Understanding Cholesterol and Holistic Health Management with Dr. Maria Colon Gonzalez

The biggest factor influencing your levels of cholesterol is definitely food. If you have high levels of stress which again especially, you know that people that live in big cities actually have higher levels of stress there are studies that compare, you know, urban versus rural, right that will also affect you through that hormone called cortisol. But really the biggest impact is in how you nourish your body every day, keeping to perspective. Anything that you put in your body comes to part of you. So what do you want to become part of you? Hey there.

I'm Amy Connell. Welcome to Grace Health, the podcast for women who want simple and grace filled ways to take care of themselves. I'm a certified personal trainer and nutrition coach who wants you to know. Your eating, movement and body don't have to be perfect, you just need to be able to do what you're called to do. Earlier this year, I asked my community what they would like to hear about. I do that every now and then and I listen. I truly listen. Cholesterol came up several times. If you have high cholesterol, you are not alone. According to the CDC, about 86 million US adults age 20 and over have total cholesterol levels above 200. Nearly 25 million adults in the United States have total cholesterol levels above 240. And really 200 seems to be that line that often the medical community starts to raise their eyebrows and get a little concerned about. High cholesterol has no symptoms, so many people don't know if their cholesterol is too high and really just a simple blood test can check that. But when you do have high cholesterol, it raises the risk for heart disease, which is the leading cause of death, and also stroke, which is the fifth leading cause of death. So after we get that blood work back and learn that this is probably something you need to focus on. It can get overwhelming. What's good, what's bad? What food should I have? Should I get on medication? That's a whole discussion. So what I did was I reached out to Dr Maria Colomganzales to help us to simplify this, to make it just a little bit easier to understand. I have to admit I go down some rabbit holes because I dig talking about this kind of stuff. So please forgive me, but we talk about the different types of cholesterol, nature versus nurture, the impact of stress on your cholesterol, and then she just walks us through a holistic, realistic approach to managing it. So let me tell you a little bit about Dr Maria. She is a holistic, integrative and lifestyle medicine provider who practices online in Texas. We actually met at an organization called Forward, which, if you listened to the episode with Diane Patterson oh gosh a couple of years ago. I will link to it in the notes. This is where we met. We met at an organization for Christian professional women and we just connected right away. So I knew that she was the right person to come on and talk with us about this. So while she was in residency, dr Maria realized the many missing links in the care she provided to her patients. So she noticed patients would visit the office for medication refills but not necessarily make lifestyle changes, not necessarily live healthier. So after four years in practice, she completed her training in lifestyle medicine and then she retrained as a yoga instructor. She also trained in culinary medicine and plant based nutrition. In 2021, she started her integrative medicine fellowship, since she believes patients deserve holistic care. So she's also a trauma informed physician, recognizing that the events of harm to one's life have affected the body, mind and spirit, and her approach to care is your body tells a story and you can rewrite the narrative. She's also the author of Healing the Wounds, of Medicine stories and journaling for physicians. So just a reminder while Dr Maria is a doctor, she is here to educate and not provide medical advice, so be sure to speak with your physician about supplements and medications that we discuss. Okay, let's bring on Dr Maria. Hey there, I'm Amy Connell. Welcome to Grace Health, the podcast for women who want simple and grace filled ways to take care of themselves and enjoy a little chocolate. I'm a certified personal trainer and nutrition coach who wants you to know your eating, movement and body don't have to be perfect, you just need to be able to do what you're called to do. I am thrilled to have Dr Maria Colomganzales join us today. I want to tell you a little bit about Dr Maria before we get going. She founded Salud Revisited an integrative and lifestyle medicine practice in Texas. So while in residency, dr Maria realized the many missing links in the care she provided to her patients. She noticed patients would visit the office for medication refills but not necessarily live healthier. After four years in practice, she completed her training in lifestyle medicine. Then she retrained as a yoga instructor. She's also trained in culinary medicine and plant-based nutrition. In 2021, she started her integrative medicine fellowship, since she believes patients deserve holistic care. Amen to that, she is a trauma-informed physician, recognizing that the events of harm to one's life have affected the body, mind and spirit, and her approach to care is your body tells a story and you can rewrite the narrative. She is also author of Healing the Wounds, of Medicine Stories and Journaling for Physicians. Dr Maria, welcome to Grace Health.

