Last blog I discussed the topic of “congestive heart failure” or CHF which is not actually a specific diagnosis, but a disease state when the heart is no longer able to pump normally and /or fill adequately to supply blood and nutrients throughout the entire body. CHF is the most common cause of hospitalization in those over the age of seventy. The pharmaceutical approach is the standard therapy and indeed there are many classes of drugs that are useful in treating heart failure. However, this approach treats the symptoms and ignores the fact that a failing heart is a usually a nutritionally starved organ. As a result, the heart, which works 24/7, is no longer able to generate an adequate amount of energy. Fortunately, there are various supplements or neutraceuticals available to fill this gap.

I previously mentioned what is commonly referred to as the “awesome foursome” a term so coined by my mentor and friend Stephen Sinatra, MD, a well known integrative cardiologist on the East coast. These four nutritional supplements can treat the gamut of heart disease, from coronary disease to heart failure. Each of these naturally occurring supplements work in the mitochondria of the heart cell, sometimes referred to as the energy powerhouses of the cell. Here lies the difference between the medications commonly prescribed and such supplements. Drugs treat symptoms. They are mandatory in most cases of heart failure. They remove excess fluid and decrease the stress load on the heart, but they do not provide any nutritional support or energy boost. By supplying nutrients to the mitochondria of the heart cell, energy in the form of ATP can be produced. 

CO-ENZYME Q 10
This is like a vitamin which is produced within the body, but the production declines with age and with heart disease. A diseased heart lacks adequate amounts of CoQ10 which results in impaired energy production. CoQ10 production is also suppressed by commonly used drugs such as statins and beta blockers. CoQ10 is a co-factor and plays an important role in what’s called the electron transport chain within the mitochondria. This chain is vital for the production of ATP, an immediate source of energy. The nutrient also doubles as a free radical scavenger, which is extremely important when you consider the fact that ATP or energy production generates a significant amount of free radicals which, if left unchecked, could lead to chronic inflammation and premature aging. So CoQ10 is important in protecting against oxidative stress caused by too many free radicals and inflammatory damage.

L-CARNITINE
L-carnitine is an amino-acid–like compound, a break-down product of protein, found primarily in meat, especially lamb. The body can also make it. It is an important transport compound, and it carries fatty acids within the cell to the mitochondria. This transport allows energy in the form of ATP to be produced. This function is vital since the heart obtains 60 per cent of its fuel from fat. Equally important, this compound carries out wastes from the mitochondria. A diseased heart needs all the energy boosting possible. Supplementing with L-carnitine can make a significant difference for patients suffering from heart disease.

D-RIBOSE
This compound is a simple sugar and serves as the energy substrate for not only the heart cell, but for every cell in the body. You may have an ample supply of CoQ10 and L-carnitine, but without this major building block for ATP production, energy repletion in diseased hearts will always be impaired. Unlike sucrose (table sugar) or glucose which are 6-carbon sugars, d-ribose is a 5-carbon sugar which the body processes differently. In most cases this compound can be safely taken by diabetics without upsetting their glucose metabolism.

MAGNESIUM
More than half of all Americans may be deficient in magnesium, a critical mineral. Most patients with heart disease are depleted, especially diabetics and postmenopausal women. Magnesium plays an important role in more than three hundred enzymatic reactions in the body, including the generation of cellular energy and muscle relaxation. It is important to remember that as we age our hearts get stiffer and this impairment of muscle relaxation can lead to inadequate filling of the heart. Inadequate cardiac filling, even in the face of normal pumping action can still lead to heart failure. Magnesium can play an important role here. There are many other vital functions for this magnesium as well, both cardiac and extra-cardiac.

*********************************************************************************

There is a role for other supplements with regard to the cardiovascular system, but these four are extremely useful in energy production for diseased hearts. It is important to remember that these do not replace pharmaceutical products of known efficacy. However when appropriately supplemented along with a healthy diet, they may make a major difference in cellular energy while improving quality of life in those suffering from heart failure.

Dr. Elkin is a board-certified internist, cardiologist and anti-aging medical specialist.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements.
©Howard Elkin MD FACC, 2012

*Originally posted Friday, December 9, 2011