By: Dr. Amy Whittington, Trilogy’s Naturopathic Physician

Over the years, many nutritional studies have focused on cardiovascular diseases including myocardial infarctions (heart attacks) and stroke, and rightfully so, as this disease group is responsible for much morbidity, and most mortality in this country.  As an integrative physician, my goal is to treat “the whole person,” and to elevate every patient’s nutritional status, immune function, and cardiovascular health.  Unfortunately, many times I find myself treating each component of cardiovascular risk much the way any type of physician would.  The tenets we follow are all about keeping your cardiovascular “pipes” clear, which is basically done by relaxing those pipes (aka the arteries and capillaries) by treating hypertension, decreasing the thick and fatty material (otherwise known as cholesterol) that might block those pipes, repairing any sticky sides with anti-inflammatories, and then thinning the fluid that must go through them with blood-thinners.  And so, a cardiovascular patient might leave my office with a list of supplements just as long as the medication list I would give if I were a traditional physician, including perhaps some magnesium for their hypertension, red yeast rice for their cholesterol, fish oil as an anti-inflammatory, and enzymes to thin out their blood.  Had the patient visited a more traditional physician, the same conditions would have been treated with pharmaceutical prescriptions.  This is all well and good, as we can all rest easy knowing that we are effectively decreasing the risk of a future cardiovascular event.

The question is: regardless of what type of medicine we are using, shouldn’t we go beyond the goal of decreasing future events?  Consider this: according to the CDC, one out of every six deaths is due to cardiovascular disease.  But beyond this, one out of nine death certificates lists congestive heart failure (CHF) as a contributing factor.  Heart events tend to entail myocardial infarctions and stroke, but heart failure is usually a slow,  progressive disease.  Heart failure occurs when the heart is working too hard to pump blood through the body, and as a result, it expands in size in an effort to maintain circulation.  The stretched muscles of the heart, however, usually still can’t maintain enough of an ejection fracture (the blood pushed out of the heart per beat), and eventually fluid builds up in other tissues including the lungs.  Heart failure can occur after years of elevated blood pressure because the pipes are too narrow for easy flow, or after a damaging myocardial infarction after which some of the heart tissue is no longer functional. Hypertension and myocardial infarction are two common causes of CHF.  These causes of CHF make our tenets of cardiovascular treatment that much more important, but as practitioners of all kinds, we should be asking ourselves how we can  make the heart stronger and more efficient for those with long-term dysfunction. And, if we can do this, should we not only treat the “pipes” to prevent a future event, but also feed the heart the proper nutrition to prevent any future failure?

The good news is that adding nutrients for heart health is a relatively easy and safe addition to your regime.* The biochemistry behind feeding the heart centers on increasing the production of cellular fuel through the production of a component called ATP (adenosine tri-phosphate).  ATP is a component of energy produced from oxygen, glucose, and several co-factors in a biochemical system called the Kreb’s cycle.  Any time that we are able to increase the Kreb’s cycle we can produce more cellular fuel.  Every cell in the body uses ATP, but increasing it is exceptionally good for the heart muscle because it requires so much energy to function.

You have probably heard of the primary nutrient to increase ATP, which is Coenzyme Q10 (CoQ10).  As an anti-oxidant and primary co-factor in the Kreb’s cycle, CoQ10 has been shown to decrease pulmonary edema associated with CHF by 60 percent, and improve quality of life for those with CHF by 53 percent.**  CoQ10 should be taken in the ubiquinol form, versus ubiquinone (found on the ingredient list of the bottle), and is particularly important to replace if you are using medications including statins, oral medications for diabetes, beta-blockers, or anti-depressants classified as SSRIs.  I typically prescribe 100-300mg of CoQ10 per day for anyone at increased risk for cardiovascular disease or CHF or for anyone using any of the medications listed above.

Another nutrient shown to increase energy production (and therefore improve the function of the heart muscle) is D-ribose.  A naturally occurring sugar molecule, D-ribose is used in the body as a building block for ATP.  D-ribose has been shown to increase productivity of the heart, and CHF patients report having more energy after adding this nutrient.  In addition to benefits for the heart, D-ribose has also been shown to be favorable for athletes desiring to improve energy production before workouts, and the increased energy production has been shown to decrease symptoms of fibromyalgia.

L-carnitine is an amino acid that functions to shuttle fatty components into the cell, also for use in the production of energy.  Because of its role in fat metabolism, L-carnitine has the extra benefit of promoting fat loss and lean tissue production, a physique improvement especially good for the cardiovascular system.  Taureen is a similar component that plays a protective role in the production of energy, and likewise has been shown to improve the heart function.  Both L-carnitine and taureen are generally dosed at 500-1,500mg per day.

Finally, an herb known as Hawthorne berry has been shown to be effective at improving productivity of the heart.  Nutrients used for other benefits for the “pipes” include magnesium, pomegranate, green tea, and fish oil, which also act as nutrition for the heart muscle itself.

Regardless of what type of medicine you subscribe to, it should be obvious at this point that we not only need to prevent cardiovascular events associated with disruption in blood flow, but also to improve the health of the heart muscle to prevent long-term complications that can lead to heart failure for many people.  Taking these preventive steps is relatively easy and safe, and just entails a little nutrition for the heart.

Take Care & Stay Healthy,
Dr. Amy Whittington

*Any addition to your supplement regime should be reviewed by your treating physician prior to use.  Those taking warfarin should slowly add supplements under supervision while having their INRs tested.

**References available upon request.