 |
|
|
|
|
|
Return
To Home | List
All Recommendations
Cardiomyopathy or Congestive Heart
Failure
View
Related Case Studies The heart is not a
complicated organ. It is primarily a muscle whose main job is
to pump blood throughout the body. It has its own electrical
system, which allows it to beat in an efficient manner. And
the heart’s valves keep the blood flowing in the right
direction. It’s about that simple, as long as it remains
healthy.
Though elementary in its function, this
primary muscle’s responsibility for pumping life-giving blood
to every organ in the body means it must continue beating
consistently at all times and therefore has remarkably high
energy requirements. It also needs a blood supply to provide
itself with an adequate amount of oxygen and nutrients to
perform its job. This is accomplished via the coronary
arteries.
Here we are going to discuss congestive
heart failure and cardiomyopathy, two diseases involving the
heart muscle. When the heart muscle becomes weak it is not
able to pump all the blood that it receives from the body and
the lungs. It then attempts to compensate for its weakened
state by dilating and beating faster, but blood backs up into
the lungs, filling them with fluid. Essentially the person
begins to drown. This is called congestive heart failure.
Cardiomyopathy is a more severe form of heart failure; it’s
hallmark being an uncommonly large, dilated heart.
Congestive heart failure and cardiomyopathy have
numerous causes: hypertension, coronary artery disease,
repeated or severe heart attacks, and viral infections, to
name a few. The standard medical treatment for this disease is
diuretics, digitalis, and angiotensin converting enzyme
inhibitors known more commonly as ACE inhibitors, and more
recently Beta blockers. Patients with cardiomyopathy usually
have only minimal improvement on these traditional medical
regiments. Therefore, the only option for many of these people
is to be placed on a heart transplant list.
Heart
muscle cells have a remarkably high-energy requirement.
Biochemical research in recent years has demonstrated that the
heart muscles in patients with congestive heart failure and
cardiomyopathy are deficient in a nutrient called Coenzyme
Q10. The more severe the heart failure, the more severe is the
depletion of Coenzyme Q10 (CoQ10). This has been a consistent
finding no matter what the underlying cause of the heart
failure happens to be. In fact, there is speculation among
researchers that CoQ10 deficiency may well be an underlying
cause of heart failure.
WHAT IS COENZYME
Q10?
Coenzyme Q10 (CoQ10) or ubiquinone is a
fat-soluble vitamin or vitamin-like substance that is also a
potent antioxidant. Trace amounts of CoQ10 exist in a variety
of foods such as organ meats, beef, soy oil, sardines,
mackerel, and peanuts. The body also has the ability to make
CoQ10 from the amino acid, tyrosine, but this requires a
seventeen step process needing at least eight vitamins and
several trace minerals to complete. A deficiency in any one of
these nutrients can hinder the body's natural production of
CoQ10.
Coenzymes as a group are cofactors essential for
a large number of enzymatic reactions within the body.
Coenzyme Q10 is the cofactor for at least three very important
enzymes used within the mitochondria of the cell. Remember,
the mitochondria is the battery or furnace of the cell where
the energy is produced. Mitochondrial enzymes are essential
for the production of the high-energy phosphate called
adenosine triphosphate (ATP), upon which all cellular function
depends.
COENZYME Q10 DEFICIENCY AND HEART
FAILURE
The normal blood levels of CoQ10 have been
well established by numerous investigators. Significantly
decreased amounts of CoQ10 have also been noted in several
diseases. This deficiency can be caused by: 1) poor dietary
intake 2) impairment of the body's ability to synthesize CoQ10
3) excessive utilization of CoQ10 by the body or a combination
of these factors.
Because Coenzyme Q10 has been noted
to be significantly depleted in the blood and heart muscle of
patients with heart failure, investigators in the early 1980's
began supplementing these patients with CoQ10 to test possible
improvement. These clinical trials were made possible by the
availability of pure CoQ10 in large quantities from
pharmaceutical companies in Japan and the ability to directly
measure the level of CoQ10 within the blood and
tissue.
Several clinical trials have now been done
comparing the effect of supplementing medication with CoQ10
for cardiomyopathy or congestive heart failure patients’ and
comparing them with those who took a placebo. No fewer than
nine placebo controlled clinical trials have taken place
around the world to evaluate the treatment of heart failure
with CoQ10. There have also been eight international symposia
on the biomedical and clinical aspects of CoQ10 wherein
physicians and scientists from eighteen different countries
presented over 300 papers.
