The Many Faces of Heart Disease and Cardiovascular Disease

By: Robert L. Bard, MD, Lennard Goetze, Ed.D and Graciella Davi

Heart disease and cardiovascular disease (CVD) are umbrella terms encompassing a wide range of conditions that affect the heart and blood vessels. These conditions can lead to serious complications, including heart attacks, strokes, and even death. Understanding the various types of heart disease can help individuals recognize symptoms early, seek appropriate treatment, and take preventative measures to maintain heart health.

1) CORONARY ARTERY DISEASE (CAD) is one of the most common types of heart disease. It occurs when the coronary arteries, which supply oxygen-rich blood to the heart, become narrowed or blocked due to plaque buildup (atherosclerosis). This can lead to chest pain (angina), shortness of breath, and heart attacks. Lifestyle changes, medications, and procedures such as angioplasty or bypass surgery can help manage CAD.

2) HEART FAILURE, also known as congestive heart failure (CHF), occurs when the heart cannot pump blood effectively to meet the body’s needs. It can result from conditions such as CAD, high blood pressure, or cardiomyopathy. Symptoms include fatigue, shortness of breath, and fluid retention. Treatment includes medications, lifestyle changes, and in severe cases, devices like pacemakers or heart transplants.

3) ARRHYTHMIAS are irregular heartbeats that can be too fast (tachycardia), too slow (bradycardia), or erratic. These abnormal rhythms can interfere with the heart’s ability to pump blood effectively. Causes range from heart disease and electrolyte imbalances to stress and medications. Treatments include medications, lifestyle modifications, and procedures such as ablation or the implantation of pacemakers.

4) HEART VALVE DISEASE occurs when one or more of the heart’s valves do not function properly, leading to issues such as stenosis (narrowing of the valve) or regurgitation (leakage of blood backward). Common symptoms include fatigue, chest pain, and swelling in the legs. Treatment options vary from medication management to surgical repair or replacement of the affected valve.

5) CARDIOMYOPATHY refers to diseases of the heart muscle that make it harder for the heart to pump blood efficiently. Types include dilated, hypertrophic, and restrictive cardiomyopathy. Symptoms often include breathlessness, swelling in the legs, and irregular heartbeats. Treatment depends on the type but may involve medications, lifestyle changes, and in severe cases, heart transplants.

6) CONGENITAL HEART DISEASE (CHD) refers to structural heart abnormalities present at birth. These defects can range from minor to severe and may involve holes in the heart, abnormal connections between blood vessels, or improperly formed valves. Some cases require surgical correction, while others may be managed with medications and ongoing monitoring.

7) DEEP VEIN THROMBOSIS (DVT)

is the formation of blood clots in deep veins, usually in the legs. If untreated, these clots can break loose and travel to the lungs, causing a pulmonary embolism. Risk factors include prolonged immobility, surgery, and clotting disorders. Treatment includes anticoagulant medications, compression stockings, and lifestyle changes.

8) PERIPHERAL ARTERY DISEASE (PAD) occurs when arteries outside the heart, particularly in the legs, become narrowed due to atherosclerosis. This can lead to pain, numbness, and even tissue damage in severe cases. PAD increases the risk of heart attack and stroke. Treatment focuses on lifestyle changes, medications, and procedures to restore blood flow.

9) AORTIC DISEASE affects the body’s main artery, the aorta. Conditions such as aortic aneurysm (a bulging or weakened area in the aorta) or aortic dissection (a tear in the artery’s wall) can be life-threatening. Symptoms include severe chest or back pain, dizziness, and difficulty breathing. Treatment ranges from monitoring to emergency surgical repair.

10) RHEUMATIC HEART DISEASE is caused by rheumatic fever, an inflammatory disease that can damage heart valves. It often develops from untreated or inadequately treated strep throat infections. Symptoms include breathlessness, fatigue, and irregular heartbeats. Prevention through early treatment of strep infections is crucial, and management includes medications and sometimes valve surgery.

11) STROKE occurs when blood flow to the brain is disrupted, either due to a blocked artery (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke). This can cause brain damage, disability, or death. Symptoms include sudden weakness, confusion, trouble speaking, and loss of coordination. Treatment involves clot-busting drugs, surgery, and rehabilitation.

12) PULMONARY EMBOLISM (PE) occurs when a blood clot, usually from a DVT, travels to the lungs, blocking blood flow. This can be life-threatening, causing sudden shortness of breath, chest pain, and rapid heart rate. Immediate treatment with anticoagulants, thrombolytics, or surgery is necessary to prevent fatal complications.

Conclusion

Heart disease and cardiovascular disease manifest in many forms, each with its own causes, symptoms, and treatment options. Early detection, lifestyle modifications, and appropriate medical intervention are key to managing these conditions and improving overall heart health. Regular check-ups, maintaining a balanced diet, engaging in physical activity, and managing stress can significantly reduce the risk of developing these life-threatening diseases.

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EXTRA

CIMT and Longevity   By: BardDiagnostics Science Dept.

Carotid (artery) Intimal Thickness is a vital marker for evaluating peri-menopause related illness. The paired carotid vessel system is the main channel for brain oxygenation and is the main target for hypertension, autoimmune disease (Hashimoto’s thyroiditis, lupus, psoriasis, rheumatoid arthritis) and cardiovascular hemodynamic disorders. 

