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Congestive Heart Failure

Treating congestive heart failure (CHF) is one of the first skills a young doctor learns in medical school. This process essentially involves balancing one group of medicines to clear excessive fluid (the “congestion” building up behind the weakened heart) with another group of drugs to strengthen the heart’s role as a pump. And often within a few hours many patients treated for severe CHF feel better. So despite its scary sounding name (“heart failure”) most primary-care doctors can probably sleepwalk through a treatment of CHF. But don’t you try it; CHF is definitely not in the do-it-yourself category of common ailments. However, if you agree to work with your doctor using the information from this WholeHealth Chicago Healing Center, then certain herbs, supplements, and lifestyle changes can make a positive difference.

What is Congestive Heart Failure?
Congestive heart failure (CHF) is a serious but treatable medical condition in which the heart is unable to pump enough blood to meet the body’s oxygen needs. Heart failure is actually the consequence of another medical problem. Damage to the heart muscle following a heart attack is the most common cause. Other conditions that can precipitate heart failure include high blood pressure, severe anemia, an overactive thyroid, an arrhythmia, emphysema, and congenital heart defects. In each of these medical conditions, the heart must work harder to pump the same amount of blood. To compensate, it beats faster, or the muscular walls of the heart have to thicken. Unfortunately, this compensation is only temporary, and heart failure, a slow process that worsens over time, follows.
Specific CHF symptoms depend on which part of the heart fails. Left-sided failure causes fluid to back up in the lungs, bringing on fatigue and shortness of breath. Right-sided heart failure causes fluid to accumulate in the legs and ankles, producing swelling. CHF occurs predominantly in individuals over the age of 60.

When people receive good treatment for CHF, it’s quite compatible with enjoying a normal level of activity for many years. It’s also possible to “cure” heart failure when it is the result of another treatable condition, such as high blood pressure, an overactive thyroid, or anemia. In addition, good research is now showing that by adding specific supplements and a few positive lifestyle changes to conventional medications, the outlook for a CHF patient can be even better.

Key Symptoms

Fatigue and constant sense of feeling unusually weak
Shortness of breath–initially after minimal physical exertion, then even during rest. Later, shortness of breath may occur when lying flat in bed, with relief only when propped upright with pillows.
Unusually fast or irregular heartbeat
During the night awakened by breathlessness, cough, or wheezing
Swollen ankles or legs
Abdominal discomfort, a sense of fullness, and frequent indigestion
What Causes Congestive Heart Failure?
Left-sided heart failure: Heart damage following one or more heart attacks and high blood pressure are the most common causes of left-sided CHF. Other conditions that might damage the heart muscle are infections by certain viruses and the effects of alcoholism. Additional causes of left-sided CHF (those not associated with heart-muscle damage) include a heart valve defect, arrhythmias, severe anemia, an overactive thyroid, and certain nutritional deficiencies.

Right-sided heart failure: This is usually caused by a lung condition, such as chronic bronchitis and emphysema, but it’s also associated with congenital heart defects.

Treatment and Prevention
Once CHF has been diagnosed, your doctor will treat the symptoms and also seek out and treat the precipitating cause. For example, heart failure due to anemia or an overactive thyroid usually disappears permanently once these conditions have been treated. However, the typical heart failure that follows heart damage due to a heart attack will require continuous medical care and monitoring.

Prescription medications usually consist of diuretics (to remove excess fluid from the body); vasodilators (to relax the blood vessels and ease the workload of the heart); and digitalis (to strengthen the force of each heartbeat).

Supplements are good adjuncts to conventional therapies. For example, many people with CHF have reported improvement after adding coenzyme Q10 to their medication regimen. And according to a recent study from Japan, vitamin C may help increase the effectiveness of nitroglycerin, a prescription drug (and vasodilator) given to many CHF patients to ease the work of the heart. Once a supplement regimen is begun, benefits can be apparent in as little as three weeks.

The supplements suggested here can be taken with conventional medications. But be sure to talk to your doctor about any supplements you decide to try–and never use any supplements as substitutes for your regular medication.

Just a reminder: If you have a serious medical condition, it’s wise to check with your doctor before beginning a supplement program.

