Treatment of Heart Disease
use of nutritional supplements in the treatment as well as prevention
of disease is clearly the future of medicine. Nutrition is currently
going through a renaissance, and the prospects for alleviating
suffering and improving the quality of life are very real, and have
generated an excitement heretofore unknown. It's not just in the
laboratories; clinicians are finding that nutrient and herbal
supplements are indeed quite effective if, and only if, the proper
combinations at the proper doses are provided to the appropriate
is a novel nutritional therapy composed of four
nutritional factors each one having been shown to be remarkably
effective in the treatment (as well as the prevention) of heart
disease. This empirical, but effective, formulation aptly illustrates
the three fundamental principles of nutritional therapeutics: type,
dose, and site.
insufficiency (with its plethora of symptoms, including arrhythmias,
pulse abnormalities, pressure on the chest, difficulty breathing, and
a sense of something being wrong in the area of the heart) is a
condition which, if left untreated, will result in heart attack.
Although there are many causes of cardiac insufficiency (i.e.,
atherosclerosis, ischemia, vasospasm), the ultimate biochemical defect
is an insufficient supply of cellular energy (i.e., ATP). The
combination of L-Carnitine, coenzyme
E is an extremely effective treatment for cardiac insufficiency, as the
nutrients provided cover most of the known mechanisms of cardiac
L-carnitine, Coenzyme Q10, Magnesium, and Vitamin E
CCME stands for L-Carnitine, Coenzyme Q10, Magnesium, and vitamin
E a combination of the most important energy-generating nutrients.
This quartet of nutrients regulates the most remarkable process in
life, because the process is life, at least multicellular life. Of all
the nutritional factors required for life, L-carnitine, coenzyme Q10,
magnesium, and vitamin E must be ranked among the most important for
optimizing mitochondrial energy production. Other nutrients are
essential, to be sure, and the emphasis on CCME should not be
interpreted as diminishing the cardiovascular benefits of niacin,
riboflavin, pantothenic acid, thiamin, and many other nutrients and
coenzyme Q10, magnesium, and vitamin E all interact in the
mitochondrial generation of energy. Carnitine carries fats across the
inner membrane for beta-oxidation. Coenzyme Q10 is the key factor in
the electron transport system. Magnesium is an essential cofactor for
many of the enzyme systems which support energy production. Moreover,
it is required for ATP stability, as ATP is synthesized as the
magnesium complex. Vitamin E is in the membrane where it can scavenge
the free radicals generated by the electron transport system.
L-carnitine (the rate-determining factor in beta oxidation)
increases ATP generation via its effects on beta oxidation, as well as
its role in the removal of acetyl units from the mitochondria. The
latter process is important because accumulation of acetyl units is
known to inhibit various parts of the respiratory process. Other
important actions of L-carnitine include vasodilation of the blood
vessels and increased ability to sustain cardiac contractions.1
Finally, supplemental L-carnitine has been well-documented to reduce
blood and tissue lipids, which is associated with a reduced risk of
developing heart disease.6-8
provide 60-80% of the metabolic energy required by the heart, which
explains why such high levels of L-carnitine are stored in cardiac
muscle. Moreover, interference with fatty acid oxidation can have dire
consequences on myocardial function. Cognizance of L-carnitine's
import has led to numerous investigations, the results of which have
documented its cardiovascular benefits in both animals2,3 and
humans.4-6 Carnitine is perhaps best known for its lipid-lowering
activity, specifically, its ability to
rapidly and markedly decrease plasma
triglycerides7 and increase HDL cholesterol.8
Coenzyme Q10 is an integral part of the electron transport system,
and hence regulates the ATP-generating capabilities. In addition to
its well-known role in carrying electrons, recent studies have shown
that coenzyme Q10 transports protons for the proton gradient used to
drive oxidative phosphorylation. The latter, of course, is required
for ATP synthesis. Thus, coenzyme Q10 plays a pivotal role in all
energy-generating systems. All organisms with an Electron Transport
System have an absolute requirement for coenzyme Q10. Both animal9
and human10,11 studies have unequivocally proven the
beneficial effects of supplementary coenzyme Q10 in numerous types of
heart disease, as well as hypertension and stroke.12
Magnesium is now recognized as a first-line medicine for the
treatment of heart attacks.13-14 A study published in The Lancet, for
example, reported the effects of a double-blind, randomized, placebo
controlled study in 2,316 patients with suspected myocardial
infarction.15 The dose of magnesium was high (about 8.7 grams given
intravenously over a 24-hour period), but the results were remarkable:
magnesium reduced cardiovascular mortality by 25. The author's
magnesium sulfate is a simple, safe, and widely applicable treatment.
