Redakcja VitMode — Serce i układ krążenia

Psilocybin-Assisted Therapy for Depression

Psilocybin administered once, in tightly controlled clinical settings with trained therapists present, is one of the most actively researched directions in psychiatry for treatment-resistant depression — with real, published phase 2 trials, but also real methodological limitations and a legal status that, in Poland and most of Europe, does not allow its legal use outside a strictly supervised clinical trial.

Niacinamide (Nicotinamide)

A rare ingredient that genuinely spans two different worlds: as vitamin B3 taken orally it prevents pellagra and serves as an NAD+ precursor, while as a skincare ingredient it regulates sebum, strengthens the skin barrier and brightens discoloration — with real, if differently weighted, clinical evidence on both sides.

Can Testosterone Affect Cholesterol?

Long before anyone starts TRT, natural testosterone level correlates with lipid profile in population studies — lower testosterone is linked to higher triglycerides and lower HDL. We explain this broader, epidemiological relationship and why it shouldn't be confused with the specific effect of testosterone therapy itself.

Asthma

A chronic inflammatory disease of the airways, in which hyperreactive bronchi respond with constriction, mucosal swelling, and excess mucus production to stimuli that are usually harmless to a healthy person — causing attacks of breathlessness, wheezing, chest tightness, and coughing. Well-controlled, it allows a fully normal life; poorly recognized or neglected, it can cause severe, life-threatening exacerbations.

Troponin and NT-proBNP (Cardiac Markers)

Cardiac troponin and NT-proBNP are two distinct, complementary blood biomarkers used in cardiology — the first detects ongoing damage to heart muscle cells, the second signals hemodynamic strain on the heart's ventricles. Together they play a key role in diagnosing acute coronary syndrome and heart failure, though an elevated result in either doesn't always mean a heart attack or heart failure.

Fibrinogen

Fibrinogen is a plasma protein that serves as the final substrate of the coagulation cascade and is also one of the main acute-phase inflammatory proteins — its concentration is assessed both in diagnosing clotting disorders and as an independent cardiovascular risk indicator. This test evaluates clotting function and inflammatory status, distinct from D-dimer, which detects an already-existing clot.

Sleep and Cardiovascular Health

The American Heart Association recognizes sleep as one of eight essential pillars of cardiovascular health — both too little and chronically fragmented sleep measurably raise the risk of hypertension, atherosclerosis, and cardiac events.

Mammography

An X-ray examination of the breast that is the primary method for screening detection of breast cancer at an early, asymptomatic stage — the only imaging test with mortality reduction documented in randomized clinical trials.

Pap Smear (Cervical Cytology)

A microscopic examination of cells collected from the cervix that can detect precancerous changes years before cancer could develop — one of the most effective screening tests in oncology, responsible for a dramatic drop in cervical cancer mortality wherever it's performed systematically.

Resting ECG

The resting electrocardiogram is the simplest and fastest test of the heart's electrical activity — a few-minute, painless recording of 12 leads that can be the first sign of arrhythmia, ischemia, or a conduction disorder, though a normal result doesn't rule out structural or paroxysmal heart disease.

Echocardiography (Cardiac Echo)

Echocardiography is a real-time ultrasound test of the heart that — unlike an ECG, which only assesses electrical activity — shows chamber structure, valve function, and the strength of the heart muscle's contraction, with no radiation exposure.

Exercise Stress Test

An exercise stress test monitors the heart's electrical activity, blood pressure, and symptoms during gradually increasing physical exertion on a treadmill or stationary bike, revealing heart muscle ischemia that remains invisible on a resting ECG.

Holter ECG and Ambulatory Blood Pressure Monitoring

Holter ECG and ambulatory blood pressure monitoring (ABPM) are two distinct ambulatory tests that record — respectively — an electrocardiographic trace or blood pressure values during everyday life over 24 hours or longer, catching disturbances invisible on a single office measurement.

Vascular Doppler Ultrasound

Vascular Doppler ultrasound is a non-invasive imaging test that uses sound waves and the Doppler effect to assess blood flow in arteries and veins — the basic tool for diagnosing venous thrombosis, arterial atherosclerosis, and other vascular diseases.

Angiography and CT Angiography

Classic (catheter) angiography and computed tomography angiography (CT angiography) are two methods for precisely imaging the inside of blood vessels after contrast injection — the first invasive and allowing treatment in the same procedure, the second non-invasive and performed on an outpatient basis.

