Congestive Heart Failure

Congestive Heart Failure

Congestive Heart
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Caution: A number of readers have written to tell me that they feel that this page is discouraging. Read it carefully and you will see that there are many positive alternatives for persons dealing with CHF to consider. However, congestive heart failure is a serious problem and this website does not take any disease lightly.

In an average lifetime, your heart will beat two and a half BILLION times.

Congestive heart failure (CHF) is the end product of any of a number of cardiovascular diseases that can degrade the heart’s ability to pump blood efficiently. Much has been written on diagnosing congestive heart failure but rather less is known about treating it. This is because broken hearts are tough to fix. A diagnosis of CHF means that it is too late for nutritional prevention. The horse is long gone by the time many people decide to shut the stable door. But nutritional intervention can still greatly help even a damaged heart.

In the past, drugs such as digitalis or one of its ilk were often given to strengthen and to some extent regulate heartbeat. Vasodilators (blood vessel opening drugs) are given to improve cardiac output and relieve backed-up blood from blood vessels throughout the body, especially in the lungs. Fluid buildup (edema) is commonly treated with diuretic drugs.

It may be possible to naturally augment, or perhaps substitute for, these pharmaceutical drugs.

Vitamin E
One of the body’s most powerful defenses against free radical damage is the antioxidant vitamin E. The natural form, d-alpha tocopherol, can also be cautiously used to strengthen and regulate heartbeat. An initial dose of vitamin E would be only about 50 International Units (I.U.) daily. This is roughly equivalent to 35 milligrams (mg). To avoid any possible issues, patients with congestive heart failure need to start small with vitamin E. Doses may be gradually increased under medical supervision. For additional information, it is most worthwhile read any books by Drs. Wilfrid or Evan Shute
( http://www.doctoryourself.com/biblio_shute.html ). If their books are hard to find, try an interlibrary loan at any public library.

Thiamin
Some congestive heart failure is actually caused by thiamin (vitamin B-1) deficiency. 25 to 50 mg with each meal might be worth a therapeutic trial. I think a thiamin-containing 50 mg "balanced B-complex" tablet each meal would be even better.

Common Sense
If overweight, lose it. No smoking. No kidding.

Herbal Diuretics
It may be possible to use herbal medicines to reduce swelling due to retained fluids. There are no fewer than 180 herbs with diuretic properties listed just on pages 53-54 of John Lust’s The Herb Book. (NY:Bantam. 1974. ISBN 0-553-13082-X). I am not suggesting that you take 180 herbs. I am suggesting that you read up on your options before committing yourself only to drugs.

Selenium
Selenium deficiency can cause a congestive heart disease called Keshan disease. 100 to 300 micrograms (mcg) of selenium daily would insure against this. In addition, selenium works to help your body recharge and efficiently reuse its vitamin E.

Magnesium
The role of magnesium in normal heart function is tremendous. Profound magnesium deficiency causes muscles to underfunction, malfunction or not function at all. Several hundred of your body’s most important biochemical reactions depend on this mineral. "The synthesis of all proteins, vital cell nuclear materials such as nucleic acids and nucleotides, lipids, and carbohydrates require ionized magnesium (Mg ++)." (Williams, SR Nutrition and Diet Therapy, Seventh Ed, St. Louis: Mosby, 1993, pp 230-233) Even most, ah, "healthy" adults fail to get the US RDA of magnesium, which ranges from 280 to 400 mg for adults. These figures are elemental weights: just the corn, not the can. Most magnesium supplements are compounds of magnesium with something else. The weight of the "something else" is often obscured in dosage recommendations. That is why Melvyn Werbach, M.D. cites studies that advocate daily dosages of 2,000 mg of magnesium per day for CHF. (Textbook of Nutritional Medicine. Tarzana, CA:Third Line Press, 1999, pp 273 and 275.) The elemental quantity is significantly lower than that. Green vegetables and whole grains contain quite a bit of magnesium. Pinto beans, almonds, and especially figs are oustanding food sources. And you’ll like this: another good source of magnesium is dark chocolate. One square provides 95 milligrams. If four squares of dark chocolate provide the RDA of magnesium, there is no excuse for Mg deficiency in the USA.

On the other hand, "Half to three-quarters of adults in the United Kingdom are consuming less than the RDA of Magnesium." (Food Standards Agency: The National Diet and Nutrition Survey: Adults Aged 19 to 64 Years, Vol 3. London: The Stationery Office, 2003.) Somebody tell Cadbury's, and fast.

