760. Stress and Heart Disease


What’s worse for your heart? If you had to choose between smoking, cholesterol or obesity, which one would you choose? Most people would pick smoking, but the answer is actually stress!

A recent study out of The Journal of the American Medical Association is saying that stress is the number one most dangerous factor for your heart. When we are stressed, high levels of cortisol start circulating.

Join Dr. Martin in today’s episode as he explains why cortisol plays a huge factor in a diagnosis of heart disease.


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Dr. Martin:  Well, good afternoon, everyone. Hope you were having a great end to your day. A new study that came out in November, okay, I don't know if I missed it because I just picked it up in the last few days, but it was out in the Journal of American Medical Association in November. And before I tell you the results of the study, I am going to ask you a question, because when you read the study they ask questions too. And what they did is, they followed 918 patients, watched them between four and nine years and had a pretty interesting conclusion. Okay? And I think we'll unpack this a little bit today and talk about it. Okay? So here's the question I'm going to ask you, you guys know this to some extent, but then I'm going to bring in something that this study talked about and I think you'll find it interesting. Okay, what is worse for your heart? What's worse for your heart? Smoking, one. Cholesterol, two. Obesity, three. The question is what's worse for your heart?

Okay? Smoking, cholesterol, obesity or high blood pressure? Now, this study didn't talk about of these, but I want to ask you the question. Okay? Obesity, Grace says. Rosa says obesity. And Terrill says obesity. Diane says obesity. And Donna says smoking, good, too. Overweight or obesity. Yep, Brenda says smoking and a couple of more. Glenna, what do you think? Morris, you say smoking and Jose says obesity. And Debbie says high blood pressure. Now, it's a trick question. Okay, it is a trick question because the answer is not any of those. Now, I'm glad none of you have put cholesterol, even though every day I get asked a cholesterol question. I do. And I don't mind you asking me the questions. I really don't. And I certainly don't mind if you send me your blood work and you want me to pontificate on it. Okay? If you send me your blood work, I'll be happy to look at the things I look at for metabolic health because that's what I look at. Okay?

But this study in The Journal of American Medical Association, smoking, do we all agree, smoking is bad. For me, if you would've asked me, because I sort of did this mental exercise before I read the article. What's worse? Smoking, obesity, high blood pressure? Here's Dr. Martin on those four. I would've picked high blood pressure and smoking. Okay? That's just me. All answers are good except cholesterol. Okay? And of course it's in this study because most people, most doctors, even today in 2022, think that one of the biggest problems for your heart is cholesterol. And on this podcast, I try and debunk that almost every day. Okay? But you know what, here is what came out of left field. Not any of those four things, keep cholesterol aside, the other three are certainly contributing factors, but you know what the worst one was for heart attacks?

Stress. The Journal of American Medical Association says that the number one most dangerous factor for your heart is stress. Wow. Now, I've written several books and I can't remember one of them where I didn't talk about stress. You see, I'm a big guy on cortisol. Okay? I'm a big guy on it. I've been talking about it for many, many, many years. I bring you back to late eighties, early nineties when I wrote a book about chronic fatigue syndrome and that had to do with long lasting cortisol creating a cascade of symptoms, fibromyalgia, chronic fatigue syndrome. I wrote my thesis on it. I published a book. I traveled the world and talked about stress cortisol and its implications, long lasting effects. But isn't this interesting that the American Medical Association Journal says that stress is worse than smoking. Not that they're telling you to smoke, but it's worse.

And it was pretty interesting. And this wasn't a short term study. Here's what they said. Let me just read some of it. Loss of job, loss of a loved one, natural disasters, prolonged stress had more implications on the heart and damaging the heart than they suspected. They didn't suspect, they didn't think they were going to get this as an answer. Now, let's look at this a little closer. What does stress do? Physiologically, how would it damage your heart? How could it cause you to have a heart attack? So, I didn't have to read the rest of the article for that because I know and I've talked about for a long time, what cortisol does. Okay? So again, if you're not sure what cortisol is, it's this. Okay? Ooh, you're uptight, and how do you know if you're uptight? How do you know, because some people, we used to measure cortisol in the office.

So I said, "Well, your cortisol was elevated." And they said, "Well doc, I don't think I'm stressed." I said, "Are you sleeping?" "I don't sleep that good, or I fall asleep but I wake up in the middle of the night." I said, "That's cortisol. That's what cortisol does." Cortisol is natural, by the way, you need cortisol even to wake you up in the morning. Your highest levels of cortisol are in the morning because it goes with your circadian rhythm, the clock, your internal clock. So when you wake up, it wakes you up, it gets your blood sugar going. Somebody said to me yesterday and I answered this, "Well doc, my blood sugars are higher in the morning." They're supposed to be higher in the morning. Cortisol will elevate your blood sugar. Why? It's waking you up. I never recommend people to take their blood sugar when they first get up. What are you taking your blood sugar for? If your cortisol's working, your blood sugar's going to be a little bit higher, normal, even before you eat.