The intimal thickness of 6-8mm in middle age is considered physiologic while a measurement over 1 mm is strongly associated with increased cardiovascular risk. Some studies have shown that estradiol may reduce systolic blood pressure in older women.  The arterial wall has 3 layers; an outer layer-the adventitia-the strong support structure to maintain the vessel shape; the muscular media that cause the artery to constrict as a response to high blood pressure; and the inner lining of a thin layer of cells called the intima

A closer look at the inner lining of any artery is the single cell layer called the “endothelium” which, like the ovary, has many functions. The skin is considered the largest organ in the human body but the endothelial lining is 14,000 square feet (or 6.5 tennis courts) when measured. It is a protective barrier and a hormone producing entity that is vital to the maintenance of every system in our body.  Hypertension increases pressure in the arterial wall and the endothelium reacts with a hormonal shield to reduce the structural damage to the heart, brain, eyes and kidneys. 

Reducing damage to the arterial system is improved due to better evaluation of the abnormal pressures in each organs blood supply. Hemodynamic assessment is now improved by tracking flow abnormalities using spectral Doppler ultrasound that pinpoints the weakest link in the body's vascular defense mechanism. Advance warning of the “at risk” area is key to targeting focal therapy-is it the retina, the heart, the brain, the liver or the kidney separately or in combination? New pressure dynamic imaging highlights vulnerable structures so damage may be mitigated or repaired before permanent issues occur.

Note that the thyroid gland sits adjacent to the carotid system and tumors of the thyroid or parathyroid may be discovered at the same time.  More importantly, high blood flow of inflammation or hyperthyroid disease and low blood flow associated with autoimmune disorders such as Hashimoto’s or lupus may reveal themselves in similar scan sections. The reverse is true where clinically significant plaque is detected during a neck scan for abnormal lab results. Similarly, the recent application of Elastography for thyroid fibrosis also differentiates friable and dangerous soft carotid plaque that may embolize causing stroke.

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RELATED NEWS

Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.  See Dr. Angela Mazza's full report on Thyroid Health @ this season's MenoNews.

PERIMENOPAUSAL LINKS TO CARDIOVASCULAR DISEASE (CVD) IN WOMEN / Imaging Solutions

By: Dr. Robert L. Bard     Edited by: L. Goetze, Ed.D / C. R. DeWitt /  G. Davi

One of the most concerning risks associated with menopause is heart disease. Estrogen plays a protective role in maintaining healthy blood vessels and cholesterol levels. Its decline leads to increased LDL (bad cholesterol), reduced HDL (good cholesterol), higher blood pressure, and arterial stiffness, all of which contribute to cardiovascular disease. The risk of heart disease increases substantially for women during and after menopause. Although exact prevalence rates vary, research indicates that nearly 45% of women aged 20 and older are affected by some form of cardiovascular disease. The menopausal transition is marked by significant hormonal shifts, particularly a decline in estrogen, which reduces its cardioprotective effects and heightens the risk of cardiovascular complications. Notably, women who undergo natural menopause at a later age tend to have a lower risk of cardiovascular disease and mortality. Given these factors, it is essential for women experiencing menopause to actively monitor their heart health and adopt preventive strategies.

IMAGING HEART HEALTH

Ultrasound plays a vital role in assessing heart health in premenopausal women by providing a non-invasive, real-time evaluation of cardiac function. Echocardiography offers detailed imaging of the heart’s chambers, valves, and function, aiding in early detection of cardiovascular disease. As estrogen declines during menopause, risks like hypertension, arrhythmias, and reduced arterial elasticity increase. Early ultrasound detection helps guide lifestyle changes and medical interventions to prevent complications.

Carotid ultrasound is also crucial for detecting early atherosclerosis, a key driver of heart disease. By evaluating plaque buildup and arterial thickness, it identifies cardiovascular risks before major events occur.  Since heart disease risk rises post-menopause, early vascular screening allows for timely preventive strategies.

Spasticity: Ultrasound elastography (USE), particularly shear wave elastography (SWE), shows promise as a non-invasive tool for assessing spasticity and monitoring treatment efficacy. While further research is needed to establish its reliability and validity, elastography is a well-established ultrasound imaging technique that measures tissue stiffness or elasticity. It has been widely used for liver fibrosis assessment and is now being explored off-label for other organs. In the context of spasticity, SWE can quantify muscle stiffness, potentially offering a more objective measure than traditional clinical assessments.

Incorporating ultrasound into routine assessments enables early intervention, guiding lifestyle and medical management to reduce heart disease risks. Given that cardiovascular disease is the leading cause of death in women, proactive imaging supports a healthier transition into menopause. Incorporating ultrasound into routine assessments enables early intervention, guiding lifestyle and medical management to reduce heart disease risks. Given that cardiovascular disease is the leading cause of death in women, proactive imaging supports a healthier transition into menopause.

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SLIDE 1: DETECTING SILENT MYOCARDIAL AND CARDIOVASCULAR DISEASE

Many years ago, the Framingham study, conducted for life insurance purposes, identified carotid intima-media thickness (CIMT) as an indicator of decreased life expectancy. Since that study, which is now over 20 years old, further research has shown that the lining of the carotid artery can thicken up to one centimeter. CIMT is now recognized as a key health marker and a measure of longevity.

Advanced imaging techniques, such as super-selective B-flow ultrasound, allow for precise measurement of CIMT. In this case, the ultrasound scan shows a CIMT of 1.2 millimeters. The adjacent image highlights the underlying cause: inflammatory vessels associated with arteritis. These inflamed vessels contribute to arterial wall thickening, even in the absence of significant arterial blockage. A microvascular imaging scan of the same carotid artery further demonstrates the contrast between normal and thickened arterial walls.

Although the artery may not be obstructed, individuals with a CIMT exceeding 1.0 millimeters face an increased risk of stroke. The rightmost image presents an innovative technique for assessing the hardness of arterial plaques. Soft plaques are more prone to embolization and can travel to the brain, whereas calcified plaques are generally more stable. Shear wave ultrasound technology enables early detection of arterial stiffness, providing insight into vascular health before overt disease develops. In addition to measuring arterial inflammation and fibrosis, this method helps evaluate the extent of arterial wall scarring.

