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Special "Heart Health Report" Edition

11/02/07

This Week In HealthBeat News:

  • Special "Heart Health Report" - Heart Attack and Stroke - what are your real risks?
  • Dave Checks in - What to do for shingles?
  • Laughter is the best medicine: From the kids...

Heart Attack and Stroke: What are Your Real Risks?

By Dr. Dana Myatt

Your Risk Factors

Heart disease and cancer are the two leading causes of death for adults who make it past the teen years. Heart disease includes problems with the heart muscle itself (weakness of pumping action, irregular rhythm, and “congestion” due to fluid retention). A leading cause of heart disease and stroke is atherosclerosis, or hardening of the arteries. (See here: http://www.drmyattswellnessclub.com/atherosclerosis.htm for a complete discussion of Atherosclerosis).

For years, conventional medicine has focused on total cholesterol levels almost exclusively to tell us who is at risk for such disease, but cholesterol levels alone provide only a very limited answer to this question. A significant number of people suffer from cardiovascular disease who have never had a total cholesterol level above the “normal” range. (Desirable range is below 200). Clearly, other factors besides cholesterol play a role in the development of atherosclerosis.

In spite of the fact that this information is well-known, I find that many doctors, including cardiologists, fail to give patients a comprehensive work-up to determine true risks. Just recently I talked with a patient who has had multiple angioplasty surgeries for blocked coronary arteries. The problem reoccurs within a matter of weeks. Her cholesterol is 150, which is low normal. Obviously, high cholesterol isn’t her problem. In spite of these facts, her doctors are encouraging her to go for a another worthless (in her case) angioplasty, and no doctor before me has mentioned to her that her high triglycerides and high red blood cell count are also risks, even though the results of her tests are plainly abnormal. Further, no one has performed a high speed C-RP (see below in this article), yet this number represent a bigger risk factor for heart disease than cholesterol.

Bottom line? Don’t expect that your doctor, even if he/she is a cardiologist, is doing a thorough job or evaluating you for cardiovascular risk. Putting someone on a cholesterol-lowering drug seems to be a popular treatment today, even for people in whom such treatment is not indicated. In the mean time, we are overlooking other easily tested-for and easily treated risk factors.

Are we playing the fiddle while Rome is on fire? See below for the complete details and tests to evaluate your heart health.

Cardiovascular Risk Factors: “The Rest of the Story”

Don’t let medical complacency and insurance/HMO cost-cutting put you at risk for heart disease and stroke. The following tests are each independent risk factors for cardiovascular (heart and blood vessel) disease. They are standard medical tests, well-proven, inexpensive. For a true look medical evaluation of your risks, these factors should be looked at as part of a comprehensive evaluation for cardiac/stroke risk.

Blood Test

“Standard Range”

Optimal Range

What to do if elevated:

Cholesterol:

     

 

Total cholesterol

 

under 200

 

160-200

Ketogenic diet, niacin,
Red Rice Yeast, green tea

 

HDL

 

above 35

 

the higher the better

Exercise, niacin, garlic,
Vit. C & E, Red Rice Yeast

 

Chol:HDL ratio

   

see cholesterol and HDL recommendations, above

 

LDL

 

up to 129

 

below 100

niacin, vitamin E

 

Homocysteine

 

up to 15 mm/l

 

below 7 mm/l

Vitamin B6, B12 and folic acid (Maxi Multi covers this)

 

Triglycerides

 

up to 200 mg/dl

 

below 100 mg/dl

Ketogenic diet, niacin,
Red Rice Yeast, garlic*

 

high-speed C-RP

 

up to 4.9 mg/L

 

under 1.3 mg/L

aspirin (low dose-81mg/day); vitamin E, Red Rice Yeast

 

Fibrinogen

 

up to 460 mg/dl

 

under 300 mg/dl

Bromelain, fish oil,
vitamin C, niacin, garlic

Minimum work-up for CardioVascular Risk (more than the conventional work-up) for people with no personal history of heart or blood vessel disease and no other known risk factors (see facing page for other risks):
I.) Lipid profile (cholesterol, HDL, LDL, triglycerides and cholesterol :HDL ratio)
II.) hs-C-RP
[NOTE: I do not routinely perform a homocysteine test in people with no other risk factors because this risk is reliably and predicatabley lowered by simply taking adequate doses of vitamin B6, B12, and folic acid, as in Maxi Multi or B complex. Other standard multiples often do not contain sufficient doses of these B vitamins to lower homocysteine].
Additional work-up
for someone with a history of heart disease, stroke, or who has other risk factors:
III.) Fibrinogen
IV.) “Other risks” as listed below.

