Heart Failure

  • Angina Pectoris

    Angina Pectoris by Prof Gene Bruno

    The heart is a functioning muscle and needs oxygen and fuel in order to do its work. It is the job of the coronary arteries to supply the necessary oxygen and nutrients to the muscle. When one of the three major coronary arteries become narrowed or blocked, blood flow to the muscle is reduced, resulting in angina pectoris—a feeling of tightness or pressure in the chest often associated with shortness of breath. At first, angina may only be obvious during periods of exercise or emotional stress, and may go away when the activity ceases. Later, it may occur even while resting. If the blood flow to an area of the heart completely stops, heart muscle cells die, causing a heart attack, or myocardial infarction. While healing, the infarcted or damaged area forms a scar, but is no longer a functioning part of heart muscle.

    Conventional medical treatments for angina include blood vessel dilators such as nitroglycerine and other nitrites and calcium channel blockers. If arteriograms show clogged coronary arteries, bypass surgery is usually recommended.

    Dietary Supplements: Primary Recommendations

    Vitamin C
    Those pesky little free radicals really get around. They seem to be involved in almost every cardiovascular condition, and angina is no exception.1,2 Consequently, it's not surprising that vitamin C and other antioxidants, which neutralize free radicals, are beneficial in the prevention and treatment of angina. In fact, studies have shown that men and women with lower blood levels of vitamin C have a higher risk for angina.3,4,5,6 Furthermore, research has also shown that vitamin C supplementation, with or without other antioxidants, has been able to reduce the incidence of angina.7,8,9 About 2,000 mg of vitamin C daily is recommended.

    Co-enzyme Q10
    Co-enzyme Q10 is a vitamin-like substance involved in cellular energy metabolism. It is also an antioxidant, like vitamin C, that is beneficial in the prevention and treatment of angina. In a study, which reviewed the scientific literature, Co-enzyme Q10 was revealed to be used in oral form to treat various cardiovascular disorders including angina.10 In one study, patients with acute myocardial infarction experienced a significant reduction in angina, arrhythmias (abnormal heartbeat), and poor heart function when supplemented with 120 mg of Co-enzyme Q10 daily.11 Of course everyone knows that exercise is good to prevent cardiovascular disease. But in one study, patients with ischemic heart disease/effort angina were found to experience a faster loss of Co-enzyme Q10 during exercise.12 Does this mean that you shouldn't exercise if you have angina? No, it just means you should supplement with Co-enzyme Q10. In another study, 150 mg of Co-enzyme Q10 given to angina patients not only increased their blood levels of Co-enzyme Q10, but also increased their ability to exercise longer. These results lead the researchers to conclude, "This study suggests that Co-enzyme Q10 is a safe and promising treatment for angina pectoris."13 (Note: If you have acute angina, you should only exercise in accordance to a program approved by your physician.)

    Vitamin E
    Vitamin E is considered by many to be the granddaddy of all antioxidant and cardiovascular support vitamins—and this reputation certainly holds true in the case of angina. As with vitamin C and Co-enzyme Q10 previously discussed, vitamin E protects against the free radical damage associated with angina. But what happens when there are inadequate levels of vitamin E? Not surprisingly, research shows that blood levels of vitamin E are significantly lower in patients with angina, and that these lower levels render them more susceptible to further cardiovascular damage.14,15,16 And what happens if vitamin E is supplemented? Various studies show that vitamin E supplementation, with or without other antioxidants, is able to successfully decrease the incidence of angina in affected patients.17,18,19 In fact, in a study, which examined vitamin use in 2313 men, vitamin E supplementation was found to have the strongest association with a reduced risk of ischemic heart disease, including angina.20 Finally, vitamin E supplementation together with conventional anti-anginal drug therapy has been found to bring a higher response and exercise improvement, as well as other positive changes, than drug therapy alone.21 About 100 –400 IU of vitamin E daily is recommended.