Thank you, amy, thank you for having me here today.

You just do it all. I don't know how you have been able to do all of that, and there's so many things I want to get into. But first, in that bio that I read, you talked about being a holistic healthcare provider. Talk to us some and just kind of give us that framework or that foundation of what you do and what a holistic healthcare provider does.

Yeah. So I think the best way to explain it is so is a clinician that will see you as a person having a disease or a medical condition, rather than the disease first and the person second. Right, and recognizing that when we talk about health, health is not only the absence of like symptoms, of you not feeling sick. So health encompasses a lot more, and if we only targeted, you know, let's reduce symptoms or let's get rid of the symptoms, there's a lot that you will be missing in terms of living a healthy lifestyle and being healthy the rest of your life. So that would be the easiest way for me to explain it. One and two would be we also use different healing modalities where Western medicine tends to do the approach of you know symptoms, diagnoses of illness, medication right, but we will not only provide you with that, but we will also provide other healing modalities. That could be not only supplements and herbs, which is what a lot of people know, but we can also do a lot of mind, body, you know, healing modalities and therapies, and I think that is specifically in those body modalities like acupuncture, there's a lot of power to it.

I completely agree and, without breaking too much of any kind of client privilege that I have, I have definitely worked with people who I can, who whose body is clearly dealing with harm or trauma or something from the past, and I've gotten, honestly, it's just from my time on here with other people Emily Baker comes to mind, talking about your story and trauma and how trauma affects the body that I have been able to kind of put some of the pieces together, because it does come out in so many different ways, it's not just in the head. So I love that you're putting all of that together. I mean, I feel like I could take the bio and pull that apart and we could have 10 different conversations about that. But what I wanted to hone in on today is cholesterol, because that is something that my community has been saying and I think you're a good person to speak about cholesterol, because it's not like you just said, it's a whole person dealing with something and not just come on and let's slap some lipitor or you know, I know there's a lot of different things on there, so lipitor don't. I probably shouldn't have done any kind of brand names, but anyway. So I wanted to just kind of focus in on that and then at the end, let's talk about what you do from a holistic perspective, because you do so much more than just talk about cholesterol. But that's what we're going to talk about today. So, to start off with, bring us up to speed on just on cholesterol, the different types, what it does good, bad, all of that kind of stuff. So bring us kind of to that beginning point that we all need to know as we talk, as we enter into this.

Yes, I want you to think about cholesterol as a ball that is formed by other little balls, right? I don't know if you remember these games where you were opened them up and then the doll will come out and a smaller one, and a smaller one, and a smaller one. So think about Nesting dolls, yes. So think about cholesterol in that way, right, and what we call cholesterol would be like the biggest doll that is on the outside, but then when you start opening it, that's where you get what we call HDL, ldl, vdl. So a couple of things. Before I go into talking about what is each one specifically, a couple of things. I want you to know that one, cholesterol is what forms all the cells of your body. So we need cholesterol, okay, because if not, then our body cannot produce those cells. That is what forms you. The other thing is that your body produces cholesterol. So this is one I'm going to say nutrient right, but this is suggested through the food right. This is something that really what you need to think about the way that I'm eating is supporting how my body is going to produce it in the healthiest way, because your body produces it. The other reason why cholesterol is important is not only because it forms all of your cells, but there is a couple of vitamins that your body needs that are carried with cholesterol. So in the body you either have proteins being carbs or you have fat being carbs. So cholesterol is one of those carbs that take what I call all-dogs-eat kibble around your body. So that's vitamin A, d, e, k all-dogs-eat kibble. Yeah, so those four are vitamins, right, okay?

I was like did I just miss something? Okay?

