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Suzy Cohen, R.Ph.

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Abnormal Heart Rhythm? The Heart-Talk You and Your Doctor Need to Have

Posted: 05/ 2/11 08:26 AM ET

Many people experience "benign" arrhythmias and these can last for years. Cardiologists can sometimes find the cause, but not always. People who suffer with these can occasionally link them to activities, foods, beverages or medicines, but not always. There are many people who simply cannot figure out why they feel a butterfly in their chest, or why they feel a 'skipped' beat, or delay (termed "pause"). Doctors will traditionally order any number of drugs from their pharmaceutical arsenal, including digoxin, the blood thinner warfarin, calcium channel blockers (like diltiazem or nifedipine), beta blockers (like propranolol, sotalol or metoprolol) or anti-arrhythmic drugs like propafenone, procainamide, disopyramide or amiodarone.

These may or may not work, depending on your type of heart disease and arrhythmia. If you've been told you have a benign arrhythmia, or pacemaker syndrome, junctional dysrhythmia, sick sinus syndrome or some other arrhythmia, it's possible that your doctor has offered to fix it with ablation or a pacemaker. If you're symptoms are severe, this could absolutely help you, but depending on the condition, your mild arrhythmia might just make you lightheaded, dizzy or fatigued. Many people wonder if they should undergo the procedure. It's definitely something to think about if your symptoms are mild or unnoticeable.

I always feel a second opinion is in order, and perhaps you need to see an "electrophysiologist" which is a a cardiologist who specializes in electrical disturbances of the heart. You may also need to see a neurologist to rule out whether the rhythm disturbance is related to your vagus nerve or some other aberrant nerve problem. I insist that you figure out WHY you have the arrhythmia. They may be "benign" in the sense that they haven't caused cardiac arrest, but they're not benign when it comes to quality of life.

The standard of care in America includes ablation which is sort of like 'burning' one of the nodes in your heart, and installation of a pacemaker which forces your heart to beat in perfect rhythm. For sure, some people benefit from these procedures, but they do not improve mortality rates for everyone. Personally, I wish that testing RBC magnesium was routinely done before performing all the procedures. A deficiency of magnesium is a contributing factor in heart attack and it's often given IV to resuscitate a person whose flat line -- that's how important it is! Sometimes you can fix an arrhythmia with magnesium alone as many holistic physicians will attest.

I just bang my head trying to figure out why it hasn't become the "standard of care" to determine underlying cause of heart disease before all the irreversible or invasive procedures like ablation, angioplasty, stenting and pacemakers! No doubt in my mind, these have procedures have a place and can save lives, but is it ever wrong to check for simple imbalances of essential minerals, amino acids and so forth?

It's really hard to cure arrhythmias, when you don't know what the trigger is. There are a number of reasons that one may experience arrhythmias such as nicotine, caffeine, alcohol, stress, candida albicans, infections and even medications. The condition of hyperthyroidism could cause it, as can dehydration and electrolyte imbalances. All of these factors come into play, and should be considered as possible causes before invasive procedures are done.

There are also medications that can cause abnormal heart rhythm, including anti-anxiety medications, antibiotics, antidepressants, breathing medications, cough and cold remedies and statin cholesterol drugs. Please refer to page 165 of my book, "Diabetes Without Drugs " for a complete list of drugs that cause abnormal heart rhythm, as well as Chapter 8 of that book, on Heart Disease.

Let me tell you why I've become so passionate about this. Recently, I went to the cardiologist with a friend of mine who had been experiencing a benign arrhythmia for two years. Before the visit that I attended, my friend had been tested thoroughly with a stress test, ultrasound, EKG and Holter monitor. It's the next visit that I went to, where he was offered the ablation/pacemaker procedure by his cardiologist. He did not immediately opt for that since he is a curious sort and wanted a few opinions. On my recommendation, he saw a functional medicine physician afterward, who ordered a blood test to evaluate his micronutrient status. Lo and behold, he was found to be deficient in taurine and magnesium.