    L-Carnitine
    L-carnitine is an amino acid involved in energy metabolism. Extensive research has also shown that l-carnitine has a valuable role to play in cardiovascular disease, especially where angina is concerned. Several studies have demonstrated that supplementation with l-carnitine (2000 to 4000 mg daily) is able to reduce the incidence of anginal attacks in cardiovascular disease patients.22,23,24,25 Furthermore, in studies involving patients with angina pectoris and effort angina (i.e., angina induced by physical effort, such as exercise), supplementation with l-carnitine (2000 or 3000 mg daily) was able to improve exercise performance.26,27,28,29,30 Furthermore, in a study where l-carnitine was given to patients with effort angina along with anti-arrhythmic drugs, the l-carnitine was found to improve the action of those drugs.31

    Hawthorne
    Germany's Commission E has validated the use of Hawthorn in cases of cardiac insufficiency, resulted in an improvement of subjective findings as well as an increase in heart work tolerance, and a decrease in pressure/heart rate product.32 (Although Hawthorne Berry products are often marketed, it is the Hawthorne leaves and flowers which have been so carefully researched and validated.). In one study, a 60 mg hawthorn extract taken three times per day improved heart function and exercise tolerance in angina patients.33

    L-Arginine
    Typically physicians will give their angina patients a prescription for nitroglycerin tablets, which are used in case of an angina attack. Nitroglycerine works through dilation of arteries, which in turn, works through an interaction with nitric oxide, which stimulates dilation. It is interesting to note that nitric oxide is made from the amino acid arginine. Furthermore, blood cells in people with angina have been shown to make insufficient nitric oxide,34 (possibly due to abnormalities of arginine metabolism). Of greatest significance is research showing that 2 grams (2,000 mg) of arginine, three times per day for as little as three days improved the ability of angina sufferers to exercise.35 Additional research has shown that the mechanism by which arginine operates is through stimulating blood vessel dilation.36 (Note: If you have an active herpes virus, you should avoid arginine supplements since they can "feed" the virus.)

    Dietary Supplements: Secondary Recommendations

    Magnesium
    The heartbeat normalizing effects of magnesium has been described repeatedly since 1935, both as a factor in human disease and in animal experiments. Nevertheless, this therapeutic effectiveness is rarely mentioned in textbooks. Both the therapeutic effect of magnesium and the correction of magnesium deficiency have been used in treatment of digitalis toxicity (a drug used to treat angina), angina, as well as in arrhythmia (abnormal heartbeat) of unknown origin. Magnesium deficiency can be caused by a number of situations. Of possible concern to the angina sufferer are the uses of drugs such as digitalis, diuretics, gentamicin, as well as cisplatinum, which appreciably enhance urinary magnesium loss. Correction of magnesium deficiency should lead to recovery.37 About 300 – 500 mg daily is recommended. Please note, however, that it may take weeks or even months of magnesium supplementation, to achieve an angina-relieving result.

    Omega-3 fatty acids
    The omega-3 fatty acids EPA and DHA have been studied in the treatment of angina. Some research indicates that 3 grams or more of omega-3 oils (e.g., fish oils) three times per day (providing a total of about 3 grams of EPA and 2 grams of DHA) have reduced chest pain as well as the need for nitroglycerin, a common medication used to treat angina.38 However, other research did not confirm these benefits.39 In any case, if omega-3's are used, vitamin E should be supplemented with it, since the vitamin E may protect the oils against free radical oxidation.40 Also, if you are using any type of blood-thinning medication, consult with your doctor before using omega-3 fatty acids.

    Bromelain
    Bromelain acts naturally as a blood thinner agent since it prevents excessive blood platelet from clumping together,41 which would otherwise cause "sludgy" blood. Furthermore, there have been positive reports in a few clinical trials of bromelain to decrease thrombophlebitis (inflammation of veins) and pain from angina and thrombophlebitis.42,43 About 1200–1500 mg daily (derived from at least 900 GDU/Gram material) is recommended.

    References:

