Empowering Midlife Wellness with Dr. Susan Dr. Susan Hardwick-Smith

Most of us have heard a lot about insulin resistance but many of us still don't understand why it should be considered a disease in and of itself, separate from diabetes. Insulin resistance affects more than 50% of our patients and causes weight gain around the middle, as well as increasing heart disease, Alzheimer's disease and of course, diabetes and its related complications.
My hope is that with a better understanding of how this process works we can each get more involved in doing the things that are necessary to cure insulin resistance. This can almost always be cured with nutrition and exercise alone, without medications. Once we truly understand how the process works, we can become internally motivated with a clear reason WHY to stick to our healthy nutrition and exercise program.

Today I'm back with my partner, Dr. Leah Antoniewicz, discussing Nitric oxide. This fascinating molecule is made of one nitrogen and one oxygen atom (NO), and reduction in nitric oxide has been shown to be associated with an increase in multiple diseases as we age. Today, I'll be talking to you about the science of how nitric oxide works, as well as how to naturally increase it and some things to avoid that might be decreasing it.

Our understanding of the vital importance of the gut biome has skyrocketed in the past 10 years, yet we are still just beginning to learn all of the incredible functions of these healthy bacteria. Today I'll be reviewing the role of healthy gut bacteria in the prevention of multiple disease processes, including the most common diseases that affect American women- obesity, insulin resistance, diabetes and cardiovascular disease. I will particularly be talking about a really interesting key bacteria called Akkermansia, and a growing body of research suggesting its importance in weight maintenance and insulin sensitivity, amongst other things.
Since learning about this, I have started taking the Pendulum brand Akkermansia product myself (I'll explain why I prefer this brand in the video though I have no affiliation with the company), and recommend it to many of our patients. I think after listening to this, you will consider it too!

Iron is a vital micronutrient that is sub-optimal in more than 50% of women. This is frequently missed because it masks as many other things, and most doctors don't check the labs that are necessary to evaluate this completely. Today I'll be talking about where we find iron in our diet, how to diagnose low iron and how to address it by evaluating our input, absorption, and ruling out any sources of blood loss. I'll also tell you about my own story with low iron, how I corrected it, and how both my patients and I feel so much better when our iron is optimized!

We all know that alcohol is a toxin with numerous effects on our health - from weight gain, to sleep and mood disruption as well as causing multiple cancers, diabetes, heart disease, gut dysbiosis, liver damage and dementia - even at "socially acceptable levels." Many of us drink in moderation and don't consider it to be a "problem"- but today I'm discussing an interesting way of reframing your relationship with alcohol and being very clear about where it might be causing problems in your life.

I came across an amazing community called "One Year No Beer" (link and tag on social) and joined their 28 day alcohol free challenge. This challenge is supported with emails, videos and connecting with others on the same journey, and invites you to experience how you feel without alcohol for a prolonged period. Like me- a break from drinking makes most people realize that we are being held back by alcohol, and without it many things improve! My personal goal is to be someone who drinks "as much as I like as often as I like"- which will amount to very little, and not very often.

The most common killer of both men and women is heart attack, so understanding how to reduce our risk could not be more important. Since the 1980's, studies have consistently shown that menopausal hormone therapy (particularly estrogen) reduces the risk of heart disease in women. The now infamous Women's Health Initiative study surprised the medical community in 2002 by suggesting that hormone therapy increased the risk of heart attack in a small subset of women. After 22 years of gathering more data, multiple large studies have now confirmed what we previously understood, which is that estrogen has a highly beneficial effect for the heart if it's started in the first 10 years after menopause, and benefit seems to be negligible if it's started later (but not harmful). We no longer recommend taking the lowest dose for the shortest time, but rather suggest starting menopausal hormone therapy as early as possible and continuing it long term. For the great majority of patients the benefits far outweigh any potential risks.