Don't worry about that. This is why I'm not that big on blood sugar. You know, I wish I would've invested in these companies that made the glucose monitors. My word. I used to tell patients in the office would you stop measuring your blood sugar every five minutes? It costs a buck and you don't need to know that all the time. Just watch what you eat. Anyway, let's get back to cortisol. When cortisol is elevated over a period of time, usually the first thing that it effects is your sleep. It's one of the biggest factors in the lack of sleep. Now look, I've described women usually in their menopausal years, it's like an airplane. As you come into your menopausal years, and sometimes it's earlier for some women than others, pretend you're in an airplane. You're coming in for landing and your wings are doing this.

Okay, that's all right. There's a little bit of fluctuation. But some women get major turbulence, like ooh, it's really hitting turbulence and the body changes and they don't sleep. Well, cortisol is involved in the that but it's not the primary thing. It's usually your estrogen, progesterone. Okay? But leave that aside for a minute. Let's come back to the heart. What happens over a period of time? If I come up behind you and scare you, okay, of course you're going to secrete cortisol temporarily. The hairs on the back of your head are going to go up. You're scared. You're going to kick me or you're going to run. That's called the fight or flight. Your body has adrenals. It's normal, but it's not supposed to last. And what The Journal of American Medical Association is saying, when it goes on too long, one of the worst things... and I hate going off on, no I don't, I love going off on rabbit trails, but I don't mean to all the time.

But I talked to you, I think, before Christmas. I talked to you about what cortisol in cancer. Okay? It pours gasoline on the fire of cancer. And that's why I'm a big history buff, not only world history, but I want to know your history because the biggest thing that I found in my office is when people, they came in to see me, they already had breast cancer. And I said, because I would do the history taking, "Tell me about the trauma you've been through. Tell me about the stress you've been through in your life. Let's go back five years, maybe even longer." So we know it is a huge factor, especially in breast cancer. It's a big risk factor. Why? Because cortisol pours gasoline on inflammation and cortisol over a prolonged period of time will create inflammation.

Okay? And inflammation left unchecked will damage your blood vessels, especially your little capillaries. Cortisol will elevate your blood pressure. See, blood pressure's surely a factor in heart attacks, for sure, and stroke. We know that. But there's a reason. I always tell you guys, look, blood pressure is a symptom. It's not the cause, it's a symptom. What causes high blood pressure? Oh, okay. Insulin. It affects the kidneys. The kidneys vasoconstrict and you get high blood pressure. That's food. But the other one is stress, cortisol. It stresses. It elevates the blood vessels. You know what happens too when your cortisol is high? You clot in your blood a lot more. You make a lot more clotting factors. That's really important that you know that. Your blood becomes more like molasses. It clots easily. That's part of the fight or flight. A short period of time, who cares? Over a long period of time, dangerous. Dangerous for that heart attack.

And the clots can leave your leg. You can get a pulmonary embolism. You can get a myocardial infarction, which is a blood clot in the blood vessel. It's not cholesterol. Cholesterol is at the scene, but cholesterol's always there. Why would you blame the police if they're at the crime scene? They're not the bad guy. Of course cholesterol is running through your blood vessels. Of course cholesterol is there. Would you blame a fireman for being at a fire? See, medicine has blamed the wrong people. They've got a villain, cholesterol. It's the boogieman, but it's not true. Cortisol is dangerous over a period of time. We know that it zaps your energy. We know that it affects your sleep. We know that cortisol can give you mood swings. We know that cortisol can affect your memory. Think of if you're being chased. Do you care about your memory if you're being chased? You don't care about that. Neither does your body.

Your body's not thinking, "Oh, I wonder what my childhood was like," if a bear is chasing you. You don't care about that. Your body is in high fighting mode. When you're fighting, your blood vessels are opening up. Your blood pressure's going to go up of course. When you're running, of course, but it's meant to stop. You see, it's when it doesn't stop. So we know cortisol does these things, we know cortisol gives you belly fat. You combine cortisol with a bad diet, this is the book I wrote years ago, Serial Killers: Two Hormones That Want You Dead. One of them was cortisol and the other one was insulin. I mean, I was right on the money. One was food and the other was stress. And if your cortisol is high for a period of time, you know what it does? It makes your cells even more resistant to insulin. You get insulin resistance.

