Foundational Supplements for Heart Health
Fish and Other Healthy Oils. It would be hard to list all of the benefits of the omega-3 fats in fish oils. At a very basic level fish oil bolsters the health of your cell membranes, ensuring proper absorption of nutrients into the cell and proper communication between cells. This helps not only with heart disease, but literally any condition that you have. Fish oils boost low HDL, reduce IDL (see above), reduce triglycerides and VLDL and reduce C-reactive protein (CRP), an inflammatory marker. Omega-3s can also be obtained through eating fatty fish such as salmon, cod, mackerel, anchovies and sardines at least 3 times per week. For general health, 1200 mg of omega-3 per day is adequate, but if a condition is being treated by your practitioner, they may suggest an amount anywhere in the range of 3000-10,000 mg per day. As you can imagine, that would be a lot of fish. Ground flax seed, while it can benefit the heart in many ways, does not provide a therapeutic level of omega-3s and therefore cannot be used for the above purposes. It is recommended, however, as one of the healthy fats, along with those present in olive oil, avocado, chia seeds, hemp seeds and nuts. While saturated fat should be limited, it is okay to have meat and poultry that are organic, grass-fed and pasture-raised 2-3 times per week. Trans fats and hydrogenated oils should be completely avoided as they provoke an inflammatory response. Healthy fats should account for roughly 20% of calories, as it has been found that very low fat diets actually reduce beneficial HDL cholesterol.
Magnesium. Low magnesium levels are the greatest predictor of heart disease risk, according to a 2013 study that reviewed cardiovascular studies over the past seven decades.A deficiency of this macronutrient is very common in those with heart disease and the population at large. Over-farming has caused a depletion of this mineral in our soils and thus in our food. For blood pressure that is trending upward (greater than 120/80), this is the first nutrient you should look to. Magnesium relaxes the blood vessels, has a calming effect on the nerves, assists in managing blood sugar (a factor in inflammation), and balances calcium in the body. In a recent study showing that supplemental calcium may cause calcification to blood vessels, calcium intake was not being balanced with magnesium. Since these two nutrients work in concert for a number of functions in the body it is important that a balance between the two be maintained. Magnesium is used in 300 biochemical reactions in the body and therefore is a nutrient that you don't want to be deficient in! Doses of 250-1000 mg per day are safe, depending on your size, diet, and conditions you are trying to address. Magnesium can have a laxative effect because it relaxes the muscles, so start at a lower dose and build from there. Magnesium glycinate is a form that is easier on the stomach. Foods that are high in magnesium include nuts, dark, leafy greens, kelp, avocado and dark chocolate.
Potassium. Next to magnesium, potassium is probably one of the best nutrients for managing blood pressure. Potassium, along with sodium, helps the body to maintain water balance, a factor in blood pressure. A diet focused on packaged foods is generally very high in sodium and therefore needs to be balanced with extra potassium. Since supplements are only available in doses of 99 mg, it is best to get potassium from food sources. The best source is coconut water (400-600mg), and avocado, potato, and many fruits are also high in potassium. Rather than reducing your salt intake, you may want to reduce your intake of packaged foods, most of which are loaded with sodium. A high quality salt contains healthy minerals and, if iodized, enhances thyroid function.
Fiber. It is recommended that you consume at least 30 grams of fiber each day. Most Americans get 12-14 grams a day. Fiber is a superstar for heart health. It reduces the Lp (a) component of cholesterol, lowers triglycerides and VLDL, and reduces CRP. It also binds heavy metals and other toxins that can be a factor in heart disease in the digestive tract so that they can be removed from the system. Using a fiber supplement each night before bed is a great way to boost fiber intake and manage your blood sugar. Supplements can be found that have psyllium fiber, glucomannan, acacia fiber, oat or wheat bran, or some combination thereof. Many fruits and vegetables are high in fiber. Apples are considered a superfood for the heart due to the pectin fiber they contain, along with being high in potassium. Alternatively, adding 2 TBSP of ground flax, chia seeds, or hemp seeds to a protein shake is another great way to add fiber. Nuts are a good source of fiber and healthy fats.
