Why Thyroid disease Matters to your Cardiologist

Why Thyroid Disease Matters to your Cardiologist

The thyroid gland regulates the body’s metabolism through the production of the hormones thyroxine (T4) and triiodothyronine (T3). While often associated with weight management and energy levels, thyroid health also has a significant impact on cardiovascular health. Thyroid function can easily be assessed with simple blood tests.

Thyroid hormones influence heart rate, cardiac output, and vascular resistance. When thyroid function is disrupted—either by hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid)—it can lead to complications that increase the risk of heart disease.

In hypothyroidism, low levels of thyroid hormones slow the heart rate and reduce cardiac output. It also raises levels of LDL cholesterol (“bad cholesterol”), which contributes to atherosclerosis, the disease process that results in coronary arteries becoming narrowed, thereby increasing the risk of heart attacks. Additionally, hypothyroidism may lead to diastolic dysfunction, where the heart has difficulty relaxing between beats.

Conversely, hyperthyroidism accelerates the heart rate and increases cardiac workload. This can result in conditions like atrial fibrillation, an irregular heartbeat that heightens the risk of blood clots and stroke. Persistent hyperthyroidism can also cause cardiomyopathy, weakening the heart muscle over time.

Recognizing the link between thyroid health and heart disease is essential for early detection and prevention. Symptoms such as fatigue, unexplained weight changes, palpitations, or swelling should prompt a discussion with your doctor. Early detection of thyroid imbalance and proper management whether through medication, lifestyle changes, or surgery, can significantly reduce cardiovascular risks. 

Contributed by
Dr Rohit Khurana
Consultant Cardiologist

Harley Street Heart and Vascular Centre
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A Healthier You This Festive Season

A Healthier You This Festive Season

The festive season is a time for indulgent feasts and heartfelt connections. However, it’s also a time when calorie-dense foods and a sedentary lifestyle can take a toll on our health. Studies show adults can gain between 0.4 to 0.9 kg during the holidays, primarily due to increased food intake and reduced physical activity (1).

While the festive season is a time for enjoyment, making mindful choices can help you stay healthy and feel your best.

Tips for Healthy Eating

Here are some tips to maintain a balanced approach to eating during the festive season:

  1. Mindful Portion Control: Using smaller plates can help manage portion sizes, and starting meals with high-fibre foods like salads can promote satiety.
  2. Healthier Cooking Methods: Opt for baking, steaming, or grilling over deep-frying. For example, baking or air-frying snacks can reduce fat content.
  3. Limit Sugary Beverages: Alcoholic and sugary drinks can add unnecessary calories. Consider water or sugar-free options to maintain calorie balance.

Staying Active

Physical activity often takes a backseat during the festive season. To counteract this:

  • Incorporate Movement: Engage in family activities like walking tours of festive light-ups, shopping to keep up with steps or playing games.
  • Set Realistic Goals: Aim for at least 150 mins of moderate-intensity aerobic activity weekly, as recommended by the Health Promotion Board (HPB) (2).

Managing Stress

Sometimes the hustle and bustle of festivities such as financial pressure or last minute preparations can lead to stress. Here are some tips to help manage it more effectively:

  • Prioritise Sleep: Ensure you get 7-9 hours of quality sleep to help manage stress and maintain energy levels (3).
  • Practice Mindfulness: Techniques such as deep breathing or meditation can help reduce anxiety (4).
  • Plan Ahead: Organise your schedule to balance social commitments with personal downtime.

While indulging in the festivities, don’t forget to keep an eye on your overall health. By making mindful choices in eating, staying active, and managing stress, you can enjoy the festivities without compromising your health. Let’s embrace a balanced approach to ensure a joyful and healthy holiday season.

Thank you for your time. 

