Brain Health

#155 Kathryn Retzler, ND- How Gut Health Affects Cardiovascular Disease and Hormones and Brain

by Mike Mutzel


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Mike Mutzel Podcast High Intensity Health



About Kathryn Retzler, ND

Dr. Retzler received her doctorate from the National College of Naturopathic Medicine in Portland, Oregon in 2001. After completing an internship in integrative medicine with Andrew Weil MD, and a residency in McMinnville, OR with Dr. Bruce Dickson, she decided to focus my enthusiasm, talents, and knowledge in building bridges between conventional and alternative medicine.

Books Discussed in this Episode

HormoneSynergy — Optimal Aging and Hormone Balance

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Show Notes

04:37 Biomarkers for Cardiovascular Disease: AMDA (asymmetric dimethylarginine) is one of many biomarkers linked with cellular ageing, endothelial dysfunction and cardiovascular disease. Cardiovascular disease is the number one killer of Americans. What is good for the heart and the blood vessels is good for the brain and good for cancer prevention. Half of people who have heart attacks, have normal cholesterol. Plaque rupture causes most heart attacks and strokes. It is not the choking off of the vessel by long term plaque accumulation and calcification of that plaque. It is that there is plaque there and it festers, like a pimple on the inside wall of the artery.

05:59 Cholesterol: LDL particle numbers show how many bad cholesterol particles are being produced. The size of these particles is important. If they are big and fluffy, they are rolling off the artery wall rather than getting through. If you have endothelial dysfunction, it would mean that you have leaky arteries, open to LDL entry and the beginning of the plaque cascade. We can measure the oxidation (inflammatory) levels of LDLs. We can measure myeloperoxidase, an enzyme made by white blood cells that contribute to unstable plaque. CRP is non-specific. However, if it is high, it tells us that there is inflammation somewhere. This inflammation could come from the gut, excess fat tissue from obesity or periodontal disease.

07:00 Imaging for Risk Evaluation: Dr. Retzler’s patients who have high lipids/high risk receive a CT to check their calcium score. A score of 0 reflects nearly a 0 likelihood of heart attack within the next 15 years. A low score means that therapies do not need to be aggressive. In addition, one could look at an IMT and carotid ultrasound too view the vessels to see if the disease process has begun.

08:02 Extending Healthspan: It is rare to have a vibrant and optimally healthy 40 year old patient. In the concept of functional reserve, our organs are only meant to last a certain amount of time. Dr. Retzler tries to extend the functional reserve or functional lifetime of organs. We have to tools to be optimally healthy and free of chronic disease into our 80s. Many doctors are stuck in the sick care model. Drug companies are the ones who educate doctors.

10:28 Lifestyle and Hormones: Testosterone levels and sperm counts in men are declining at younger ages. Lifestyle factors play a role in whether we can make optimal hormones. Dr. Retzler calls hormones the icing on the cake. It is difficult to age well without hormones. It is difficult to be in your 60s without supplemental hormones with energy as well as optimal brain, bone and cardiovascular health. We are programmed to break down once we have passed reproductive capacity. Dr. Retzler will not treat patients who ignore lifestyle. We don’t know enough about how supplemental hormones mix with bodies impacted with chronic disease. The body is smarter than we are. The disease process is some sort of homeostasis. Every hormone impacts every other hormone.

16:21 Hormone Delivery: Bioidentical means that it is the same molecule that is made in the human body. There are pharmaceutical or compounded options. Dr. Retzler believes that it is important to use the same molecule that the human body makes.For estrogen replacement therapy, Dr. Retzler mainly uses estrodiol. She uses the twice a week patch and for estrogen replacement. Vaginal is used most often, especially for women with vaginal atrophy. It is absorptive without going through the liver. Topical estrogens do not work well. It is harder to dose and harder to get consistent results. Injections are 100% absorbed. She also has great results with pellets.

22:11 Assessment Tools: The average patient may run into resistance from their practitioner on ordering some of the tests that Dr. Retzler recommends. Practitioners may not know what to do with the information. She would run a lipid panel, including LDL particle size and Apo A-I, HDL particles. She uses Boston Heart for their HDL map, which provides alpha 1 and alpha 2 particles. This allows you to see HDL particle size and allows you to infer HDL functionality. She runs CRP, fibrinogen, NPO, myeloperoxidase, and sometimes lipoprotein phospholipase a2, TNF alpha or il-6. She mainly uses True Health in Boston. She also runs essential fatty acids to see saturated fat, trans fat, EPA and DHA level. She also tests for hormones, thyroid, blood sugar, hemoglobin A1C, insulin and vitamin D levels. Biomarkers indicate risk factors, not disease.

28:17 Assessing Cognitive Function: The mindset is that there is nothing you can do for dementia or Alzhiemer’s and it is not true. Research shows that changes in cognition appear 30 to 40 years before dementia is diagnosed. With any other disease, upstream changes can effect outcomes. Fall in love with your brain. There are things that you can do to prevent dementia. We are often afraid to do cognitive function testing for fear of a negative diagnosis.

33:34 Preventing Dementia/Alzheimer’s: Not only can cognitive decline be prevented, it can be treated once it has taken hold. There will never be a drug that fixes Alzheimer’s. We need to teach our children about food choices, exercise, and protecting the brain. Trauma increases dementia risk. Your brain is the consistency of soft tofu or butter at room temperature. The skull is hard and has lots of pokey ridges. If you let your kid do things where their head can get hit, they can end up with brain injuries. Young brains are plastic and can do a better job of repair than an older brain.

37:26 Brain Assessment: Dr. Retzler uses CNS Vital Signs for cognitive testing. It is validated, easy for the patient to do and she can track them. She uses a detailed questionnaire from Dr. Daniel Amen. If Dr. Retzler is concerned, she will send her patient for a SPECT scan. It is a two day scan.

43:34 Dr. Retzler’s Morning Routine: She is not a morning person. Two mornings a week she goes to spin class. She checks patient messages, reviews notes, listens to podcasts or reads something science based. She does HeartMath before she sees patients.

46:38 Dr. Retzler’s Favorite Supplement/Nutrient: She would practice calorie restriction. She doesn’t eat from dinner until 10 to 11 in the morning. Calorie restriction is the only intervention shown to extend lifespan. She tried prolonged fasting years ago, but found that she gained weight and suppressed her T3. She does not recommend prolonged fasting to her patients. She is focused on mitochondrial biogenesis, so she takes resveratrol, quercetin, antioxidants and she eats an antioxidant rich diet. Her supplement of choice is CoQ10, the rate limiting enzyme in ATP production. If you want ATP, you need CoQ10.

50:03 Dr. Retzler’s Elevator Pitch: The American people need to be taught about prevention and that they have control over their health destiny.

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