During menopause, most myocardial and cardiovascular events occur silently. Women experiencing heart attacks are often misdiagnosed with chest pain, pruritus, or musculoskeletal discomfort. However, a simple one-minute carotid artery scan can help detect silent myocardial and cardiovascular disease, making it a valuable tool for identifying potential serious conditions in asymptomatic menopausal patients.

SLIDE 2: HASHIMOTO’S / THYROIDITIS

One incidental benefit of scanning the thyroid for tumors or inflammatory disease is the ability to assess nearby structures, including lymph nodes—where cancer may spread—and the carotid artery, which supplies blood to the brain. In this case, the arrow indicates plaque in the carotid artery, measuring 1.3 millimeters in thickness. Since the normal threshold is 1.0 millimeter, this finding suggests an early potential cardiovascular issue. This discovery is relevant to both thyroid and heart disease. Additionally, the scan reveals an incidental thyroid cyst and an abnormal, non-homogeneous thyroid.

SLIDE 3: AORTIC ADVENTITIAL PLAQUE

When scanning for aortic aneurysms or aortic adenopathy to assess whether breast cancer has spread to the lymph node chain, we typically observe the aorta as a midline vessel. In this case, during scanning, we detected abnormal echoes in the peri-aortic region. To further investigate, a Doppler blood flow scan was performed, which ruled out an aneurysm. Subsequently, an aortic scan with blood flow analysis was conducted to assess abnormal arterial activity, revealing that the thickened area had no discernible arterial inflammatory blood flow. However, the elastogram on the far right indicated abnormal fibrosis of the aortic wall, which could weaken the structure and potentially lead to rupture.

SLIDE 4: THYROID SCAN WITH POINT OF CARE ULTRASOUND

Portable high-resolution thyroid scanning is clinically available. In the labeled scan, the thyroid tissue appears milky white, while a dark area represents a cyst. We can confirm this is a cyst because, to its left, the carotid artery—filled with blood—also appears dark. A magnified scan (third image) reveals that this is not a simple cyst. The cyst wall contains internal micro-calcifications, and a follow-up study indicates inflammation. The presence of red arterial flow suggests irritation of the cyst wall. I could tag the middle image, which clearly shows the carotid artery.

ABOUT THE AUTHOR-

ROBERT L. BARD, MD, PC, DABR, FASLMS - Advanced Imaging & Diagnostic Specialist

Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered Sonograms, Spectral Doppler, sonofluoroscopy, 3D/4D Image Reconstruction and the Spectral Doppler are safe, noninvasive, and does not use ionizing radiation. It is used as a complement to find anomalies and help diagnose the causes of pain, swelling and infection in the body’s internal organs while allowing the diagnostician the ability to zoom and ‘travel’ deep into the body for maximum exploration.

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SUPPLEMENTAL

The Many Faces of Heart Disease and Cardiovascular Disease

By: Lennard Goetze, Ed.D and Graciella Davi

Heart disease and cardiovascular disease (CVD) are umbrella terms encompassing a wide range of conditions that affect the heart and blood vessels. These conditions can lead to serious complications, including heart attacks, strokes, and even death. Understanding the various types of heart disease can help individuals recognize symptoms early, seek appropriate treatment, and take preventative measures to maintain heart health.

1) CORONARY ARTERY DISEASE (CAD) is one of the most common types of heart disease. It occurs when the coronary arteries, which supply oxygen-rich blood to the heart, become narrowed or blocked due to plaque buildup (atherosclerosis). This can lead to chest pain (angina), shortness of breath, and heart attacks. Lifestyle changes, medications, and procedures such as angioplasty or bypass surgery can help manage CAD.

2) HEART FAILURE, also known as congestive heart failure (CHF), occurs when the heart cannot pump blood effectively to meet the body’s needs. It can result from conditions such as CAD, high blood pressure, or cardiomyopathy. Symptoms include fatigue, shortness of breath, and fluid retention. Treatment includes medications, lifestyle changes, and in severe cases, devices like pacemakers or heart transplants.

3) ARRHYTHMIAS are irregular heartbeats that can be too fast (tachycardia), too slow (bradycardia), or erratic. These abnormal rhythms can interfere with the heart’s ability to pump blood effectively. Causes range from heart disease and electrolyte imbalances to stress and medications. Treatments include medications, lifestyle modifications, and procedures such as ablation or the implantation of pacemakers.

4) HEART VALVE DISEASE occurs when one or more of the heart’s valves do not function properly, leading to issues such as stenosis (narrowing of the valve) or regurgitation (leakage of blood backward). Common symptoms include fatigue, chest pain, and swelling in the legs. Treatment options vary from medication management to surgical repair or replacement of the affected valve.

5) CARDIOMYOPATHY refers to diseases of the heart muscle that make it harder for the heart to pump blood efficiently. Types include dilated, hypertrophic, and restrictive cardiomyopathy. Symptoms often include breathlessness, swelling in the legs, and irregular heartbeats. Treatment depends on the type but may involve medications, lifestyle changes, and in severe cases, heart transplants.

6) CONGENITAL HEART DISEASE (CHD) refers to structural heart abnormalities present at birth. These defects can range from minor to severe and may involve holes in the heart, abnormal connections between blood vessels, or improperly formed valves. Some cases require surgical correction, while others may be managed with medications and ongoing monitoring.