How Supplements Can Help
A daily high-potency multivitamin and a good quality antioxidant complex are an excellent place to begin. They’ll supply the basic nutrients, such as vitamin C and vitamin E, which are capable of disarming the free radicals that can cause damage to the heart and other organs on the cellular level.

Coenzyme Q10 and the amino acid carnitine are also useful because they act as spark plugs to the mitochondria, the energy centers of each living cell. Both of these supplements have shown positive results in clinical testing for the treatment of heart failure.

The herb hawthorn is widely prescribed in Europe for many heart-related diseases. It acts directly on the heart muscle and widens blood vessels to reduce the workload of the heart. Both magnesium and potassium are vital to the proper functioning of the entire cardiovascular system. Numerous clinical studies have shown that supplementation with these minerals can help congestive heart disease, arrhythmias, high blood pressure, and angina pectoris. Unless you have kidney disease, adding magnesium as a supplement is very safe. Potassium supplements require a prescription and must be done only under medical supervision. Food is a better source: The amount of potassium found in health-food store supplements is about the same as one-fourth of a banana.

Adding thiamin (vitamin B1) may be useful for older patients with CHF, especially those using the diuretic Lasix (furosemide), which is known to lower thiamin levels. A thiamin deficiency by itself produces the disease beriberi, one of the symptoms of heart failure. B-vitamin deficiency diseases are rare in the United States, but because of poor diets, many older people have lower levels of B vitamins than doctors initially suspect.

Self-Care Remedies
Decrease your salt intake. Too much salt can lead to fluid retention and swelling.

Eat more frequently but have smaller portions. It takes a lot of energy to digest big meals.

Avoid cigarettes, caffeine, and alcohol. Smoking (even passive smoking) contributes to heart disease. Caffeine may trigger heart rhythm disturbances, and excessive alcohol consumption can stress the heart.

Avoid pollution. This means not going out on days when there are air pollution warnings.

Take it easy. Get plenty of rest. Under your doctor’s supervision, a mild exercise program is beneficial for CHF. However, don’t engage in excessively vigorous exercise.

Learn to control stress. Whether you’re exasperated by a traffic jam or frustrated by a long line at the post office, stress raises your blood pressure and increases your heart rate. Regular meditation or tai chi are excellent antidotes for any form of heart disease.

Eat more fish. Fish oil has been shown to prevent, or even reverse heart disease, and help reduce the heart’s susceptibility to arrhythmia.

When to Call a Doctor

If you experience severe chest pain or shortness of breath.
If you fatigue easily, even after minor exertion.
If you already have CHF and spike a fever or experience shortness of breath, an irregular heartbeat, or a worsening of any other CHF symptoms.

Supplement Recommendations

From David Edelberg, M.D. at WholeHealth Chicago: A range of drugs can boost your heart’s pumping power, widen blood vessels, improve blood flow, and rid your body of excess fluid. All the supplements suggested here can be taken with conventional medications to slow down congestive heart failure (CHF). (Enlist your doctor as your partner in the enterprise.) You could see benefits within three to four weeks.
How to Take the Supplements
Taking a daily high-potency multivitamin and a good-quality antioxidant complex will provide plenty of vitamins B, C, and E as well as a lot of other potent antioxidants, so continue using all of these regularly.

Very definitely start taking hawthorn, magnesium, coenzyme Q10, and carnitine, since good studies support using each of these for the congestive failure associated with atherosclerosis, high blood pressure, and other conditions that weaken heart muscle. Add extra thiamin only if you’re on a diuretic or you believe your B-vitamin intake is poor.

Potassium is often needed when the doctor prescribes a diuretic (“water pill”). But only use prescription potassium and avoid the over-the-counter potassium supplements. The amount of actual potassium sold in these supplements is so tiny that you’re better off getting this valuable mineral from your diet. Potassium-containing foods include bananas, oranges and orange juice, beans, milk, and most vegetables.

As a start, and for convenience, you should take each of these supplements in the recommended doses twice a day for at least a month. This dose schedule may be all that’s necessary. If clinically warranted, you can add another dose of both hawthorn and carnitine in the middle of the day.

Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.

Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.

For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.

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