Electrolytes: Sodium, Potassium, and Chloride

Sodium, potassium, and chloride sound like a chemistry-class topic, but their blood levels determine how your heart, muscles, and kidneys function — and even a small deviation can be an urgent warning sign.

Homocysteine

Homocysteine is an intermediate amino acid of methionine metabolism, linked for decades to cardiovascular and neurological risk — though how much lowering it actually reduces that risk remains a point of controversy in the literature.

Apolipoprotein B (ApoB)

While a standard lipid panel measures the amount of cholesterol carried in your blood, apolipoprotein B measures something different — the number of particles themselves that can actually penetrate the artery wall. That distinction can matter when a standard lipid panel looks fine but cardiovascular risk remains elevated.

Lipoprotein(a) [Lp(a)]

Unlike LDL or triglycerides, lipoprotein(a) levels are over 80–90% determined by genetics — diet and lifestyle have minimal effect on it. It's the one lipid marker worth testing once in a lifetime, not periodically.

Coffee and Blood Pressure: The Acute Spike, Tolerance and How Many Cups Are Safe

Coffee raises blood pressure for a few hours, but in most people regular drinking does not lead to lasting hypertension. In a meta-analysis of studies in people with hypertension, 200-300 mg of caffeine raised systolic pressure by about 8 mm Hg and the effect lasted at least 3 hours; cohort studies, however, found no higher risk of heart disease in regular coffee drinkers. We explain how tolerance works, who reacts most strongly, how many cups do not seem to cause harm and why you should not measure your blood pressure right after coffee.

October 24, 2026

Coffee and Arrhythmias and Heart Palpitations: What the Studies Show, Including the First Randomized Trial

Contrary to popular belief, studies do not show that coffee raises the risk of atrial fibrillation or the number of extra heartbeats in most people. In the randomized DECAF trial in 200 patients after cardioversion, coffee drinking was linked to fewer recurrences of arrhythmia (47% versus 64% with complete abstinence), and a meta-analysis of 10 cohorts showed no rise in risk. These are averages, though: some people are sensitive and clearly get palpitations from coffee. We explain how to recognise it and when to stop drinking coffee and see a doctor.

October 24, 2026

Home Blood Pressure: Morning or Evening, and How Often Should You Measure?

The best-studied way to measure blood pressure at home is twice a day, morning and evening, taking two readings about a minute apart each time, for seven consecutive days. In a large Finnish study (2,081 people, 6.8 years of follow-up) this kind of average predicted heart attacks and strokes better than single clinic readings. We explain why the number of readings matters more than the exact hour, how to prepare, and what to write down for your doctor.

October 24, 2026

Wrist or Upper-Arm Blood Pressure Monitor: Which Is More Accurate?

An upper-arm monitor is the default choice for home measurement because it produces fewer errors caused by body position. A wrist device can be accurate, but only if it has been clinically validated and your wrist is exactly at heart level during the measurement. We explain where the differences in readings come from, when a wrist monitor is a sensible option, how to check whether a specific model has been validated, and why cuff size is often more important than the measurement site itself.

October 24, 2026

Different Blood Pressure in Both Arms: When Is the Difference Worrying?

A small difference in blood pressure between the right and left arm is common and usually reflects natural variability and measurement error. Only a systolic difference of at least 10, and especially 15 mmHg, that repeats across measurements is linked in studies with vascular disease: narrowing of the subclavian artery, peripheral artery disease and higher cardiovascular mortality. We explain the thresholds doctors use, how to measure the difference correctly at home, which arm to keep using, and when vascular imaging is needed.

October 24, 2026

High Systolic but Normal Diastolic Blood Pressure: Isolated Systolic Hypertension

Isolated systolic hypertension is a situation in which the top number is at least 140 mmHg while the bottom number stays below 90 mmHg. In people over 60 it is the most common form of hypertension and results mainly from stiffening of the arteries; in this group two large randomized trials (SHEP, Syst-Eur) showed that treatment reduces stroke risk by about 36-42%. In young adults, especially tall men, the picture is more complex: some cases are spurious, but cohort data show a higher cardiovascular risk. We explain the causes, the significance and the next steps.

October 24, 2026

Night-Time Blood Pressure and Non-Dipper: What Does No Nocturnal Dip Mean?

