Dr. Nathan Goodyear

Between Valentine’s Day and American Heart Month, there’s no denying that hearts and February go hand-in-hand. This month, as we celebrate the things that make our hearts melt, let’s also think about preventing heart disease with the 4 Pillars of Heart Health: Minerals, CoQ10, Alpha Lipoic Acid, and L-Carnitine.

Not only is Cardiovascular Disease (CVD) one of the most widespread and costly problems in the U.S., it is among the most preventable. Like any other part of the body, the heart requires preventive care to ensure it will operate at its best. These days I see more preventive care for cars than for the heart. Prevention is not early detection. It is identifying those at risk and instituting therapy to actually prevent the disease. And while early detection and treatment is needed and saves lives, we need also to focus on preventing CVD altogether.

Current statistics on Cardiovascular Disease (CVD):

•   33.5% (149 million) of US adults have been diagnosed with high blood pressure
•   8% (18.3 million) of the US adult population has been diagnosed with diabetes
•   67% (34% of which are obese [149.3 million]) of US adults are either obese or overweight

These 2012 statistics tell us that we are not gaining much ground in the battle against heart disease.

So, what is the heart? The heart is complex organ, but essentially it is a big hunk of muscle. The heart is responsible for pumping the blood to the lungs to be oxygenated and then deliver that oxygenated blood throughout the body. To pump that oxygenated blood, the heart needs lots, and lots of energy (ATP). The heart uses the “power house” of the cell, called mitochondria, to generate all this needed energy.

How much energy does the heart make? The heart makes enough energy, everyday, to drive a truck 20 miles. That mileage, over an average lifespan, will get you to the moon and back. The ability of mitochondria within the heart (which is muscle) to generate energy is critical to life. In fact, the result of compromised mitochondria is aging and death. The lack of ability to produce energy, actually triggers apoptosis (cell death). Enough cell death equals organ death, which results in the body’s death. Obviously, this is not what we want. Mitochondria are crucial to the heart’s ability to make energy and avoid all the, well…unintended consequences.

At Seasons Wellness Clinic, we focus on the 4 Pillars of Heart Health which support mitochondrial function.

1. Minerals

•  Magnesium is a nutrient. Magnesium is needed for more enzyme reactions than any other nutrient, which makes it extremely important.
•  B Vitamins give us energy. Why? One reason is B vitamins are co-factors in energy production. Many of the B vitamins are co-factors in the Kreb’s cycle, another very important pathway for energy production.

2. CoQ10 is critical in energy production. CoQ10 is a carrier protein between complex I and complex II of the electron transport chain (ETC). The ETC is where your body makes most of the ATP (energy). CoQ10 is an antioxidant as well.

3. Alpha Lipoic Acid is very important in the pyruvate dehydrogenase enzyme complex. This enzyme complex is very important in the first steps of energy production from glucose, a process called glycolysis. Alpha Lipoic Acid, like CoQ10, is an antioxidant.

4. L-Carnitine is involved in the “fat shuttle.” Carnitine is involved in how the cell shuttles fat into the mitochondria for energy production. You can see how a compromised “fat shuttle” can effect energy production and fat production. L-carnitine, too, is an antioxidant.

Not only do we want to evaluate these critical components (and yes, we can test for these essential molecules), but we want to prevent any compromise to their function. A major cause of component malfunction in the body’s processes is mineral depletion, and the #1 cause of mineral depletion is prescription drugs.

To demonstrate my point, let’s use Metformin and Statin drugs as examples. First, Metformin, a good prescription drug for Diabetes, is known to deplete the body of Magnesium, B12, folic acid, CoQ10.  And second, Statin drugs, for cholesterol, are known as disruptors of CoQ10. Ever wonder why those on statin therapies complain of muscle pains/cramps?  If you poisoned your muscle’s ability to make energy, you would do the same. I am not opposed to these medications, it is just very important that we understand that a patient with Diabetes and high cholesterol (closely linked) must avoid therapies that actually worsen the problems.

To help the heart live long and strong, remember the 4 Pillars of Heart Health. There are four major vessels of the heart as well as four major obstacles to heart health. For more information about heart health, specialized testing, and medical-grade supplements, contact a Patient Relations Specialist at Seasons Wellness Clinic at (318) 255-3223.

Definitions.

Health can best be defined as the absence of disease.  Wellness is best defined as the existence of positive health.  So health and wellness can be best defined as the absence of disease in the presence of positive health.

Why the focus on health and wellness these days? I think modern medicine gets a failing grade. Obesity is epidemic in the American culture today. One of my patients knew that her weight was not healthy. However, her previous physician told her that she should learn to live with her new heavier weight and maybe the weight would level out. That statement haunted her and led her to find a physician who offered her more hope and solutions.

