Heart Sense for Thyroid Patients

An Interview with Cardiologist Dr. Stephen Sinatra

Dr. Stephen Sinatra

Heart disease is the leading cause of death among women today, yet women's heart problems are frequently overlooked. Many women are more worried about breast cancer, which is far less likely to strike a woman than a heart attack.

Stephen Sinatra, M.D., F.A.C.C., F.A.C.N., is a board-certified cardiologist and certified psychotherapist with more than 25 years of experience helping patients prevent and reverse heart disease. In Dr. Sinatra's book, Heart Sense for Women: Your Plan for Natural Prevention and Treatment, published by LifeLine Press, he explores the innovative information about heart disease and women, including early warning symptoms, cholesterol, homocysteine, lipoprotein, and LDL oxidation, plus a natural program for reducing blood pressure and reducing reliance on medication.

We had an opportunity to talk to Dr. Sinatra about Heart Sense for Women, and what he felt that women with thyroid disease should know about heart health.

Is There An Increased Risk of Heart Disease for Thyroid Patients?

According to Dr. Sinatra writing in his newsletter, "HeartSense," even subclinical hypothyroidism—normal to high-normal thyroid stimulating hormone (TSH) levels—can increase the risk of heart disease in women. Dr. Sinatra puts that risk at "14 percent, or similar to the risk associated with the combination of high blood pressure and cigarette smoking."
Still, Dr. Sinatra believes that the main risk is not a causal one, where thyroid problems directly cause the heart problems. Rather, says Sinatra:

"If a woman has a thyroid problem, she needs to know that her risk is increased not necessarily because of the thyroid disease or the drugs she's taking specifically, but because of the other risk factors such asweight gain, and lipid abnormalities that result from the thyroid disease. A woman with thyroid disease needs to take more responsibility for her heart."

What's the Role of Coenzyme Q10?

One contributing risk factor, according to Dr. Sinatra, is a deficiency of Coenzyme Q10, or CoQ10, as it's known. Dr. Sinatra considers CoQ10 a true wonder-nutrient, because, as he says in his book, "it essentially improves the heart's ability to pump more effectively."
Women are naturally more deficient in CoQ10, and nowhere are deficiencies in this nutrient greater than in women with thyroid conditions. "If there is one thing a female thyroid patient can do, it's supplement with CoQ10," Dr. Sinatra says.
In particular, hyperthyroidism is a key risk for women. Says Dr. Sinatra:

"If a woman is hyperthyroid, this can be a disaster, because, in hyperthyroidism, a hyperactive thyroid gland can burn up all the CoQ10 in the body. The metabolism is so high that CoQ10 is stolen away from the heart. When this happens, the woman can go into heart failure. Many times I have seen a hyperthyroid storm in a woman associated with heart failure. We didn't understand why women got heart failure and hyperthyroidism at the same time. We used to think it was a virus, but now we know the hyperthyroidism takes away the CoQ10."

Dr. Sinatra emphasized how important he feels CoQ10 is for women with thyroid disease. "The way I treat women with any thyroid problem is with a minimum of 100-200 mg of CoQ10. If a woman is on a statin drug or has heart problems, then 200-400 mg a day."

Thyroid Drugs: The Controversy Over T3

We asked Dr. Sinatra if he felt that the use of T3 was a danger to the heart, as some doctors claim. With some patients, Dr. Sinatra is particularly cautious. "For a woman with heart disease or active angina, T3 can be a problem. It can make the heart work harder. Under those circumstances, I would hold back T3."

Otherwise, Dr. Sinatra prefers the desiccated natural form of thyroid hormone such as Armour or Nature-throid,which includes both T4 and T3. He did not feel that it poses any special dangers to patients.
Dr. Sinatra has said: 

"Be very skeptical of any health care provider who says that there's only one type of thyroid treatment that works. There are generally two opposing camps on this subject, each with their own dogma. One postulates that synthetic thyroid is the only safe and effective medication, while the other endorses only natural thyroid as an effective treatment option. However, both camps are correct in part. Some patients respond only to traditional pharmacologic while others will respond only to natural hormone."

Dr. Sinatra's philosophy is, "When it comes to thyroid, one size doesn't fit all. I treat patients, not lab data. I treat quality of life issues."

The Issue of Soy

Dr. Sinatra recommends soy for women, but I asked him about the soy/thyroid connection. Says Sinatra: "Daily soy can be a problem for women. I still think soy is one of the healthy foods for women, although women with a risk of breast cancer need to do their homework before they take soy. But, ultimately, the best soy for women is from foods -- fresh soybeans......natural soy, tofu. I'm a believer in natural soy."

Dr. Sinatra's book provides greater details on other top foods for women, which include: flax, fish, nuts, and legumes, like chickpeas and lentils.

The Cholesterol Connection

While Dr. Sinatra believes that cholesterol levels should be controlled, he feels that the role of cholesterol is overplayed. "There are probably millions of women who are being treated too aggressively for high cholesterol," he says. I do not like to give women statins, I try to treat cholesterol by natural means. His concern with statin drugs are that "they knock out the natural pathway for CoQ10, increasing the risk for cancer." So, he tends to focus on his natural approaches.
For a women with high cholesterol who has a thyroid problem, Dr. Sinatra feels that sufficient thyroid treatment is the place to start. But if your cholesterol is still elevated, he recommends a low-carbohydrate "Mediterranean" diet to combat insulin resistance, with more healthy fats, and slightly increased protein. He would also add fish oil, garlic, l-carnitine, CoQ10, guggul, plus regular exercise, such as 20 to 60 minutes of walking a day.

A Word from VeryWell

Some patients with thyroid problems also suffer from troublesome heart palpitations as part of mitral valve prolapse, also known as MVP. Dr. Sinatra recommends that any woman with MVP take supplemental CoQ10. In addition, according to Dr. Sinatra, "You can eradicate about 70 percent of the symptoms of MVP with magnesium at 400 to 800 mg a day."
About Dr. Sinatra: Dr. Stephen Sinatra is a Fellow of the American College of Cardiology and former Chief of Cardiology at Manchester Memorial Hospital where he has been Director of Medical education for the last ten years. Dr. Sinatra also is an Assistant Clinical Professor of Medicine at the University of Connecticut School of Medicine. His New England Heart & Longevity Center in Manchester, Conn., integrates conventional medical treatments for heart disease with complementary nutritional, anti-aging and psychological therapies that help heal the heart.

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Article Sources
  • Email interview with Dr. Stephen Sinatra, 2011