8 Energy Boosters to Beat Menopause Fatigue

tired-zombie
Menopause got you dragging? Here are a few simple ways to fight menopause energy drain and regain your oomph.

If you’re like many women, you’ll probably experience bothersome symptoms during menopause — one of which may be fatigue. Fatigue is a common menopause complaint, especially in the early stages of menopause, as your body adjusts to its new chemistry.

But low energy can be also caused by number of other medical conditions, including anemia, coronary artery disease, diabetes, heart failure, hypothyroidism, hyperthyroidism, and kidney or liver disease. If you are fatigued, “you should talk to your doctor just to be sure it’s a menopause symptom,” says Wendy Klein, MD, associate professor emeritus of internal medicine, obstetrics, and gynecology and chair of the Women’s Health Conference at the Virgina Commonwealth University School of Medicine.

“Most women don’t need treatment for their menopause symptoms,” Klein says. “The majority of women will have symptoms that are transient. They last two or three years and abate by themselves.” But there are lifestyle changes you can make to help relieve symptoms you may experience.

If you’re dealing with fatigue as you go through menopause, try these eight simple tricks to boost low energy:

1. Exercise daily. You should aim for at least 30 — and preferably 60 — minutes of exercise most days of the week. Exercising may be the last thing you want to do when you’re feeling weak or tired, but exercise actually boosts your energy, says Staness Jonekos, who co-authored The Menopause Makeover with Dr. Klein. “Exercise is your fountain of youth,” Jonekos says. “It produces those feel-good hormones and gives you the energy you’re looking for when you’re not feeling good.” Some people find it helps to exercise earlier in the day rather than close to bedtime.

2. Cap caffeine and alcohol consumption. Caffeine and alcohol can both affect energy levels and interfere with getting a good night’s sleep if you indulge in the evening. They may give you an immediate rush, but when they wear off, they can leave you feeling more drained than before. Nicotine can also have this effect, so if you smoke, quit. You’ll find you have more energy without artificial stimulants.

3. Limit food portions. Being overweight during menopause can cause you to feel sluggish. The best diet is one that is rich in fruits, vegetables, and whole grains and that includes lean sources of protein (poultry, lean meats, and fish) and low- or no-fat dairy products. Limit the amount of fats and sweets you eat. Eating smaller meals more frequently can provide energy throughout the day, Jonekos says. But if you eat more often, be sure you’re not overeating — watch your total calories.

4. Embrace relaxation. How do you unwind? Whether you like to read, take long walks, or meditate, take the time to indulge in your favorite activities. “You’re entitled to pamper yourself and take time for yourself,” Jonekos says. “As a result, you will be more energetic.” Stress and anxiety could be causing your fatigue, and relaxation techniques can be very helpful in learning to overcome them. A study published in Menopause: The Journal of the North American Menopause Society shows that stress-reduction therapy may also help with menopause symptoms, decreasing the degree to which women were bothered by hot flashes by 22 percent.

5. Get your Zzz’s. Another menopause symptom is hot flashes or night sweats, which can keep you up at night. Restful sleep is important during menopause so you’re not overly tired during the day. This may require keeping your bedroom cooler than you usually do. Use a ceiling fan and wear lighter bed clothes. Make sure the room is dark and set your body clock by going to bed and waking up around the same time every day — even on weekends.

6. Stay hydrated. “You need to nourish your body with healthy food and water,” Jonekos says. Thirst is your body’s way of telling you that you need more fluid. When you’re dehydrated, your body has to work harder to perform, which can lead to fatigue. Dehydration also can cause nausea and difficulty concentrating. Keep a water bottle handy so you can drink when you’re thirsty. Choose water or caffeine-free tea or coffee — not calorie-laden drinks, as weight gain can make you sluggish.

7. Don’t overbook. You may be fatigued because you’re trying to do too much. Learn to say no. Know your limits and what you can and can’t accomplish in a day. Also, if you set reasonable limits, you’ll be less stressed, Jonekos says.

8. Try herbal remedies. Two herbal remedies that may help reduce menopause symptoms that can cause fatigue and anxiety are black cohosh and valerian. Talk to your doctor before taking herbs as teas or supplements as they can interfere with some medications.

“No one recipe fits everyone,” Jonekos says. “But if you’re suffering from fatigue during menopause, you need to take control, and you can do that by adopting a healthy lifestyle.” Eat right, exercise, get adequate sleep, and learn to relax — you will find you have more energy to enjoy your life.

From http://www.everydayhealth.com/hs/guide-to-managing-menopause/8-energy-boosters-for-menopause-fatigue/

Cushing’s syndrome increased risk for coronary arterial atherosclerosis

cushings-ladyNeary NM. Clin Endocrinol Metab. 2013;doi:10.1210/jc.2012-3754.

In a recent study supported by the NIH, researchers determined that patients with Cushing’s syndrome have a greater risk for developing coronary arterial atherosclerosis, increasing their rate of cardiovascular morbidity. These findings were published in the Journal of Clinical Endocrinology & Metabolism.

