Why am I always tired even when I sleep? - Ep. 70 - I AM YOU

Why am I always tired even when I sleep? - Ep. 70 - I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health. In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles one of the most overlooked symptoms women experience during perimenopause and menopause: feeling exhausted even after a full night of sleep. If you go to bed early, sleep through the night, and still wake up tired, this episode reframes fatigue as more than stress, aging, or “just being busy.” Dr. Alvarez explains that persistent fatigue can be a signal of deeper changes happening in the body — especially involving hormones, inflammation, oxygen delivery, sleep quality, and cardiovascular stress.   With clarity and urgency, she breaks down: * Why sleep time and sleep quality are not the same * How declining estrogen can disrupt deep, restorative sleep * Why inflammation increases during perimenopause and menopause * How sleep apnea can show up differently in women * Why snoring, brain fog, morning headaches, insomnia, and fatigue may be signs of sleep-disordered breathing * How poor sleep can affect blood pressure, insulin resistance, weight gain, palpitations, stroke risk, and heart disease * Why wearable devices like Oura Ring, Whoop, or Apple Watch may help women gather useful sleep data * When a formal sleep study may be needed * What labs and evaluations to ask about, including hormone status, thyroid panel, cortisol, and sleep quality testing Dr. Alvarez also challenges common myths, including the belief that sleep apnea only affects overweight men, or that fatigue is simply part of getting older. Instead, she explains that fatigue may be a physiology signal — your body’s way of showing that something is changing before disease develops. This episode is a direct call-to-action for women who feel tired but dismissed: don’t stop at “I’m just tired.” Ask why your body is not restoring. Becoming the CEO of your own health starts with listening to your body, asking better questions, and getting the right evaluation before symptoms become disease. Visit NitzaMD.com  Follow @NitzaMD on Instagram and Facebook

Why do I feel off but my tests are normal? - Ep. 69 - I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health. In this episode, Dr. Alvarez addresses one of the most common and frustrating experiences women face during perimenopause: feeling “off” even when their labs come back normal. If you’ve ever been told “everything looks fine,” “it’s just stress,” or “this is just aging” — while still feeling tired, anxious, foggy, wired, or not like yourself — this episode reframes those symptoms as signals worth taking seriously. Dr. Alvarez explains why normal lab results do not always tell the full story, especially during perimenopause, when estrogen levels can fluctuate dramatically from one day to the next. These hormonal shifts can affect the brain, blood vessels, metabolism, nervous system, inflammation, cholesterol, sleep, and cardiovascular risk. With clarity and urgency, she breaks down: * Why estrogen is more than a reproductive hormone — and how it affects the brain, blood vessels, metabolism, and heart * Why perimenopause can make women feel anxious, foggy, tired, wired, and unlike themselves * Why “normal labs” may miss hormonal fluctuation and early physiologic changes * Why perimenopause can begin in the late 30s and 40s * What women should consider evaluating beyond basic labs, including: * Hormonal patterns, including estradiol, progesterone, testosterone, free testosterone, thyroid markers, and cortisol * Cardiometabolic markers such as fasting glucose, hemoglobin A1c, fasting insulin, and insulin resistance * Advanced lipid markers including LDL, HDL, triglycerides, non-HDL cholesterol, ApoB, and lipoprotein(a) * Blood pressure and vascular health, including ambulatory blood pressure monitoring when appropriate * Body composition, including waist circumference, visceral fat, body fat percentage, and lean muscle mass * Inflammation markers such as high-sensitivity C-reactive protein, homocysteine, and ferritin Dr. Alvarez also shares why these symptoms matter from a prevention standpoint. Perimenopause is not just about symptoms — it can be a critical window to detect early cardiovascular risk before it becomes disease. This episode is a direct call-to-action for women who have been dismissed, minimized, or told to ignore what their body is signaling. Becoming the CEO of your own health starts with asking better questions, understanding what should be evaluated, and taking symptoms seriously before they become something more. Visit NitzaMD.com  Follow @NitzaMD on Instagram and Facebook