Maxi Multi  Vitamins

For those of you who take Maxi Multi as your vitamin/mineral supplement (for health’s sake, I wish this included everybody!), please note that this formula contains the recommended, optimal doses of B complex vitamins & vitamin C & E. You do not need additional supplementation of these nutrients (unless you have a specific complaint to address) if you are taking this formula. “I’ve got you covered”! AND, I make changes to the formula to constantly reflect new findings in medicine, so your multiple will always be up-to-the-minute when it comes to formulation.

C-Reactive Protein: First reported in the medical journals and reported to YOU from ME in 1998, this risk factor for heart disease and stroke risk is just now being reported by many other conventional and holistic medical journals and newsletters. C-Reactive Protein (C-RP) is a protein found in the blood. It is indicative of inflammation. A growing body of evidence shows that it is not just cholesterol that clogs arteries and cuts off blood flow to the heart and brain. Low-level inflammation in the body appears to be an even greater risk factor (see chart below).

This low level of inflammation is so small that it doesn’t cause pain. (Ordinarily, inflammation makes itself known by pain, swelling, or redness of an area). Older C-RP tests are used to monitor certain autoimmune diseases, but the test is not sensitive enough to detect the small elevations of C-RP that lead to heart disease and stroke. Instead, the “new” test is highly sensitive (hence, the “hs”-C-RP designation).

As you can see from the chart at right, elevations of C-RP are more predictive of heart attack and stroke than any other blood risk factor commonly evaluated for. Because of this, it may be more important to look at hs-C-RP than cholesterol.

The test is inexpensive ($20-30) and my prediction is that it will become a routine part of cardiac risk testing, performed right along with the cholesterol profile, within the next several years. But don’t wait until your insurance pays for the test. Ask your doctor to order it next time you have a cholesterol check.

Blood Test

Amount of Increased risk above normal if elevated:

C-Reactive Protein
(high sensitivity)

 

4.4

Cholesterol:HDL ratio

 

3.4

Total Cholesterol

 

2.4

LDL Cholesterol

 

2.4

Source:New England Journal of Medicine, 342:841, 2000, based on studies conducted by Dr. Paul Ridker at Bringham and Women’s Hospital.

“Other” Risk factors (The ones your doctor didn’t tell you about)

Any factor that increases blood viscosity (thickness) can put additional stress on the vascular system and trigger a myocardial infarction ("MI"; an “attack” of the heart due to decreased blood flow) or stroke. I frequently see one or several of these factors elevated on a patient’s medical records, with the doctor’s note at the bottom of the page saying “all normal.” The patient often never hears about those lab values and risks that are indicative of increase blood viscosity, and therefore, an opportunity is lost to correct a risk factor. Additional risk factors that are easily identified through routine lab work include :
1.) Elevated RBC (red blood cell) count
2.) Elevated platelet count
3.) Elevated serum iron or ferritin (storage iron)
4.) Elevated fasting blood sugar

Lifestyle factors that influence blood viscosity:
1.) Overweight & obesity (associated with increased cholesterol, LDL, triglycerides and C-RP).
2.) Dehydration. Yes, a simple lack of water causes the blood to thicken, increasing risk. Drink water!
3.) Smoking: this is SO risky for the circulation that I refer readers to our webpage here: http://www.drmyattswellnessclub.com/smoking.htm for a full disclosure.
4.) Dietary fats (especially trans fats and heat-damaged essential fatty acids)

“Action Steps” to take to alleviate these risks:

For high RBC and/or platelet count: be generous - donate blood! Phlebotomy (having blood drawn) is an easy way to decrease platelet and RBC count. You doctor can help you know how often to give blood based on your repeat Complete Blood Counts (“CBC,” a standard test that tells numbers of red and white cells, platelets, and how much iron the RBC’s contain. It is a very inexpensive and routine blood test and should probably be used more often than it is).

