23 Reasons to Get a Heart Scan

1.     Heart disease is the leading killer in the USA for both men and women.

2.     About 610,000 people a year die from heart disease.

3.     One in four deaths is related to heart disease.

4.     735,000 Americans have heart attacks annually.

5.     Heart disease kills about the same number of people annually as does cancer, lower respiratory disease, and accidents combined.

6.     47% of sudden death from heart attacks occurs outside the hospital. This suggests that people do not understand the risk and/or symptoms of heart attacks.

7.     Men are at higher risk than women.

8.     African-American men are 35% more likely to have heart disease.

9.     High blood pressure, high cholesterol, and smoking are key risk factors for heart disease.

10.  About 47% of Americans have at least one of these risk factors.

11.  Family history of heart disease increases your chances of having a heart attack.

12.  Diabetes, poor diet, physical inactivity, obesity, and excessive alcohol use greatly increase your risk of heart disease.

13.  Oklahoma has one of the highest incidences of heart disease in all of the USA.

14.  About 800,000 people a year have a stroke.

15.  Heart disease and stroke cost about $313 billion a year in healthcare costs and lost productivity.

16.  The American Heart Association predicts the annual cost of heart disease will exceed 1 trillion dollars by 2035.

17.  According to the American Heart Association, your risk of cardiovascular disease is 50% at age 45.

18.  It is 80% at age 65.

19.  The emotional pain and suffering inflicted on people is unmeasurable.

20.  No one wants to die too early.

21.  Heart disease can be treated and prevented.

22.  Screening for heart disease is easy.

23.  Not knowing if you are at risk is not very smart!

Heart disease does not have to keep kicking our proverbial butts! Screening is very simple. A heart scan is an inexpensive way to screen for cardiovascular disease. It is not perfect, but you do get valuable information to help evaluate your personal risk for coronary heart disease.

A CT heart scan measures the amount of calcium that builds up in the arteries that feed your heart. It can be correlated to a degree of blockage in those arteries. It is not super accurate in the sense that you will not get a number such as 76% blockage. It will get you in the ballpark. It will generally correlate to no blockage, mild, moderate, or severe blockage. If you are in the moderate or severe category, generally you should have more testing.

Most places will do a heart scan for around $50. Insurance does not cover heart scans. Since you are paying cash for it, you do not need a doctor’s order. Simply call your favorite place and schedule.

Remember, this is only a screen. If you are having any symptoms at all, check with your doctor. You can still have problems in spite of having a normal heart scan. It is not perfect, but you do get good information and it is relatively inexpensive. (It is also pain-free!)

If you have a family history of heart disease or if you have other risk factors such as smoking or hypertension, start screening around age 40 to 45. If you score a zero (perfect), probably good to get one every five years. If you do not score a zero, I would check more often.

Oh. I just had mine and I scored a 23. My previous one was a zero. I have a strong family history of coronary artery disease. I am going to repeat in one year and I am going to double-check my lipid panel and watch my blood pressure closely.

Time to go exercise!

Wishing You an Amazing Life,

Dr. Curtis Brown

Low on Energy? A Few Thoughts on Fatigue

One of the most common complaints I hear in my office is, “I have no energy. I just shouldn’t be this tired all the time.”

This seems to be pervasive in our culture.

If you simply search fatigue, you will get over 11 million results. There are also as many cures for fatigue as there are variations of this complaint. If you search for information on cures for fatigue, you will get over 9 million results. Clearly, this is an issue for many people.

There are many causes of fatigue. Most patients are convinced that their thyroid, blood sugar, iron levels, or hormones are low or not right. All you have to do these days is turn on your radio or TV and within fifteen minutes, you will probably hear a commercial for men about low T.

I do believe it is important to check on these things when appropriate, but rarely are these the cure for fatigue. Certainly, if you have low T or hypothyroidism, replacing these hormones can help with your energy, but most people have normal results.

Over the years, I have found the quickest fix for low energy for most people is to start an exercise program. “Motion is lotion.” You will simply feel better and have more energy. On the other extreme, if you are working out 7 days a week, taking a true Sabbath from your workouts will help.

I am also amazed at how little sleep many people get. We need to consistently get around 8 hours of sleep. Some people seem to do okay with 7 while other may need 9 hours of sleep. Those patients that routinely sleep less than 7 hours will usually push back against my suggestion for more sleep. They will usually say they have always only needed 5–6 hours of sleep. Of course, when asked how long they have been tired, they reject the association to lack of sleep to their fatigue even though they have been tired all those years.