A non-dipper is a person whose blood pressure falls by less than 10% at night compared with the day. This profile can be linked with higher cardiovascular risk, but it is also very unstable: in studies a repeat measurement often gives a different result, and the effect of medication timing on cardiovascular events, after the conflicting results of the Hygia and TIME trials, has not been confirmed. We explain how non-dipping is diagnosed, what causes it (including sleep apnoea and chronic kidney disease) and what to do about it.

October 24, 2026

Resting Heart Rate: Normal Range, What Lowers It and the Link to Longevity

Resting heart rate is one of the simplest numbers your watch shows and one of the best studied in epidemiology. A meta-analysis of 46 cohort studies shows that a higher resting heart rate goes with higher mortality, yet genetic analyses suggest it is more a marker of fitness and health than a direct cause. We explain what the normal range is, what shapes this number, what actually lowers it, how to measure it properly and how far to trust your wearable.

October 22, 2026

Slow Heart Rate in Athletes (Bradycardia): When It Is Normal and When It Is a Symptom

A resting pulse of 40 beats per minute in a runner or cyclist is usually not a disease but a result of training. In a cohort of 465 endurance athletes, 38% had a minimum heart rate of 40/min or lower on Holter monitoring, and pauses of at least 2 seconds occurred in 25% and were well tolerated. We explain where athletic bradycardia comes from, how it differs from sinus node disease or atrioventricular block, which symptoms are alarm signs and which tests are worth doing.

October 22, 2026

Heart Palpitations: Causes and When to See a Doctor

Palpitations are the subjective sensation of a fast, forceful or irregular heartbeat. In a classic study of 190 patients, a cause was found in 84%: cardiac in 43%, psychiatric (anxiety, panic attacks) in 31%, and the prognosis was generally good. We explain what most often triggers palpitations (caffeine, alcohol, stress, thyroid, anemia, arrhythmias), when they are an alarm sign, which tests to do (ECG, Holter, event recorder) and how helpful a watch with an ECG is.

October 22, 2026

Extrasystoles (Premature Heartbeats): When They Are Harmless

Extrasystoles, or premature extra heartbeats, occur in most people and are very often harmless. What decides their significance is above all the arrhythmia burden (the percentage of heartbeats), the presence of structural heart disease and symptoms. In a study of 174 patients, a ventricular beat burden above 24% best separated people with impaired left ventricular function, and the lowest burden causing reversible cardiomyopathy was 10%. We explain when extrasystoles need investigation, which tests to do and how they are treated.

October 22, 2026

Ketogenic Diet and High LDL Cholesterol: Is It Dangerous?

On a ketogenic diet, LDL cholesterol rises by tens and sometimes hundreds of mg/dL in some people, and often in lean, metabolically healthy people who chose the diet for their health. The biohacker community calls this the 'lean mass hyper-responder' phenotype and often claims that a high LDL in this setting is harmless. We look at what the evidence really shows: a meta-analysis of randomized trials, the only available artery imaging data and clinical reviews, and which measurements (ApoB, Lp(a), coronary artery calcium) make sense before you decide whether to modify the diet.

October 21, 2026

Low HDL Cholesterol: Causes, Is It Dangerous and What to Do

Low HDL is one of the most common 'red' results on a lipid panel and also one of the most misunderstood. It is usually not a disease in its own right but a sign of something else: insulin resistance, high triglycerides, inactivity or smoking. Importantly, many large trials showed that raising HDL artificially with drugs did not reduce heart attacks, so the goal of treatment should not be 'raise HDL'. We explain where low HDL comes from, what the result really says about risk and which lifestyle changes make sense.

October 21, 2026

Elevated Lp(a): What It Means and What to Do

Lipoprotein(a), or Lp(a), is an LDL-like particle whose level is overwhelmingly written in the genes and barely changes during life. An elevated Lp(a) (above 50 mg/dL, or about 125 nmol/L) affects roughly one person in five and raises the risk of heart attack, stroke and aortic valve stenosis. Diet and exercise hardly lower it, and Lp(a)-specific drugs are only now going through trials; in October 2026 it was announced that the first large drug, pelacarsen, lowered Lp(a) but did not reduce cardiovascular events. We explain how to read the result, what can really be done and why the core of the matter is aggressive control of LDL and ApoB.