For high iron: this one is tricky, because it depends on whether or not your body is using iron correctly. However, iron excess is far more common than iron deficiency in adults (women of menstrual age excepted). Be sure your supplements DO NOT contain iron unless you are told to take iron by a doctor. Your Maxi Multi does NOT contain iron for this very reason.

To offset the effects of dietary fats: Fats in the diet make red blood cells stick together for hours after a meal is eaten. Vitamin C & E, taken with meals, “erases” this “sticky” effect and RBC’s behave as if no fats were eaten. That is why I recommend Maxi Multi (with optimal vitamin C & E doses), be taken with each meal instead of just once or twice per day!

Herbs & Blood Viscosity: Nature’s Blood-Thinning Remedies

Conventional medical blood thinning is accomplished by coumadin compounds, which prevent platelet aggregation. This therapy is reserved for people with severe cardiac arrhythmias and other serious problems, because the blood-thinning effects of therapy can have serious consequences. (Coumadin is used as rat poison. The rats eat it, and bleed to death internally). There are some circumstances where this type of blood thinning may be advisable, but treatment must be carefully and frequently monitored by blood testing. Furthermore, coumadin therapy only prevents platelet aggregation. According to conventional medical sources (the Merck manual, 17th edition), only 1/3 of all causative agents of abnormal blood clotting are prevented by the administration of this drug. Bottom line: coumadin is useful in very limited circumstances and must be carefully monitored. So what is the “average Joe or Jane” (without a history of serious blood viscosity problems) supposed to do to help keep the blood flowing smoothly? Mother nature has given us a number of healthful choices.

There are many herbs that act to normalize blood viscosity at different points. A combination of these herbs can actually have a broader “coverage” of clotting risk factors than coumadin alone. The difference is that the herbs are safer than coumadin, can be taken without medical supervision, and can be used in a preventive fashion. The only caution (and this is minor), is to tell your doctor that you are using these herbs IF you are on or going to begin coumadin therapy OR if you are scheduled for surgery. (Blood tests can and should be conducted before surgery to see how viscous your blood is anyway, so blood-thinning herbs aren’t “risky” as some conventional medical sources have portrayed).

Blood Viscosity-Aiding Herbs: The Short Course

1.) Garlic: decreases platelet aggregation, increases HDL cholesterol, decreases triglycerides and decreases fibrin.
2.) Ginkgo: prevents blood platelets from aggregating.
3.) Turmeric: Anti-inflammatory, so may lower C-RP. Turmeric also has other blood viscosity-normalizing effects that are beyond the scope of this article. (Please refer to page 89 in your Holistic Health Handbook for more information).
4.) Bromelain: Anti-inflammatory, anti-fibrinolytic. This herbal substance from pineapple is a well-researched, unsung hero. It has a broad range of utility. Everyone should have this on hand whether you take it daily or only on an “as needed” basis. (see pages 19, 89, 114, 122 in your Handbook for info.)
5.) Bilberry: decreases platelet aggregation in a manner similar to ginkgo. Also has potent antioxidant effects and strengthens blood vessel integrity, making it useful for varicose veins, capillary fragility and venous insufficiency.
6.) Grape seed Extract: potent antioxidant, decreases platelet aggregation.
7.) Green Tea: inhibits oxidation of LDL and prevents platelet aggregation.

Other proven anti-clotting herbs include: ginger, gugulipid.

Nutritional Factors Influencing Blood Viscosity

Be SURE to get the following nutrients for their helpfulness in maintaining normal blood flow and minimizing stroke/heart attack risk:
I.) Vitamin C & E (with every meal; included in Maxi Multi or take separately.
II.) B6, B12 and folic acid: daily. Included in Maxi Multi or take separately as Multi B Complex.
III.) Omega-3 fats: (found in fish and flax seed). Unlike other fats which cause red cells to “clump,” Omega-3 fats have an anti-inflammatory, anti-clotting action. (click here to learn more about Omega-3 Fatty acids). Best sources: eat fish (especially salmon) twice a week and take 2 teaspoons of flax seed meal daily.

Maxi Greens

Wellness Club brand formula Maxi Greens contains Bilberry, green tea, grape seed extract and bromelain, plus many other “green foods” and herbs, offering broad-spectrum coverage for blood viscosity. (Maxi Greens has many other health benefits besides this. Please see page 109-110 in your Holistic Health Handbook for complete information.

