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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