The largest of these
international studies was the Italian multi-center trial by
Baggio involving 2,664 patients with heart failure. In the
United States the leading investigator has been Peter
Langsjoen, M.D. who is not only a cardiologist but also a
biochemist. He has reported several studies in the medical
literature showing the beneficial effects of CoQ10 in
cardiomyopathy.
The patients tested continued their
conventional medical treatment and CoQ10 was added to their
regime. Comparison was then made with those who either
received a placebo or conventional medical therapy. Heart
function was determined by the percent of blood that the heart
was able to pump during a contraction (ejection fraction). In
most cases, this was established by echocardiography, which is
a sound wave study of the heart.
All of these studies
have confirmed the effectiveness of Coenzyme Q10 in congestive
heart failure and cardiomyopathy along with its safety.
Clinical improvement was determined by using the New York
Heart Association classification (NYHA) for functional
capacity. The function of the heart showed gradual and
sustained improvement in the muscle contraction as noted by
improved ejection fraction, heart wall motion, and heart size.
The overwhelming majority of these patients showed improvement
in their symptoms of fatigue, chest pain, shortness of breath,
exercise ability, and palpitations. The improvement in some
patients was dramatic, with the heart size and heart function
returning to normal.
The patients who started CoQ10 in
supplementation shortly after developing their disease seemed
to have the most dramatic improvement. For those who had
suffered with their heart disease for a longer time improved
but usually not to the same degree. In marked contrast,
individuals with the worse heart failure actually had the
greatest percentage of improvement. These amazing results were
coupled with the fact that the CoQ10 did not create any
serious side-effects even at the highest doses. An eight-year
follow up study has shown that improvements were sustained as
long as the patients continued taking
CoQ10.
Approximately 20,000 patients under the age of
65 are eligible for a heart transplant that will cost in the
area of $250,000 to $400,000. Thousands more patients over 65
have cardiomyopathy but are ineligible for a heart transplant
due to their age. They are receiving maximal medical treatment
but most are still totally disabled. Only one in ten who are
eligible for a heart transplant will actually receive one; the
other nine will most likely die from their disease. These
numbers don’t include the hundreds of thousands of patients
who suffer from congestive heart failure who are not able to
function normally because of their disease, but whose
conditions are not severe enough to be placed on a heart
transplant list.
Dr. Folkers and Peter Langsjoen, M.D.
reported a study in the medical literature in 1992 that I
believe brings all of this to an obvious conclusion. They
placed eleven exemplary transplant candidates on Coenzyme Q10.
All patients improved remarkably and would have all been taken
off the heart transplant list. Folkers and Langsjoen concluded
that with these case histories and the substantial clinical
trials already reported in the medical literature show proof
that all patients with end stage heart failure awaiting
transplantation should receive CoQ10.
CoQ10 is a prime
example of a natural vitamin/antioxidant shown in several
clinical trials to be effective and safe. This is nutritional
medicine at its core. When the heart muscle is weakened, for
whatever reason, it places an increased demand on the
nutrients needed by the heart cells in order to create energy.
Because of excessive utilization of these nutrients, the heart
muscle eventually becomes depleted of CoQ10, which is the most
important nutrient needed to create energy. When patients take
this nutrient as a supplement, the weakened heart muscle is
able to replenish its stores of CoQ10, generate more energy,
and compensate for its weakened state.
A note of
caution: Doctors should use CoQ10 in support of traditional
medical treatment, not in place of it. This is complementary
medicine, not alternative medicine. Although in many studies
patients improved so much they were able to stop taking
several of their medications, they were nevertheless not cured
of their underlying disease.
It is important to also
note that patients should continue taking supplemental CoQ10
long term. Clinical studies report that when patients
discontinue using supplemental CoQ10, the needed fuel source
becomes depleted again and heart function slowly decreases
back to its previous poor level. On the other hand, Dr.
Langsjoen reported after a six-year follow-up study of
patients, those who maintained their supplemental dosage
maintained their heart function improvement.
WHY
AREN'T PHYSICIANS RECOMMENDING COENZYME Q10?
Here
we have a life-threatening disease for which traditional
medical therapy offers little hope for improvement. The cost
of taking CoQ10 in supplementation is approximately two to
three dollars a day. That is substantially less than a
$250,000 to $400,000 heart transplant for which most of these
patients are waiting! Furthermore, the use of CoQ10 has never
shown any side effects or problems and most of the studies
show marked improvement within four months. So why don’t
physicians recommend a trial of CoQ10 to their cardiomyopathy
patients?