Taurine is a natural amino acid, and magnesium is a mineral, both of these were purchased at the health food store along with an herbal supplement of hawthorn extract. His heart sank into a near-perfect rhythm within two weeks, after suffering for almost two years. Had he gone for the ablation procedure, he would have become pacemaker dependent and the underlying deficiencies would have gone undetected. In this particular case, it would have literally left him a ticking time bomb, pacemaker and all because the deficiencies would have gone uncorrected and the pacemaker would have masked his poor nutritional status and declining health. The first cardiologist wanted to hear nothing of this discovery. Shame on him for not wanting to learn!

I understand that some doctors believe natural dietary supplements to be "snake oil" and in fact, some of them are. But when a patient looks their doctor straight in the eyes (and has been to hell and back for years with frightening arrhythmias) and tearfully tells him that he's virtually cured with dietary supplements that total less than $20, you would think this would spark some interest on the part of the physician. Truly caring physicians would have taken 10 seconds to jot down the name of the two nutrients to look up later and see just what it was that cured his patient. To be dismissed like that made my friend feel that this particular doctor didn't care about him at all. It made me downright mad to hear this, and the doctor didn't even know who I was, what I did for a living or that I would one day write about his cavalier attitude.

Let me share more about some heart-healthy nutrients so you can discuss them with your cardiologist:

Aged Garlic Extract by Kyolic: A recent UCLA study found that this supplement slows and may even reverse atherosclerosis, even in people with moderate plaque build up. Aged garlic is a rock star when it comes to heart health. When you go to the health food store, you will see about a dozen different Aged Garlic products made by Kyolic. Kyolic is the only manufacturer of aged garlic, which is a much more effective (and scientifically-backed) form of garlic than formulas which contain just "allicin" or "alliin" for example. These products only contain a standardized extract of one or two components of garlic and this does not do the job the way aged garlic does, the whole herb. Kyolic has over 650 scientifically peer-reviewed papers on it and is the most frequently used brand in clinical trials of garlic.

There are two products that I think are good when it comes to the heart specifically. The first one is called "Kyolic Aged Garlic Extract" which uses 100% organically grown garlic bulbs and they are aged using a unique extraction process to eliminate odor (what the company calls "sociable garlic" because it's odorless.

Take two capsules twice-daily with food. The other product is called "Kyolic Aged Garlic Extract Blood Pressure Health, Formula 109" and this is a blend of the same Aged Garlic plus nattokinase (a natural enzyme that thins the blood and could help prevent stroke/heart attack) as well as SunTheanine which is a brand of L-theanine (an extract of green tea) that slows down heart rate. You can take two capsules twice-daily with food for this supplement too.

Coenzyme Q10 (CoQ10): This antioxidant lives in the heart and generates a spark of ATP, or energy. It stabilizes your heart beat by maintaining sinus rhythm. It prevents and may reverse symptoms of congestive heart failure. Your heart can't survive without CoQ10. You can now buy the active form of this nutrient as "ubiquinol." Statins and blood pressure pills are drug muggers of this nutrient. You should refer to my Drug Muggers book to read the chapter on CoQ10 and see over 200 drugs which steal it. For pennies a day, you can put back what medication stole. There are hundreds of studies to support the benefit of CoQ10 on heart muscle function and it's ability to improve heart failure symptoms.

Dr. Peter Langsjoen, a pioneer in the field of cardiac research and CoQ10 found that 51 percent of patients were able to stop one to three antihypertensive medications after four and a half months of starting CoQ10 therapy. The dosage of CoQ10 varies widely, and since there are few if any adverse events, it's okay to play around with the dose. Give it a week or two before upping your dosage. It ranges from 50 mg-200 mg daily (in divided doses so you could easily do 50 mg four times a day, or 100 mg twice daily, etc.) You could also take a lower dose if you get the more active body-ready form of "ubiquinol" and take about 100 mg daily.

L-carnitine: Works in tandem with CoQ10, this amino acid helps prevent premature ventricular contractions (PVCs). If you can find "Propionyl L-carnitine" this version targets the heart. Carnitine is a potential treatment for intermittent claudication. A large, double-blind, placebo-controlled trial used Propionyl L-carnitine in 271 heart failure patients, while placebo group (266 patients received an inactive supplement. Exercise tolerance was improved in the heart failure patients who received the carnitine. Dosage varies between 1,000 -- 3,000 mg per day in divided dosages.