Sometimes, the cure is more water. If you are chronically mildly dehydrated, it can cause fatigue. Our bodies are around 60% water. We need water!

Over the long haul, sugar is a zapper of energy. It will give you a quick burst of energy but usually leads to low levels of motivation and/or energy after the initial surge. Eliminate sugar and things that turn to sugar as much as you can.

I take a B-complex vitamin from Thorne Research called Methyl-Guard. It has B12, B6, and folate. I think it helps me. Whether it actually helps or if it is simply all in my mind, it works for me.

But the most common cause for fatigue that I have found in my 25 years of being a family doctor is stress. Stress comes disguised in many forms. Most people do not believe they are stressed. I think it is the “boiling frog” theory. They are so used to low levels of stress and as their lives get more complicated and stressful, they do not see the increase temperature of the water as they are slowly coming to a “boiling” point in their lives.

Our culture promotes stress. We have a tendency to get over involved in all sorts of things. Mostly, these are good things. Look at little league games these days. There was a time when a T-ball team would play 8–12 games in a season. Usually the kids would have the same hat and maybe T-shirt. Now, these kids are in $200 uniforms, and playing tournaments on weekends. It is nothing for an active T-ball team to play 35–50 games.

There is nothing wrong with T-ball. It is great for kids to be active and compete. What I see happening in our lives is lack of any margin. We cram as much as we can in our 24-hour day. When something unplanned occurs (and it always does), we have no margin, no breathing room, and that puts added stress to complete our scheduled activities such as work.

This often leads to stress in our relationships. Isn’t it true that we seem to take it out on those we love the most? Keeping our relationships healthy will dramatically improve our energy level. It will take energy to invest in those relationships, but we will get more back than we put in.

Another drain of our energy is the constant distractions that keep our minds buzzing with information. When was the last time you allowed your mind to be bored? With all of the technology that keeps us connected to our stressed-out world, we seemingly never disconnect. I believe one of the best “fixes” for fatigue is to disconnect and recharge your emotional batteries.

Disconnecting looks different from one person to another, but one of the keys is to allow your mind to get bored or at least not be distracted with all of the information we have available to us today. Take time to meditate. “Dwell on what is pure and noble.”

I have found exercise is one of the best ways for me to disconnect from the chaos and to recharge my emotional energy. Sometimes reading a good book will do the same thing. Take some time to figure out what it is for you that will help you stay emotionally energized. Plan for it and invest in it.

When your emotional energy is good, you will find your physical energy will follow. It may not happen simultaneously, but it will correlate. Allow your mind to occasionally be disconnected from all of the chaos we live in every day. The world will not stop rotating if you do not check in on Facebook or Instagram every day!

Wishing You an Amazing Life,

Curtis Brown, MD

The Season for Sneezing

It's that time of year all over again. The pollen count is high and the winds are changing daily. The cool air is starting to stay longer, but we have yet to have a good freeze.

Allergy sufferers dread this time of the year! The itchy eyes, runny nose, cough, congestion, drainage, fatigue are just some of the symptoms people are complaining of and I should know because I have allergies too.

Fortunately, there are many treatments available over the counter. The non-sedating antihistamines such as Claritin, Allegra, and Zyrtec were at one time available by prescription only. They now are OTC and have generic equivalents available for a fraction of the cost. Many people can treat their symptoms with these medications and do well. Others need more help and recently two of the prescription nasal steroids went OTC, Nasocort and Flonase. They do not have generics but are usually available for around 20 dollars a month. They do have competitors that are available with a prescription, but they do not offer any tremendous advantages over what you can purchase OTC.

I often recommend saline nasal sprays to help clean out your sinuses. It is especially useful if used right after coming in from being outdoors. Some patients use colloidal silver rinses and report good results.

Benadryl has been the gold standard and is what most things are compared to. One of the main problems with Benadryl is that it is sedating. It is what is in several OTC sleep aids.

Hang in there, all those who are suffering with allergies! We are going to have freeze soon and the pollen counts and other allergens will start to decline. Now if you suffer from allergies year around, you might consider getting skin testing to see what it is you are allergic to. The best treatment is to avoid those things.

How Does Caffeine Work?

Have you ever wondered how caffeine works? How does it help keep you awake and more alert?

Caffeine has been shown to help with many types of brain problems. There have been studies that show caffeine consumption may benefit Parkinson’s disease, Alzheimer’s disease, depression, migraines, and may even enhance memory.