October 21, 2026

MDMA-Assisted Therapy for PTSD: Does It Work? What the Trials Showed, and Why the FDA Rejected It

Two phase 3 trials (MAPP1 and MAPP2) showed strong, reproducible effects of MDMA-assisted therapy in post-traumatic stress disorder. In August 2024, the FDA nonetheless refused to approve the drug, citing serious concerns about data quality and reliability. It's a rare case where promising clinical results and a real, documented regulatory rejection coexist — and both sides of this story need to be understood to grasp the therapy's current status.

October 17, 2026

LSD Microdosing in Biohacking: What Do Placebo-Controlled Trials Actually Show?

LSD microdosing — taking sub-perceptual doses every few days to improve mood, creativity and focus — is one of the most popular practices in the biohacking community. The problem is that when rigorous, blinded trials with genuine placebo actually tested it, the reported benefits mostly didn't outperform placebo. It's a non-obvious, well-documented finding worth knowing before trying this practice — alongside its genuinely illegal status in Poland.

October 17, 2026

Hormonal Birth Control and B6, B12, and Folate Deficiency

Combined hormonal contraceptives are taken by hundreds of millions of women worldwide and are considered one of the best-studied drug classes in medicine. Less often discussed is their long-term effect on the status of several B vitamins — especially B6, B12, and folate. A meta-analysis covering nearly 3,000 women found a significant drop in folate levels, and other systematic reviews confirm a similar, though usually moderate, pattern for B6 and B12. This has particular practical relevance at one specific moment: the period of planning a pregnancy after stopping birth control.

October 5, 2026

Retinol vs Retinal: What's the Difference and Which Should You Choose?

Retinol still has to be converted twice before skin can turn it into active retinoic acid. Retinal (retinaldehyde) needs only one enzymatic step to get there — and that seemingly small biochemical difference translates into real, measured differences in onset speed and skin tolerance.

October 5, 2026

St. John's Wort and Hormonal Birth Control: Why It Can Cancel It Out

St. John's wort, sold over the counter as a mild mood supplement, is one of the best-documented examples of an herb-drug interaction with real, clinically confirmed consequences: it significantly weakens hormonal contraception's effectiveness. The mechanism is precisely described — induction of the enzymes that metabolize ethinylestradiol — and the effects, from breakthrough bleeding to unintended ovulation, are confirmed in clinical trials on women, not just in pharmacological theory.

October 3, 2026

Grapefruit and Statins: Why Grapefruit Juice Boosts the Drug's Effect

The “don't combine with grapefruit juice” warning on a statin's leaflet isn't a formality — it's the result of one of the best-studied food-drug interactions in clinical pharmacology. Furanocoumarins in grapefruit block the CYP3A4 enzyme in the gut, which for simvastatin can increase its blood level several-fold. The problem doesn't affect all statins equally, though — pitavastatin, pravastatin, and rosuvastatin are metabolized through a different pathway, and this interaction barely touches them.

October 3, 2026

Salt and Blood Pressure: Is Everyone Salt-Sensitive?

“Cut back on salt, it raises your blood pressure” is one of the most commonly repeated pieces of health advice — and also one of the more imprecise ones. Salt sensitivity is a real, well-documented but heterogeneous trait: in some people, blood pressure responds strongly to changes in sodium intake, while in others it barely responds at all. Long-term studies estimate that salt-sensitive people make up roughly a third of healthy individuals and more than half of people with hypertension — but not everyone, and not to the same degree.

October 3, 2026

Vitamin D and Statins: Does Supplementation Affect Cholesterol Drug Effectiveness?

For years, a popular belief has circulated that low vitamin D worsens the painful side effects of statins, and that supplementing it can prevent them. A large, randomized trial called VITAL, involving more than 2,000 new statin users, gave a clear but under-reported answer — and explains why this intuitive hypothesis didn't hold up under closer scrutiny.

September 30, 2026

Magnesium and Blood Pressure Medications: Interactions and Safety

Magnesium is sometimes called a “natural calcium channel blocker” — and that's not just a catchy marketing phrase, but a description of a real physiological mechanism. That also means that for people on blood-pressure medication, magnesium supplementation isn't neutral: it can add to a drug's effect, especially with calcium channel blockers, and the risk grows further when kidney function is impaired.

September 30, 2026

Omega-3 and Blood Thinners: The Real Bleeding Risk

The warning “omega-3 thins your blood, be careful with blood thinners” repeats online so often it's treated as settled fact. Yet the largest meta-analysis of clinical trials to date, covering more than 120,000 patients, paints a far more measured picture than the popular warnings suggest — though not entirely free of nuance at very high doses.

