A PERSONAL EXPERIENCE
by Paul J. Dunn, MD, charter member of the American Holistic Medical Association; member of the American College of Advancement in Medicine, the American Academy of Environmental Medicine, and the Academy of Orthomolecular Medicine; and member and past president of the International Academy of Nutrition and Preventive Medicine, with a private practice in holistic medicine in Oak Park, Illinois.
What does a nutritionally oriented, holistic physician do when confronted with traditional treatment for his own episode of chest pain due to coronary vessel spasm? In this edition of "The Doctorís Corner," by relating my own experience, I hope to help integrate old and new information and provide motivation for readers to follow through and act on their knowledge.
Most physicians during their education have not been exposed to nutritional medicine and, subsequently, have not had the desire or the motivation to investigate it. Therefore, it is up to each one of us to educate ourselves, and hopefully our physicians, about other ways besides drugs and surgery of treating and preventing heart disease. I do emphasize, however, that there are times when drugs are indicated and occasionally surgery. Just so they are not considered the main and only thrust of treatment. My own personal experience is an example of the benefits not only of obtaining, but also, most importantly, of being really motivated to implement the nutritional and other life-style information.
I have been practicing holistic, complementary medicine for almost thirty years and always tried to practice what I preached. I ate right, took nutritional supplements, exercised, and did all those good things I recommended to patients. For a few months prior to June 23, 1994 there did not seem to be enough time for exercise. My nutritional program could have been better. My stress level increased. Within six weeks I had been to four medical meetings all over the country and was packed to go to another in Oklahoma City.
Early in the morning of June 23 I awoke with an aching across the chest. It persisted so I went to the emergency room of the hospital where Iím on staff. Before leaving I took 500 milligrams of magnesium. The pain left as I arrived there; but I was admitted anyway. EKG and blood tests were normal. Echocardiogram was perfectly normal. Subsequently, nine minutes on the stress test did not produce symptoms but did show some EKG changes. It was not a myocardial infarction or heart attack as such; but there was some ischemia or diminished blood flow to the septum or wall between the ventricles that pump blood out to the lungs and the rest of the body. There was also a slight rise in certain enzymes.
Treatment consisted of intravenous heparin, a nitroglycerin patch, oxygen, aspirin, and a beta blocker, Lopressor®. This drug helps prevent further episodes of pain but it also lowers blood pressure. (My blood pressure has been and was at that time perfectly normal.) Overall I felt comfortable except for being depressed and exhausted over the whole affair.
After the thallium stress test my cardiologist said, "The next thing to do is an angiogram." I said, "Forget it. No angiogram. An angiogram is not accurate1,2 to begin with. Itís also an invasive test with significant complications. My younger brother died as a result of angiogram complications. Besides, I prefer more conservative methods of treatment rather than surgery, which might very well be the next recommendation." His response was, "I kind of thought thatís what you would say." (He was aware of my holistic approach.) We politely discussed alternatives such as chelation and supplements. He said he didnít agree with these but if a patient wanted them elsewhere it was OK. I was discharged after three days. I agreed to stay home for two weeks and to continue to take the drugs I was on in the hospital. My wife, a certified clinical nutritionist, supervised the office in my absence, relative to patientsí nutrition.
My resting at home alone was not pleasant. I became more and more depressed and exhausted and had all sorts of very negative thoughts. One evening after being on the drugs for ten days my blood pressure was about 94 and my resting pulse was 105. I felt that if I took another Lopressor® that I would go into shock before the night was over. I decided to stop the medication and removed the nitroglycerin patch.
About a week later I was with the cardiologist and told him that I had stopped the medication and was feeling much better. A repeat EKG was normal. I appreciate the excellent care I received in the emergency situation. My subsequent regime is based on my own experience and further recommendations from other holistic colleagues and from my wife, Certified Clinical Nutritionist Kathryn Dunn.
This whole episode made me reassess what I had been doing and not doing concerning my own health. I have really become much more careful about what I eat and donít eat. I exercise more regularly. I am reducing stress. My cholesterol and other blood tests are very good. My weight, which was about fifteen pounds too much, has now stabilized around my 1942 Navy weight. I have had no further problem and I feel very well.