I have never heard a discussion of the use of
CoQ10 at any medical meeting or with any cardiologist. And
I’ve never heard of a cardiologist placing any of my patients
with congestive heart failure or cardiomyopathy on CoQ10.
After reviewing these studies, I too am amazed at the
unwillingness of the medical profession to offer this option
to patients. It is not as if they have good alternative
therapy. (I don’t consider a heart transplant as a great
option even if you are able to get one).
The National
Institute of Health has funded most of the studies involving
CoQ10 in the United States. But unlike the plethora of
synthetic drugs, Coenzyme Q10 is a natural product. As such,
it cannot be patented through the FDA. Pharmaceutical
companies are not going to spend the hundreds of millions of
dollars required to get a drug or natural product approved by
the FDA if there is little economic incentive. Why don’t
doctors recommend CoQ10? Pharmaceutical reps are not
presenting it to them--there is simply no money in
it.
Physicians must become the patient's advocate. I
cannot emphasize a basic principle here too much: when we
support the natural functioning of the body and try to elevate
this function to its optimal level, then and only then have we
done everything possible to promote healing. The lives of
several of my patients give testimony to this. After following
the recommendation below, they too have been removed from the
heart transplant list. Your doctor won’t recommend it, so you
must be especially assertive in obtaining CoQ10 for treatment.
Below you will find guidelines to help you.
Nutritional Supplement Recommendations
I recommend that all my patients take the basic nutritional
support I refer to as cellular
nutrition. This foundational regime provides all the
necessary micronutrients to the cell at ideal levels (not RDA
levels) for significant health benefits as documented in the
medical literature. When the cell is given maximum support, it
can then determine what it does and does not need. Over a
six-month period each cell is able to not only overcome
nutritional deficiencies but also to optimize
ALL the nutrients, which are needed to combat oxidative
stress.
The synergistic affect of providing all the nutrients
needed by one’s body at the most advantageous levels results
in optimizing and rebuilding the body’s natural immune system,
antioxidant, and repair systems back to their fullest fighting
potential against disease.
Minimal support for Cellular
Nutrition:
My minimal recommendation for creating cellular
nutrition is to simply take Usana’s Mega Antioxidant and
Chelated Minerals, called "The Essentials" at their
recommended doses (3 of each daily). The Essentials offers the
cell ALL of the antioxidants, B-cofactors, and antioxidant
minerals needed by the cell at ideal levels. In order to
achieve the best results, I recommend taking 1 Mega
Antioxidant and 1 Chelated Mineral with each meal.
Nutritionals should always be taken with food because of
better absorption and better tolerance. However, as a
physician, I realize that compliance with taking supplements
three times a day is a major issue. Therefore, if you tend to
frequently forget the lunchtime dose, I suggest taking the
supplements twice daily: taking 2 Mega Antioxidants and 1
Chelated Mineral in the morning with breakfast and 1 Mega
Antioxidant and 2 Chelated Minerals in the evening with the
evening meal.
Optimal support for Cellular
Nutrition:
For the most favorable results for basic cellular
nutrition, I also recommend adding to the Usana Essentials
either OptOmega (2 tsps daily) or BiOmega-3 (4 capsules
daily), which provides the essential fats and Fibergy, which
assures the individual is receiving the additional fiber his
or her body needs. I also recommend adding Active Calcium (4
tablets daily) to provide additional calcium, magnesium, and
vitamin D that our bodies need. These recommendations provide
all the nutrients at their ideal levels creating the cellular
nutrition I recommend in my book, What Your Doctor Doesn’t
Know About Nutritional Medicine May Be Killing You.
Optimizers
It is critical that you know the necessity of adding
optimizers to your foundational cellular nutrition for optimal
results. Patients who are suffering from a chronic
degenerative disease or illness are under more oxidative
stress than the average healthy individual. Therefore, adding
potent Optimizers to the basic cellular nutrition offers you
the best chance to bring this oxidative stress back under
control. The synergy and increased potency created by this
approach to nutritional medicine is why I’m able to get such
consistent results in my patients.
However, to suit each individual’s unique needs, I always
offer both an optimal and a minimal plan for cellular
nutrition and for adding Optimizers. Obviously, one’s
improvement will be quicker and more consistent with the
optimal recommendations; however, a minimal regime can still
produce significant clinical results.
