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What ain’t broke, don’t replace it

December 16th, 2015

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What ain’t broke, don’t replace it

In the past few years, there has been much debate about the benefits of taking vitamins, especially vitamin E and vitamin C, in a higher dosage than the body’s daily requirement, in the light that whether it can help prevent heart diseases and hardening of artery. These two vitamins have antioxidant properties, but can they also prevent diseases?

Vitamin C and vitamin E occur naturally in the food that we eat, so essentially they pose no harm. They are also affordable and widely available, so they are quite popular with the crowds because most people think they are “natural” substances and won’t do any damage to their health. They hope that it will help them stay forever young and healthy. The truth is too much of a good thing can turn out to be bad.

However, this topic has reached some scientific findings as there has been some systematic experiments to determine whether these vitamins do what they are claimed to do. Comparing a group of people who receive vitamin E and vitamin C to a group of those who don’t, it was evident that after a year, there was no significant indicator that the vitamins help with the artery or the heart in general.

Contrastingly, it was found that vitamin E could have a negative effect on some treatments for the heart. It might reduce the effectiveness of stain drugs used in reducing blood cholesterol. Now it is believed that supplementary vitamins, especially vitamin E and vitamin C, cannot really prevent heart diseases, and might even do the opposite.

Another popular supplement taken by many women is hormone replacement for menopausal women. Since certain hormones take a dip after women reach menopause, and since many menopausal women have heart diseases, especially myocardial infarction, it was suspected that hormone replacement might help reduce the risk for heart diseases and hardening of artery in women.

Menopausal women are also characterized by unexplainable symptoms, so many doctors believe that hormone replacement will help them feel better.

I had a patient who was a 52-year-old woman. She was fit, active and in good shape. She told me that her heart felt light sometimes and every once in a while she would wake up with a sharp pain in her left chest. The condition was irrelevant to exercise – strangely she felt better, not worse, after working out. She exercised regularly by walking and jogging for 30-40 minutes every day. Sometimes she felt hot flushes for no reason. Sometimes she couldn’t sleep. Sometimes she felt sleepy all day. Sometimes walking up the stairs made her tired while exercising was never a problem.

I found that there was nothing wrong with her physically. Her blood pressure, pulse and cholesterol level were not something to worry about. Everything else also seemed fine to me.

However, she said that she might have narrowed artery because her father did, and had the same symptoms as she did at the time. She also said that her period had always been regular when she was younger, but recently it had been irregular.

I told her that the symptoms did not point to narrowed artery, but to menopause, and recommended her to talk to a gynecologist. I also told her to watch her cholesterol level if she was worried about having narrowed artery in the future.

Two months on, she came back to see me and said that she felt much better after undergoing Hormone Replacement Therapy (HRT), but she would like to check her cholesterol level just in case. She told me she had been watching her food and exercising even more.

To my surprise, her cholesterol level had gone up to 300mg/dl. She told me that she had been eating healthy food and exercising more. Could the hormone replacement be the reason?

We used to believe that hormone replacement could help menopausal women prevent heart diseases, but then again, women’s heart is always unpredictable. Many studies have shown that hormone replacement could lead to higher risk for heart diseases and artery diseases. Paralysis is more common in women who receive hormone replacement compared to those who don’t. In other words, hormone replacement could reduce the effectiveness of medicine that is supposed to keep the cholesterol level in check.

Hormone replacement is something that should be reserved for menopausal women who have very severe symptoms. Mild symptoms could be treated with a healthier lifestyle. It only takes a while for hormones to adjust themselves, so the nasty symptoms would go away on their own.

Back to that patient, I told her to stop taking hormone replacement and exercised more. I complimented her on her strict diet and told her to continue eating fruits and vegetables. About 3-4 months later, she came back to see me again, and her cholesterol level had gone down to 180 mg/dl without any help from medicine.

So, let me conclude my point here. Supplementary vitamins and hormones do not really help with menopause, if woman lives a healthy life-style by eating plenty of vegetable fruits and nut as well as exercise. They might even have adverse effects. There is no reason why you should take them, except if your doctor recommends it.

Personally I would recommend exercise instead, because it doesn’t come with any undesirable side effects.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.

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