The researchers conducted a prospective case-control study of 15 consecutive patients with adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome who were matched with 15 controls (aged 32 to 66 years) with at least one risk factor for cardiac disease (ie, diabetes, hypertension, hyperlipidemia, family history of early-onset coronary artery disease and previous or current smoking).

Researchers used a multidetector CT (MDCT) coronary angiogram scan to measure calcified and noncalcified coronary plaque volume and Agatston scores. Additional variables included fasting lipids, BP, history of hypertension or diabetes and 24-hour urine free cortisol excretion.

According to data, patients with Cushing’s syndrome had significantly greater noncalcified plaque volume and Agatston scores compared with controls (noncalcified plaque volume median [interquartile ranges]: 49.5 vs. 17.9,P<.001; Agatston score: 70.6 vs. 0, P<.05).

Patients with Cushing’s syndrome also demonstrated higher systolic (143 mm Hg) and diastolic (86 mm Hg) BP compared with controls (systolic: 134 mm Hg, diastolic: 76 mm Hg).

The limitations of the study include the small cohort of patients and potential selection bias due to ectopic ACTH secretion. However, the researchers wrote that these findings demonstrate a significant difference between the two groups included in the study.

“Overall, the findings point to the possible causes of cardiovascular morbidity in patients treated with exogenous steroids and indicate the need for further studies of that population,” they wrote.