Health and wellness cannot be achieved through a traditional, allopathic (Western modern medicine) medical approach. Why? Western modern medicine (we’ll call it traditional for our purposes) uses a disease-focused model utilizing pharmaceuticals. Pharmaceuticals block biochemical reactions, produce mitochondrial toxins, and deplete important nutrients. There is no positive health there.

In fact, the 4^th – 6^th leading cause of death is from prescription drugs (Mol Aspects Med. 2005 Aug-Oct;26(4-5):363-78). In contrast, functional medicine is a health and wellness model utilizing natural substances found in the body to enhance cellular processes. A health and wellness model looks to work with the body, to facilitate metabolic reactions and optimize physiologic function (The principles of metabolic therapy for heart disease. Heart, Lung and Circulation 2003; 12:S55-S62).

In some ways, the two are complementary; but in many ways, the two are not. I am not advocating a boycott of traditional medicine. In fact, I still practice some traditional medicine when disease exists.

The key is this — does disease exist or not?  If disease doesn’t exist, and health and wellness or health restoration is your goal, then a functional or integrative approach is the way to go to facilitate and optimize physiologic function.

So, what is a functional medicine approach?  To help define functional medicine, let’s look at a few examples.

The traditional medicine approach.

Metformin or Glucophage is a well-recognized drug used to treat diabetes.  Metformin works to improve insulin sensitivity and thus facilitate glucose uptake inside the cells.  Type II Diabetes is marked by very poor insulin sensitivity and thus blood sugar rises.  Traditional medicine prescribes Metformin to provide a 13% improvement in insulin sensitivity.

Remember, pharmaceuticals block biochemical reactions.  Metformin reduces folic acid and vitamin B12 and can elevate homocysteine. Elevated homocysteine levels increase blood clot risk (this is one of the ways that birth control pills increase blood clot risk).  Diabetics and those with insulin resistance are already at an increased risk of blood clots. Can you see how the treatment is piling on in this situation?

The functional medicine approach.

Let’s contrast that with a functional medicine approach. Vitamin D deficiency is rampant today. Vitamin D deficiency has been implicated in heart failure, myocardial dysfunction, sudden cardiac death, and is required for normal insulin release and glucose control.  Remember the 13% for metformin? Higher vitamin D levels resulted in a 60% improvement in insulin sensitivity (Chiu K., et al., “hypovitaminosis D is associated with insulin resistance and beta cell dysfunction,” Amer Jour Clin Nutr  2004).

Remember, functional medicine works with and facilitates the body’s functions. Vitamin D does not block any biochemical reactions, nor does it interfere with any. Thus, there is no negative effect comparable to Metformin. Now, too much of a good thing can be a problem. Too much Vitamin D can elevate calcium. Because of this, Vitamin D should be prescribed under the watchful eye of a physician.

Why do I do what I do?

Amazing results — as naturally as possible. This is why I practice functional medicine. This is why I created Seasons. A health and wellness model, through functional medicine, works with the body to enhance and optimize physiologic function.  Health and health restoration can only be achieved by working with the body. Let’s get out of the way and let the body heal itself.

Metabolic syndrome is a collection of conditions that occur together to increase a women’s risk of heart disease, peripheral vascular disease, stroke, and type II diabetes.

It isn’t a disease, so much as a collection of conditions. However, it can still be dangerous if left untreated, possibly leading to the diseases listed above: peripheral vascular disease, heart disease, stroke, and type II diabetes.

The identification of metabolic syndrome provides a window of opportunity for treatment to prevent disease.

The following risk factors co-exist in metabolic syndrome…

• abdominal obesity
• blood fat and cholesterol disorders
• elevated blood pressures
• insulin resistance
• pro-blood clot state
• pro-inflammatory state

Abdominal obesity and insulin resistance are the dominant risk factors. Other conditions that affect metabolic syndrome include physical inactivity, aging, hormonal imbalances, and genetic predisposition.

Since it isn’t a disease, we diagnose metabolic syndrome by looking for co-existing symptoms. Any three of the following are required to meet the classification of metabolic syndrome…

• abdominal obesity (waist circumference >35 inches)
• elevated triglycerides (>150)
• low HDL (<50)
• elevated blood pressure (> 130/85)
• elevated fasting glucose (>110)

Metabolic Syndrome is not uncommon. It is estimated that over 50 million Americans have it. We treat it by managing a patient’s weight loss, increasing physical activity, treating hypertension, prescribing daily aspirin therapy to reduce pro-blood clot states, and treating elevated triglycerides and/or low HDL levels.