Magnesium citrate supplemets are inexpensive and readily available. Magnesium chloride, magnesium gluconate, and several other forms are also good. The cheapest, most widely found, and worst supplemental form of magnesium is magnesium oxide. Magnesium oxide is poorly absorbed, perhaps only a bit more than 5% or so. Of all the oral supplements, magnesium aspartate or magnesium orotate may have the best chance of getting into cardiac muscle cells. These forms of magnesium are rarely found on store shelves. Your doctor may be able to have them compounded for you by a cooperative pharmacist, or you might find them with an internet search. Intravenous administration of magnesium may be necessary in more serious cases of congestive heart failure. Have a test ordered to check serum magnesium. Most doctors don’t. It is even better to check myocardial magnesium (Textbook, p 275). This is because the amount of magnesium in the heart muscle cells may be considerably lower than in the blood.

A great deal of information about magnesium will be found at
http://www.mgwater.com and in the work of Dr. Hans Nieper, M.D.
(listed at http://www.doctoryourself.com/biblio_nieper.html ).

Potassium
Potassium deficiency is associated with congestive heart failure, and is connected with magnesium deficiency, mentioned above. Low potassium can cause erratic heartbeat (heart arrhythmia). A non-technical way of increasing dietary potassium is to eat lots of easy to digest fruits, and juiced vegetables. They are loaded with potassium. Nuts, whole grains and legumes (beans) are good, too. 4 ounces of almonds contains a whopping 800 mg. Brazil nuts have almost as much.

Co-Enzyme Q10. This is very important.
One of the best things about Co-Enzyme Q 10 is that it is harmless, having no negative side effects or contraindications of any kind. No physician or hospital can make a case against taking it. The down side is that it is pricey. But then, so are heart transplants. Clinical studies and patient reports that show success with Co Q 10 usually use somewhere around 400 mg a day, divided into several doses. I personally would favor 600 mg/day, in three 200 mg doses. 35 or 50 mg/day simply will not work.

"I have had patients with such severe CHF that they were waiting for a heart transplant. After taking CoQ10, they no longer needed a transplant." Jullian Whitaker, M.D. (Health & Healing, December 1997).

If there is higher praise than this, I have not yet seen it.

Amino Acids
As a rule, I am in favor of getting amino acids from protein foods in ones diet. With really sick people, a case can be made for amino acid supplementation. In Werbach's Textbook of Nutritional Medicine, the case is indeed well made.

Dr. Werbach recommends L-Arginine at a daily dose somewhere between 5,600 and 12,600 mg because it "causes peripheral vasodilation and improves cardiac output." (p 273). The benefit to patients was an increase in "the distance they could walk in 6 minutes, and the rate of blood flow during exercise." Arginine is normally considered by dieticians to be a "semiessential" amino acid, necessary only for growth. It is possible that growth includes regrowth, strengthening, and repair of cardiac muscle. Eggs, cheese, whole grains, and legumes (beans) are good food sources. Peanuts are absolutely loaded with arginine, containing three times as much as meat does. You’d need to consume roughly a twelve-ounce can of peanuts a day to get in the middle of the dose mentioned above. Chew nuts well for best absorption. That, or consider supplements. Or do both.

Taurine is an amino acid normally made in your body from another amino acid, methionine. Methionine is found in eggs, cheese, beans, nuts, and whole grains. Brazil nuts have over twice as much methionine as meat, ounce for ounce. Extreme stresses to the body (hospital food, perhaps?) can cause taurine deficiency. (Desai TK et al. Taurine deficiency after intensive chemotherapy and/or radiation. American Journal of Clinical Nutrition. 55:708, 1991.) Taurine appears to help regulate heartbeat. Dr. Werbach mentions a doseage of 4,000 to 6,000 mg/day.

The amino acid L-Carnitine is also made in your body IF (and, to quote Ed Sullivan, this is a "really big" IF) you consume plenty of methionine, lysine, vitamin B-6 (pyridoxine), niacin, and vitamin C. (Iron is also necessary; adult men do not need to seek after iron.) Most people, especially the elderly with chronic illness, do not get nearly enough of those three vitamins. This study recommends 2,000 mg of L-carnitine daily, specifically for CHF: Ghidini O, Azzurro M, Vita A, Sartori G. (1988) Evaluation of the therapeutic efficacy of L-carnitine in congestive heart failure. International Journal of Clinical Pharmacology, Therapy and Toxicology 26: 217-220.