Caffeine has many reported benefits and several modes of action. Caffeine can block phosphodiesterases, promote calcium release from intracellular stores, and interfere with GABA-A receptors (these can affect our moods and concentration).

The longer we are awake and the more we use our brains, the more adenosine (a chemical manufactured by our brains) builds up in our brains. Adenosine binds to adenosine receptors on glia cells. Glia cells are a type of brain cell that triggers sleepiness when activated by adenosine.

The way caffeine works on the brain to keep us awake and more alert is by blocking adenosine receptors on glia cells. Caffeine is structurally similar to adenosine and will latch on to the adenosine receptors. It blocks the adenosine from binding to these sites. Caffeine, however, does not activate the receptors—it just blocks them.

Our bodies are fearfully and wonderfully made. After a few days of consuming caffeine, our glia cells start to manufacture more adenosine receptors. It then takes more caffeine to block the receptors and we develop a tolerance to the effects of caffeine.

If you stop caffeine for about three or four days (on average), the adenosine receptors return to the baseline. Then the next time you drink caffeine, you are more likely to notice the buzz.

So the next time you drink a cup of coffee, remember it is blocking your adenosine receptors in your brain. I am sure this information is extremely valuable to you! Who knows, maybe it will help you answer a trivial pursuit question.

Do Anxious People Live Longer?

As I write this post, we are in the heat of summer here in Oklahoma. The heat index has been setting records this week. It has ben HOT!

The heat does funny things to people. I have seen a dramatic increase in patients suffering from essentially anxiety. Generally, they do not openly say they are anxious. It is usually disguised in a somatic complaint such as chest pain, dizziness, fatigue, or shortness of breath.

Anxiety is a part of human nature. Human nature has the tendency to take a thought and go to the darkest place with it. A headache can quickly become a tumor or stroke in some people’s imagination. I am not immune to this tendency.

A few years ago, I had a spell of vertigo. Vertigo will cause you to get dizzy with just about any kind of motion. For a few moments, I was convinced that I must have had a blood clot that would eventually lead to a stroke! To say the least, I survived, and it made me slightly more sympathetic to my patients with vertigo.

In the book The Longevity Project, the authors found that having a little bit of anxiety or concern correlated to longer life. They dismissed the theory that the happy-go-lucky guy lives the longest. It seems that those who have some level of anxiety tend to make healthier choices. For example, maybe they do not take that extra drink or start smoking. They are a little more reserved with their choices.

So it would seem that a little anxiety is probably healthy for you, but too much anxiety can make you ill. I have seen people worry themselves into ulcers or heart attacks. Proverbs 12:25 says, “Anxiety in a person’s heart weighs him down, but an encouraging word brings him joy.”

I think that anxiety and fear are very similar. Most anxiety is caused from fear of loss. We tend to be anxious when we fear loss of health or loss of an opportunity or loss of a relationship or loss of material things.

Some fear is healthy. For instance, fear of falling will keep most people from leaning over the edge of a tall building. Our fears do tend to set limits for us.

I have a slight fear of heights. Anything passed the second rung on the ladder is orthopedic height (you fall, you break!) for me. I will never work on a high-rise building. Fear of getting a speeding ticket and having my insurance rates go up keeps me from driving too crazy.

“The fear of the Lord is the beginning of wisdom.” My fear (or respect of God) sets limits on my choices. It keeps me from doing stupid things. It sets healthy boundaries for me. It gives me a framework from which to make choices.

Some fears can be paralyzing. These usually occur when I have high levels of anxiety, or fear of loss of something. When I drill down on this, I find when I am overly anxious, I have placed that something in the center of my heart. It consumes me and becomes a horrible master. Anything in the center of my heart other than Jesus (the fear of the Lord) will tend to lead to some level of unhealthy anxiety.

I do think having some anxiety is just part of life. If you are human, you will have some anxiety. It would seem a little anxiety might lead to a longer life. The next time you are feeling anxious, do a heart check. Make sure that you truly have Christ in the center of your heart and I believe He will give you peace that surpasses all understanding.

Golden Years: Big Gain in the Future

Have you ever thought about how long you want to live? Most people I know want to live to a good old age as long as they have their mind and can take care of basic daily needs. Most people are more afraid of having a debilitating stroke than a crippling heart attack.

Nobody really enjoys thinking about our golden years and how we want to end our time hear on earth. Our future selves will thank us if we do start thinking and planning for our golden years. I had a patient tell me the only thing golden about his golden years was the front of his underwear!