If Your Bladder Changed After 40… Watch This - Ep. 68 - I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health. In this episode, Dr. Alvarez addresses a topic many women experience but rarely talk about openly: urinary changes after 40. If you’ve found yourself planning your day around the nearest bathroom, waking up multiple times at night to urinate, or avoiding exercise because you’re afraid of leaking, this episode explains why these symptoms are common — but not something women should simply accept as “normal.”   Dr. Alvarez explains how bladder function is connected to hormones, pelvic floor strength, tissue health, metabolism, and the body’s support systems. During perimenopause and menopause, fluctuating and declining estrogen levels can affect the tissues of the bladder and urethra, contributing to urgency, frequency, nighttime urination, and leakage.   With clarity and compassion, she breaks down: * Why urinary symptoms can increase during perimenopause and menopause * How estrogen supports urinary tract tissue, elasticity, blood flow, and pelvic strength * Why pelvic floor weakness can contribute to stress incontinence during coughing, laughing, or exercise * Why urinary symptoms are treatable — and not just an unavoidable part of aging * Why women who have never had children can still experience bladder changes * What minimum testing may include: * Urinalysis to check for infection, blood, or inflammation * Post-void residual measurement to evaluate how well the bladder is emptying * Hormonal evaluation, including estradiol * Metabolic testing, including blood sugar/glucose levels * Practical prevention steps: * Strengthening the pelvic floor * Maintaining a healthy weight * Staying hydrated while limiting bladder irritants like caffeine * Addressing hormonal health * Seeking pelvic floor therapy when needed This episode is a reminder that urinary symptoms are not a source of shame. They are often the body asking for attention. If you are planning your day around the bathroom, avoiding movement because of leakage, or feeling like your body has changed and no one has explained why, it may be time to seek a real evaluation. Because common does not always mean normal — and becoming the CEO of your own health starts with listening to your body and asking for answers. Visit NitzaMD.com  Follow @NitzaMD on Instagram and Facebook

Why Your Hair Is Suddenly Thinning After 35 – Ep. 67 – I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health. In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles a symptom many women quietly struggle with: hair thinning after 35. If you’ve noticed more hair in your brush, a wider part, or a thinner ponytail and wondered, “Is this stress? My shampoo? Or is something wrong with me?” — this episode reframes hair loss as more than a cosmetic issue. It can be a signal from the body.   Dr. Alvarez explains why hair changes are common during perimenopause and menopause, when shifting estrogen levels, relative androgen changes, sleep disruption, stress, insulin resistance, and metabolic changes can all affect the hair growth cycle. She also explains why, from a cardiologist’s perspective, symptoms like hair thinning, fatigue, weight changes, and sleep problems should not be looked at in isolation — because this stage of life is also a metabolic and cardiovascular transition.   With clarity and compassion, she breaks down: * Why hair loss can feel so emotional for women * How estrogen helps support the hair growth cycle * Why perimenopause can shift the balance between growth and shedding * Why hair follicles are sensitive to hormones, blood flow, nutrition, sleep, and stress * Common myths about hair loss, including the belief that “nothing can be done” * Minimum tests to discuss with your doctor, including iron levels, thyroid function, lipid panel, and metabolic markers * Five practical steps to support hair and overall health: sleep, protein and nutrient-dense foods, strength training, stress management, and working with clinicians who understand women’s midlife physiology This episode is a reminder that hair loss is not vanity, and it is not something women should be told to simply accept. Hair can be information — biology growing in plain sight. If your body is changing, listen early, ask better questions, and work with a clinician who understands the connection between hormones, metabolism, and women’s heart health. Because becoming the CEO of your own health starts with taking your symptoms seriously. Visit NitzaMD.com  Follow @NitzaMD on Instagram and Facebook

When “Anxiety” Is Actually a Hormone Signal – Ep. 66 – I AM YOU

I AM YOU is hosted by Dr. Nitza I. Alvarez, MD, FACC — board-certified cardiologist, Women’s Heart Specialist, and bestselling author. Each episode shares real stories and expert insights to help women protect the heart that carries them through every stage of life — and step into their power as the CEO of their own health. In this Ask the Heart Doctor-style episode, Dr. Alvarez tackles one of the most misunderstood symptoms many women experience in their late 30s and 40s: sudden anxiety. If your heart starts racing, your chest feels tight, your mind starts spinning, or you wake up at night with nervous energy, you may have been told it is “just stress” or “just anxiety.” But what if your body is actually sending a hormone signal? Dr. Alvarez explains why anxiety-like symptoms can appear during perimenopause, even when nothing major has changed in your life. As estrogen and other hormones begin to fluctuate, they can affect the brain, nervous system, blood vessels, sleep, and even the heart. What feels emotional may actually be physiological.   With clarity and compassion, she breaks down: * Why hormones are not just about reproduction — they are communication signals throughout the body * How estrogen interacts with serotonin, dopamine, the nervous system, blood vessels, and the heart * Why women can become more sensitive to stress, caffeine, poor sleep, and heart palpitations during hormonal shifts * Why perimenopause can begin earlier than many women realize, sometimes in the late 30s * Why palpitations are often benign, but should still be evaluated when they are new or disruptive * The minimum tests women should know about, including thyroid testing, complete blood count, ferritin/iron levels, blood sugar markers, hemoglobin A1c, and lipid panel * Five practical steps women can take: tracking symptoms and cycles, prioritizing sleep, strength training, reducing caffeine, and advocating for themselves during medical visits This episode is a powerful reminder that anxiety is not always weakness, and it is not always “all in your head.” Sometimes it is information. Sometimes it is your nervous system responding to real changes happening inside your body. And when women understand those signals early, they can stop blaming themselves and start asking better questions. Because becoming the CEO of your own health starts with listening to your body — and taking your symptoms seriously. Visit NitzaMD.com Follow @NitzaMD on Instagram and Facebook.