Recommended Optimizers:
Optimal:
- Proflavanol 90*--2 tablets daily
- Coquinone 30—6 capsules daily
- Additional Magnesium in the form of Active Calcium—6
tablets daily
Minimal:
- Coquinone 30—4 capsules daily
*Proflavanol 90 is equal to 3 Proflavanol
C
Optimal Recommendations
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Active
Calcium |
2 |
2 |
2 |
| Proflavanol
90 |
1 |
|
1 |
| Coquinone
30 |
2 |
2 |
2 |
| Optomega |
2
tsps. |
|
|
| Biomega-3 (an
option instead of Optomega) |
1 |
|
1 |
*Adding at least one serving of
Fibergy daily will enhance these
recommendations.
Minimal Recommendation
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Coquinone
30 |
2 |
1 |
1 |
If you are frequently going to miss taking your lunchtime
dose, it is better to simply take your nutritionals twice
daily. I recommend taking 2 Mega Antioxidants, 1 Chelated
Mineral in the morning with breakfast and then taking 1 Mega
Antioxidant, 2 Chelated Minerals in the evening. You should
try to divide up your Active Calcium, essential fats, and
Optimizers equally as possible between the AM and PM
dose.
Consider a Power Shake
USANA has a fantastic line of nutritionally balanced drinks
that many of my patients consume as a meal substitute. In
fact, I personally start every morning with 2 scoops of
Fibergy, 2 scoops of Soyomax, and 2 teaspoonfuls of OptOmega.
This provides me with a perfect, balanced, unpolluted meal to
start my day. It allows me the opportunity to supplement my
diet with soy protein; extra needed fiber, and essential fat.
This meal is also a low-glycemic meal, which will not spike my
blood sugar. Likewise, many USANA associates are using their
imaginations to create exceptionally tasting meals with
Fibergy and OptOmega. By blending in frozen, whole fruit for
added flavor they are creating a variety of great tasting
drinks.
Isn’t it remarkable that by simply taking USANA Essentials,
Active Calcium and a power drink (remember, to consider this
part of your food budget, since it is replacing an entire
meal), the body is supplied with complete, and balanced cellular
nutrition for every cell in the body? The synergy that is
created, especially when adding needed Optimizers is
phenomenal. Remember, the underlying problem is oxidative
stress NOT a nutritional deficiency.
Why I recommend USANA Products
USANA strictly follows pharmaceutical-grade Good
Manufacturing Practices (GMP). This means they not only
purchase pharmaceutical-grade raw products, but also
manufacture the products according to tough
pharmaceutical-quality guidelines. In addition, USANA Health
Sciences follows USP guidelines for potency, uniformity, and
dissolution of the tablet. In a nutshell, USANA manufactures
their products to the strict standards of over-the-counter
drugs even though not required to do so—assuring all of their
customers and associates that what is on the label is actually
in the tablet.
Usana's essentials are complete and balanced and provides
the cellular nutrition that I strongly recommend in my book,
What Your Doctor Doesn't Know About Nutritional Medicine May
Be Killing You. This improves compliance and makes taking
these advanced levels of nutritional supplements
easier.
Starting Your USANA Nutritional Program
Over eighty percent of my patients are able to start the
USANA Nutritional Program with absolutely no set backs while
beginning to experience the health benefits of high-quality
nutritional supplements immediately. Please keep in mind these
supplements are extremely potent and optimal levels of
nutrients are being provided that the body has never had
before. The body is therefore able to finally rid itself of
toxins, which have been accumulating for years (called
detoxification). This is especially true in those who are
suffering from a serious illness and are taking a significant
amount of medication. It is important to understand the
possible signs and symptoms of detoxification so that you can
deal with them confidently and properly.
Detoxification:
The most common detoxification reaction is muscle aches
and/or mild headache. These symptoms will usually pass within
a few weeks. If the discomfort is not unbearable, I simply
have my patients continue their program as I have prescribed.
However, occasionally there is a more severe reaction. The
patient is not in danger, rather, the amounts of nutrients are
just too much too fast. In this case, I have my patients quit
their supplements for a few days until the reaction subsides.
I will then have them start back on their program but
initially at lower doses (approximately one third of the
recommended dose). Once they are tolerating this amount of
supplementation, I suggest slowly building up to the
recommended doses.