So that's why, you know, sometimes we say, oh, we have to eat like a pat-free diet and that sort of stuff. Well, I mean, really think about it. You need that little fat car let's call it like that, even though some people, you know, hear the word fat and something activates in their brain to carry all of these vitamins through your body that are super important to then your body. You know the metabolism of the body. The other thing is that we need cholesterol to produce hormones like artisphosterone and our cortisol. So the body needs this molecule, this little doll, in order to function well, right? So the thing that we need to focus on is not like, oh, I don't want this doll in my body. No, your body needs it. How can we make this doll the best doll, so that then your body can utilize it to the best of its ability?

That's a great example, and I love all of those visuals because I think that that really helps us remember it all. And the A, d, e and K all dogs eat kibble. Those are your fat soluble vitamins as well, which I know you know, but as a, those are kind of the four that you do store and so, anyway, just as a random fact, I don't know why, I added that in it's rotten up.

I've run up like all the actually kibble. That's the way that I learned it. That's great.

Now talk to us. Talk to us about going. Let's now talk about the HDL, LDL, vdl, some of those little nesting dolls as well.

Okay. So the one that we know as HDL is high density, like a protein, okay. So basically, what happens is that now this little fat needs to marry with the protein so that your body can use it. So if they're not married, they cannot use it. So, basically, the high density. What it means is is, let's say, this is like a tall, handsome, muscular man. The HDL is the HDL is Okay, yes, six feet. You know a kind of like guy, okay, and who doesn't want a tall handsome? you know six feet man in their life and you really want a lot of this handsome husband, because the thing is that it will help reduce the amount of cholesterol that your body starts to accumulate, okay. So remember the reason that sometimes you focus on cholesterol Okay is because our blood vessels, that are these tubes. The cholesterol sticks to it and then the amount of blood that can pass through the tube, it becomes light, it becomes sticky, but this is actually, again, the handsome husband that you want to have at home. So this is the one that you want to be high, right, if you can use that word, and especially when I see female patients and once you lose those hormones and menopause, you really want this number to be high. That's really protective for your heart. And then there is, like the low density, like a protein, the LDL. So I want you to think of this as being, instead of six feet, a tall and handsome, maybe your five feet a little bit of belly, you know. Going on, let's be honest, let's be real, as women who do, we tend to be attracted to. So what happens? This one, if you have it a lot in your body, this is the one that's going to stick to your blood vessels. This is the one that slowly is going to reduce the diameter of your blood vessels. It's going to make it very hard for that blood to go from the heart to all of your organs. And this is the one that not only can provoke, right, a heart attack which is what we are trying to avoid or a stroke, but really the small blood vessels. The smaller the blood vessels, the faster you start to have problems with it. That's why sometimes people start to have problems with circulation, like a blood right Eat, smaller blood vessels. So you know, the LDL is what we call, like the bad cholesterol, depending on you know, certain medical conditions that you might have. The number might be a little bit different, but the important is we always want the LDL to be the lowest that we can get it to, with the HDL being higher. And there is a formula that we use where, basically, we'll look at the ratio of the total cholesterol. So that big little doll, right From that big little doll, we want the majority of it to be HDL. So once you open it, the first one that should come out is the HDL. If it's the LDL, then that's when we start to have problems.

I want to pause here. So when you were talking about the HDL just to kind of clarify and put these two together, and you were talking about the HDL pulls the cholesterol away, you're actually talking about the LDL. So it pulls the LDL away, yes, okay. And then the other thing too that I want to make sure I heard you correctly. You said it accumulates. The LDL will accumulate in smaller vessels first, smaller blood vessels first. So we may start to feel that in terms of nerve damage or circulation or something like that. Am I hearing you correctly on that?

Yeah, so one and two, what is when you have a heart attack? The blood vessels that are covering the heart, the heart by itself and the big blood vessel that comes out, which is the oar-tether, really big in diameter. Right, but why is that heart attacks are so fatal? Because the blood vessels that give blood to your own heart are extremely, extremely, extremely small. So a little bit of cholesterol there is extremely damaging compared to the oar-tether that is so big in diameter.