7) DEEP VEIN THROMBOSIS (DVT)

is the formation of blood clots in deep veins, usually in the legs. If untreated, these clots can break loose and travel to the lungs, causing a pulmonary embolism. Risk factors include prolonged immobility, surgery, and clotting disorders. Treatment includes anticoagulant medications, compression stockings, and lifestyle changes.

8) PERIPHERAL ARTERY DISEASE (PAD) occurs when arteries outside the heart, particularly in the legs, become narrowed due to atherosclerosis. This can lead to pain, numbness, and even tissue damage in severe cases. PAD increases the risk of heart attack and stroke. Treatment focuses on lifestyle changes, medications, and procedures to restore blood flow.

9) AORTIC DISEASE affects the body’s main artery, the aorta. Conditions such as aortic aneurysm (a bulging or weakened area in the aorta) or aortic dissection (a tear in the artery’s wall) can be life-threatening. Symptoms include severe chest or back pain, dizziness, and difficulty breathing. Treatment ranges from monitoring to emergency surgical repair.

10) RHEUMATIC HEART DISEASE is caused by rheumatic fever, an inflammatory disease that can damage heart valves. It often develops from untreated or inadequately treated strep throat infections. Symptoms include breathlessness, fatigue, and irregular heartbeats. Prevention through early treatment of strep infections is crucial, and management includes medications and sometimes valve surgery.

11) STROKE occurs when blood flow to the brain is disrupted, either due to a blocked artery (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke). This can cause brain damage, disability, or death. Symptoms include sudden weakness, confusion, trouble speaking, and loss of coordination. Treatment involves clot-busting drugs, surgery, and rehabilitation.

12) PULMONARY EMBOLISM (PE) occurs when a blood clot, usually from a DVT, travels to the lungs, blocking blood flow. This can be life-threatening, causing sudden shortness of breath, chest pain, and rapid heart rate. Immediate treatment with anticoagulants, thrombolytics, or surgery is necessary to prevent fatal complications.

 

Conclusion

Heart disease and cardiovascular disease manifest in many forms, each with its own causes, symptoms, and treatment options. Early detection, lifestyle modifications, and appropriate medical intervention are key to managing these conditions and improving overall heart health. Regular check-ups, maintaining a balanced diet, engaging in physical activity, and managing stress can significantly reduce the risk of developing these life-threatening diseases.

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RELATED ARTICLE 

Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.  See Dr. Angela Mazza's full report on Thyroid Health @ this season's MenoNews.

For more information on this article, or to explore diagnostic imaging related to cardiovascular health, visit: www.menoscan.org or www.BardDiagnostics.com. You can also contact our editorial team at: 516-522-0777, or email us at: editor.prevention101@gmail.com

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Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

 

From an exclusive interview with Dr. Angela Mazza, Integrative Endocrinologist

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.

The Essential Role of Thyroid Health
The thyroid, a butterfly-shaped gland located in the neck, is responsible for producing hormones that regulate metabolism. However, its influence extends far beyond just energy production. Thyroid hormones affect growth, cognition, mood, and even the function of vital organs. Research indicates that every system in the body—whether it's the heart, the gut, or the brain—is impacted by thyroid hormone levels.

However, what constitutes "optimal" thyroid function is not always clear. The standard reference ranges used to assess thyroid health are based on large population studies, but these ranges do not necessarily account for individual variations. Moreover, as we age, our thyroid function can naturally change, raising questions about whether slight imbalances might, in fact, be beneficial. Long-term studies on centenarians suggest that slightly elevated levels of thyroid-stimulating hormone (TSH) may be associated with longevity. This highlights the complexity of thyroid health and the need for more research on how it influences aging and overall quality of life.

Hormone Imbalances and Their Impact
Hormonal imbalances are a common concern, especially as we age. While thyroid imbalances are often discussed in isolation, they are frequently part of a broader picture that includes changes in other hormones such as estrogen, progesterone, testosterone, and cortisol. These imbalances can manifest in a variety of ways, ranging from fatigue and weight gain to mood swings and cognitive changes.

For women, hormonal shifts associated with perimenopause often overlap with thyroid issues, making it challenging to distinguish between the two. A thorough clinical history and lab testing are essential for diagnosing hormone imbalances and crafting personalized treatment plans. Advances in genetic research, such as polygenic studies for thyroid function, promise to refine our understanding of the optimal thyroid range for each individual, helping to move towards more personalized healthcare.

However, balancing hormones isn't just about supplementation; lifestyle factors play an equally crucial role. Chronic stress, poor diet, and a lack of physical activity can exacerbate hormonal imbalances. Cortisol, the body’s primary stress hormone, affects nearly every other hormone in the body, which is why stress management is key. Additionally, micronutrient deficiencies can impair hormone production, underscoring the importance of a balanced, nutrient-rich diet.

Anti-Aging vs. Longevity: A Holistic Perspective
While “anti-aging” has become a buzzword in the wellness industry, it often focuses on superficial aspects of aging, such as appearance and external beauty. In contrast, longevity is a more holistic concept, emphasizing not only the length of life but also the quality of life—what some experts call “health span.” True longevity involves maintaining physical, cognitive, and emotional well-being as we age, enabling individuals to continue doing what they love and pursuing new goals well into their later years.

Regenerative medicine and longevity research focus on optimizing health from the inside out. This approach encourages healthier lifestyles, stress management, and the prevention of chronic diseases—ensuring that the years we do live are as full and vibrant as possible.

The Complexities of Hair Loss: A Window into Health
Hair loss is often one of the most noticeable signs of an underlying health issue, which is why it’s such a common concern for many people. While the external appearance of hair loss can be distressing, it is often linked to internal factors such as hormonal imbalances, stress, and nutritional deficiencies.