    1. Ito K, et al, Am J Cardiol(1998) 82 (6):762-7.
    2. Kugiyama K , et al, J Am Coll Cardiol (1998) 32(1):103–9.
    3. Ibid.
    4. Riemersma RA, et al, Ann NY Acad Sci (1989) 570:29–5.
    5. Riemersma RA, et al, Lancet (1991) 337(8732):1–5.
    6. Ness AR, et al, J Cardiovasc Risk (1996) 3(4):373–7.
    7. Ito K, et al, Am J Cardiol (1998) 82 (6):762–7.
    8. Kugiyama K, et al, J Am Coll Cardiol (1998) 32(1):103–9.
    9. Singh RB, et al, Am J Cardiol (1996) 77(4):232–6.
    10. Greenberg S, Frishman WH, J Clin Pharmacol (1990)30(7):596–608.
    11. Singh RB, et al, Cardiovasc Drugs Ther (1998) 12(4):347–53.
    12. Karlsson J, et al, Ann Med (1991) 23(3):339–44.
    13. Kamikawa T, Am J Cardiol (1985) 56 (4):247–51.
    14. Miwa K, et al, Cardiovasc Res (1999) 41(1):291–8.
    15. Miwa K, et al, Circulation (1996) 94(1):14–8.
    16. Pucheu S, et al, Free Radic Biol Med (1995) 19(6):873–81.
    17. Rapola JM, et al, JAMA(1996) 275(9):693–8.
    18. Singh RB, et al, Am J Cardiol (1996) 77(4):232–6.
    19. Motoyama T, et al, J Am Coll Cardiol (1998) 32(6):1672–9.
    20. Meyer F, Bairati I, Dagenais GR, Can J Cardiol (1996)12(10):930–4.
    21. Pimenov LT, Churshin AD, Ezhov AV, Klin Med (1997) 75(1):32–5.
    22. Singh RB, et al, Postgrad Med J (1996) 72(843):45–50.
    23. Davini P, et al, Drugs Exp Clin Res (1992) 18(8):355–65.
    24. Fernandez C, Proto C, Clin Ter (1992) 140(4):353–77.
    25. Ferrari R, Cucchini F, Visioli O, Int J Cardiol (1984) 5(2):213–6.
    26. Kobayashi A, Masumura Y, Yamazaki N, Jpn Circ J (1992) 56(1):86–94.
    27. Cacciatore L, et al, Drugs Exp Clin Res (1991) 17(4):225–35.
    28. Canale C, et al, Int J Clin Pharmacol Ther Toxicol(1988) 26(4):221–4.
    29. Cherchi A, et al, Int J Clin Pharmacol Ther Toxicol (1985) 23(10):569–72.
    30. Kamikawa T, et al, Jpn Heart J (1984) 25(4):587–97.
    31. Mondillo S, et al, Clin Ter (1995) 146(12):769–74.
    32. Blumenthal, M., et al, The Complete German Commission E Monogrpahs: Therapeutic Guide to Herbal Medicines/CD version (1998) American Botanical Council, Austin, Texas.
    33. Hanack T, Bruckel MH, Therapiewoche (983) 33:4331–33 [in German].
    34. Mollace V, et al, Am J Cardiol (1994) 74:65–68.
    35. Ceremuzynski L, Chamiec T, Herbaczynska-Cedro K, Am J Cardiol (1997) 80:331–33.
    36. Egashira K, et al, Circulation (1996) 94:130–34.
    37. Laban E, Charbon GA, J Am Coll Nutr (1986) 5(6):521–32.
    38. Saynor R, Verel D, Gillott T, Atheroscl (1984) 50:3–10.
    39. Mehta JL, et al, Am J Med (1988) 84:45–52.
    40. Wander RC, et al, J Nutr (1996) 126:643–52.
    41. Heinicke R, van der Wal L, Yokoyama M, Experientia (1972) 28:844–45.
    42. Nieper HA, Acta Med Empirica (1978) 5:274–78.
    43. Seligman B, Angiology (1969) 20:22–26.
  • February 2017

    Total Health Magazine February 2017

    Dear Readers,

    Welcome to the February 2017 issue of TotalHealth. February is National Heart Month, there are several articles on heart health in this issue.

    In our Studies section this month we report Kyolic Aged Garlic’s Hypertension Benefits Confirmed.

    Dallas Clouatre, PhD, in "Three Pillars Of GI-Tract Health" gives us a look inside at our GI tract. He describes the workings of the this body system, what can go wrong and how we can influence the GI-track to healthy working order. You'll be impressed with how complicated the whole operation is—even without much consideration from us.

    Elson Haas, MD, presents "Self Care And Stress Reduction." Guiding us on a tour by looking at ways to protect our body and heart from the negative effects of stress and to create better health. Beginning with a self-inventory, included is an explanation of the three major areas of stress for most of us and goes on to describe seven types of stress. You'll find this educational and healthful.

    In "Sugar Addiction and Fibromyalgia," Jacob Teitelbaum MD addresses the pitfalls of sugar and its influence on all of us, our heart health and hypertension. Included are suggestions on dealing with "sugar cravings."

    Gloria Gilbère, CDP, DAHom, PhD, shares her recipe for "Salsa Jovan—Nightshade Free." She suggests using it in place of salsa and salad dressing, using it with eggs, on burritos or to accompany chips and vegetables as a dip. It is a healthy and easy to make recipe. Gilbère includes all the health benefits of the ingredients for her natural health recipes.