Taurine: The most abundant amino acid in the heart, it improves contractions, maintains potassium levels in the heart and dampens down the sympathetic nervous system. It is directly involved in heart rhythm and may help with PACs, PVCs, pauses and tachycardia. Aspartame is a drug mugger of this nutrient. Low taurine levels are observed in patients who have had a heart attack so it stands to reason that a deficiency could be contributory, at least to some degree. Taurine levels may drop to one-third normal levels after ischemia/necrosis. Taurine protects the heart by stabilizing membraines, reducing free radicals and this protects the starving heart from reperfusion-induced arrhythmias too. Docs in hospitals have used IV taurine to prevent arrhythmias caused by digitalis drug. Buy taurine at any health food store, take anywhere from 500 mg-3,000 mg per day. Some studies suggest more is okay but with any good thing (especially if you combine with other heart-healthy supplements or medications) using the lowest effective dose is best.

Physicians and consumers who want a little more information about taurine can read about some case studies regarding the "Elimination of Cardiac Arrhythmias using Oral Taurine with L-Arginine, Stabilization of the SinoAtrial Node."

Magnesium glycinate or "chelate": If you have Afib, you are likely mag deficient! The use of magnesium is helpful because it lowers blood pressure, reducing risk of stroke, plus it functions in the electrical circuitry of the heart. It's useful for people with angina and atherosclerosis. Conventional blood tests will be normal, don't bother. It's the intracellular level you want, so ask for a "RBC magnesium" level. It could take six months to normalize, shoot for 600mg-800 mg daily, and work your way up. If oral supplements bother you, apply Ancient Minerals Magnesium Oil to your skin. This is a topical form of magnesium and it goes right through the skin into your bloodstream bypassing the gut.

Arginine: You can't talk about coronary artery disease without the mention of this amino acid, which works in tandem with taurine. Arginine widens the blood vessels, allowing for more blood flow throughout the body. Those two together could be of tremendous benefit for someone with cardiac arrhythmias. There is some information on the Internet about how one should NOT take arginine if they have had a heart attack, but I explain in my Diabetes Without Drugs book why this study is so incredibly flawed and why I believe it's okay to use arginine to reduce risk of a second heart attack (of course with your cardiologists approval). This is thoroughly explained in my book. I hate how the media jumps on one study and scares people away from nutrients that might otherwise save (or extend their life), and certainly improve quality of life (reduce those painful, scary angina attacks). Follow label directions. Argininine is sold widely in the U.S., sometimes under the brand name Perfusia, made by Thorne Research.

Ribose: A naturally occurring sugar that the body uses to make ATP, your energy molecule. Ribose improves blood flow and provides much-needed oxygen to the heart. Ischemia may cause the heart to lose up to 50 percent of energy. The problem is that even if blood flow and O2 levels are restored to normal, it takes a week to 10 days to rebuild cellular energy and to normalize cardiac function, so basically, your heart could be starving for days, even after the ischemia (stubborn angina) attack. When peole with CAD (coronary artery disease) are given D-ribose, symptoms improve faster. Dr. Stephen Sinatra spearheads a lot of the work on ribose. Ribose can't really be measured, so it's not something you can evaluate in a person, even with micronutrient testing, but this doesn't mean it can't help you. It's specifically good for people with fatigue (heart disease or not) because ribose is food for the mitochondria (which makes energy).

Patients with heart disease on drugs intended to increase the contractile strength of their heart are also good candidates for D-ribose. These drugs, known as inotropic agents, make the heart beat harder. This places considerable strain on the heart's ability to supply enough energy to support the extra metabolic stress. Long-term treatment with these agents drains the energy reserve, essentially running the heart out of energy. Patients with heart failure, chronic coronary artery disease, or cardiomyopathy should take D-ribose to offset the energy-draining effects of inotropic drugs such as digoxin. Research shows that supplementation reduces the energy drain without any negative impact on the activity of the drug. People who are weak, or constantly fatigued or short of breath could benefit, and naturally, this includes those with congestive heart failure. I buy the Jarrow brand, it's a powder so I can gauge my dose better, and use it in smoothies. It tastes great. The dosage for this is one to three scoops per day.