Hormones play a pivotal role in hair health. For women, conditions like androgenic alopecia, which is influenced by elevated testosterone, can cause thinning hair. Similarly, stress-induced hair loss typically becomes visible three months after the triggering event. As we age, hair follicles naturally shrink and produce thinner strands, contributing to the perception of hair loss. However, stress management, proper nutrition, and addressing underlying health conditions can help mitigate the effects.

Women's Health: Addressing Unique Needs and Risks
The awareness of women’s health has grown over the years, but significant gaps still remain. Women face unique health challenges that are often overlooked, especially when it comes to hormone balance, cardiovascular health, osteoporosis, and dementia. More research is needed to understand how these issues impact women across the lifespan.

One particularly crucial time in a woman’s life is perimenopause, the transitional phase leading up to menopause. This phase often brings symptoms that are misunderstood or dismissed, such as weight gain, mood changes, and cognitive shifts. It is vital that women understand these changes and seek appropriate care to manage them. Additionally, postmenopausal women face increased risks of cardiovascular disease and dementia, highlighting the importance of proactive health measures and lifestyle interventions.

A Personalized Approach to Pre-Menopause Health
For women in their 30s and 40s, establishing healthy habits before menopause can significantly improve long-term health outcomes. A well-rounded pre-menopause program should focus on stress management, sleep hygiene, balanced nutrition, and regular exercise. It is essential to monitor thyroid health during this time, as thyroid imbalances often emerge in this age range.

A plant-based diet rich in micronutrients, healthy fats, and protein supports hormonal balance and overall wellness, keeping blood glucose levels stable, supporting brain health, and preserving bone density.

Combatting the Obesity Epidemic: A Call for Early Intervention
Type 2 diabetes and obesity are at epidemic levels, with children increasingly being diagnosed with conditions that were once considered adult-onset. These conditions are closely linked to lifestyle factors, including poor diet and lack of physical activity, and are major contributors to inflammation, cardiovascular disease, and insulin resistance.

Preventive measures, such as regular screenings for children and educating families about healthy lifestyles, are critical to reversing these trends. Early intervention can help set the foundation for a healthier, longer life. Preventive care and education about longevity should begin at the earliest stages of life, empowering individuals to take control of their health before chronic conditions set in.

The Power of Collaboration in Healthcare
One of the most significant challenges in healthcare today is the fragmentation of medical specialties. The siloed approach, where cardiologists, endocrinologists, gastroenterologists, and other specialists work in isolation, often fails to provide the comprehensive care that patients need. Collaboration between various healthcare professionals is vital for providing holistic care that addresses all aspects of health—physical, mental, and emotional.

Integrative medicine, which combines traditional and alternative approaches, holds great promise in bridging these gaps. By addressing lifestyle factors like diet and stress, along with appropriate medical interventions, patients can receive a more complete and personalized treatment plan.

Conclusion: A Holistic Approach to Health and Longevity
Health is not a one-size-fits-all approach. Whether it’s managing thyroid health, balancing hormones, or preventing chronic conditions, the key to optimal health is understanding the individual and creating a personalized plan. With ongoing research, early intervention, and a commitment to lifestyle changes, we can empower individuals to lead healthier, longer lives. Collaboration across the medical community will be essential to achieving this goal, ensuring that every patient receives the comprehensive care they need to thrive.

ABOUT THE AUTHOR

Angela D. Mazza, DO, ABAARM, FAAMFM, ECNU is triple board-certified in Endocrinology, Diabetes and Metabolism, Internal Medicine, and Anti-aging and Regenerative Medicine. Dr. Mazza’s broad medical background includes significant research in both basic and clinical realms of endocrinology. Dr. Mazza is the founder of Metabolic Center for Wellness in Oviedo, FL, where she spends a great majority of her time caring for persons with autoimmune thyroid disease, thyroid nodules, and thyroid cancer. She is the only physician in Central Florida currently performing radiofrequency ablation (RFA) of thyroid nodules and saving thyroids from unnecessary surgery. She is also an international speaker, a best-selling author, and the host of her long-running podcast, "Thyroid Talk with Dr. Angela Mazza." Highly regarded for her individualized approach to patient care, Dr. Mazza empowers each person to achieve their unique goals by providing education, lifestyle management and support. Dr. Mazza believes that hormonal changes that happen in women and men as they age play a huge part in their overall health, longevity, and quality of life. Her passion is helping her patients achieve metabolic as well as hormonal balance.

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RELATED ARTICLES

The Essentials of Thyroid Imaging
By: Dr. Robert Bard

When imaging detects a suspicious area, it can guide selective biopsies to obtain small tissue samples for further laboratory analysis (pathology). Combining imaging with pathology provides the most accurate information about the size, location, and aggressiveness of any issue detected.  In the case of thyroid imaging, use of an ultrasound uses sound waves to create images of the thyroid gland in the neck. It is often used for this organ because it is a non-invasive procedure that does not use ionizing radiation. It’s commonly used to evaluate lumps or nodules detected during a physical exam or other imaging tests and requires minimal preparation. (SEE COMPLETE ARTICLE)

Part 2:

RECENT FINDINGS RELATING HASHIMOTO’S THYROIDITIS WITH ABNORMAL VASCULARITY

By: Robert L. Bard, MD

A woman in her 70s presented for routine follow-up of a previously identified left thyroid nodule, though there was no immediate clinical indication for concern. 

Slide 1: On ultrasound imaging, the left thyroid lobe revealed a complex nodule with features that appeared likely benign. Notably, there were no suspicious characteristics such as irregular margins, microcalcifications, or abnormal vascularity.