Some of my patients actually develop a "detox" skin rash
somewhere on their body. As you know, the skin is an important
route for ridding the body’s toxins. This rash is a dry, red
rash that looks almost like a mild sunburn. Some people
confuse this with an allergic reaction to the supplements.
This is not typically so. I have never seen an allergic
reaction to the USANA Essentials and can only recall a couple
of patients who reacted to Proflavanol because they were
actually allergic to grapes.
Patients may also experience some aspect of loose stools or
even diarrhea. This again is a common "detox" reaction because
the GI tract is another prime route for eliminating toxins
from the body. This symptom will usually diminish within a
couple of weeks. It is an important part of the detoxification
and healing process. Therefore, I usually encourage my
patients to continue the supplements as recommended unless
their bottom gets too sore. I will then again recommend lower
doses of the supplements until they feel better and then begin
adding the supplements back more slowly until the recommended
doses are reached. Diarrhea can be the result of the magnesium
in the Active Calcium or by the Proflavanol. Again, this is
usually a mild reaction and will improve over the first week
or two. However, some of my patients need to discontinue the
Active Calcium and/or the Proflavanol until this settles down.
I then have them slowly add back the Proflavanol and
eventually the Active Calcium.
Increasing dietary fiber may also increase the amount of
intestinal gas and the frequency of bowel movements. This will
improve with time as the body adjusts to the higher intake of
fiber, but is an important aspect of getting rid of the
toxins, which have accumulated in the body.
Natural Relaxation Response:
A small percentage of patients develop a natural relaxation
response when minerals are absorbed into their body. This is
of great concern to those patients who have just been told
that nutritional supplementation will help improve their
energy level. They take the supplements as recommended only to
find themselves more fatigued and dragging themselves through
their day. If you experience this response, I recommend that
you take all of your minerals (including the Active Calcium)
with a light bedtime snack. This allows you to take advantage
of your body’s response while getting a good night’s
sleep.
Stomach Upset:
A small percentage of patients have difficulty tolerating
vitamin C. It can cause an upset stomach that will usually
become evident a couple days after starting their nutritional
program. With USANA’s specially combined vitamin C into Poly
C, I have seen many of people who could not previously
tolerate any nutritional supplements do very well with USANA’s
Mega Antioxidant. However, if nausea is experienced, I suggest
taking one Mega Antioxidant with the largest meal. Once this
level of supplementation is better tolerated, I suggest slowly
adding another Mega Antioxidant to the next largest meal. I
anticipate building them up to the recommended level of
supplementation, but sometimes this is just not possible. For
those extremely sensitive, I advise using Body Rox (the
teenage dose of Antioxidants and Minerals) as the best
alternative option.
Taking Your Supplements with Your Medication
I am often asked, "Can I take my nutritionals with my
medication?" To this I respond with this question, "Can you
eat?" I hope my point is made gently but clearly—nutritional
supplements simply contain nutrients we should be getting from
our foods, but at levels we can no longer obtain from our
foods. If you can eat anything, you can also take nutritional
supplements. The only exception to this is for those taking
the medication, Coumadin (Warfarin), which blocks vitamin K in
the body as a way of thinning the blood. If a patient is on
Coumadin, I recommend he or she take the Canadian Essentials
and Canadian Active Calcium because they contain no vitamin K.
Also, patients who are on thyroid medication should take their
medication on an empty stomach at least 1 hour prior to meals
or prior to taking supplements. Thyroid medication should not
be taken with food or with supplements because calcium can
block the absorption of the medication.
Disclaimer
Every effort has been made to make this web site as
accurate as possible. The purpose of this site is to educate
and inform. As such it is based on scientific evidence and my
clinical training and experience. No individual should at any
time use the information found on this web site for
self-diagnosis, treatment, or justification in accepting or
declining any medical therapy for any health problems or
diseases. Any application of the advice herein is at the
reader’s own discretion and risk. Therefore, any individual
who has a specific health problem or is taking medications
must first seek advice from his or her personal physician or
healthcare provider before starting a nutritional supplement
program. Dr. Strand shall have neither liability nor
responsibility to any person or entity with respect to loss,
damage, or injury caused or alleged to be caused directly or
indirectly by the information contained in this web site. We
assume no responsibility for errors, inaccuracies, omissions,
or any inconsistency herein. Any slights of people, places, or
organizations are unintentional.
Return
To Home | List
All
Recommendations |
|
|
|
© 1999, 2000, 2001,
2002, 2003, 2004 Ray D Strand, M.D. P.C.
| | |