Specifically, what have I done to arrive at this state? First of all, I have been getting chelation treatments, a series of intravenous infusions that have a great variety of benefits particularly regarding the heart. Among my supplements that are especially helpful to the heart, and that are discussed in detail later, are vitamin E in adequate amounts, l-carnitine, taurine, CoQ10, vitamin C, beta carotene, magnesium, potassium, hawthorn berry, cayenne pepper, lysine, proline, DHEA, and testosterone.
Other aspects of my present regime really began shortly before June 23 with a number of tests I did on myself in the office. These showed various unsuspected food sensitivities, an underactive thyroid, somewhat high cholesterol, including high LDL (the bad kind), and low HDL (the good kind). Now with my present regime, which includes Armourís thyroid, my cholesterol is 170 with good levels of HDL and LDL. Iíve eliminated my sensitive foods. A prior adrenal stress index done on four samples of saliva collected from 8:00 am till midnight showed my cortisol to be high during the afternoon and at midnight when it is supposed to be low. This is related to various factors including glucose regulation and stress. My diet now completely eliminates refined sugar. Iím also relieving stress in other ways such as occasional brief rest periods during the day. All the above factors plus my stay in the hospital certainly motivate me strongly to stick to my treatment plan consistently.
Diet, of course, is of primary importance. It should include vegetables, fruits, legumes, whole grains, fish, poultry, occasional red meat, nuts, seeds, sprouts, fiber, and sufficient essential fatty acids (omega 3 and omega 6). The diet should be low in fat and should eliminate refined sugars and processed foods including the trans fatty acids in margarine and other hydrogenated oils. Adequate amounts of the supplements mentioned above are likewise essential for preventing and treating coronary disorders.
The first steps in plaque formation and the consequent blood vessel narrowing are slight injury to a blood vessel wall, followed by oxidation of LDL. Vitamin E, vitamin C, and beta carotene are powerful antioxidants so that with adequate amounts they can prevent the oxidation of LDL. Research has shown their important properties in treating and preventing coronary disorders. Vitamin C will help dissolve clots that have already formed.3 Vitamin E deficiency is a greater risk for heart attack than high cholesterol or high blood pressure.4 A study was initiated at Harvard Medical School involving a total of 22,000 physician volunteers half of whom took beta carotene. The study lasted 10 years. In a subgroup of the physicians, who had a history of coronary artery disease, those who took beta carotene had a 50% reduction in major cardiovascular events such as heart attacks, strokes, bypass surgery, and cardiovascular death.5 Even if one only takes adequate amounts of vitamins C, E, and beta carotene a big step would have been taken in preventing not only coronary disease but also a variety of other chronic degenerative diseases. This also implies, of course, a good diet and regular exercise. Vitamin C reduces the risk of cardio-vascular disease in three ways: First, it prevents build-up of deposits by preventing injury to the vessel wall. Second, it prevents spasm of the blood vessel, thus preventing high blood pressure. Third, it prevents blood clot formation.6,7,8, L-lysine and l-proline, two amino acids, prevent other sclerotic deposits in blood vessels.9,10 There is evidence that these two amino acids along with vitamin C and vitamin E could actually reverse atherosclerotic deposit.
Carnitine is an amino acid derivative that not only reduces high blood levels of harmful fats but also it helps normalize the levels and increases the beneficial HDL.11 Carnitine also reduces the incidence of angina attacks and is very helpful in heart failure.
Co-enzyme Q10 (CoQ10) is a vital catalyst in the creation of the energy that all cells need for life. It is related to all bodily functionsóespecially the pumping heartówhich needs abundant energy. Heart tissue contains more CoQ10 than any other muscle in the body. Among the many benefits of this catalyst are the relief and prevention of angina.12
Among the herbs, hawthorn berry and cayenne pepper13 are very helpful in heart problems. More information on these can be obtained in one of the many books on herbal medicine. One of these is The Science of Herbal Medicine, John Heinerman, BiWorld Publishing, Orem, Utah.
Magnesium is vital to the heart, especially regarding its rhythm. Studies have shown magnesium can reduce complications of acute coronary attacks by 50%. It is also very valuable in preventing the attack. Potassium and calcium are similarly important.
Taurine is required by heart cells for retention of calcium and potassium. It is the most abundant free amino acid in cardiac tissue. It helps maintain normal cardiac rhythm by mobilizing calcium.14 Taurine has been used successfully in the treatment of congestive heart failure. It is implicated in angina, atherosclerosis, arrythmias, and high cholesterol.15 Where these have been problems, taurine is a very helpful aspect of treatment.