Large amounts of supplemental Creatine, still another amino acid that your body normally produces, may help strengthen heartbeat. As creatine phosphate, it is involved in supplying energy to power muscle tissue, especially cardiac muscle. Dr.Werbach cites studies that indicate that persons with CHF have a deficiency of creatine in the heart muscle itself, and that daily doses of 20,000 mg/day "improve cardiac function… physical strength and endurance." (Textbook of Nutritional Medicine, p 276)

All quantities mentioned above should be divided up into several smaller doses throughout the day. I would add vitamin C, about 4,000 to 10,000/day (or to bowel tolerance) both because of its antioxidant properties and also because of its role in amino acid synthesis. I also would add zinc 50 mg/day of the chelated, gluconate or citrate form. I suspect that since the heart prefers fatty acids for fuel, a long-standing deficiency of essential fatty acids causes deterioration of heart muscle. Lecithin, nuts, fish, and various natural oils are sources of essential fatty acids. http://www.doctoryourself.com/lecithin.html

If these natural options do not speak strongly enough to you, bear in mind that

1) There is no drug cure for congestive heart failure; and

2) The pharmaceutical drugs given in an attempt to cope with the condition have many side effects; and

3) The excerpt (below) from an article by the US National Institutes of Health is admittedly quite depressing. When you’ve finished reading it, I recommend that you then read this entire webpage again, from the top.

National Heart, Lung, and Blood Institute
National Institutes of Health Data Fact Sheet:
Congestive Heart Failure in the United States: A New Epidemic

An estimated 4.8 million Americans have congestive heart failure (CHF). Each year, there are an estimated 400,000 new cases.

CHF is the… most common diagnosis in hospital patients age 65 years and older. In that age group, one fifth of all hospitalizations have a primary or secondary diagnosis of heart failure.

Incidence of CHF is equally frequent in men and women, and annual incidence approaches 10 per 1,000 population after 65 years of age. Incidence is twice as common in persons with hypertension compared with normotensive persons and five times greater in persons who have had a heart attack compared to persons who have not…

Survival following diagnosis of congestive heart failure is worse in men than women, but even in women, only about 20 percent survive much longer than 8 to 12 years. The outlook is not much better than for most forms of cancer. The fatality rate for CHF is high, with one in five persons dying within 1 year… CHF remains a highly lethal condition. With the use of angiotensin-converting enzyme (ACE) inhibitors as a possible exception, advances in the treatment of hypertension, myocardial ischemia, and valvular heart disease have not resulted in substantial improvements in survival once CHF ensues.

The death rate for congestive heart failure increased most years between 1968 and 1993. These increases are in contrast to mortality declines for most heart and blood vessel diseases. In 1993, there were 42,000 deaths where CHF was identified as the primary cause of death and another 219,000 deaths where it was listed as a secondary cause on the death certificate. The death rate for CHF in 1993 was nearly 1.5 times higher in black men and women than in white men and women).

(An ideal) drug (to cure CHF) might improve the heart's pumping ability, open clogged arteries, and prevent tissue damage from free radicals, a byproduct of the body's metabolic processes. Free radicals are thought to contribute to the development of atherosclerosis.)

(end of NIH excerpt)

Given this, it can be all the more clearly seen why people really need to investigate natural treatments for congestive heart failure. Typically, doctors offer patients very little reason to believe that there are serious options for dealing with CHF.

But there are alternatives, and they are well worth your serious consideration. Now back to the top of the page?

Andrew Saul is the author of the books FIRE YOUR DOCTOR! How to be Independently Healthy (reader reviews at http://www.doctoryourself.com/review.html ) and DOCTOR YOURSELF: Natural Healing that Works. (reviewed at http://www.doctoryourself.com/saulbooks.html )

Andrew W. Saul

AN IMPORTANT NOTE: This page is not in any way offered as prescription, diagnosis nor treatment for any disease, illness, infirmity or physical condition. Any form of self-treatment or alternative health program necessarily must involve an individual's acceptance of some risk, and no one should assume otherwise. Persons needing medical care should obtain it from a physician. Consult your doctor before making any health decision.

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