The Great Cholesterol Myth (23 page)
Read The Great Cholesterol Myth Online
Authors: Jonny Bowden
Let’s be clear. Conventional medicine is simply terrific at keeping people alive in emergencies. Both of us know that if we were to be in a car accident, we wouldn’t want the ambulance rushing us to the nearest herbalist’s office. We’d want to go to the emergency room of the best hospital we could find. But as good as conventional medicine is at treating people in acute situations, it’s astonishingly bad at overall preventive care. It’s great at keeping your heart beating if you’ve just had a heart attack. It’s not nearly as good at keeping your heart healthy for the long run and keeping you, the heart’s owner, out of the hospital in the first place.
The supplements listed in this chapter are some of the superstars for heart health that Dr. Sinatra uses in his practice (as he has for decades) and that Dr. Jonny has recommended to clients and written about extensively in his books and newsletters. Neither of us is saying you should just throw out your prescriptions and start randomly taking vitamins. But we
are
saying that natural substances such as vitamins, antioxidants, omega-3 fats, and many of the thousands of compounds found in foods may affect the health of the heart in an even more profound way than many of the medicines routinely prescribed as the first order of business.
Even if you’re already on medication, nutritional supplements can still improve your health. In the case of coenzyme Q
10
(CoQ
10
), for example, supplementation is an absolute must if you’re on a statin drug (more on that in a moment). Magnesium is often used in conjunction with blood sugar drugs such as metformin (Glucophage) or blood pressure medications such as beta blockers. And virtually everyone needs a little help in reducing oxidation and inflammation, two of the most important drivers in the development of heart disease. Omega-3 fatty acids, for example, can be used by just about anyone, whether he or she is on medication or not (check with your doctor for any possible contraindications, such as right before going into surgery).
The following list is far from exhaustive, but it will give you a good idea of how you can use supplements to keep your heart healthy, either alone or, in some cases, as an adjunct to conventional therapy.
10
: THE SPARK OF LIFE
Coenzyme Q
10
is a vitamin-like substance found throughout the body and made in every cell. Among the many important things it does, CoQ
10
helps
create energy from fuel (food) in the human body, just as a spark plug creates energy from fuel (gasoline) in a car.
A CoQ
10
deficiency affects your heart as profoundly as a calcium deficiency would affect your bones. We create less of it as we age, making it all the more important to supplement with CoQ
10
as we grow older.
Here’s how it works: Your body uses a molecule called
adenosine triphosphate
, or ATP, as a source of energy (which is why ATP is nicknamed “the energy molecule”). Much like gasoline is the fuel that allows you to actually drive a car to any of a million destinations, ATP is the fuel that allows your body to perform any of a million activities, ranging from cellular metabolism to doing bench presses to dancing the tango. The body makes ATP by stripping electrons—tiny subatomic particles that carry a negative electrical charge—from food and then delivering those electrons to oxygen, which is an
electron receptor
. CoQ
10
is one of the carriers of these electrons, so it essentially helps the cells use oxygen and create more energy. Bottom line: CoQ
10
has the ability to increase the body’s production of the energy molecule ATP, and this is a very good thing indeed.
Just as a gasoline engine can’t work without spark plugs, the human body can’t work without CoQ
10
. It’s an essential component of the
mitochondria,
which is command central for the production of cellular energy (ATP). Not coincidentally, the heart is one of the two organs where the most CoQ
10
is concentrated (the other being the liver). The heart never sleeps, and it never takes a vacation. It beats more than one hundred thousand times a day, making it one of the most metabolically active tissues in the body, so it’s very dependent on the energy-generating power of CoQ
10
.
A CoQ
10
deficiency affects your heart as profoundly as a calcium deficiency would affect your bones. We create less of it as we age, making it all the more important to supplement with CoQ
10
as we grow older. (Although it’s present in food, the only foods that have any CoQ
10
to speak of are organ meats such as heart and liver. It’s also easily destroyed by too much heat or overcooking.)
As we’ve said, one of the biggest problems with statin drugs is that they significantly deplete CoQ
10
levels. You may recall from the previous chapter on statins that the same pathway that produces cholesterol (the mevalonate pathway) also produces CoQ
10
, so when you block that pathway at its virtual starting gate (as statin drugs do), you not only reduce the
body’s ability to make cholesterol but you also interfere with its ability to make CoQ
10
.
We’ve said this before, but in case you missed it the first time, it’s important enough to repeat: If you are on a statin drug you must, repeat
must
, supplement with CoQ
10
. We recommend at least 100 mg twice a day.
But CoQ
10
isn’t just essential for those on statin drugs. We believe it’s essential for everyone else as well, and
especially
for anyone at risk for heart disease.
CoQ
10
has been approved in Japan as a prescription drug for congestive heart failure since 1974. And even in the United States, the benefits of CoQ
10
for the heart have been well known since at least the mid-1980s. A study published in the
Proceedings of the National Academy of Sciences of the United States of America
in 1985 gave either CoQ
10
or a placebo to two groups of patients having class III or class IV cardiomyopathy according to the definitions put forth by the New York Heart Association (NYHA).
2
These are seriously ill folks. Class III patients have marked limitation in activity because of symptoms and can basically only be comfortable at rest or with minimal activity; class IV patients have severe limitations and experience symptoms even while resting. (Most class IV patients are bedbound.)