When blood levels are low, two other supplements that I and many other holistic physicians are including in our own personal health programs, as well as for patients, are DHEA (dehydroxyepiandrosterone) and testosterone. Both of these are valuable adjuncts in the prevention and treatment of heart disease and a variety of other conditions. These hormones are available only by prescription and their use needs to be monitored. When indicated they are exceedingly helpful.
All of the above are very valuable for a healthy lifestyle and a healthy heart. Ideally itís best to work the details out with someone familiar with nutritional medicine. Certainly, if there has been a heart problem one should tell their physician what supplements are being used. You might suggest that the doctor may be interested in reading, ERADICATING HEART DISEASE, a book written by Matthias Rath, MD, published in 1993 by Health Now, 387 Ivy Street, San Francisco, California 94102. Dr. Rath, a leading expert in cardiovascular disease and nutrition, explains the scientific basis for the nutritional program. I suggest presenting the doctor with a copy of the book.
I thank the present and past board members of NOHA and all their assistants, who for all these years have done such outstanding work in nutrition education. I urge everyone not to wait for a frightening episode like mine to motivate them to use all available information to obtain optimal health. Really use this knowledge now and consistently in the future. By doing so it is possible eventually to "die young at an old age."
1Grodin, C. M., et al, "Discrepancies Between Cineangiographic [Angiogram] and Postmortem [Autopsy] Findings in Patients with Coronary Artery Disease and Recent Myocardial Revascularization[Bypass Surgery]," Circulation, 49: 703-8, 1974.
2Zir, L.M., et al, "Interobserver Variability in Coronary Angiography," Circulation, 53: 627-32, 1976.
3Bordia, A.K., "The Effects of Vitamin C on Blood Lipids, Fibrinolytic Activity and Platelet Adhesiveness in Patients with Coronary Artery Disease," Atherosclerosis, 35: 181-7, 1979.
4Gey, K.F., "Inverse Correlation Between Plasma Vitamin E and Mortality from Ischemic Heart Disease in Cross-Cultural Epidemiology," American Journal of Clinical Nutrition, 53 (Supplement): 326, 1991.
5Gaziano, J.M., Circulation, 82 (III): 201, 1990.
6Rath, M., and Pauling, L., "Solution to the Puzzle of Human Cardiovascular Disease: Its Primary Cause Is Ascorbate Deficiency, Leading to the Deposition of Lipoprotein(a) and Fibrinogen/Fibrin in the Vascular Wall," Journal of Orthomolecular Medicine, 6: 125-34, 1991.
7Spittle, C.R., "Vitamin C and Deep-Vein Thrombosis," The Lancet, 7822 (2): 199-201, 1973.
8Bordia, A.K., "The Effects of Vitamin C on Blood Lipids, Fibrinolytic Activity, and Platelet Adhesiveness in Patients with Coronary Artery Disease," Artherosclerosis, 35:181-7.
9Boscoboinik, D., A. Szewczyk, C. Hensey, and A Assi, "Inhibition of Cell Proliferation by Alpha-tocopherol," Journal of Biological Chemistry, 266: 6188-94,1993.
10Grainger, D.J., H.L. Kirschenlohr, J.C. Metcaffe, P.L. Weissberg, D.P. Wade, R.M. Lawn, "Proliferation of Smooth Muscle Cells Promoted by Lipoprotein(a)," Science, 260: 1655-8, 1993.
11Opie, L., "Role of Carnitine in Fatty Acid Metabolism of Normal and Ischemic Myocardium," American Heart Journal, 97: 375-88, 1979.
12Hiasa, Miracle Nutrients, 1984, p. 104.
13Mowrey, Daniel, The Scientific Validation of Herbal Medicine, Keats, New Canaan, Connecticut, 1985.
14 Bland, J. (Ed.) "Anti-inflammatory Aspects of Amino Acids," Yearbook of Nutritional Medicine,.Keats, New Canaan, Connecticut,1985.
15Husetable, R. T., Taurine in Nutrition and Neurology, Plenum, New York, 1982.
Article from NOHA NEWS, Vol. XX, No. 2, Spring 1995, pages 4-6.