Where Preventable Disease Begins - Ep 80 - I AM YOU

I AM YOU is hosted by Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights that help women understand their unique heart health, manage stress, and take charge of their well-being. Dr. Alvarez’s mission is simple: to inspire every woman to become the CEO of her own health—with knowledge, confidence, and community.

In this episode, Dr. Alvarez explains why the first signs of preventable disease may appear long before anything shows up on a test. For many women, symptoms such as disrupted sleep, anxiety, heart palpitations, brain fog, fatigue, weight changes, and simply feeling “off” can begin during perimenopause—and they should not automatically be dismissed as stress or aging.

Dr. Alvarez breaks down how fluctuating estrogen affects far more than reproduction. It plays an important role in regulating the brain, nervous system, blood vessels, inflammation, metabolism, and insulin sensitivity. As estrogen becomes less stable during perimenopause, these interconnected systems can begin to change in ways that may increase future cardiovascular risk.

She explains how reduced nitric oxide can affect blood vessel flexibility, how inflammation can increase, how insulin resistance can begin, and why body fat may shift toward the abdomen. These changes can occur years before cardiovascular disease becomes visible.

With clarity and compassion, Dr. Alvarez explains:

• Why perimenopause is a system-wide biological transition
• How changing estrogen affects the brain, nervous system, blood vessels, and metabolism
• Why palpitations, brain fog, anxiety, fatigue, and sleep changes may be connected
• How insulin resistance and abdominal fat can increase cardiovascular risk
• Why “normal” lab results do not always tell the whole story
• Why heart disease can begin years before a heart attack or obvious diagnosis
• What women should evaluate beyond basic labs, weight, and BMI
• Why listening to your body early is one of the most important steps in prevention

The central message is simple: your symptoms are not necessarily random. They may be early signals that your physiology is changing—and recognizing those patterns creates an opportunity to intervene before they become disease.

This episode is a powerful reminder that prevention begins by listening to your body, understanding the changes happening beneath the surface, and becoming the CEO of your own health.

Listen in. Share it with the women you love. And learn why protecting your heart may begin years before heart disease ever appears on a test.

Take the Heart Health Risk Assessment:
https://nitzamd.com/are-you-at-risk/

Visit https://NitzaMD.com

Follow @NitzaMD on Instagram and Facebook.