Its efficacy in reducing early mortality of myocardial infarction is
comparable to, but independent of, that of thrombolytic or
findings have been confirmed and reconfirmed in many clinics and
laboratories. Teo and colleagues, for example, in an analysis of seven
clinical studies, concluded that magnesium (in doses of 5-10 grams by
intravenous injection) reduced the odds of death by an astounding
of magnesium have revealed it to be Nature's "calcium channel
blockerÓ17; unlike its drug counterparts, however, magnesium has no
toxic side effects. Another important effect of supplemental magnesium
is its ability to mitigate the cardiotoxic effects of catecholamines.
Prielipp and associates, for example, published results of a clinical
trial in which magnesium (10 mg per kg body weight per hour, or
approximately 700 mg per hour for an average adult) attenuated the
cardiotoxic effects of epinephrine in 17 bypass patients.18
Interestingly, the drug captopril-an angiotensin-converting enzyme
(ACE) inhibitor-has been demonstrated to work by raising intracellular
The fourth member of this team is vitamin E-the major
lipid-soluble antioxidant. A substantial body of evidence has
accumulated on vitamin E's therapeutic as well as preventive actions
against disease of the heart and blood vessels.20 Supplemental vitamin
E, for example, is known to decrease LDL oxidation, which reduces
macrophage-mediated (inflammatory) damage to endothelial cells,
thereby preventing the production of foam cells and plaque which are
characteristic of atherosclerosis.21 By blocking inflammation, vitamin
E acts as a primary defense against cardiovascular diseases.
E also plays a pivotal role in the inhibition of platelet
aggregation.22 Platelets aggregate because arachidonic acid is
converted into pro-aggregatory thromboxanes; this conversion is an
oxidative process responsive to vitamin E treatment.23 The ability of
vitamin E to inhibit platelet aggregation is vitally important, as
excessive, uncontrolled platelet aggregation is now acknowledged to be
a primary causative factor in myocardial infarction. An ancillary
mechanism involves vitamin E's ability to block redox cycling of
catecholamine - the net result being a diminution in abnormal
sympathetic stimulation of the heart.
Effective, Easy, and Economical
CCME is a combination of four nutrients that individually are
documented to be effective in treating heart disease. My
recommendations for doses of CCME are listed in Table III. As can be
seen, treatment requires higher levels than does prevention of heart
disease. CCME is by no means an optimal formulation, as it lacks other
cardioprotective nutrients (e.g., vitamin C, B-carotene, taurine,
selenium, isoflavonoids, and garlic).
is, however, therapeutically effective; more importantly, it is
practical, hence patient compliance is not a problem. CCME is
completely safe, and no toxic side effects have ever been reported
(save for the laxative effect of magnesium salts). The icing on the
cake is that CCME - in addition to being effective and safe - is very
inexpensive as compared with currently prescribed drugs. CCME's cost
efficacy is even more impressive when compared to mechanical
procedures (e.g., heart transplantation and bypass surgery) that are
major contributors to the spiraling cost of health care. CCME is
effective, easy, and economical: what more could one possibly expect
in clinical medicine?
from the Journal of Optimal Nutrition (JON) Vol. 3(3), 1994
source of nutrients and supplements.
How did we
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