Life Extension Magazine December 2003
Life Extension Magazine December 2003
Natural Approaches In the Treatment of Congestive Heart Failure
Most patients with CHF symptoms have been shown to be significantly malnourished. Specific deficiencies that have been found in the failing myocardium include: a reduction in L-carnitine, CoQ10, creatine, and thiamine, which are important nutrient cofactors for myocardial energy production; a relative deficiency of taurine, an amino acid integral to intracellular calcium homeostasis; and increased myocardial oxidative stress with a reduction of antioxidant defenses. Deficiencies of carnitine or taurine result in dilated cardiomyopathy in animals and humans. Each of these deficiencies can be corrected through dietary supplementation. A comprehensive restoration of adequate myocyte nutrition is critical to any therapeutic strategy designed to benefit patients suffering from CHF.15,16 Supplementation that results in higher myocardial levels of CoQ10, taurine, and carnitine levels is associated with a reduction in left ventricular end-diastolic volume in patients with left ventricular dysfunction.17
Supplements for Cardiovascular Health
While the optimal dose of CoQ10 for treating CHF has not been defined, studies have utilized dosages ranging from 30 to 600 mg daily, and most practitioners prescribe 100-300 mg daily.
Carnitine Another vitamin-like substance, carnitine, is essential in the transport of fatty acids into the myocardium and mitochondria for energy production. Carnitine appears to have beneficial effects on CHF.36 If the heart does not have a good oxygen supply, then carnitine levels decline quickly. Several double-blind clinical studies have shown that carnitine improves cardiac function in CHF patients.37-39 The longer carnitine was used, the more dramatic the improvement. After six months of use, patients’ ejection fraction increased by 12.1% and 13.6%, respectively.38,39 Chronic administration of carnitine has been shown to improve ventricular function, reduce systemic vascular resistance, and increase exercise tolerance.38,40 The dosage used in most studies is 1-3 grams daily.
Taurine The amino acid taurine is an important nutrient found in very high concentrations in excitable tissue. Its lack in heart muscle cells is a particularly frequent cause of heart failure. Generally, CHF responds favorably to taurine therapy. In double-blind studies, taurine supplementation has been shown to reduce signs and symptoms of CHF.41,42 Taurine promotes natriuresis (sodium excretion) and diuresis (urine excretion), and minimizes many of the adverse actions of angiotensin II, including the induction of cardiac hypertrophy, volume overload, and myocardial remodeling. Since ACE inhibitors are the mainstay treatment for CHF, taurine supplementation is extremely important.43 The recommended dosage is 2-3 grams daily.
Hawthorn (or its related species) Herbs in the hawthorn family have been used in the treatment of cardiovascular diseases.44 Clinical studies have found that standardized extracts of these herbs show promise as supplementary agents for the treatment of left ventricular dysfunction.45-48 Other trials consistently demonstrate hawthorn’s ability to improve exercise tolerance as well as symptoms associated with mild to moderate CHF.49,50 Its effectiveness has been demonstrated repeatedly in double-blind studies.45,47,51 Hawthorn extract shows some beneficial effects in animal and human studies, including enhanced heart pumping efficiency (improved contractility), ACE inhibition, antidysrhythmic effects, and mild reduction in systemic vascular resistance.49,52,53
The recommended daily dose ranges from 160 to 900 mg.
Magnesium Magnesium plays an important role in the functioning of the cardiovascular system. A decrease in magnesium has been linked with tachydysrhythmias (fast, irregular heartbeats) and increased mortality in CHF patients.54 The research shows that use of magnesium supplements in these situations may be beneficial for treating and preventing life-threatening conditions. Magnesium supplements can be administered safely either orally or by injection depending on the situation.55,56 In one study, patients with severe CHF took a supplement of 300 mg of oral magnesium citrate daily for 30 days. In some of these patients, oral magnesium supplementation was effective in achieving substantial increments in intracellular magnesium.55
Alpha Lipoic Acid Scientists at The Linus Pauling Institute measured DNA damage in rat hearts and found that old hearts produce three times more free radicals than young hearts. The scientists then gave old rats alpha lipoic acid for just two weeks before their death. Necropsy findings showed that heart muscle cells from these old rats given alpha lipoic acid did not differ from those of un-supplemented young rat hearts. The scientists concluded their study report by stating that “the aging rat heart is under increased mitochondrial-induced oxidative stress, which is significantly attenuated by lipoic acid supplementation.”
Since oxidative stress plays a role in the development and progression of CHF, it would appear prudent for CHF patients to supplement with at least 250 mg of alpha lipoic acid each day.57
Neuroendocrine function has a very close relationship with metabolism and is usually abnormal in CHF patients.60 Several studies show these patients have relatively low levels of DHEA, testosterone, estrogen, and IGF-1.61-66