you
know 34 uh so it was that linkthat first made me so interested
in how the genetic uh and andmetabolic profile could put
(33:47):
somebody in that in that riskand here the gentleman was uh
still with the tennis gear andeverybody thought uh uh he was
in complete excellent health butthere was way more to the story
and since I uh since I learnedabout the the slipidemia and the
(34:08):
metabolic component to how thataffected that man's risk it
it's that that's what got methinking about it.
And Sean deals that with that alot in the ER.
Dr. Lauren Young (34:19):
Yeah I think one of the takeaways I take from
today is that there's a falsesense of security with a lipid
panel and a calcium score maybeeven you know that we want to
make sure we're doing a deeperdive and really looking at the
tissue down from like either abattery pack to the cells, the
mitochondria or looking down tolike the the lining of our blood
vessels that endothelialdysfunctions that we're looking
(34:40):
at that piece of things tostart, right?
And then really making surethat we're good there so that we
can build off of that.
And knowing that like thenervous system and the
cardiovascular system work sointerconnected and so um
dependent on each other that youreally can't treat one without
looking at the other.
They're really that connectedso any other final thoughts as
(35:06):
we kind of tell people, youknow, there are a lot of things
we can do we have a lot oftools.
I thought that was reallyinteresting to hear from you
guys as well that you know youcan reverse things, you can
address things, you can gethearts working better, you can
get people their brains workingbetter if we address their sleep
apnea and underlyingconditions.
Dr. Ashley Burkman (35:22):
I was thinking you know for people who
are listening who don't have aprovider they can talk about
this stuff with I just wanted toleave them with some tangible
things that they could startlooking at today.
And really for me I think likeSean said we're just in this
overstressed environment so ifwe can chill out that probably
is one of the best things youcould do.
So creating a gratitude listdecluttering your space and
(35:45):
really connecting the researchand science behind connection
and lack of it during thepandemic was huge on
cardiovascular health, onneurologic health, you know,
just mental health in general soI feel like connection is is
key.
So connecting with peersconnecting with friends.
Dr. Jeffrey Thompsen (36:00):
And let's go back to books and not the
phone maybe not people peoplecome to me you know on their
phones and like we're talkingthe heart here and you could
almost see they're they'rethey're on overdrive from from
the events that they're lookinglooking at on a second by second
(36:22):
basis on these problems.
Dr. Lauren Young (36:24):
I'm guilty as charged but uh you know it's
something that we need to goback to to the basics uh in
terms of you know our ouroverall wellness that's probably
all the time with a patientthat I'm questioning about so
sorry I've been I've been buyingmagazines for that same reason
of like magazines in the housephones get tucked away you know
(36:47):
read a fun article in NationalGeographics or something you
know I love it.
I love it.
Well Dr.
Thompson uh Sean thank you somuch for your time Dr.
Berkman for your time todayguys I feel like we've given
people some some great umthinking points and some tools
to kind of bring to theirphysicians and to their lives um
and to all our listeners thankyou for tuning in to your health
(37:09):
toolkit um we absolutely lovetalking about health and
wellness so if you have aquestion or a topic idea please
find us online atctnaturalhealth.com or on social
media.
Until next time it's me Dr.
Lauren Young wishing you thebest in health happiness and
longevity
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