The problem for most of us is that we are always going to start tomorrow, and tomorrow really never gets here. I judge other people by what they do, but I tend to judge myself by what I intend to do. I have really good intentions like learning Spanish, but . . . I will start tomorrow!

I want to encourage you today to start thinking about the “future you” and consider developing a plan to not only “go long” but to thrive. I do think it is possible to make some small changes now for big gains in the future.

I am currently reading a book, The Longevity Project, and have found it fascinating. It is based on a study started by Dr. Terman in 1921. He started following thousands of California children in grade school. He developed an extensive questionnaire for the kids, their parents, and their teachers. He wanted to look at personalities and see which ones tended to be more successful in health and life. He followed them until he retired and then others took up his work. All of the participants are now deceased.

The main takeaway from the book is that “Personality is an excellent predictor of health and longevity, often in counterintuitive ways.” It was not the carefree, "enjoy life, grab all the gusto while you can" personality type that lived the longest or for that matter was the happiest. “The findings clearly revealed that the best childhood personality predictor of longevity was conscientiousness—the qualities of a prudent, persistent, well-organized person, like a scientist-professor—somewhat obsessive and not at all carefree.”

Our personalities are difficult to change, but with some thoughtful effort we can make some differences. I tend to be an introvert. (My family may say to the extreme.) I can, however, function as an extrovert. It is not my natural self, but I can pull it off for a while. I think the same is true with other parts of our personalities.

I want to encourage you to think about your golden years and start coming up with a plan. 

Vitamin D: The Sunshine Vitamin

I am amazed at how often I find patients with low vitamin D. I do not test everyone, but about 70 percent of the people I test are either low or borderline low.

It has only been recently that the technology has made it affordable and readily available for routine clinical testing.

The classic vitamin D deficiency disease is rickets. I have never seen a case of rickets nor do I know anyone that has seen a case of rickets. The US started fortifying milk with vitamin D in the 1930s and rickets has since become a very rare problem in the US.

Vitamin D is associated with many enzymes and cells in the human body. It helps our intestines to absorb calcium and phosphorous. Some experts have called it a hormone because of the many things it can affect.

There is a growing body of research that indicates that vitamin D could affect cancer risk. It appears to protect against colon, prostate, and breast cancer.

I have frequently found vitamin D to be low in patients complaining of fatigue, depression, and body aches. There is some association with vitamin D deficiency and adult onset diabetes. We certainly think of vitamin D when we are dealing with osteoporosis or osteopenia.

Our bodies naturally make vitamin D when exposed to the sunlight. The amount of vitamin D manufactured depends on the amount of skin exposed to sunlight, time of day, and color of skin. Darker skin blocks the UVB light from penetrating as much as lighter skin.

Vitamin D is fat soluble and can become toxic if you take too much. I have personally never seen a high level of vitamin D, but it is possible. It can cause heart arrhythmias, anorexia, and weight loss.

The US government health authorities have stated that vitamin D deficiency occurs when the levels are below 30 nmol/L. I personally like to see levels above 50nmol/L. It is checked with a simple blood test.

I would recommend that you consider getting your vitamin D levels checked if you are homebound and or otherwise cannot get out in the sun. It is probably worthwhile to check your levels if you have any questions about your ability to get some sun exposure or if you have osteoporosis or osteopenia. You might consider checking your levels if you are dealing with prolonged fatigue or depression.

If you are low, OTC supplements are readily available. Vitamin D3 is the best form to get. It is more easily converted to the active form of vitamin D. I routinely advise patients to take 1-3,000 units daily and often recommend higher doses if levels are low. You should monitor blood levels. I would recommend you to discuss this with your healthcare provider before starting vitamin D.

Go get some natural vitamin D, but do so with caution. Never get sunburned, and remember sun exposure can lead to skin problems, including increased risk for skin cancer.

Olive Oil and Walnuts

Many people are fans of the Mediterranean diet. The Mediterranean diet is basically a diet high in vegetables and olive oil and low on animal protein. A recent study published in JAMA Internal Medicine seems to validate the benefits of this diet, especially when supplemented with nuts and olive oil.

The study was a small one done in Spain. The average age of the participants was 67. Most of the participants were overweight and had hypertension and/or elevated cholesterol levels. They were divided into three groups. One group followed a low-fat diet. Another group followed a Mediterranean diet supplemented with nuts. The third group followed a Mediterranean diet and supplemented with 5 teaspoons of olive oil a day.

Each group underwent memory testing and cognitive function testing before the diet and at 4 years. The group following a Mediterranean diet with supplemental nuts had significant improvements in memory, while the group adding extra virgin olive oil experienced significantly better cognitive function.

