I’m Doing Everything Right…So Why Are My Labs Worse? Heart Health and Menopause with Michelle Routhenstein, MS, RD, CDN (Episode 278)

About this episode

The episode discusses the complexities of heart health in women, particularly during menopause, with insights from dietitian Michelle Routhenstein.

Most of us have had that moment where we get our bloodwork back and shake our heads. We’re still our active, health‑minded selves and out of nowhere—rising LDL, ApoB, A1C, and maybe blood pressure and Lp(a), too. This week, preventive cardiology dietitian Michelle Routhenstein joins us to unpack the cardiometabolic chaos and what’s really driving it. She explains estrogen’s protective role in lipids and blood pressure, why standard risk calculators and even calcium scores can miss women’s disease, and which advanced labs are worth asking for. We also dig into how under‑fueling and low‑carb diets can worsen cardiometabolic health and plaque; why complex carbs, fiber, fermented foods, and gut health matter so much; and how to approach protein, red meat, electrolytes, nitric oxide, and statins in a personalized, empowering way—remembering that 80–90% of heart disease remains preventable when women get the right information and advocate for themselves. Michelle Routhenstein, MS, RD, CDCES, CDN is a preventive cardiology dietitian and founder of Entirely Nourished, a virtual practice focused on personalized, science-based nutrition for heart health. With over 14 years of experience…

People in this episode

Guest: Michelle Routhenstein

Topics covered

• heart health
• menopause
• cardiometabolic health
• nutrition
• women's health

Keywords

• LDL
• ApoB
• A1C
• blood pressure
• cardiovascular disease
• nutrition
• estrogen
• gut health
• personalized diet

Mentioned in this episode

Organizations: Entirely Nourished, Forbes Health Advisory Board, New York University

More episodes of Hit Play Not Pause

• Take the Leap: Kate Veronneau on Adventure and Trying Something New at FeistyFest · June 7, 2026 · 22 min
• Nourishing Menopause: Food, Stress, Sleep, Supplements & More with Andrea Donsky, RHN · June 3, 2026 · 1h 3m
• Unraveling Menopause: From Chasing Fixes to Finding Your Own Way with Sara Larson (Episode 276) · May 27, 2026 · 54 min
• Mindset Mastery for Midlife Athletes with Sonya Looney (Episode 275) · May 20, 2026 · 1h 1m
• Why Even Active Women Lose Bone—and How to Build It Back with Belinda Beck, PhD (Episode 274) · May 13, 2026 · 1h 20m
• Hormone Therapy Real Talk: Testing, Trial and Error & Finding Your Way with Dr. Heather Hirsch (Episode 273) · May 6, 2026 · 1h 30m