Vitamin D. Low levels of vitamin D are linked to an increased risk of heart disease. It acts as a hormone, regulating more than 200 genes throughout the body. It affects bone and muscle strength, immune function, and is cancer-protective. It is protective against diabetes, a huge factor in the risk of heart disease, and it tempers damaging inflammatory responses. Since Vitamin D is an immune system modulator, it would provide a buffer for damage to the arteries that originates in an immune response. Vitamin D is made by the skin from cholesterol when sunlight hits the skin. Those who are dark-skinned, overweight, older, live in northern climates, or who cover up when in the sun will generally not make enough. A deficiency of this vitamin can be detected from the 25-hydroxy vitamin D test. Recommended levels are 50-80 ng/ml. If you are deficient, you can take 5000 IU's per day and retest your levels after 2 months. Daily doses for others who are not getting sun exposure are usually recommended at 1000-2000 IU's per day. Not many foods are high in vitamin D, but eggs, salmon, mushrooms, and milk do provide some. Always choose dairy products from grass-fed, organic sources.
Vitamin K2. Vitamin K2, particularly its MK-7 form, tells us how to use the calcium that our bodies absorb. Calcium that is not directed to the bones by this vitamin can build up in the blood causing plaque, high blood pressure, stroke and even heart attacks. Vitamin K, like some other vitamins, has several different forms. Vitamin K1 is in dark, leafy greens and is relatively easy to get through the diet. Vitamin K2 and its various forms are mainly present in a Japanese food called natto, some other fermented foods, and animal livers. Since the American diet is generally low in these food sources, supplementing with K2 can greatly benefit heart health, as well as bone health. Dosages in the range of 45-150 mcg are usually recommended.
CoQ10. This coenzyme is a factor in the energy-making process in every cell of the body and thus is important to the pumping action of the heart. It is also a strong antioxidant, helping to clear toxins from the body. CoQ10 is depleted by several drugs used to treat heart disease, including statins, beta blockers, and diuretics. CoQ10 has been shown in some studies to reduce blood pressure and is most helpful in the case of congestive heart failure. It also reduces the inflammatory marker CRP. For preventative benefit or to replace what is lost with prescription drugs, dosages of 100-300 mg are usually recommended. If your doctor is using CoQ10 to treat congestive heart failure, dosages may be much higher.
B Vitamins. The B vitamins help us break down our food, produce energy, and nourish the nerves, thus reducing stress. Certain of the B vitamins are also directly related to the management of heart disease risk. High homocysteine, an inflammation marker that is a risk factor for heart disease, can be reduced by supplementing with vitamins B6, B12 and folic acid. You can find a supplement that combines all three. Pantothenic acid, or vitamin B5, lowers cholesterol by blocking an enzyme involved in the production of cholesterol in the liver. It is also an excellent nutrient for the adrenal glands and thus counters a negative response to stress. If you are taking individual B vitamins to help with specific issues, then you may need to take more than is included in a B complex.
Additional Supplements for the Heart
While almost anyone can take the foundational nutrients above (after checking for drug interactions), additional supplements may benefit you depending on which risk factors for heart disease you personally have. These include:
Niacin. Also known as Vitamin B3, it has been used for years in Europe and even in the U.S. for the treatment of heart disease. Niacin lowers many problematic types of cholesterol including Lp (a), LDL particle number, IDL, and small LDL. It also lowers CRP and fibrinogen levels. Some forms can cause a flushing of the face and skin itching that is more irritating than harmful. Using niacin longer term may cause liver irritation, so its effect on the liver should be monitored. Therapeutic doses of 1200 mg to 3000 mg are usually required, so it is best to use niacin under the direction of your doctor. A side benefit of niacin is that it can be very beneficial to those with high anxiety and other mental and emotional issues. If your heart issues are fed by either of these things niacin may be a good choice for you.
Anti-inflammatory Herbs and Nutrients. The most notable of these are curcumin (from turmeric), resveratrol and aged garlic extract. Curcumin is a powerful anti-inflammatory and antioxidant. It also assists the liver in detoxification. Doses of 500-1000 mg are usually recommended. Resvertrol activates the SIRT1 gene, also known as the longevity gene. It is an excellent anti-inflammatory and thus can benefit those with heart disease risk accompanied by high levels of inflammatory markers. It is usually recommended in doses of 100-250 mg. It is found in red wine, chocolate, grapes and peanuts in smaller amounts. Drinking 2 glasses of red wine per day (if you are at a normal weight and do not have blood sugar issues) is thought to be beneficial in the prevention of heart disease. Garlic has been used in Asian cultures for centuries for the treatment of heart disease. Garlic is anti-inflammatory and acts as a blood thinner. It stimulates circulation and prevents fluid and phlegm accumulation. It aids in the reduction of both blood pressure and cholesterol. Doses of 300-600 mg are usually recommended.