    Stephen T. Sinatra, MD, FAAC, presents "For A Healthier Heart, Try the Mother Earth Rx." In this article, it's explained—"a well-established, but little known scientific fact that the surface of the Earth contains a subtle, natural, negative electric charge. You may have felt it sometime when walking along the wet sand at the beach and noticed a bit of tingling or warmth in your feet. That's it. You were getting charged up by Mother Earth." Read on for the heart benefits it offers and become familiar with the Mother Earth Rx.

    In "A Healthy Heart At Any Age," Ann Louise Gittleman, PhD, CNS, tells there are over 250 risk factors for heart disease that have been identified. However, you'll be relieved to know that a large number of these factors—including many that are especially dangerous—can be lowered with lifestyle choices and changes. Covered are effects of smoking, obesity, diabetes, and a sedentary lifestyle. Your daily choices have a significant influence on your health.

    Gene Bruno, MS, MHS, RH(AHG), in "Pros and Cons of Coffee and Caffeine" includes the sources of caffeine, how much is in each source and how it can effect various health issues. He also lists contraindications for caffeine intake and reminds those who are sensitive to caffeine to forego it.

    Charles Bens, PhD, in "Lowering Blood Pressure Naturally," defines high blood pressure, lists the causes, includes prevention using nutrition, which foods to favor and which to avoid and suggestions on exercise.

    In Pet Care, Shawn Messonnier, DVM, presents Part 2 of a four part series on cancer, many pet owners are seeking this information for their pets.

    Best in health,

    TWIP The Wellness Imperative People

    Click here to read the full February issue.

    Click here to read the full February issue.

  • Natural Remedies that Help From Head to Toe

    I've been a pharmacist for 25 years now. Let's face, I know the good, the bad and the ugly drugs. I know we need some of them, and I know that others are not useful, or worse, they are harmful. So today I've decided to share the best remedies that help from head to toe:

    Headaches- Taking butterbur (Petasites hybridus) at a dose of 75mg twice daily helps reduce the frequency and intensity of migraines. You can take all the triptan drugs you want (ie Imitrex, Zomig or others) but these drugs usually just reduce pain, sometimes they abort a headache. The butterbur may slash the number of attacks in half. This is HUGE if you have to hold down a job or take care of kiddos. I discussed butterbur and dozens of other solutions my book, Headache Free.

    Hypothyroidism- It's impossible to have healthy thyroid function without selenium. Not only will it hinder your ability to make thyroid hormone, it will also stifle your ability to use the hormone inside the cell. There's more about selenium, iodine, B12 and ashwagandha at my website where I archive other articles on thyroid health.

    Heart Failure- Niacin (vitamin B3) was found to reduce heart attack and stroke risk in a 2010 study published in the Journal of Cardiovascular Pharmacology and Therapeutics. Doses vary tremendously, so please do nothing until you have your physician's approval. Niacin causes vasodilation (opens vessels) which reduces arterial pressure. I would be remiss if I didn't mention CoQ10 while discussing the heart or heart failure. CoQ10 also lowers blood pressure. I like about 100 to 200 mg daily but again, please always ask your doctor what's right for you.

    Digestive disorders- My number one go-to supplement is probiotics. These improve digestion and support a healthy immune system and mood. Digestive enzymes break down the food you eat into absorbable molecules. For heartburn, I recommend slippery elm or marshmallow root. As for nausea and vomiting, ginger tea is gentle and popular. It's a mild blood thinner though, so be careful. And finally peppermint supplements can help with irritable bowel syndrome. The value of peppermint has been discussed many times, even in the British Medical Journal in 2008.

    Bone loss- We all know about calcium. But did you know without enough magnesium, vitamin D or K2, you don't even incorporate the calcium into your bones?! So keep in mind the best bone-building supplements contain key minerals, you don't just push one like calcium all by itself. Natural strontium is another over-the-counter mineral used for bone integrity.

    Painful knees- Glucosamine sulfate promotes cartilage formation. Collagen is another supplement that reduces pain in the knee joint of osteoarthritis sufferers. A 2012 study in the Annals of Rheumatic Disease found that losing weight helped reduce the amount of cartilage loss while increasing proteoglycan content (squishiness).

    Toenail fungus- Apply essential oil of tea tree, and eliminate all sugars. You should also be checked for diabetes if you have a lot of toenail fungus.