Fish Oils: There are books on the subject! This is a no-brainer, helps reduce inflammatory compounds in the body, reduce triglycerides and regulate production of cholesterol. Studies repeatedly show that fish oils can decrease arrhythmias (which can lead to sudden death), decrease the growth rate of atherosclerotic plaque and slightly reduce blood pressure. In 2002, the American Heart Association released a scientific statement called "Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardiovascular Disease" which discussed the positive benefits of omega-3 fatty acids on heart disease. Dosage varies widely, from 500 mg-5,000 mg daily! With food of course. A typical dose is 500 to 1,000 mg one- to three-times daily. These may thin the blood so be careful if mixing with anticoagulants (ask your doctor) and also, if you'd like a vegetarian source, you have that option. I've been taking plant-based oils, Dr. Ohhira's Essential Living Oils for the past year and enjoying the effects of this brand, it's sold in health food stores nationwide.

There are various tests available today, among the best, the Cardio/ION by Metametrix and the NutrEval by Genova Diagnostics. There is no excuse for a doctor to NOT order these tests for you, since they are returned with a complete interpretation and the labs are staffed with scientists and physicians to help your doctor learn and recommend specific nutrients for you. FYI, it costs your doctor nothing to order these tests and your insurance may even cover a portion. For more on that, refer to their respective websites above.

This information has not been evaluated by the FDA. The products listed above are for nutritional support only and are not intended to cure, prescribe, diagnose, or replace proper medical advice. Please check with your nutritionally aware doctor or cardiologist. If you are having a serious medical problem, please seek proper medical attention.

 
 
 

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Many people experience "benign" arrhythmias and these can last for years. Cardiologists can sometimes find the cause, but not always. People who suffer with these can occasionally link them to activi...
Many people experience "benign" arrhythmias and these can last for years. Cardiologists can sometimes find the cause, but not always. People who suffer with these can occasionally link them to activi...
 
 
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03:10 PM on 06/13/2011
16 years ago I had a fainting incident. Tilt table test (no induced fainting), 24 hours monitor - no irregular heart activity; electrophys test, heart electrical pathways - normal. Pacemaker installed, heart rate < 60 bpm, "bradycardia"; normal heart rate always less 45 bpm, trained athlete, At 60 bpm, my heart was racing; pacer rate was decreased to 45. I was not told that the pacer was installed because of low heart rate. After a year or so, I requested the hospital records for the operation, which revealed that the pacer installation was due not to irregular electrical measurements but due to my "abnormal" low heart rate. The tennis great, B. Borg, has had a lifetime rate of 35 bpm. So far, 3 pacer changes - battery wear, and both leads extracted (broke in place), difficult operation with a mortality threat. Taking blood thinner and propafenone (decreases my normal heart rate, allowing the pacer to pace). I now have irregular rate incidents, atrial flutter, I suspect are the interaction of my heart rate with the pacer determined rate. If pacer is turned off, non-paced heart rate decreases to less 30 bpm, less than normal 45 due to propafenone. How to wean off of the propafenone to be pacer free? Cost of medical operations, regular visits, medications, and time loss - inconvenience at metal detectors, no MRI scans for repairing physical injuries. Competitive swimming curtailed, leads breakage due to repetitive motion. NO PATIENT INFORMED CONSENT. Pacer patients - the gift $$$
04:30 PM on 05/04/2011
I wrote this article. Do any of you realize that HEART ABLATION IS NOT FDA APPROVED for arrhythmias? It's only supposed to be used for sealing off a blood vessel that the surgeon can directly see while doing open-heart surgery. Yet for 10+ years, cardiologists are performing this procedure making people pacemaker dependent, to the tune of about $25,000.00 each, and more money depending on complications for cardiac arrhythmias-- which are often the result of some imbalance in the hormone/nutrient/electrolyte system. Do you all think that's okay? Personally, if I spent that kind of money on a procedure to fix my heart, and it failed, I'd be pissed off. You're not?
Suzy Cohen, RPh
11:53 PM on 05/07/2011
After my first afib episode three years ago, I came across a website dedicated to educating people about the use of diet and nutritional supplements in the management of afib. I was impressed by the number of regular commenters there who claimed they had cured their afib using diet and nutrition. However, after reading there for a couple of years, I learned that almost every one of these people had undergone an ablation. When pressed, most of them will admit that the ablation was the major factor in the control or elimination of their afib.

