complementary and alternative treatment in cv disease
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COMPLEMENTARY AND ALTERNATIVE TREATMENT IN CV DISEASE. DEFINITIONS. Complementary: Enhances treatments currently used Alternative: Replaces treatment currently used. OBJECTIVES. Explain what works, or might work Explain what does not work and may harm

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definitions
DEFINITIONS
  • Complementary: Enhances treatments currently used
  • Alternative: Replaces treatment currently used.
objectives
OBJECTIVES
  • Explain what works, or might work
  • Explain what does not work and may harm
  • Have the courage to explain the difference
importance of herbal medications
IMPORTANCE OF HERBAL MEDICATIONS
  • 1/3 of what we use began as herbal medications.
  • Digitalis from the foxglove plant
  • Aspirin from willow bark
  • Statins from red rice yeast.
diet as an herbal therapy
DIET AS AN HERBAL THERAPY
  • Grains
  • Vegetables
  • Fruits
  • Oils, Olive, Canola, Peanut, Soy etc.
  • Milk and cheese
  • Meat and beans
  • Discretionary
suplements for high cholesterol
SUPLEMENTS FOR HIGH CHOLESTEROL
  • Fish Oil
  • Red Rice Yeast
  • Artichoke Leaf
  • Niacin
  • Garlic
  • Fiber
fish oil
FISH OIL
  • Omega 3 Fatty Acids
  • DHA and EPA
  • Fatty fish-Salmon, Mackerel, Lake trout
  • Lowers Triglycerides but not LDL or TC
  • Fish Burp
  • Lovaza
  • May elevate glucose.
red yeast rice
RED YEAST RICE
  • Ferment rice with yeast-Monascus purpureus
  • Asian digestive tonic
  • Monacolin K=Lovastatin
  • Highly variable levels of Monacolin and potential muscle injury.
plant sterols
PLANT STEROLS
  • Sterols and Stanols=Phytochemicals
  • Lower LDL
  • 10% reduction in LDL
  • Very effective when added to a statin.
  • Block intestinal absorption
soluble fiber
SOLUBLE FIBER
  • Psyllium=Metamucil
  • Oats, Barley,Apples, Broccoli, Beans
  • Binds with bile acids, removes bile acid and makes the liver convert more cholesterol into bile acids.
  • Use only if you cannot get enough from your diet.
garlic
GARLIC
  • Little evidence for significant cholesterol lowering
  • Small reduction in TC.
  • Increased risk of bleeding with coumadin.
niacin
NIACIN
  • Vitamin B6
  • Lower triglycerides and raise HDL
  • May cause flushing
  • Hepatotoxic, especially OC varieties
  • Stick to Niaspan.
  • Take after aspirin and with a meal.
artichoke leaf
ARTICHOKE LEAF
  • Plant, Cynara scolymus contains antioxidants
  • Very Small effect on cholesterol
  • Not recommended.
bottom line
BOTTOM LINE
  • Applies to all C and A treaatment
  • Even if its natural it still can have serious side effects-Kava Kave, Yohimbine.
  • Natural does not mean safe
  • Make sure it will not diminish or increase the effectiveness or risk of what you are on.
  • Tell your doctor what you are taking.
vitamin a
VITAMIN A
  • Liver, eggs, fortified foods, Carrots (foods that contain b carotene)
  • Essential for night vision, skin
  • Women 700 mcg
  • Men 900 mcg
  • Toxic in higher doses (3000 mcg)
vitamin c
VITAMIN C
  • Ascorbic acid-citrus fruits and juices
  • Promotes healty gums and teeth, Antioxidant
  • Women- 75 mg
  • Men-90 mg
  • Smokers need 35mg more
  • Tissue levels do not change above 250mg
vitamin d
VITAMIN D
  • Milk and fish and fortified foods.
  • Body produces in response to sunlight.
  • Bone density
  • Can be tested
  • Adults 19-50 200 IU
  • Adults 51-70 400 IU
  • Maine 1000 iu a day in winter
vitamin e
VITAMIN E
  • Nuts, vegetable oils, whole grains
  • Antioxidant
  • Ask MD if you are taking aspirin or coumadin
vitamin k
VITAMIN K

Green vegetables

Bacteria in the gut produce most of what we need

Essential for blood clotting

Women 90 mcg

Men 120 mcg

Suplements are not recommended.

thiamin b1
THIAMIN (B1)
  • Whole and fortified grains, beans, wheat germ
  • Needed for the conversion of carbohydrates into energy
  • Women 1.1mg
  • Men 1.2 mg
  • Supplements are not necessary.
riboflavin b2
RIBOFLAVIN (B2)
  • Dairy products, red meat
  • Helps convert carbohydrates into energy
  • Red cell production
  • Women 1.1mg
  • Men 1.3
  • Supplements are not necessary
niacin b3
NIACIN (B3)
  • Nuts, grains, red meat, fish
  • Aids in the release of energy
  • May be prescribed to reduce cholesterol and triglycerides.
  • Women 14 mg
  • Men-16mg
  • May cause flushing, gout, liver damage in high doses.
vitamin b6
VITAMIN B6
  • Pyridoxine
  • Grains, bananas, meat
  • Maintains reactions in proteins and amino acids.
  • Immune function.
  • Adults 1.3-1.7 mg
  • In large doses can cause neurological disorders
folic acid b9
FOLIC ACID (B9)
  • Leafy greens, beans, citrus fruit
  • Important in the synthesis of DNA
  • Aids normal growth and development
  • Adults 400 mg
  • Do not exceed 1000 mg
vitamin b12
VITAMIN B12
  • Cobalamin
  • Liver, Beef, poultry
  • Essential to RBC development
  • Maintains the nervous system
  • Adults 2.4 mcg
  • No benefits from megadoses.
panothenic acid
PANOTHENIC ACID
  • Whole grains, beans, milk
  • Vital for metabolism.
  • Adults 5 mg
  • Supplements are not necessary
biotin
BIOTIN
  • Peanuts, eggs, milk
  • Important in metabolism
  • Adults 30 mcg
  • Supplements not recommended
  • If you are concerned take a good multivitamin.
drugs to avoid
DRUGS TO AVOID
  • St John’s wort-hypertension
  • Ginseng-hypertension, reduces effect of warfarin, hypoglycemia
  • Ginko biloba-bleeding risk, seizures
  • Hawthorn berry-potentiates cardiac glycosides and nitrates
  • Saw palmeto-bleeding, hepatitis, floppy iris
drugs to avoid1
DRUGS TO AVOID
  • Yohimbine-hypertension, kidney disease
  • Licorice-hypertension, dig toxicity
  • Black cohosh
  • BOTTOM LINE-check with you doctor before trying any herbal product.
problems with herbals
PROBLEMS WITH HERBALS
  • Lack of scientific evidence and safety
  • Lack of regulatory oversight
  • Lack of quality control
  • Public misinformation
  • Lack of knowledge of the interactions by patients and providers.
  • Underreporting of adverse reactions
what do i take
WHAT DO I TAKE?
  • I eat a healthy balanced diet
  • I am very active
  • I take my blood pressure pill
  • I take my multivitamin
  • I take fish oil
  • I take vitamin d and calcium
  • I take one aspirin.
i also
I ALSO
  • Try to exercise regularly
  • Do Pilates
  • Do Yoga
  • Meditate
  • Bucket list-more exercise, tai-chi, more fly fishing and sailing.
  • More family time.
questions
QUESTIONS
  • One at a time
  • No I do not support supplements with multiple components claiming to make one young, sexy, and physically vibrant
  • More than 5-8 bottles on the shelf is a waste of your money.
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