Heart-Healthy Nutrients

CoQ10

CoQ10 is a powerful antioxidant and oxygenator made by the body. It is universally deficient in people with heart disease, high blood pressure, cardiac arrhythmias and cancer. The correlation between heart disease and CoQ10 is now so well known that even conventional cardiologists often recommend it to their patients. Further, cholesterol-lowering drugs deplete CoQ10. Although it is not known to specifically impact blood viscosity, it’s role in oxygenation of heart and muscle tissue is vitally important. ANYONE with ANY cardiac risk should be taking supplemental CoQ10. Supplemental CoQ10 is also necessary for anyone on a cholesterol-lowering drug.

Magnesium

Magnesium is a mineral which plays a key role in energy production. It is found in high concentrations in the brain, heart, liver and kidneys. It is also a crucial component of bone.

According to the U.S. Surgeon General, magnesium is the most common nutrient deficiency in the American diet. That’s unfortunate, because without sufficient magnesium, the heart fails to beat correctly. in fact, magnesium is rightly known as “Nature’s calcium channel blocker.” Deficiencies of this mineral can lead to heart arrhythmia, high blood pressure, low HDL cholesterol, cardiomyopathy and acute MI (heart attack). [NOTE: magnesium is routinely used IV in emergency cardiac medicine in many European countries, but less frequently here since it's not a patent medicine].
Like CoQ10, magnesium supplementation is extremely safe and vitally important for heart health. (Maxi Multi contains a generous 500mg per day).

An “Action Plan” for Protecting Your Heart and Circulation

For those with no elevated risk
1.) Maxi Multi: 3 caps, 3 times per day supplies optimal, “heart-protective” doses of Vitamins C & E, B complex (including target doses of B6, B12, and folic acid), and magnesium.

For those with one or more elevated risk factors of already-established disease:
1.) Maxi Multi: as above.
2.) CoQ10: 100-400mg daily (see page 111 & 117) in your Holistic Health Handbook).
3.) Specific herbs or nutrients as indicated:
I.) For normalizing blood viscosity: Bromelain and/or Maxi Greens and/or any of the herbs listed in this article.
II.) For decreasing cholesterol:
niacin or Red Rice Yeast or both (they can be taken together if needed for resistant cases).
III.) For high blood pressure: additional Magnesium to total 800-1,000mg daily.

What I take for heart and cardiovascular health :

1.) Maxi Multi   2.) Maxi Greens   3.) CoQ10

Here's to Your Healthy Heart!

Dr. Myatt

Readers Write: Remedies for Shingles?

Dave, our friend and regular Reader writes us  with questions from time to time - you've read some of them here. He wrote us recently to ask about shingles - a particularly unpleasant viral infection:

Hello again friends. Hope all is well.
I need some advice and help perhaps. What is a good remedy for shingles? My daughter has a case and cant get to the doctor for three weeks she says. I'm hoping you have some ideas what we can do to ease her pains. She has it above the knees and below the navel she said and she is struggling to make it through the day without pain.
Have you any recommendations?
Thanks,
Dave


Dr. Myatt's answer:

Hi Dave:

Everything is well here, thanks for asking.

Shingles. First, how do we know this is the right diagnosis? Having shingles in two locations at once, especially these two unusual locations (for shingles), makes me question the diagnosis.

Secondly, after three weeks have passed, it's a bust to go to the doctor. The stuff will be past helping by conventional treatments (which are of dubious help anyway).

Here is what I recommend (and again, I'm not confident of the diagnosis given the locations):

A good all-around optimal dose multiple such as Maxi Multi is highly recommended. http://www.drmyattswellnessclub.com/maximulti.htm (One-a-day's don't cut it).