In the right lobe, we observed a small, simple cyst—anechoic and well-circumscribed, consistent with benign features. However, situated just beneath the cyst was a hypoechoic area lacking the echogenic brightness typically associated with cystic thyroid lesions. This darker region raised suspicion due to its decreased reflectivity, potentially indicating underlying fibrosis or chronic inflammatory changes rather than a simple fluid-filled structure.

To further characterize these findings, we evaluated vascular flow using Doppler imaging. The left lobe lesion demonstrated internal complex components but lacked hypervascularity or flow patterns consistent with malignancy. In contrast, the right lobe's suspicious area prompted us to perform elastography (strain imaging), which revealed a dark blue signal in the region. This finding suggests increased stiffness in the tissue, which is commonly associated with edema or inflammatory infiltration—features that are often seen in early or non-fibrosing Hashimoto’s thyroiditis. These findings warrant closer follow-up and possible serologic correlation for thyroid autoimmunity (e.g., TPO antibodies).

Slide Two (below): In a separate view, the carotid artery appears as a dark red structure lateral to the thyroid. Medial to the artery lies a well-defined, low-vascular lesion. Its stable appearance over time, combined with its imaging characteristics, supports a benign etiology—most likely an inflammatory pseudonodule or a reactive lymph node, both of which are common in autoimmune thyroiditis.

These slides help illustrate a key principle in ultrasound interpretation: the transmission of sound through different tissues. Fluid-filled cysts tend to have high acoustic transmission, resulting in enhanced posterior echoes or acoustic enhancement—appearing whiter behind the cyst due to increased signal. In contrast, solid lesions with dense fibrosis or malignant components attenuate sound waves, leading to darker posterior shadows. Therefore, areas with poor posterior enhancement (i.e., low acoustic transmission) are more likely to represent fibrotic tissue or malignancy.

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The Ulgy Faces of Heart Disease

Produced by the Women's Heart Health Alliance / BardDiagnostics

One of the most concerning risks associated with menopause is heart disease. The risk of heart disease increases substantially for women during and after menopause. Although exact prevalence rates vary, research indicates that nearly 45% of women aged 20 and older are affected by some form of cardiovascular disease. The menopausal transition is marked by significant hormonal shifts, particularly a decline in estrogen, which reduces its cardioprotective effects and heightens the risk of cardiovascular complications. Notably, women who undergo natural menopause at a later age tend to have a lower risk of cardiovascular disease and mortality. Given these factors, it is essential for women experiencing menopause to actively monitor their heart health and adopt preventive strategies.

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Restoring Thyroid Balance Through Nature’s Medicine

By: Emanuela Visone 

My journey toward healing was one filled with frustration, trial and error, and ultimately, discovery. For years, I struggled with thyroid issues, adrenal fatigue, and premature menopause. I searched for answers within conventional medicine, only to find temporary relief at best. It wasn’t until I turned to holistic healing—incorporating whole foods, natural supplements, and a shift in mindset—that I experienced true transformation.  According to The American Thyroid Association (ATA), an estimated 20 million people in the United States suffer from some form of thyroid disease, yet many remain undiagnosed. Thyroid disorders affect metabolism, energy levels, and overall well-being, making it crucial to address underlying causes rather than simply managing symptoms with medication (American Thyroid Association - Thyroid Disease Facts).

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SCIENCE NEWS

Inflammation, DHT, and the Biochemical Cascade of Hair Loss: A Scientific Overview: by Dr. Jordan Plews

Hair loss is a multifactorial condition influenced by genetic, hormonal, and inflammatory factors. Understanding the roles of DHT and inflammation provides insight into the pathogenesis of AGA and informs effective prevention and treatment strategies. Early intervention is crucial, as inflammation and follicular damage can progress unnoticed until significant hair loss has occurred, while genetic factors (such as expression of MMP genes) in some can lead to fibrosis and result in more difficult to treat hair loss. By focusing on inflammation as an early warning sign, treatment target, and significant factor to consider when diagnosing, tracking, and treating hair loss, existing methodologies can be greatly improved. Ongoing research continues to elucidate the complex mechanisms underlying hair loss, paving the way for more targeted and effective therapies. See Dr. Jordan Plews comprehensive overview on MENONEWS and the recent issue on the HOUSE OF HAIR

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"I have been dealing with thyroid issues for years and truly wish a book like this had existed when I was first diagnosed. "Thyroid Talk" is an invaluable tool for anyone looking to understand and manage their thyroid health. Dr. Mazza also touches on the emotional struggles of thyroid disease and offers tips on nutrition, stress management, and natural supplements, offering a more holistic view of thyroid care. This book is written for medical professionals as well as patients. I will be referring back to it often!"

Thyroid Talk: An Integrative Guide to Optimal Thyroid Health Paperback – October 11, 2023

By Dr. Angela D. Mazza (Author) - 4.8 4.8 out of 5 stars    71 ratings

Are you among the twenty million Americans feeling constantly exhausted, battling creeping weight gain, or wrestling with feelings of depression despite your best efforts? Do you find yourself reminiscing about those days of vitality, wishing you could revert back while simultaneously yearning to forge an ambitious, brighter future? If these challenges resonate with you or your patients, Thyroid Talk: An Integrative Endocrinologist’s Guide to Optimal Health by Dr. Mazza may just be the enlightening resource you've been seeking. Dr. Mazza, triple-board certified in Endocrinology, Internal Medicine, and Anti-Aging and Regenerative Medicine, goes beyond conventional medical “guidelines” and “standards of care.” She champions holistic health, tackles the thyroid epidemic directly, and envisions a future where doctors and patients collaborate seamlessly for optimal wellness and weight management.