Sincerely,
MHC Asia Group

References

  1. Díaz-Zavala, R.G., Castro-Cantú, M.F., Valencia, M.E., Álvarez-Hernández, G., Haby, M.M. and Esparza-Romero, J. (2017). Effect of the Holiday Season on Weight Gain: A Narrative Review. Journal of Obesity, [online] 2017, p.2085136. doi:https://doi.org/10.1155/2017/2085136.
  2. Lee, Y.S., Biddle, S., Chan, M.F., Cheng, A., Cheong, M., Chong, Y.S., Foo, L.L., Lee, C.H., Lim, S.C., Ong, W.S., Pang, J., Pasupathy, S., Sloan, R., Seow, M., Soon, G., Tan, B., Tan, T.C., Teo, S.L., Tham, K.W. and van Dam, R.M. (2016). Health Promotion Board–Ministry of Health Clinical Practice Guidelines: Obesity. Singapore Medical Journal, [online] 57(6), pp.292–300. PubMed: https://pubmed.ncbi.nlm.nih.gov/27353244/.
  3. Baranwal, N., Yu, P.K. and Siegel, N.S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in Cardiovascular Diseases, [online] 77(77), pp.59–69. doi:https://doi.org/10.1016/j.pcad.2023.02.005.
  4. Shattell, M. and Johnson, A. (2017). Three Simple Mindfulness Practices to Manage Holiday Stress. Journal of Psychosocial Nursing and Mental Health Services, 55(12), pp.2–4. doi:https://doi.org/10.3928/02793695-20171117-01.

Red Face After Drinking Alcohol – Is My Liver “Stronger”?

Red Face After Drinking Alcohol – Is My Liver “Stronger”?

Having a red face after drinking alcohol is commonly believed to be a sign of strong qi (energy flow) or good blood circulation. The truth is that this is an indication that one’s body is not breaking down alcohol efficiently.

This condition is known as “Asian Flush Syndrome” which is commonly observed in East Asian descent (Chinese, Japanese, Korean, etc). It can manifest as facial flushing and increased heart rate, amongst other symptoms.

Causes of Asian Flush Syndrome

How well the body metabolises or breaks down alcohol is dependent on 2 enzymes: alcohol dehydrogenase (converts alcohol into acetaldehyde), and acetaldehyde dehydrogenase (ALDH2) which breaks down acetaldehyde into harmless substances (1).

About 80% of Asians have an overactive alcohol dehydrogenase, this causes alcohol to break down to acetaldehyde faster – up to 100 times faster. As alcohol is broken down faster, there may be little or no alcohol “buzz”.

Making matters worse, most Asians have an inactive variant of the liver enzyme ALDH2. This means that acetaldehyde takes much longer to clear from the blood. This is the primary cause of Asian Flush Syndrome. Acetaldehyde accumulates in the body, causing the characteristic flushing when blood vessels dilate. The flushing is also associated with nausea, headache and increased heart rate.

Risk of cancer

The build-up of acetaldehyde causes the facial flushing as blood vessels dilate. This problem is not just aesthetic, as acetaldehyde is more toxic than alcohol, and is a known cancer-causing agent (2).

Acetaldehyde can cause inflammation of the upper gastrointestinal tract, and cause DNA damage. As such, individuals with ALDH2 deficiency who regularly consume alcohol have an increased risk of developing oesophageal cancers, stomach cancers and peptic ulcers.

Tips to manage Asian Flush Syndrome

1) Drink moderately, or don’t drink 

Drink moderately if you must drink. Men should limit themselves to 2 standard alcoholic drinks per day, and women should limit to 1standard drink per day. One standard alcoholic drink is equivalent to 1 glass of wine (150 ml/12.5% alcohol), or 1 can of beer (350 ml/5% alcohol)

2) No binge drinking

Binge drinking overloads the body’s ability to breakdown alcohol. With the Asian Flush Syndrome, one should wait till the redness subside before taking another drink. This is because the liver can only metabolise 1 ounce of alcohol per hour, which is equivalent to 1 standard drink (1 can of beer or 1 glass of wine).

3) Choose drinks with lower alcohol content

Be mindful of the bottle labels. As a rule, beers, or wines have a lower alcohol content than spirits.

Contributed by:
Dr Victor Lee Tswen Wen
Senior Consultant,
Hepatobiliary/General Surgeon
HMI Medical Centre (Farrer Park)
12 Farrer Park Station Road, Singapore 217565
Other locations: https://www.liversurgery.com/contact-us.html

References

  1. Edenberg HJ. The genetics of alcohol metabolism: role of alcohol dehydrogenase and aldehyde dehydrogenase variants. Alcohol Res Health. 2007;30(1):5-13.
  2. Sim W, Pan JT, Chua CWX, Fong KY, Wong SH, Lee B, Oon HH. Association between alcohol flushing syndrome and cancer: A systematic review and meta-analysis. Ann Acad Med Singap. 2024 Jul 30;53(7):420-434.