That's because the herpes virus is thwarted by adequate doses of Vitamin A, Beta-carotene, Vitamin C, Vitamin E, Zinc and Selenium. The right doses are found in Maxi Multi or view this optimal dose chart here: http://www.drmyattswellnessclub.com/supplements.htm#Which

Lithium Orotate reduces the pain and itching of herpes and post-herpetic neuralgia (which can linger for months and years after lesions have resolved). Two caps, 3 times per day for a week, then drop back to 1 cap, 3 times per week until the discomfort is gone.
Read up on lithium orotate here: http://www.drmyattswellnessclub.com/lithiumorotate.htm

I also use my own Immune Support formula (6 caps per day during active shingles) http://www.drmyattswellnessclub.com/immunesupport.htm
and Immune Boost (1 dropperful, 3 times per day) until resolution. http://www.drmyattswellnessclub.com/immuneformulas.htm#Immune%20Boost

I've had shingles before and it's definitely no fun, but these treatments will help it resolve faster AND help prevent the "post-herpetic neuralgia," pain that can stick around for months or years. Hypericum oil topically help ensure that this "lingering pain" doesn't happen. http://www.drmyattswellnessclub.com/stjohnswort.htm#Oil

Hope this helps!

Dr. Dana

P.S. you'll read about lysine and other stuff, but I have never been impressed with the effectiveness of most "they say" remedies!

Laughter is Good Medicine: Out of the mouths of children...

You gotta love them. They keep us young! This is sent to us by a HealthBeat reader: We don't know where these came from or how true they are - but we can't imagine that they are not true - because we know kids...

NUDITY I was driving with my three young children one warm summer evening when a woman in the convertible ahead of us stood up and waved. She was stark naked! As I was reeling from the shock, I heard my 5-year- old shout from the back seat, "Mom! That lady isn't wearing a seat belt!"

OPINIONS On the first day of school, a first-grader handed his teacher a note from his mother. The note read, "The opinions expressed by this child are not necessarily those of his parents."

KETCHUP A woman was trying hard to get the ketchup out of the jar. During her struggle the phone rang so she asked her 4-year-old daughter to answer the phone. "Mommy can't come to the phone to talk to you right now. She's hitting the bottle."

MORE NUDITY A little boy got lost at the YMCA and found himself in the women's locker room. When he was spotted, the room burst into shrieks, with ladies grabbing towels and running for cover. The little boy watched in amazement and then asked, "What's the matter, haven't you ever seen a little boy before?" P

POLICE # 1 While taking a routine vandalism report at an elementary school, I was interrupted by a little girl about 6 years old. Looking up and down at my uniform, she asked, "Are you a cop?"

"Yes," I answered and continued writing the report.

"My mother said if I ever needed help I should ask the police. Is that right?"

"Yes, that's right," I told her.

"Well, then," she said as she extended her foot toward me, "would you please tie my shoe?"

POLICE #2 It was the end of the day when I parked my police van in front of the station. As I gathered my equipment, my K-9 partner, Jake, was barking, and I saw a little boy staring in at me. "Is that a dog you got back there?" he asked.

"It sure is," I replied.

Puzzled, the boy looked at me and then looked toward the back of the van. Finally he said," What did he do?"

ELDERLY While working for an organization that delivers lunches to elderly shut-ins, I used to take my 4-year-old daughter on my afternoon rounds. She was unfailingly intrigued by the various appliances of old age, particularly the canes, walkers and wheelchairs. One day I found her staring at a pair of false teeth soaking in a glass. As I braced myself for the inevitable barrage of questions, she merely turned and whispered, "The tooth fairy will never believe this!"

DRESS-UP A little girl was watching her parents dress for a party. When she saw her dad donning his tuxedo, she warned, "Daddy, you shouldn't wear that suit."

"And why not, darling?"

"You know that it always gives you a headache the next morning."

DEATH While walking along the sidewalk in front of his church, our minister heard the intoning of a prayer that nearly made his collar wilt. Apparently, his 5-year-old son and his playmates had found a dead Robin. Feeling that proper burial should be performed, they had secured a small box and cotton batting, then dug a hole and made ready for the disposal of the deceased. The minister's son was chosen to say the appropriate prayers and with sonorous dignity intoned his version of what he thought his father always said: "Glory be unto the Faaaather, and unto the Sonnn, and into the hole he gooooes."

SCHOOL A little girl had just finished her first week of school. "I'm just wasting my time," she said to her mother. "I can't read, I can't write, and they won't let me talk!"

BIBLE A little boy opened the big family bible He was fascinated as he fingered through the old pages. Suddenly, something fell out of the Bible. He picked up the object and looked at it. What he saw was an old leaf that had been pressed in between the pages. "Mama, look what I found," the boy called out.

"What have you got there, dear?"

With astonishment in the young boy's voice, he answered, "I think it's Adam's underwear."

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