Personally, I have done everything I can to manage by afib with supplements but it hasn't had a noticable effect. In my case, stress and emotions are my triggers so that's the area I continue to focus on. I agree that people should educate themselves and do everything they can to take control of their health but I also think people need be realistic about controlling their afib using only diet and supplements. I've read comments from people who feel like failures because they weren't able to control their condition by their own efforts.

Successful ablations have given many people with afib their lives back. It shouldn't be dismissed so readily.
11:55 PM on 05/07/2011
BTW - I forgot to add that most ablations done to eliminate afib do not result in people becoming dependent on pacemakers.
MommyMD
MD, Professor, Mom
03:26 AM on 05/04/2011
Props to Kat4show. Lovely reply. Magnesium is well-studied for benign arrthymias. Every MD should have include it in a med list. Taurine has no real data behind it (only observational or case repots) Your post was essentially a lovely case report with Mag. as a huge confounder. Of cousre, politeness is mandatory for ALL docs, but we also have the responsibilty to tell you if what you are taking is not FDA-approved, or studied in a well designed, peer reviewed reputable Journal.
MommyMD
MD, Professor, Mom
03:56 AM on 05/04/2011
Regarding your head-banging, : It seems you're friend got lots of non-invasive testing (Holter/Nuc. Med etc). Also, there really is a standard of care. We should all check all electrolytes/mag and calcium included. TSH (thyroid) gets checked by every cardiologist with whom I work (I'm endocrine). We should all ask about diet..caffeine...stress levels etc. Ask about all meds, including OTC meds. Non invasive Holter/stress tests etc. If you'd really like to stay non invasive an EP doc can transcutaneously test different areas of the heart (i.e. shock though the skin)...I don't think your friend would be too happy:)
If you're story isaccurate, you got a bum doc. Sorry to your friend.
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StThomas
Not until I see the holes of the nails....
04:29 PM on 05/02/2011
Second Try:
May I call readers' attention to this article, which discusses this part of the article:
"This information has not been evaluated by the FDA. The products listed above are for nutritional support only and are not intended to cure, prescribe, diagnose, or replace proper medical advice."
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StThomas
Not until I see the holes of the nails....
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StThomas
Not until I see the holes of the nails....
03:45 PM on 05/02/2011
"Recently, I went to the cardiologist with a friend of mine......."

Should everyone change what they're doing on the basis of a 'study' where n=1?
02:59 PM on 05/02/2011
Please, everyone, bear in mind that (unless you believe supplements work by magic) there is some chemical in it which affects the body's physiology. There isn't any other way - if we assume the supplement actually does something useful and nothing harmful. Would you prefer taking supplements that have not been vetted for safety or possible interactions with various diseases, drugs, and physiological questions (e.g. is it safe for women in perimenopause; men with prostate enlargement etc etc.)? Or would you prefer well researched presecription drugs which are proven to work and whose side affects have been studied, reported, and are known to your doctor?
10:48 AM on 05/02/2011
As a coronary care RN I don't see the difference between taking a handful every day of supplements/vitamins/minerals or a handful of prescribed medication.
As prescription medication is not without side effects so are supplements not without side effects.
In most cases as mentioned no one knows the standard dosing of supplements either. All your doing is switching one bunch of pills for another.
Don't get me wrong I have nothing against the search for alternative medications. Just because they can be purchases OTC does not make them any safer or more effective esp. if one has other pre-existing conditions or is mixing supplements with prescribed medications.
But yes if your physician suggests some type of serious procedure, get a second opinion, or even a third. One example of this is that there are thousands of coronary stents being done that are unnecessary. In some people the correct medication can be just as effective as stents. Look up all the recent studies on this yourself.
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RedneckDem
The top 1% stole my made in china bootstraps
10:30 AM on 05/02/2011
Don't forget potassium supplements. I had a couple cases of atrial fib and the blood showed a potassium deficiency. I now take supplements daily, as well as magnesium. Both of which, taken before bedtime, will alleviate restless leg syndrome as well.
ChangeAgent007
Changing the world everyday
09:57 AM on 05/02/2011
I have been having arythmia along with other neurological issues. This is ontop of my Lupus which I was diagnosed with two years ago. Complicated is an understatement. How would I find a professional who could help walk me through all this to make sure I'm not doing something that will exasperate the other conditions?