September 30, 2026

Ketamine for Depression Treatment

The only psychedelic or psychedelic-adjacent compound with a genuine, FDA- and EMA-approved registration for treatment-resistant depression — intranasal esketamine (Spravato) — alongside the still-unregistered but widely used off-label intravenous ketamine infusion offered at specialized clinics. A fast, unusual mechanism of action comes paired with real risks: dissociation during administration, abuse potential, and documented, serious bladder toxicity with chronic, non-medical misuse.

Orthostatic Hypotension

Dizziness and dimming vision when you stand up are easy to brush off as nothing — yet behind them sits a precise, measurable medical criterion and a list of causes ranging from plain dehydration to diseases on the Parkinsonian spectrum.

How to Interpret Testosterone, SHBG, and Albumin Together?

Total testosterone and SHBG alone say less than the two combined with albumin. We explain the Vermeulen equation — the mathematical way to calculate free and bioavailable testosterone from all three values at once.

Does a High Hematocrit on TRT Always Mean a Problem?

A single elevated hematocrit reading on a blood count doesn't necessarily mean a real problem — dehydration at the draw, altitude, or the timing of the draw relative to an injection can all inflate the number without any actual change in the body. We explain when a single result can be ignored, and when it genuinely deserves attention.

Why Does Hematocrit Rise During Testosterone Therapy?

Testosterone stimulates erythropoietin, acts directly on the bone marrow, and lowers hepcidin — three overlapping mechanisms through which it raises hematocrit, more strongly with injections than with gels. We explain why this is a predictable pharmacological effect, what determines its strength, and how it changes over time.

Can TRT Lower Fertility Even With Normal Testosterone?

Serum testosterone can look textbook-perfect, and yet a semen analysis shows a drastically reduced sperm count or none at all. This isn't a contradiction — it's a consequence of the fact that spermatogenesis depends on testosterone concentration inside the testis, dozens of times higher than in blood, which TRT suppresses even when the blood result looks ideal.

Benign Prostatic Hyperplasia (BPH)

A non-cancerous enlargement of the prostate gland affecting up to one in four men over a lifetime — and one of the few urological conditions where a large randomized trial showed a drug can cut the risk of acute urinary retention by more than half.

Chronic Kidney Disease (CKD)

A progressive, usually symptomless loss of kidney function affecting up to one in nine adults worldwide — and a condition in which even a small drop in glomerular filtration is linked, in large cohort studies, to a significantly higher risk of cardiovascular death.

Coagulation Panel — INR, aPTT, and Prothrombin Time (PT)

INR, aPTT, and prothrombin time don't detect the presence of a clot — they measure how efficiently blood can clot at all, evaluating two distinct arms of the coagulation cascade. This is a core panel before surgery, in unexplained bleeding, and for monitoring anticoagulant therapy, and interpreting it requires understanding which pathway each parameter tests.

Ultrasound (Sonography)

Ultrasound uses high-frequency sound waves, not radiation, to image organs in real time — it's safe, widely available, and inexpensive, though image quality depends heavily on the operator's experience and the patient's anatomy.

Creatinine and eGFR (Estimated Glomerular Filtration Rate)

Creatinine alone tells you surprisingly little about kidney function — only converting it into eGFR using the CKD-EPI equation reveals how much filtration capacity actually remains.

D-dimer

D-dimer is a breakdown product of a blood clot — a test with exceptionally high sensitivity for ruling out deep vein thrombosis and pulmonary embolism, but low specificity, so on its own it almost never confirms a diagnosis.

Metabolic Syndrome

A cluster of five risk factors — from abdominal obesity to elevated triglycerides — that multiplies the risk of type 2 diabetes and cardiovascular disease, but is largely modifiable through lifestyle change.

Lipid Panel

The lipid panel is one of the most important — and still one of the most frequently misread — preventive blood tests: 'total cholesterol' alone tells you less than the ratios between its fractions.

Statins

The best-researched class of LDL-cholesterol-lowering drugs, with one of the largest evidence bases in all of cardiology — yet still surrounded by numerous, largely unfounded fears.

Hypertension

The 'silent killer' — it runs symptom-free for years, yet it's one of the strongest, and largely modifiable, risk factors for stroke and heart attack in the world.

Coronary Artery Calcium (CAC)

A non-invasive CT scan that directly measures the amount of calcification in the coronary arteries — one of the strongest available predictors of a future heart attack in people without symptoms.