Antioxidant and Detoxifying Herbs and Nutrients. If oxidative stress is one of the top causes of arterial damage as Mark Houston suggests, then nutrients that are antioxidants are very important to the health of the cardiovascular system. R-Lipoic acid, NAC, and milk thistle are three such nutrients. R-Lipoic acid is a very strong antioxidant that is also responsible for recycling other antioxidants. Diabetics use this nutrient to deal with neuropathy. Doses of 300-600 mg are recommended.
It has been found that those with lower levels of glutathione, the body's main detoxifying agent, are at greater risk for heart disease. This is probably due to the fact that so many environmental factors such as pollutants, chemicals, and even things found in consumer products can put us at risk for health issues. NAC is a nutrient that boosts levels of glutathione and thus can help the body to detoxify. Doses of 500-1200 mg are usually recommended. Milk thistle, standardized for silymarin content, is one of the premier detoxifying herbs for the liver. Since the majority of our cholesterol is made in the liver, a dysfunction in the liver could cause over-production of cholesterol. Take 400-800 mg per day. Herbs like artichoke extract and beet root can also help to lower cholesterol due to their action on the liver.
Herbs and Nutrients that Promote Healthy Blood Sugar Levels. High blood sugar and its precondition of excess insulin are both strong risk factors for heart disease. Too much insulin in the blood tells the body to store fat and promotes inflammation. Eating foods that have a low glycemic index, i.e. those that release glucose less rapidly into the bloodstream are the best for prevention or treatment of heart disease. Generally, protein and fats have lower glycemic index than most other food types. Vegetable generally have a medium to low glycemic index, except for those that are very fibrous like carrots, beets, white and sweet potatoes. Some fruits have a high glycemic index and berries, apples, pears and others with more fiber are best. Whole grains are the best carbohydrates to eat and "white" carbs that release glucose into the blood quickly should be avoided. Two tablespoons of ground flax seed, chia seeds, hemp seeds is a great way to manage blood sugar.
Nutrients that Provide Energy to the Heart. D-Ribose and taurine can be used to provide energy to the heart where advanced disease has occurred. Heart disease takes a toll on the tissues and impairs the production of ATP, the body's main source of energy. D- ribose is a simple sugar that is not stored by the body that can speed up healing by increasing the energy available to the heart. The recommended dose is 5 grams. Taurine is an amino acid found in large concentrations in the heart. It can be used to treat congestive heart failure, high blood pressure, and high cholesterol. The recommended dose is 3 grams.
Be Aware of Drug Nutrient Depletions
If your doctor has decided that a drug best addresses your heart condition, be aware that certain drugs deplete nutrients in the body and often these nutrients are beneficial for heart health. Below are some drug classes and their nutrient depletions:
- Diuretics-Decrease potassium, magnesium, phosphorous, sodium, chloride, zinc, iodide, CoQ10, folate, B12, B6, thiamine and selenium.
- Beta blockers-Decrease CoQ10
- ACE Inhibitors-Decrease zinc
- Angiotensin Recepetor Blockers-Decrease zinc
- Statins-Decrease CoQ10, selenium, omega-3s, Vitamins E, A, & D, carnitine, and free thyroid hormone
If you unaware of which of these classes of drugs your prescription relates to, a google search is an easy way to check.
In summary, the majority of heart disease can be avoided by maintaining a healthy weight, smoking cessation, obtaining an optimal diet with food and supplements, exercising, and managing stress. If you have done everything right and environmental factors or inherited risks have caused you heart trouble, there are supplements that can help you regain your health. For those with serious heart disease, your doctor may recommend prescription drugs, but many of the above supplements can be used in tandem with drugs for faster healing. If you use supplements along with prescription drugs, do consult a reliable source for any potential interactions. Walsh has a reliable source that we can check, as does your pharmacist.