When it comes to our leading killers of Americans, those involving our heart and cardiovascular system are represented by two of the top five, with heart disease leading the list and stroke at the fifth position.1 Interestingly of the top ten, seven have been linked to diet and lifestyle.
Unfortunately most medications for cardiovascular disease come with some sort of side effect. Sometimes the side effects are minor or can be mitigated by increasing nutrient intake of certain vitamins or minerals. The problem is, most of the time doctors don’t test nutrient status to determine if supplementation is adequate. It’s not that they don’t necessarily want to but the insurance industry can get in their way and so, over time they learn to stick with what the insurance industry requires. Others…well, as we have seen with the opioid epidemic, some doctors are just out there to be sales people for the pharmaceutical industry. This is not to say that all these drugs are just harmful. Many of these drugs save lives, but they often do so at the expense of lifestyle and dietary changes that can actually reverse these conditions. So if you have cardiovascular disease, heart disease, or have had a heart attack or stroke, here is some information that can help you maximize your treatment when working with a functional medicine practitioner.
Some nutrients to keep an eye on when on medications related to cardiovascular disease include calcium, potassium, sodium, zinc, vitamin K, and magnesium. Depending on other conditions that may be present, other nutrients may need to be monitored as well. When gastro intestinal (GI) issues are suspected it may be wise to do a full nutrient panel to get a general baseline of nutrient status. This can be helpful when assessing GI function. Untreated GI issues make absorption and utilization of both drugs and supplements more difficult.
So you told me what to monitor. What other options may help maximize my treatment plan?
Unfortunately if you try to self-treat with supplements you may end up causing more problems than you solve. Another issue is that if there are other medical issues present, some supplements may interact, or need higher dosages to be effective. The later is true for most GI conditions, where impaired digestion and absorption of nutrients can make it impossible to get necessary nutrients from whole foods and a multivitamin may not be enough…especially a cheap multivitamin with poorly absorbed forms of vitamins.
Some potential supplement interventions to consider:
Vitamin B6, 9, or 12- These may be useful for those with hyperhomocysteinemia (elevated homocysteine, -a marker of inflammation). Blood testing is required to confirm hyperhomocysteinemia and genetic testing can help to determine need. If impaired digestive function is present it can increase our need for these vitamins, and risk of toxicity from supplementation is low in most people.
Magnesium is involved in over 300 metabolic reactions yet over half of American adults have an inadequate intake.2 Magnesium is necessary for proper vasodilation and as an aid to reduce the inflammatory process.2 It may be even more helpful if you are also suffering from hypertension. Magnesium also has a beneficial impact on our nervous system where it has been used to treat mental health issues.3 So, in addition to helping our vascular system, magnesium may also help our mental health which can make implementing other diet and lifestyle changes easier and more productive.
Oral, liposomal glutathione (GSH) has been shown to increase the blood biomarkers of GSH. GSH increases in the blood have been linked to reductions in oxidative stress, and improvements in immune function.4
Vitamin C may help but there is inconsistent evidence that supplementation is as beneficial as increasing intake from whole foods. It’s most likely that supplementation is more helpful for those with an overt deficiency in their diet but foods seem to have the biggest impact, especially when considering the antioxidants found in whole food sources of vitamin C.5 Testing can help determine which to choose, foods or supplementation.
Zinc’s usefulness is tied more too concurrent hypertension and drugs used to treat it. Anti-hypertensive drugs typically impair zinc.6 Testing is helpful to determine the supplementation dose needed. A zinc deficiency can lead to taste and smell changes, as well as cognitive/mood issues which can all impact our food cues, food desires, how much we eat, and how much salt we crave when eating.
Resveratrol (the chemical thought to be beneficial in red wine) has been shown to improve the function of the cells lining our blood vessels-the endothelial cells.7
Curcumin has been shown to reduce LDL cholesterol, triglycerides, and total cholesterol.8 In addition it’s a powerful antioxidant and one of the most highly studied herbal supplements out there.
As mentioned above, it’s important that an individual’s entire health history, symptoms, lifestyle, and diet are considered when looking to use supplements to treat a disease. Some nutrients interact with each other, especially essential minerals. Other nutrients provide synergistic support but each person should be evaluated by a functional medicine practitioner who can put all the potential interventions into context and prioritize which will work best for you based on your unique needs.
References:
- Centers for Disease Control and Prevention. (March 17, 2017). Leading causes of death. U.S. Department of Health and Human Services. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
- Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in Prevention and Therapy. Nutrients, 7(9), 8199–8226. https://doi.org/10.3390/nu7095388
- Sinha, R., et al. (2018). Oral supplementation with liposomal glutathione elevates body stores of glutathione and markers of immune function. European Journal of Clinical Nutrition, 72(1), 105–111. https://doi.org/10.1038/ejcn.2017.132
- Schwalfenberg, G. K., & Genuis, S. J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica, 2017, 4179326. doi:10.1155/2017/4179326
- Al-Khudairy, L., Flowers, N., Wheelhouse, R., Ghannam, O., Hartley, L., Stranges, S., & Rees, K. (2017). Vitamin C supplementation for the primary prevention of cardiovascular disease. The Cochrane Database of Systematic Reviews, 3, CD011114. https://doi.org/10.1002/14651858.CD011114.pub2
- Suliburska, J., Skrypnik, K., Szulińska, M., Kupsz, J., & Bogdański, P. (2018). Effect of hypotensive therapy combined with modified diet or zinc supplementation on biochemical parameters and mineral status in hypertensive patients. Journal of Trace Elements in Medicine and Biology: Organ of the Society for Minerals and Trace Elements (GMS), 47, 140–148. https://doi.org/10.1016/j.jtemb.2018.02.016
- Marques, B. C. a. A, et al. (2018). Beneficial effects of acute trans-resveratrol supplementation in treated hypertensive patients with endothelial dysfunction. Clinical and Experimental Hypertension (New York, N.Y.: 1993), 40(3), 218–223. https://doi.org/10.1080/10641963.2017.1288741
- Qin, S., Huang, L., Gong, J., Shen, S., Huang, J., Ren, H., & Hu, H. (2017). Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials. Nutrition Journal, 16(1), 68. https://doi.org/10.1186/s12937-017-0293-y
