Strengthening the Heart Muscle

Coenzyme Q10 (CoQIO)

Most patient studies used at least 100 mg of the extract. For those with congestive heart failure, the dose begins at 300 mg a day and goes up to 600 mg a day in three divided doses, that is take 200 mg three times a day. CoQIO is a fat-soluble substance and will require that you either take it with a meal containing fats (extra virgin olive oil) or take it with your DHA supplement.

Cholesterol-lowering drugs all deplete CoQIO. This is because the enzyme that generates cholesterol, HMG CoA reductase, is also responsible for the production of CoQIO. The Cholestyramine drugs (Questran, LoCHOLEST and Prevalite) also lower beta-carotene, folic acid, and vitamins A, D, E, and K by inhibiting absorption. The drug, Colestid, inhibits absorption of beta-carotene, folic acid, and vitamins A, D, and E. (Source: Natural Medicines Comprehensive Database, 2001).

L-carnitine

The dose varies from 500-1,500 mg a day. The major side effect is diarrhea at the higher doses. If you develop diarrhea and dose reduction does not help, I suggest switching to acetyl-L-carnitine which is less likely to cause this side effect and has the added advantage of entering the brain more easily, where it improves brain-cell function and memory and chelates excess iron from the brain. The dose is the same, but it is much more expensive than L-carnitine.

Ginkgo Biloba Extract

Take 120-240 mg a day. This extract has been shown to improve blood flow through all tissues, especially the heart and brain. It also contains numerous antioxidant flavonoids and special substances called ginkgolides, which have been shown to reduce blood viscosity and improve blood flow through the microvessels. There is also evidence that it reduces the irritability of the heart muscle (arrhythmia). It should not be taken with anticoagulants, aspirin, or non-steroidal anti-inflammatory medications.

Hawthorn Extract

This extract should contain both the flower and leaf of the plant. The dose is 200-500 mg three times daily. Not only does it improve heart contractions, but in patients with stage II heart failure, it has been shown to improve exercise tolerance and reduce symptoms such as angina, fatigue, and palpitations. In addition, it can lower blood pressure in hypertensive patients.

Safety precautions. Hawthorn extract can cause agitation, insomnia, GI complaints, and headaches. It should not be used with cardiac glycoside medications, since it can potentially increase toxicity. Some herbs—such as digitalis leaf, figwort, motherwort, and lily of the valley roots—also contain cardiac glycosides. Do not use with fenugreek, ginger, Panax ginseng, parsley, devil's claw, or coltsfoot.

In general, it should not be used with drugs that cause vasodilation, act as CNS depressants, or be used with digoxin. You will need to ask you doctor about these drugs. (Natural Medicines Comprehensive Database, 2001).

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