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Congestive Heart Failure–Traditional and Alternative Approach

By Tucson Functional Medicine on April 26, 2022 0 Comments

While many health screens and lab tests are overrated or unnecessary, a few are vitally important, such as vitamin D. I recommend checking your vitamin D level at least twice a year.

Two other critical tests are serum ferritin (which measures stored iron) and gamma-glutamyl transpeptidase, sometimes called gamma-glutamyltransferase (GGT; a liver enzyme correlated with iron toxicity, disease risk, and all-cause mortality). You can avoid serious health problems by monitoring your serum ferritin and GGT levels and taking steps to lower them if they’re too high.

I strongly recommend getting a serum ferritin test and GGT annually for adults. I believe it can be as dangerous to your health as vitamin D deficiency when it comes to iron overload. In this interview, Gerry Koenig, former chairman of the Iron Disorders Institute and the Hemochromatosis Foundation, explains the value of these two tests.

Iron Overload Is More Common Than Iron Deficiency

Iron is one of the most common nutritional supplements. You can get it as an isolated supplement, but it’s also added to most multivitamins. In addition, many processed foods are also fortified with iron. While iron is necessary for biological function, it can do tremendous harm when you get too much.

Unfortunately, people first think when they hear “iron” is anemia or iron deficiency, not realizing that iron overload is a more common problem and far more dangerous. Many doctors don’t understand or appreciate the importance of checking for iron overload.

Virtually all adult men and postmenopausal women are at risk for iron overload due to inefficient iron excretion since they do not lose blood regularly. Blood loss is the primary way to lower excess iron, as the body has no active excretion mechanisms. Another common cause of excess iron is the regular consumption of alcohol, which will increase the absorption of any iron in your diet.

For instance, if you drink wine with your steak, you will likely absorb more iron than you need. There’s also an inherited disease, hemochromatosis, which causes your body to accumulate excessive and dangerously damaging iron levels.

High iron can contribute to cancer, heart disease, diabetes, neurodegenerative diseases, and other health problems, including gouty arthritis. However, in a small study, 2 100 percent of the patients achieved a marked reduction in heart failure — sometimes known as congestive heart failure — occurs when the heart muscle doesn’t pump blood as well as it should. When this happens, blood often backs up, and fluid can build up in the lungs, causing shortness of breath.

Heart failure signs and symptoms may include: 

  • Shortness of breath with activity or when lying down
  • Fatigue and weakness
  • Swelling in the legs, ankles, and feet
  • Rapid or irregular heartbeat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinged mucus
  • Swelling of the belly area (abdomen)
  • Very rapid weight gain from fluid buildup
  • Nausea and lack of appetite
  • Difficulty concentrating or decreased alertness

Recommended testing for Heart Failure:

NT-proB-type Natriuretic Peptide (BNP) blood test. B-type natriuretic peptide (BNP) is a hormone produced by your heart. Levels go up when heart failure develops or gets worse, and levels go down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than in people who have normal heart function.

An average level of NT-proBNP, based on Cleveland Clinic’s Reference Range, is:

  • Less than 125 pg/mL for patients aged 0-74 years
  • Less than 450 pg/mL for patients aged 75-99 years

If you have heart failure, the following NT-proBNP levels could mean your heart function is unstable:

  • Higher than 450 pg/mL for patients under age 50
  • Higher than 900 pg/mL for patients age 50 and older

Echocardiogram

Ejection fraction (EF): Your EF measures the blood pumped out of your heart with each beat. A normal EF is between 55% and 70%

The Role of C-Reactive Protein (CRP) in Heart Failure

Some studies show that CRP is increased in heart failure. Higher levels are associated with more severe heart failure features and are independently associated with mortality and morbidity.

Traditional Medical Treatments:

The newer combination drug called Sacubitril-valsartan (Entresto) (called an ARNI, ARB with a Neprilysin Inhibitor) has been studied and shown to have improved outcomes in patients with a weak heart muscle when it replaces medications like lisinopril (an ACE Inhibitors) or losartan (an ARB, or Angiotensin Receptor Blocker). For patients with a heart muscle with reduced ejection fraction (EF< 40%), Quadruple therapy is the recommended:

  • An ACE Inhibitor, ARB, or ARNI
  • A Beta-blocker (carvedilol or metoprolol succinate)
  • An Aldosterone antagonist (spironolactone or eplerenone)
  • An SGLT2 Inhibitor (dapagliflozin)

Alternative Medicine Considerations in the Management of Heart Failure

Of the many adjunctive treatments for congestive heart failure (CHF), two of the most widely publicized in recent years are Q10 (ubiquinol) 100 mg to 300 mg/day and hawthorn. More studies need to be conducted.

References

https://www.ahajournals.org/doi/10.1161/circulationaha.104.508465

https://pubmed.ncbi.nlm.nih.gov/30114262/

https://pubmed.ncbi.nlm.nih.gov/16129801/

https://www.karger.com/Article/Fulltext/351115

https://www.aafp.org/afp/2000/0915/p1325.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287951/

https://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.115.002639

https://www.sciencedirect.com/science/article/pii/S0019483217308696

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249900/

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