Okay, I think I heard this connection that I want to clarify that your cholesterol can also impact your stroke or that can cause a stroke, and so real, quickly connect the dots with that, with cholesterol and stroke and then blood pressure.

What happens. So, again, think about the plumbing in your home. So when the you know, your tube, the plumbing in your home, something gets into it the water. Unless the water goes with a lot more pressure, the water would get like clogged, and then that's when it comes, like off, you know, and on top of your sink or your faucet. So there are a couple of things that happen in high blood pressure. One thing is, you know, the blood vessels lose their elasticity. I mean, yes, the blood vessels lose their elasticity, but also, if you have a lot of plaques, again the diameter is smaller. Therefore the heart has to pump against a greater force, right, so this is a lot of, you know, like mechanics. But the greater the force the heart has to do not only will affect your blood pressure, but it eventually can lead to things like heart failure. Right, it's like any muscle in your body, the more you work it, the heart can become hypertrophied, so bigger, and that's not something that we want. We don't want our heart to be overworking. There are muscles in your body that, yeah, you might want to build a little bit. The heart, you know, you want it to be working. I mean because the heart doesn't stop. I mean it works 24, seven, all of your life, right? So that's where you know, and the heart is a little bit different. You might want to build your biceps, but you want to be careful of how much you overwork your heart.

I'm going down into rabbit hole here, but so I apologize for that. But with regard to exercise and say cardiovascular exercise, high intensity exercise, something where we are really challenging our heart rate, our VO2 max, that kind of stuff, does that have an impact on your heart, on the size of the heart, on the hypertrophy of it?

Well, not to okay, so not to the point where you might develop heart failure necessarily.

So this debunks the. I'm not going to exercise because I don't want to wear out my heartbeats. I don't want to wear out my heart. Okay, if you're listening, she's like cutting the like, cutting the hand across the neck, like no no, no Okay. Okay, so let's go back to cholesterol. Sorry See, this is what happens when you. I love this kind of stuff. So, going back to the cholesterol, we've got the HDL we want high, the LDL we want low. You mentioned VDL. Go into that really quickly for us.

Yeah, so the VDL, which would be it's called a very low density lipoprotein, so that would be like the smallest one, and that is what your body will use to create things like triglycerides and other stuff. So we really do not measure it when you get like that lipid panel, but what we know is that your body, usually in the liver, uses that to produce other things in your body, right. So now you're very short little man. So why? Why is it even worse than the LDL? Well, because what we know is that, in terms of the function, the body uses it for some, you know, for for different things compared to the LDL, the LDL has this affinity for sticking in your blood vessels, and that's the problem.

So, in terms of prioritizing which cholesterol, we want that high HDL, we want low LDL and we want very low VDL correct?

Yes, and remember, we look also at the total, because the most important thing is the proportion. So again, when you open up this, this little woman, who comes first? That's the most important thing, who do you have more of?

Got it Okay, so let's talk some about cholesterol and the factors that influence it, and I know that there has been. I have heard a lot, so I would love your thoughts on what is controllable, what is not controllable lifestyle, genetics, nature, nurture however you want to say it. What are your thoughts on all of that?