So what happened when these very sick patients were given CoQ
10
? Here’s how the researchers themselves summarized the results: “These patients, steadily worsening and expected to die within two years under conventional therapy, generally showed an extraordinary clinical improvement, indicating that CoQ
10
therapy might extend the lives of such patients. This improvement could be due to correction of a myocardial deficiency of CoQ
10
and to enhanced synthesis of CoQ
10
-requiring enzymes.”
3
Another study that lasted six years and was published in 1990 looked at 143 patients, 98 percent of whom were in the same two classes as the patients in the 1985 study.
4
The participants were given 100 mg of CoQ
10
(orally), in addition to being treated in their conventional medical program. Eighty-five percent of the patients improved by one or two NYHA classes, and there was no positive evidence of toxicity or intolerance. “CoQ
10
is safe and effective long-term therapy for cardiomyopathy,” the study authors concluded.
CoQ
10
also has the ability to reduce blood pressure. A recent meta-analysis of CoQ
10
in the treatment of high blood pressure reviewed twelve different clinical trials and found that across the board patients who received CoQ
10
supplementation had significant reductions in blood pressure compared to control subjects who didn’t receive supplemention.
5
It’s no wonder that several studies have demonstrated a strong correlation between severity of heart disease and severity of CoQ
10
deficiency.
6
You might recall that oxidative damage (oxidation) is one of the four major culprits in heart disease, and you might also remember that cholesterol in the body is never a problem until it becomes oxidized. It’s only this oxidized cholesterol—specifically, pattern B LDL cholesterol—that is a problem, because pattern B LDL molecules are the ones that adhere to the cell walls and initiate or accelerate the process of inflammation.
Why do we mention that here? Simple. CoQ
10
is a powerful antioxidant, inhibiting oxidative damage to LDL cholesterol and thus helping to prevent cholesterol from becoming a “problem” in the first place. It’s far smarter to prevent LDL from getting damaged and sticky in the first place than to use a sledgehammer pharmaceutical to reduce LDL as much as possible!
WHAT YOU NEED TO KNOW
• Coenzyme Q
10
(CoQ
10
) is a kind of “energy fuel” for the heart.
• Statins deplete CoQ
10
; supplementation is an absolute necessity if you’re on a statin drug, and it is a very good idea even if you’re not.
• D-ribose is one of the components of the energy molecule ATP, which the body uses to power all activity.
• L-carnitine supplementation after a heart attack increases survival rate and makes it less likely you’ll suffer a second heart attack.
• Magnesium relaxes the artery walls, reduces blood pressure, and makes it easier for the heart to pump blood and for the blood to flow freely.
• Niacin will lower both triglycerides and the “bad” kind of LDL cholesterol. It also reduces a toxic substance called lipoprotein(a)—Lp(a) for short—and raises HDL. Don’t use the time-release kind.
• Omega-3s—especially from fish—lower the death rate from heart disease. They also lower triglycerides, resting heart rate, and blood pressure.
• Omega-3s are highly anti-inflammatory.
• At least twenty-eight clinical trials in humans show that pantothenic acid (vitamin B
5
) produces positive changes in triglycerides and LDL cholesterol. It also increases HDL.
• Nattokinase and lumbrokinase are natural “clot busters.”
• Other supplements worth considering include vitamin C, curcumin, resveratrol, and cocoa flavanols.
Coenzyme Q
10
and vitamin E have a strange, almost symbiotic relationship. In rats given supplemental vitamin E, increases in blood levels of CoQ
10
were observed; in
baboons given supplemental CoQ
10
, the anti-inflammatory effects of vitamin E were increased; and in one study, CoQ
10
plus vitamin E actually lowered C-reactive protein (CRP), a systemic measure of inflammation. We think it’s wise to make sure you’re getting about 200 IUs or so of vitamin E a day (from mixed tocopherols with a high gamma vitamin E formula) in addition to your CoQ
10
supplement. (But read the section on vitamin E, “The Good, the Bad, and the Ugly,” first!)
D-ribose, a five-carbon sugar, is one of the components of ATP, the energy molecule the body uses to power all activities. Without D-ribose, there would be no ATP; without ATP, there would be no energy.
Both CoQ
10
and the nutritional supplement L-carnitine help facilitate the process by which the body manufactures ATP. Metaphorically speaking, they act like little elves, shuttling the material needed to make ATP to the factories where it’s made, resulting in more efficient production of this important energy molecule. CoQ
10
and L-carnitine can be said to function like very efficient trucks transporting building materials to the factories where stuff actually gets built, but D-ribose is one of the actual building
materials
. A shortage of D-ribose means a shortage of ATP, and a shortage of ATP, especially in the heart, is bad news indeed.
D-ribose is synthesized in every cell in the body, but only slowly and to varying degrees depending on the tissue. Tissues such as the liver, adrenal cortex, and adipose tissue make plenty of D-ribose because they produce chemical compounds used to synthesize fatty acids and steroids, which are in turn used to make hormones.
But molecules of D-ribose made by these tissues are the opposite of rollover minutes on your cell phone—they have to be used right then and there and can’t be “transferred” to other tissues that might need them, such as the heart. The heart, as well as the skeletal muscles and brain, can only make enough ribose for their day-to-day needs. They have no D-ribose saving account. When the cells of the heart, for example, encounter a stressor such as oxygen deprivation, they lack the metabolic machinery needed to quickly whip up some badly needed D-ribose ribose. Tissues that are stressed because they don’t get enough blood flow or oxygen can’t make enough D-ribose to replace lost energy quickly. And when oxygen or blood flow deficits are chronic—as in heart disease—tissues can never make enough D-ribose, and cellular energy levels are constantly depleted.