Disclosure: The researchers report no relevant financial disclosures.

~~~~~~~~~~~~~~

PERSPECTIVE

Alice C. Levine, MD Alice C. Levine

  • It has long been recognized that endogenous hypercortisolism (Cushing’s syndrome) and administration of supraphysiologic doses of glucocorticoids are associated with increased mortality, primarily due to cardiovascular disease. Excess glucocorticoids induce all of the features of the metabolic syndrome including obesity with central weight gain, hypertension, impaired glucose tolerance/diabetes mellitus and dyslipidemia, all of which increase cardiovascular risk. In this small but well-designed study, the authors attempt to determine whether excess glucocorticoids have a direct adverse effect on the coronary vasculature. Utilizing multidetector computerized tomographic (MDCT) coronary angiography, a validated noninvasive method of assessing calcified and noncalcified coronary plaques, they compared measurements of coronary plaques (Agatston score) in 15 patients with ACTH-dependent Cushing’s syndrome (CS) vs. 15 age-, sex- and body weight-matched controls with at least one risk factor for cardiac disease. They found significantly greater coronary calcifications and noncalcified coronary plaque volumes in patients with active or previous hypercortisolism.There are obvious limitations to the study; most notably the small sample size, the predominance of patients with CS due to ectopic ACTH (14/15) and significantly more hypertension in the CS vs. the control group. However, other than the HTN, the groups were well-matched and there was no statistical difference in the Framingham risk scores between groups. This is the first study to demonstrate direct effects of CS on coronary plaque burden.The findings, while unsurprising, underscore several important features of CS which endocrinologists need to consider. Firstly, as there were no statistical differences in plaque burden in patients with CS who were eucortisolemic (4/15) vs. those who were hypercortisolemic (11/15) at the time of study, the effects of CS on the coronary vasculature may persist even after biochemical cure. Many previous studies in larger cohorts have similarly demonstrated that the adverse effects of high glucocorticoids on cardiovascular, metabolic, psychiatric and neurocognitive function may be only partially reversible with disease remission. Secondly, even adjusting for all the confounding variables, hypercortisolism seems to be an independent risk factor for the development of coronary artery disease. The possible mechanisms underlying this observation are discussed and include increases in prothrombotic factors, circulating levels of vascular endothelial growth factor (VEGF) and angiogenesis. It is also plausible that cortisol increases atherosclerosis through the mineralocorticoid rather than the glucocorticoid receptor, suggesting the possibility of treating this particular deleterious effect of hypercortisolism with a mineralocorticoid-receptor blocker such as spironolactone.

    Within the CS group, no significant correlations were observed between the coronary plaque volumes and the duration of CS or urinary free cortisol (UFC) either at presentation or at the time of MDCT. Although this lack of correlation may also be attributable to the small sample size, it is well known that the onset of Cushing’s syndrome is often insidious and it is impossible to pinpoint the exact duration of the abnormality in most patients. This study’s finding of direct, adverse and possibly irreversible effects of hypercortisolism on the coronary vasculature should make endocrinologists even more vigilant in diagnosing and treating the disease as early as possible in its course.

    • Alice C. Levine, MD
    • Professor of medicine, division of endocrinology, diabetes and bone diseases
      Co-Director of The Adrenal Center
      Icahn School of Medicine
      Mount Sinai, New York, NY
  • Disclosures: Levine reports no relevant financial disclosures.

From Healio.com

Short-Term Stroke Risk Higher Following CABG Than Post-PCI

CABG

Among patients with complex coronary artery disease, coronary artery bypass grafting (CABG), as compared to percutaneous coronary intervention (PCI), is associated with a greater risk of periprocedural stroke, but not long-term stroke, according to a new analysis of the SYNTAX trial published on March 20 in JACC Cardiovascular Interventions. At four-year follow-up, there was no difference in stroke incidence between treatments.

The SYNTAX trial randomized 1,800 patients with de novo three-vessel and/or left main coronary disease to CABG or PCI. Overall, 33 and 20 strokes occurred at four years in the CABG and PCI groups, respectively. In the CABG group, nine of the 33 strokes occurred within 30 days of the procedure, whereas 18 of the 20 strokes in the PCI arm occurred more than 30 days after intervention. However, in a multivariate analysis, CABG was not significantly associated with an increased stroke risk (p=0.089).

Lead investigator Michael J. Mack, MD, FACC, Baylor Healthcare System, Plano, Texas, and colleagues concluded, “The overall incidence of stroke was low at four years in the SYNTAX trial in both CABG- and PCI-treated patients. Though more strokes occurred in the CABG arm than in the PCI arm early in the study, no significant differences were found at four years.”

In an accompanying editorial, Jesse Weinberger, MD, Mount Sinai School of Medicine, New York, and Craig Smith, MD, FACC, Columbia University School of Medicine, New York, noted that this analysis reports different stroke rates than the original study where rates were higher with CABG than with PCI (2.2 vs. 0.6 percent, p=0.003). The current analysis, “focused specifically on stroke, reports a stroke difference of 1 percent (CABG) vs. 0.2 percent (PCI) at 0 to 30 days by intent-to-treat (p=0.037), and three of the nine strokes in the CABG group occurred pre-operatively, so a statistically meaningful difference in an as-treated analysis is doubtful,” they wrote.

“The SYNTAX trial was not specifically designed to determine the etiology of stroke in patients treated with CABG or PCI. It is imperative to establish the causes of stroke during CABG and develop strategies to prevent these strokes,” the editorialists concluded. “A prospective study may be warranted.”

From CardioSource – Short Term Stroke Risk CABG PCI.

Coronary Artery Bypass Graft (CABG off-pump)

heart with coronary arteries

heart with coronary arteries (Photo credit: Wikipedia)

Before we talk about treatment, let’s start with a discussion about the human body and about your medical condition.

Your doctor has recommended that you have coronary artery bypass surgery. But what does that actually mean?

  • Your heart is located in the center of your chest.
  • It is surrounded by your rib cage and protected by your breastbone.
  • Your heart’s job is to keep blood continually circulating throughout your body.
  • The vessels that supply the body with oxygen-rich blood are called arteries.
  • The vessels that return blood to the heart are called veins.
  • Like any other muscle in the body, the heart depends on a steady supply of oxygen rich blood. The arteries that carry this blood supply to the heart muscle are called coronary arteries.
  • Sometimes, these blood vessels can narrow or become blocked by deposits of fat, cholesterol and other substances collectively known as plaque.
  • Over time, plaque deposits can narrow the vessels so much that normal blood flow is restricted. In some cases, the coronary artery becomes so narrow that the heart muscle itself is in danger.
  • Coronary bypass surgery attempts to correct this serious problem. In order to restore normal blood flow, the surgeon removes a portion of a blood vessel from the patient’s leg or chest, most probably the left internal mammary artery and the saphenous vein.
  • Your doctor uses one or both of these vessels to bypass the old, diseased coronary artery and to build a new pathway for blood to reach the heart muscle.
  • These transplanted vessels are called grafts and depending on your condition, your doctor may need to perform more than one coronary artery bypass graft.

Coronary Artery Bypass (CABG) Surgery

Three coronary artery bypass grafts, a LIMA to...

Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery (RCA) system and one to the obtuse marginal (OM) system. (Photo credit: Wikipedia)

Your doctor has recommended that you have coronary artery bypass surgery. But what does that actually mean?

Your heart is located in the center of your chest. It is surrounded by your rib cage and protected by your breastbone. Your heart’s job is to keep blood continually circulating throughout your body.
The vessels that supply the body with oxygen-rich blood are called arteries.

The vessels that return blood to the heart are called veins.
Like any other muscle in the body, the heart depends on a steady supply of oxygen rich blood. The arteries that carry this blood supply to the heart muscle are called coronary arteries.

Sometimes, these blood vessels can narrow or become blocked by deposits of fat, cholesterol and other substances collectively known as plaque.
Over time, plaque deposits can narrow the vessels so much that normal blood flow is restricted. In some cases, the coronary artery becomes so narrow that the heart muscle itself is in danger.

Coronary bypass surgery attempts to correct this serious problem. In order to restore normal blood flow, the surgeon removes a portion of a blood vessel from the patient’s leg or chest, most probably the left internal mammary artery and the saphenous vein.

Your doctor uses one or both of these vessels to bypass the old, diseased coronary artery and to build a new pathway for blood to reach the heart muscle. These transplanted vessels are called grafts and depending on your condition, your doctor may need to perform more than one coronary artery bypass graft.

Of course, operating on the heart is a complex and delicate process and in the case of bypass surgery, your doctor will most likely need to stop your heart before installing the graft.

During the time that your heart is not beating, a special machine, called a heart-lung machine, will take over the job of circulating and oxygenating your blood.

By using this machine, your doctor is able to repair the heart without interfering with the blood flow to the rest of the body.

Following surgery, your heart will be restarted and you will be disconnected from the heart-lung machine