Yeah. So I think we all come with that nature, we all come with our genetics, your nurture, what you do again to this little doll, will have the biggest impact. Now, there is a genetic condition where people do have high cholesterol. It's called familial hypercholesterolemia. But it is not something that not even 50% of the population has. So when you think about you know, let's talk about the majority of the people here in the United States, right here in Texas really the biggest problem is actually and I don't want to let's not use the word problem the biggest factor influencing your levels of cholesterol is definitely food. Yes, if you have high levels of stress which again, especially, we know that people that live in big cities actually have higher levels of stress there are studies that compare, you know, urban versus rural, right, that will also affect it. You threw that hormone called cortisol, but really the biggest impact is in how you nourish your body every day. Which leads into talk to us about foods and how we nourish ourselves in order to get that ratio, that desirable ratio, yes, so it's specifically, you know, for people that already have whether it be high cholesterol, fatty liver, diabetes have already had you know what we call a cardiovascular, right? So you have had a, you know, heart attack, you have angina, which is you have people that get chest pain with exertion. There's actually studies that have shown, and they're part of the Canadian guidelines, what is called the portfolio diet and I'm calling it portfolio diet because that's how it's called, but I don't want to use the word diet, right? Yeah, so let's call the portfolio way again, a nourishing by sliddle doll. Okay, this is your little doll now, right, how are we going to take care of it? Now, what we know from these studies is that if you choose to nourish yourself with nuts which a lot of the times I hear my friends say that that has so many calories, yes, but these are very good calories. So let's not concentrate on the calories. Let's think about again the nutrients, again what it's not what you see, right, and they know that a lot of your listeners are faith-based, right, but it's in the Bible, right? Let's not what we see on the outside, so it's what you do not see on the outside that really counts of the nuts. So you want to make sure that you're eating nuts. I highly recommend, if you're going to eat nuts, try to use what we call like the raw, so they don't have like the sugar and salt and all that kind of stuff, what we call plant protein. Right, and when I speak with a lot of my patients it's very hard because of all the information that is out there in the media and the news, but when you know everything has protein, everything that we eat, let's just put it that way. People think of protein, oh, it has to be like an animal product, but we know that. You know your broccoli has protein. So we really want to increase those plant sources of proteins. And it's specifically maybe here we're in Texas, we have a little bit more of an influence from the Mexican like diet, so we might consume those legumes. But when I talk about legumes, so those are like your chickpeas, lentils, beans, samami, all of those tie. They go there together, one serving per day, and think about the traditional way that a lot of people in the United States feed themselves. Like you know, legumes are not a staple and legumes should start to be a staple in our diet. So we really have to consume more of those. And then it's what we call the sticky fiber. There's two different types of fiber, so let us concentrate on the sticky. So this would be things like oatmeal, barley Barley is really good, so you know, instead of eating like rice or even cano, I can always really healthy, but can you add like barley, even if it's just one day, you know, out of the week. And then your fruits and vegetables. So those are kind of like more of your sticky fiber, what we call viscous fiber. And then it's what we call plant sterols. And people might say what you're telling me to eat fat to lower my cholesterol. Well, yes, because again, it's what we're eating, that your body will break it down and reform it in different ways. And what we're talking about plant sterols. If you look them up online, it would say like oh, eat like certain types of margarine that are very high in that. But I think that before we go to the processed foods, I would encourage you to go to your seeds, so flax seeds, kia seeds, hemp seeds, sesame seeds, as those good sources of plant sterols. And again, this is not like you're going to be adding I don't know one fourth of cup of these seeds to everything that you eat, but you can eat the nuts and eat the seeds without the fear of the number of calories that it has or that you are going to gain weight. So that, to put it in a simple way, that's what I can tell you in terms of the food.

Now I know we talked, or in your bio you mentioned you are a plant based. That's your focus, which I love, and I think that there's a lot of. I think there's so many things about it. And I tell you what. It doesn't matter what the conversation I have on this podcast is that, like all roads lead back to eating a wide variety of plants. So I now for people who are not plant based, the fatty fish, the salmon, the, you know that kind of stuff that's a good option for some higher HDL omega three foods as well, correct?

Yes, and you can do that, but I think that you still want to, at least especially the beans, the legumes, the chickpeas. I mean, if anybody could add just at least one serving a day, their health would improve A lot. Right, and again, you know, that's why I didn't want to call it diet, because diet sounds like rigorous and religious right. But this is. Can you adopt this way of nourishing your body the majority of the time?