The study was small and definitive answers cannot be given concerning the benefits of olive oil and walnuts on memory and cognition. I do think it is safe to consume both olive oil and nuts such as walnuts or almonds and I believe that they can offer some benefits for brain health.

Olive oil and nuts have antioxidant effects and have long been advocated for brain health. They can reduce intravascular inflammation, which is a major cause of vascular damage. There are no bad side effects from these foods but do watch out for calories. (Nuts in general have about 10 calories per nut.)

So the next time you have a salad, add some olive oil and walnuts!

The Brain-Gut Connection

Did you know that over 70% of neurotransmitters are actually made in the gut? Science is beginning to unravel the complicated connections in our bodies and one of the more amazing connections is the brain-gut connection.

I think that intuitively we have known about the brain-gut connection for some time. It is even ingrained in our language. You have probably said something like this before: “I have a gut feeling.” 

There is research that shows connections to chronic diseases and to the bacteria in our intestines. Certain patterns are starting to emerge with respect to the types of bacteria in our intestines with certain illnesses.

Several studies have shown a connection to the gut microbiome and many different problems associated with our brains. Parkinson’s Disease, anxiety, and depression are a few that exemplify this connection.

It seems reasonable to me to think about keeping our guts healthy in order to keep the rest of our bodies healthy—including our brains. One of the best ways to do this is to decrease and eliminate processed and high sugar. These types of food tend to cause inflammation that can have a cascading effect throughout the body.

Probiotics are bacteria that are normal and healthy for our intestines. Each capsule will contain millions, if not billions, of bacteria. I often recommend my patients to consider probiotics for intestinal problems. If you are taking antibiotics, I encourage you to also consider taking probiotics. 

I believe that most things that can cause your intestines to be inflamed can also cause some neurological issues as well. These problems may be subclinical, meaning that it is not readily noticeable.

Probiotics will not cure anxiety or depression, but they may provide some relief for some people. If you are struggling with anxiety and depression, try a radical approach and eat healthy and exercise and take some probiotics. Avoid processed foods and sugar for a couple of weeks and see if your energy improves and the fogginess in you clears up. Try my 10-Day Diet Challenge and see if you feel better. I have a gut feeling that you will!

Intestinal Intrigue

Our intestines do some amazing things for our bodies. We obviously think first about nutrition, but our guts are more involved with our bodies than just nutritional support. The intestines influence every area in our bodies.

Did you know that your guts produce about ¾ of the neurotransmitters in your body? Most people think the neurotransmitters are just in the brain or the nervous system, but this is not so. Our intestines contain over 2/3 of the body’s immune system. There is more than 10 times the number of cells in our intestines than in the parts of our bodies. The gut even has greater metabolic activity than the liver.

If you were to completely flatten out the intestines, they would cover an area roughly the size of a tennis court. The small intestines reabsorb about 7.5L of water a day and the large intestine reabsorbs about 1.4L of water a day.

Science is continually discovering amazing things about our guts. The average person has about 4 pounds of bacteria in their intestines. These bacteria are actually communicating with our intestinal cells DNA. They use different messengers to turn certain genes on and off. There has even been research that links depression to the bacteria in our intestines.

We actually have more bacteria in our bodies than we have cells in our bodies. It makes you wonder who the host really is.

Life is usually about finding balance, and it is no different with our guts. When we have a good balance of different healthy bacteria, our intestines function much better. When we experience an unbalanced flora of our intestines (dysbiosis), we can experience a multitude of symptoms ranging from mild problems such as heartburn to severe life-threatening infections.

One good way to ensure that you maintain a healthy balance of bacteria is to consume a diet high in fiber and various healthy carbohydrates. Try to eat different colors of vegetables. The wide variety of foods helps maintain a healthy gut microbiome.

Consuming a diet high in processed foods and high glycemic carbohydrates can lead to dysbiosis.  The standard American diet (SAD) frequently leads to dysbiosis. Many Americans are suffering gastrointestinal-related symptoms that are secondary to the food they consume. Probiotics can help dysbiosis.

Probiotics are bacteria that are considered normal and healthy for the intestines. Many people benefit from taking probiotics. If you have chronic GI symptoms, first consider your diet, but also consider a trial of probiotics. I also recommend probiotics anytime you are taking antibiotics.

Our intestines are really amazing when you start to understand all the things they do for our bodies. Remember that we literally become what we eat, so choose a diet that is full of a variety of vegetables and consider supplementing this diet with probiotics.