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Enhancing Cognitive Well-Being During Menopause

By: Marilyn Abrahamson

Menopause is a time of significant change, often accompanied by cognitive shifts such as brain fog, forgetfulness, and difficulty concentrating. These challenges are common and can be effectively managed through targeted brain health strategies. 

As part of our comprehensive MenoNext menopause wellness program, the  addition of the brain health coaching program is designed to empower women with practical tools to support cognitive function and mental clarity.

Helping Women to Optimize Mindset for Cognitive Resilience

• Recognize that menopause-related cognitive changes are normal and manageable.

• Cultivate brain healthy lifestyle habits as key components of cognitive vitality.

• Shift from frustration to empowerment by adopting proactive compensatory strategies for attention and memory, decision-making and problem-solving.

Encouraging Lifestyle Habits to Include the Six Pillars of Brain Health

• Lifelong Learning & Cognitive Stimulation: Engage in new learning experiences, puzzles, and skill-building exercises to maintain neuroplasticity.

• Social Engagement: Strengthen social connections to enhance cognitive function and reduce stress-related cognitive decline.

• Stress Management: Implement mindfulness techniques, meditation, and structured relaxation exercises to mitigate cognitive strain.

• Sleep Optimization: Establish routines that promote restorative sleep, essential for memory consolidation and mental clarity.

• Nutritional Support for Brain Health: Adopt a diet rich in antioxidants, omega-3 fatty acids, and brain-supportive nutrients to reduce inflammation and promote cognitive function.

• Physical Activity & Circulation: Engage in regular exercise to improve blood flow, oxygenation, and overall brain health.

Enhancing Executive Function and Cognitive Efficiency

• Strengthen organizational and problem-solving skills to enhance daily productivity.

• Utilize structured planning tools to manage tasks effectively and reduce cognitive overload.

• Implement evidence-based techniques to improve attention, focus, and information processing.

Teaching Strategies for Memory Enhancement and Retention

• Apply memory reinforcement techniques such as visualization, association, and structured repetition.

• Improve recall through active engagement with information and strategic retrieval methods.

• Develop habits that support cognitive retention, including routine mental exercises and structured learning approaches.

Improving Decision-Making and Cognitive Agility

• Enhance critical thinking and adaptability through structured cognitive exercises.

• Strengthen decision-making frameworks to improve confidence and efficiency in daily life.

• Foster problem-solving skills that promote cognitive flexibility and strategic thinking.

The Brain Health program in MenoNext empowers women to take control of their cognitive well-being during menopause, offering practical, science-backed strategies to enhance mental clarity, improve memory, and support long-term brain health. By embracing these proven techniques, women can confidently navigate cognitive changes, feeling sharper, more focused, and in greater control of their brain health every day.

A JOURNEY THROUGH PREMATURE OVARIAN FAILURE (and Early Menopause)

Written by: Emanuela Visone

INTRODUCTION
Survivors and challengers often share their stories (in print) hoping to memorialize their journey to empower others who feel lost in their health struggles. Mine is a story of resilience and healing and I want people to know there is hope beyond conventional medicine. It became the crossroads that inspired my career as a healer through nature, where the answers I discovered are all from the foods we eat, from better strategies to managing stress and eliminate toxins. If you are going through a similar health crisis, know that there are many answers (more than the conventional) and that you are not alone. Your body has the innate ability to heal. Sometimes, it just needs a little help. Trust in nature, trust in yourself, and never stop searching for answers.

I remember the day like it was yesterday. Sitting in the doctor’s office, nervously awaiting my test results, I heard the words that would change my life forever: “You are experiencing premature ovarian failure.” I was only 38 years old. My mind raced. How could this be happening? My doctor’s next statement shook me: “If you want to have a child, you have a six-month window to try.”

I didn’t have a significant other at the time, but I had a great support system. I decided to embark on the journey of becoming a mother on my own. But the process was grueling. I endured painful tests, including a hysterosalpingogram, where air was blown through my fallopian tubes. Despite all the tests, the only abnormality was my ovaries had failed prematurely.

Understanding Premature Ovarian Insufficiency
Primary Ovarian Insufficiency (POI), also known as premature ovarian failure, occurs when the ovaries cease normal function before age 40, leading to reduced estrogen production and potential infertility.

Smoking is a significant risk factor for early menopause and POI. Studies indicate that women who smoke may experience menopause one to two years earlier than non-smokers. The toxins in cigarette smoke accelerate ovarian aging, contributing to an earlier onset of menopause.

Common symptoms of POI include irregular periods, hot flashes, night sweats, vaginal dryness, irritability, and decreased libido. These symptoms result from decreased estrogen levels and can significantly impact quality of life.

Faced with this reality, I ultimately chose not to pursue in vitro fertilization (IVF) using donor sperm. The emotional toll was heavy, but I found comfort in being an aunt, a godmother, and loving my cousin’s children as my own. Making peace with my decision was just the beginning of my journey.

The Onset of Symptoms and My Search for Healing
As if infertility wasn’t enough, I now faced another battle: menopause at 38. Hot flashes became my unwelcome companions, arriving unannounced and leaving me drenched in sweat. Mood swings turned me into someone I no longer recognized. The bloating, discomfort, and weight gain made me feel trapped in someone else’s body.

Desperate for relief, I turned to alternative medicine. My first stop was a Chinese medicine doctor who prescribed a concoction of bitter herbs. I spent $300 a month on those teas, gagging with every sip. Although I noticed slight improvements, my hormone levels remained unbalanced.

Then, I read about bioidentical hormone replacement therapy (BHRT). Inspired by a well-known actress who had successfully balanced her hormones, I sought out a specialist. Tests revealed another shocking truth, I was also suffering from adrenal fatigue. My cortisol levels were through the roof.