I love that perspective. Yes, and I'm totally with you, I do not. The word diet, for so many of us, brings up and I know you're into story work like that brings up a lot of difficult stories for us, and that can be, if you want to use the word, triggering. That can be something that we have a hard time in our heads. So I, too, try to stay away from the word diet, and I appreciate that you do as well. Okay, now you talked about stress. Some and high levels of stress can impact cholesterol. We've had conversations on here about, you know, mitigating stress in terms of either breathing or meditating, something like that. Can those types of things actually help reduce our cholesterol when done in a holistic way?

Absolutely Right Because, again, I think that it's shifting. From this perspective, if you go to, you know the traditional Western trained cardiologist's cholesterol statin, and if it doesn't get better with the statin let's add other medications. But when you're thinking about a holistic way of helping somebody, it's not this problem, this solution. So definitely you know things like meditation, yoga, breathing exercises. I like to use the heart map with my patients with increases, heart rate variability, you know, and that helps us to reduce those levels of stress. And let's say that you tell me, well, I just don't have time to sit and meditate for 10 minutes, which that can be hard for a lot of people if they have just started. You know, doing this type of like practice, something as simple as some, like a roma therapy, that if you can put that candle or that oil lavender there's a lot of studies done in lavender that by itself, even if there is a lot of chaos around you, like at work, that that by itself will help your body start to ground and again that vagal nerve and that parasympathetic nervous system, that relaxation start to increase.

Okay, so let's take a step back. I mean, we've talked about the different kinds of cholesterol, we've talked about nature and nurture and how nurturing really can have the biggest impact and stress so, from a high level perspective, a holistic approach to managing cholesterol. Everyone goes in and their doctor's like you're getting your cholesterol is getting pretty high, and they say I don't want to go on statins yet. See you next time.

Yeah, so I think that at least this is the way that I approach it. So I tell the patient okay, so these are other things that we can do. So I may talk about like exercise and specifically, you know, cardiovascular exercise or the overall big exercise. I talk about their like stress and food, and then I always give my patients the option. So where do you think that you can start? Where do you want to start? What is, you know, reachable for you, which is that you know goal with my patient? So I talk about all of that, those three things. And then the other thing that we can also add would be like certain supplements. And again, don't take this as, oh, they told me in the podcast to take certain supplements, because I do not know what medications you're on need and supplements do have interactions, but we know that there are supplements, like, for example, red cheese, that can be used and that will also-. You want to say that again, red yeast Okay.

I've never heard of that.

Okay, okay, well, we have to talk more and spend more time together. Yes, so you know something like red yeast, which is a supplement. You know that you can get, you know, in your pharmacy or in local food stores, health food stores. It's one of the things that can also be tried to really help patients get to those, you know, lower levels of cholesterol. I think that also another important thing to say is we want to view this also in the role of inflammation that somebody has in their body. What I mean by this is it's not the same if I have a patient that only has high levels of cholesterol, there's, you know, maybe, I don't know 40s, 50s versus if I have somebody that, on top of cholesterol, they might have other medical conditions see that increase inflammation in their body, and then on top of that, they smoke. So smoking is something that will really make those little plaques so, so, so, sticky. But if I have somebody that also smokes and have high cholesterol, smoking has to be one of those priorities where we try to see okay, can we reduce the amount of nicotine that we are, you know, ingesting in our body?

So you know, I love that. What do you want to become part of you? What about? I've seen some research on omega-3s Mm-hmm, mm-hmm Again not saying that Dr Maria said to take omega-3s. So you know, with that disclaimer, because work with your doctor on that. Yes, but I've seen some supporting research on that.

Yes, and I think that's also one of the other supplements that can be added if it doesn't have, you know, interference with some of your other medications. I always like to say, you know, keep in mind that the omega's been the blood, so very important. I have seen especially female patients that by itself have heavy menstrual cycles and if they put themselves in omega either, menstrual cycles get really, really, really, really, really heavy, dangerously heavy. So, and the reason that I say this is no, no, don't take them, is if you're going to, you know, buy any supplement, which is like a medication that is so worth a counter. So you might think that, oh, you know, I can just grab it, take it, I don't have to tell my doctor, I don't need to ask anybody. I would say no, on the contrary, you should go first and ask your doctor. Before you know, you put anything in your body.