So, your insulin's got a job to do but if it's got to pour out even more and more and more insulin, you're creating a cascade of inflammation and other problems that damage your blood vessels. You see, inflammation without a fever is destructive to your blood vessels. Atherosclerosis, hardening of the arteries. And so, often these heart attacks come without any warning, without any warning. This is another thing that they were saying in this study, sudden, people drop. So what do you do? Think about it. You see, it's important. Look, you go through things in your life and what are you going to do, leave the planet? I mean, one of the things that I've talked about the most, I don't know about the most, but if you've been following me for any period of time in the last 18 months coming on what, 19 now, holy moly in March we're going to be at, wait, 24, 2 years.

What have I said all along? The unintended consequences, people don't realize, you can't even get into your hospitals today for elective surgeries. It's canceled. You know how many cancers they're going to miss look, people are stressed. I talked to you about depression. I've talked to you about what it's doing to young people. I'm telling you this is going to be a disaster guys. Like you would not believe locking down and all this is going to be a disaster. People are not looking forward. They're not thinking it's just the virus. They're not talking cancer. They're not talking cardiovascular disease. I wish our elected officials would look at studies like the journal of American medical association and look at the damage. What they're saying is the number one cause of heart attacks, deadly ones, stress.

So what do we do? Well look, you can't control everything, you can't. But there's a few suggestions I'll make to you. Look guys, one thing you can do, keep the twin at bay. What's the twin of cortisol? I talked to you about it, insulin. Keep that at bay, fix it. Keep your insulin down. It'll lower your inflammation, that silent killer. Keep your inflammation down by eating good. Cut out those crappy carbs and the sugars. Get to sleep. I know that's not an easy thing. What is it, 70, 80% now of the population have trouble sleeping. You don't sleep your cortisol goes up. Your cortisol goes up, you don't sleep. It messes up your circadian rhythm. One of the things I find effective is vitamin E. The real vitamin E, exercise. Move, walk, weight resistance, lift weights, get strong. And even the study said it's helpful because it lowers cortisol.

When you put your Nikes on your cortisol goes down. I'm serious. I remember studies, I'm talking about 40 years ago, studies that showed just by putting your running shoes on... in those days you only wore your running shoes if you were going to go and work out or go for a run. But they showed just by moving it really, really helps because it lowers cortisol. It lowers your stress response. Here's another one that lowers inflammation, omega three. Make sure you're getting enough omega three, especially the high DHA, the fat that lowers your inflammation. Are you on our cortisol formula? You should be. It was so prevalent in our office, ask Jeannette, ask Nick, ask Brandy, ask anyone that worked with me over the years. I'm telling you we were shocked at cortisol readings every day, just crazy. Even in kids. It would've been unheard of 20, 30 years ago.

Now, kids go through high levels of stress. It's craziness. One of the stress vitamins, think about this, this is really important, because it not only lowers inflammation, it lowers your homocysteine. What vitamin am I talking about? Elevate your nitric oxide, B12. If you got high levels of cortisol your B12 usually is way too low. B12 is very, very important because it gets destroyed in stress. How do you get B12? Well, I want you to eat it primarily, eat your steak. That's how you get B12. But if your B12 is low, then take a methylcobalamin. Let it melt in your mouth. Get your B12 levels up because it elevates your nitric oxide. Pine bark extract, Navatol, elevates your nitric oxide. What does nitric oxide do? Opens your blood vessels. Do you know that vitamin D, the sun, opens your blood vessels. That's why the sun is so good for your heart.

Fascinating study isn't it? Fascinating study. Thank you guys for participating in my little quiz today. Nobody had the wrong answers, but it was a trick question because the right answer wasn't there. Cortisol wasn't there. I didn't give it to you. Interesting though, isn't it? I had flagged this a couple of days ago and I said how did miss this? It came out in November. Fascinating study. Okay, tomorrow question and answer Friday. Get your questions in. We appreciate them. I'll try and answer each and every one of them. We enjoy it. One of our most popular programs is question and answer. Okay? That'll be tomorrow morning. So, Martin Clinic Facebook group, tens of thousands are in it. We thank you for it. I even posted in there today. Not easy for me, being a senior. Okay. You guys are wonderful and I mean it, and I love you. Talk to you soon.

Announcer:  You've reached the end of another Doctor Is In Podcast, with your hosts, Doctor Martin Junior and Senior. Be sure to catch our next episode and thanks for listening!

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