I began taking estrogen, progesterone, and hydrocort (a low dose of hydrocortisone to balance my cortisol). At first, I felt amazing. But over time, I started gaining weight and feeling off. My body was telling me something wasn’t right.

During a routine wellness visit in 2017, my doctor expressed concern about my elevated liver function. When he asked about my supplements, he linked my high liver enzymes to the hydrocort, a steroid. So much for minimal side effects! I had spent thousands of dollars only to discover my treatment was causing more harm than good. I immediately stopped BHRT and turned back to nature for answers.

Returning to Nature for Healing
My mentor had always emphasized the power of food as medicine. She suggested incorporating phytoestrogens naturally through my diet rather than taking soy capsules. But, in my impatience, I ignored her advice and started taking soy supplements.

Within months, I felt terrible. My voice became hoarse, my body ached, and my legs throbbed at night. Heart palpitations and flu-like symptoms plagued me.

One morning, I woke up and noticed lumps protruding from both sides of my throat. I rushed to my doctor, who sent me for a thyroid sonogram. The results were alarming—my thyroid nodules had enlarged, and I had developed a new mass. My thyroid was malfunctioning, sending my cholesterol and hormone levels spiraling.

My doctor referred me to an endocrinologist for a biopsy. But before I went down that road, I had an epiphany. I had healed my dog’s irritable bowel syndrome through diet and supplements. If I could heal my dog naturally, why couldn’t I heal myself?

I dove deep into researching whole foods, enzymes, and gut-healing strategies. I overhauled my diet, eliminating inflammatory foods and focusing on nutrient-dense, alkaline foods. I incorporated superfoods, probiotics, digestive enzymes, and wildcrafted algae to support my gut and endocrine system.

Within months, the transformation was undeniable. My energy returned. My cholesterol stabilized, and I lost 24 pounds. The heart palpitations disappeared. Most importantly, when I went back for my follow-up thyroid sonogram, the mass and nodules had shrunk, and my hormone levels were normalizing.

CONCLUSION
Looking back, my battle with premature ovarian failure, leading to full-blown menopause at 43, adrenal fatigue, and thyroid dysfunction, was a blessing in disguise. It led me to uncover the body’s incredible ability to heal itself when given the right tools.

 

References: https://medlineplus.gov/primaryovarianinsufficiency.html

https://www.sciencedaily.com/releases/2001/07/010716112326.htm

https://www.lancastergeneralhealth.org/health-hub-home/2021/october/one-more-reason-not-to-smoke-early-menopause

https://my.clevelandclinic.org/health/diseases/17963-primary-ovarian-insufficiency

 AUTHOR

EMANUELA VISONE: As a Certified Functional Nutritionist Counselor, Health and Life Coach, Emanuela works with clients one-on-one in helping them make better food and lifestyle choices. Individuals who have a passion to feel better physically and mentally in order to increase daily energy and productivity. Ms. Visone was her own living experiment when she successfully healed her malfunctioning thyroid back to normal as well dramatically shrunk a mass and nodules that were also on my thyroid by more than half their size in 4 months. 

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SCIENCE NEWS

Understanding Thyroid Health: Key Insights on Hormones, Longevity, and Wellness

Thyroid health plays a critical role in nearly every physiological process of the body, influencing metabolism, brain function, heart health, and more. Yet, despite its significance, the nuances of thyroid function remain elusive for many. As we age, maintaining optimal thyroid function is an essential component of overall well-being, and understanding the balance of thyroid hormones can help prevent future health challenges.  See Dr. Angela Mazza's full report on Thyroid Health @ this season's MenoNews.

Inflammation, DHT, and the Biochemical Cascade of Hair Loss: A Scientific Overview: by Dr. Jordan Plews

Hair loss is a multifactorial condition influenced by genetic, hormonal, and inflammatory factors. Understanding the roles of DHT and inflammation provides insight into the pathogenesis of AGA and informs effective prevention and treatment strategies. Early intervention is crucial, as inflammation and follicular damage can progress unnoticed until significant hair loss has occurred, while genetic factors (such as expression of MMP genes) in some can lead to fibrosis and result in more difficult to treat hair loss. By focusing on inflammation as an early warning sign, treatment target, and significant factor to consider when diagnosing, tracking, and treating hair loss, existing methodologies can be greatly improved. Ongoing research continues to elucidate the complex mechanisms underlying hair loss, paving the way for more targeted and effective therapies. See Dr. Jordan Plews comprehensive overview on MENONEWS and the recent issue on the HOUSE OF HAIR

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Healing Through Nature's Medicine, A Story of Hope 

Paperback – Large Print, October 6, 2021

by Emanuela Visone (Author)

When I look back at how far I've come with regards to restoring my health, I am amazed at how much I've learned on this journey of naturally health my body and how miraculously wonderful our bodies are when given the right environment.

I felt like my body was my enemy for a long time. Starting at the age of 38, I was diagnosed with premature ovarian failure fast forwarding me into menapause by the age of 40. This was very hard for me to accept this because I still was not married and had no children. I had the dreams many little girls have to get married and I always wanted children. I say it all the time, I wish I knew then what I know now because the doctors all told me back then I am perfectly healthy, it's just that my ovaries were failing. I think to myself now, If I was I healthy, my ovaries would not have stopped working at such a young age? There was something obviously very wrong.

In my mid-forties my hormones were a mess, I had adrenal fatigue, bad body aches and joint pain and had also developed hypothyroidism as well as a mass and nodules on it. To put it mildly, I felt terrible. I had gained around 30 pounds that would not come off, I was always tired and that just made me very cranky and insecure. (see full story in Amazin.com)