Okay, and that's a good reminder too. I can't tell you how many times I filled out intake forms at the doctor's office and they're like what are you taking? And I'm on blood pressure medication, so I'll do that, but you know, put the omega threes down, put the calcium pills down, all and the various supplements that you're taking, because they need to know you're like, you are not in your head over here.

Yes, yes, and that's the reason that I say it, because from a physician perspective, I have learned that if you do not ask about that patient's thing that they don't, you know there's no reason to tell you for that, because that's natural, you know it doesn't have any harm.

Good reminder to make sure that we are totally forthcoming in all of the supplements that we are taking. Okay, now, when is medication necessary?

Yeah, so that's a really good question. So, again, taking the whole person in perspective, so let's say, for example, somebody that already had, you know, a coronary event, and on top of that there is smoker, that might be a person right that, even if you say, well, I don't want to be in the medication the rest of my life, I have a lot of patients that tell me that it's like great, let's work on that so that then we can take you off the medication. You know people that have diabetes. They're at very high risk of having, you know, heart events, that because of the diabetes, they don't have a lot of symptoms. So somebody with diabetes especially if you have other medical conditions, you know, and I think that we can always try without it If a patient is extremely motivated, if you are like motivated and you say like I'm going to do this because I know that this is going to cost me long term, then have that conversation with your physician and that will also depend on how control versus uncontroll your diabetes is. And I think that the other group of patients is we're seeing a lot, a lot more people, you know, developing fatty liver, but a fatty liver that is really starting to affect, like the architecture of the liver, right, and these are people that, again, if we don't help them fast, unfortunately fatty liver has become the biggest cost right now of liver failure not liver failure, cirrhosis more than even your hepatitis C. So you know, I think that's another group of persons that I would say okay, we really have to work together. And you know, statins is an option, but there are other and I have seen even cardiologists, some people that do not tolerate statin use. Other families and I know that now probably, like maybe two or three years ago, there was another medication that came out to lower triglycerides and the reality is that that medication is not indicated unless your triglycerides which we didn't talk about are extremely, extremely high. Because when the levels of triglycerides are really, really high so you're talking, you know, in the thousands, and I have seen patients in the thousands you can't develop things like pancreatitis, which can lead to being in the ICU right, being intubated. So sometimes the reason that we might say you know, we have to put you in this medication is because, even if you want to do the lifestyle and the supplements we might be trying to prevent, you know that damage that can happen until the levels come down to a level that it's okay.

Not a thought, I'm just saying that medication might be a good option when there is a higher immediacy for it. And then also I think we have to be realistic in what's the compliancy, because you know it's like, oh yeah, I'll do all of this, but then maybe if they don't yeah, in their mind they will, but in reality they won't necessarily. The other question I have, as we're talking about this just in terms in overall, so, save from a holistic perspective, taking away the addition of medications, what is a reasonable amount of time to expect to see results from lifestyle changes?

Yeah. So I think that for a patient that is really motivated and is really being I'm going to use the word strict, but it's very being very strict and disciplined with themselves all of a sudden as fast as a mom. Oh, wow, yes, oh yes, and there are studies out there. The thing is a couple of things. One, you know, we might not be able to order it that fast, like repeat cholesterol level, because the insurance and all that comes. That's another conversation. But definitely in that repeat three month test, depending on how the numbers look, you might see reductions in those numbers. So yeah, I think three months is a good.

That's really encouraging. I mean, I feel like that's something that you could say, okay, this is where we do, and then, when you get that positive reinforcement, it might be a little easier to stay disciplined, to stay compliant, rather than be like, oh, it's just taking too long, whatever, just give me, you know, just go ahead and do the medication. Okay, that's really good. Okay, so I feel like we're coming up. I want to. I have some questions that I ask all of my guests, but I want you to tell everybody about Salud Revisited, because this is a new practice of yours. It's online. People can work with you, not only with cholesterol, but with a lot of different things. So tell people about what you do, because this is like one tiny, this is like the little bitty nesting doll that you were talking about. There's so many more. I was so moved. Revisited.

Yes, so Salud Revisited is a holistic health and wellness company that I founded just this year and then basically what I do is that I help people heal from the inside out and heal their mind, body and spirit. I love working with female patients, with women that are looking for one hope. So sometimes in our journey of health we have lost hope. We have gone from one doctor to the other, we listen kind of like to the same story and we don't find the answers that we want. And then two with women that want to regain control of their health, and they want to do it gracefully, because I think that in this journey you can say I'm going to be aggressive, or can we do it more gracefully, more gentle for the body, and the body appreciates it when we're gentle towards them. Yes, I see patients virtually in the state of Texas, and not only in Houston but also in the entire state of Texas by appointment.

That's very good. You've been so generous, dr Maria, to give us a 10% off any a la carte or love yourself package and you can use grace 10 for that. So that'll be in the show notes and thank you very much for offering that to us. Okay, I've got a couple of questions I ask all my guests. The first is I love learning about people's tattoos because I have found that when they put them on their body for the rest of their life, they often have a story or a meaning behind it. I was wondering, if you have any tattoos, if you would find sharing what it is and the meaning behind it, and if not, if you had to get one, what would it be and where would it go?

Yes, I know I don't have any tattoos in my body. If I were to get one, I would do a sunflower sea star, and there is a story behind that very long. So let's just put it that in November of last year I've been with that image, right, and I had to do some research to kind of like understand what are we, what are you talking about? But basically, this is an end danger sea star species in the Pacific Northwest coast and it's actually one of the biggest predators that are out there in terms of the sea stars. And where would it go? I think that I would probably put it like in my back, but you know, lower, lower back towards like my sacrum, and the reason being because I think that for me that would be something very intimate and I would only want people that are that close to me that see that part of my body to actually see.

That's totally fair. Okay, do you have a meaningful Bible verse that you would like to share? Yeah, I'm not going to talk about faith, but you and I met at Forward, which Diane Patterson was on several years ago talking about Forward, but it is a Christian women's organization and we met at a networking thing, so we didn't really talk a whole lot about it, but I know faith is really important to you.

Yes. So this is actually the Bible verse that God put in my heart and it was the Bible verse that I used to develop the entire concept behind Salute Revisited in our missions and our values. And it's from the message translation. It is Matthew 11, 2830. And it says are you tired, Are you worn out, Are you burned out on religion? Come to me, Get away with me and you'll recover your life. I'll show you how to take a real rest. Walk with me and work with me. Watch how I do it. Learn the unforced rhythms of grace. I won't lay anything heavy or ill-fitting on you. Keep company with me and you'll learn to live freely and lightly. Yes, and in part of yes. And as I develop Salute Revisited and what I'm doing with my patients, I want to give them that freely, lightly, unforced rhythms of grace where you know it just becomes gracefully what we do for our health.

Amen, that's so wonderful. I love how you read that too. Tell people how they can connect with you and how they can learn more about your practice.

Yes, so you can visit me on the website, wwwsaluterevisitedcom. You can also follow me on social media Facebook and Instagram at Salute Revisited, and I also have a YouTube page, salute Revisited, where you can also hear some of the videos that I have put out to help people educate about what is it that not only I do, but what is Centegra of Medicine and Lifestyle Medicine, and why it is important in the care that we provide to our patients.

Yes, so good, and that's S-S. I'm sorry, s-a-l-u-d-revisitedcom. Okay, let's wrap this up by you sharing the one simple thing that you would like us to remember. It can be big, it can be small, but just one thing that you want us to remember.

I think that it is to remember everything that you put in your mouth becomes part of you. So you have been giving this little doll that you have the capacity to nourish and take care of it. You choose how you take care of it.

That's fantastic. That is all for today. I'll go out there and have a great day.