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Cardiovascular
Disease or Stroke or Coronary Artery Disease or
Peripheral Vascular Disease or Aneurysms
View
Related Case Studies The greatest killer we have
in America today, (over 900,000 deaths each year making up
approximately 42% of all deaths) is cardiovascular disease,
which involves the process of atherosclerosis or “hardening of
the arteries.” As our vessels degenerate, it just depends on
which part of our body is affected the most. If the coronary
arteries are primarily involved the risk for a heart attack
increases. When the cerebral vessels are affected, one is at
risk for a stroke. Peripheral vessels may also be involved
putting the limbs at risk as well as the possibility of an
aneurysm. Over 60 million people in the United States have
cardiovascular disease affecting some part of their body.
There are over 1,500,000 heart attacks each year from
which 500,000 people die. Most devastating perhaps is the fact
that 250,000 of these deaths occur within one hour of the
heart attack. Forty-five percent of all heart attacks occur in
people who are under the age of 65 with the first sign of
heart disease in over 30% being sudden death. When a person is
fortunate enough to have a warning sign, the symptoms are
subtle and easily passed off as minor indigestion.
Symptoms are usually characterized as substernal chest
discomfort that comes on with exertion or stress and is
relieved within a few minutes with rest or relaxation. There
may be some referral of the pain into the shoulder, back, or
down either arm and is sometimes associated with sweating or
shortness of breath. The final event leading to a heart attack
is the actual rupture of an atheromatous plaque (usually a
smaller, less mature plaque) within the artery immediately
followed by a thrombosis (blood clot) totally blocking the
artery.
Cardiovascular Disease—An Inflammatory
Disease
Heart disease, stroke, and peripheral
vascular disease are diseases of inflammation of the arteries
and NOT a disease of too much cholesterol in the blood. In
fact, over half of the patients who suffer a heart attack
actually have normal cholesterol levels. In a review article
that appeared in the January 14, 1999 issue of the New
England Journal of Medicine the cause of hardening of the
arteries is clearly attributed to inflammation of the
arteries.
Excessive free radicals created by high
blood pressure, diabetes, cigarette smoke, fatty meals,
elevated insulin levels with oxidized LDL cholesterol,
elevated homocysteine, and possibly some infectious agents
have the capability to cause inflammation of the surface
lining of the arteries called the endothelium. This either
causes an actual tear of the endothelium or causes the
endothelium to function abnormally.
LDL cholesterol is
then allowed to enter into the subendothelial space (area just
under the lining of the artery) where it becomes oxidized and
starts to build a plaque. The cholesterol actually comes along
as a band-aid trying to repair the damage to the artery caused
by inflammation. This is what creates hardening of the
arteries.
The medical literature, as well as lay media
, is finally acknowledging the fact that “hardening of the
arteries” is the result of this low-grade inflammation.
However, they still are not revealing the actual underlying
cause of the inflammation. Instead, they are simply stating
you need to be taking a “statin” drug that will not only lower
your cholesterol but also reduce inflammation.
As a
clinician, I desire to decrease or eliminate the actual causes
of this inflammation so the process doesn’t start in the first
place. Few know this can be accomplished by healthy lifestyles
and nutritional
supplementation.
Cholesterol
Did you know
that elevated cholesterol in the blood has not always been
considered a risk factor for coronary artery disease and
stroke? When I first began practicing medicine in 1972, we
considered any cholesterol level less than 320 normal. Now
everyone is aware of the dangers of elevated cholesterol and
we “know” to be especially concerned about LDL cholesterol
(bad cholesterol).
In 1989, however, Dr. Daniel
Steinberg reported in the New England Journal of Medicine
(NEJM) that native LDL cholesterol is not bad. Claims
Steinberg, it only becomes “bad” when LDL cholesterol is
oxidized or modified by excessive "free radicals". When a
person has enough antioxidants on board, LDL cholesterol does
not become oxidized or “bad”.
Since this landmark
review article, several clinical trials have substantiated the
fact that individuals who have the highest levels of
antioxidants (vitamin C, vitamin E, beta-carotene, etc.) do
have the lowest level of heart disease. Now the medical
literature is further indicating that individuals who take
supplemental antioxidants have a significantly lower incidence
of vascular disease.
In the August 7, 1997 issue of
the NEJM, Marco Diaz, M.D. wrote a review article on
the use of antioxidants and heart disease. It seems that
antioxidants not only decrease the risk of developing heart
disease, but even in patients with advanced coronary artery
disease antioxidants offer a significant benefit. The
Cambridge Heart Antioxidant Study showed individuals with
advanced coronary artery disease who consumed at least 400
I.U. of vitamin E had 77% fewer nonfatal heart attacks over
those who took a placebo. Dr. Diaz concluded that antioxidants
stabilize the atheromatous plaque by reducing the inflammation
of the artery, thus decreasing the risk of plaque rupture.
This means that even those patients who have advanced coronary
artery disease would benefit by the use of the recommendations
found on this website.
Homocysteine
In
the past few years we are seeing study after study, indicating
homocysteine as an independent risk factor for vascular
disease (hardening of the arteries). Elevated homocysteine
levels in our blood causes tremendous inflammation to our
arteries. In a 1995 issue of JAMA, Boushey reviewed 27
previous clinical trials, which all showed even mildly
elevated levels of homocysteine significantly increased the
risk of vascular disease. He concluded that between 10 and 15%
of every heart attack and stroke in this country was directly
related to elevated homocysteine levels. In other words
150,000 to 225,000 heart attacks each and every year are
solely related to elevated homocysteine levels.
WHAT
IS HOMOCYSTEINE?
Homocysteine is a
sulfur-containing amino acid that is involved in the
metabolism of methionine, an essential amino acid. Methionine
is an essential protein found most commonly in meats, eggs,
and dairy products.
During normal metabolism within the
body, methionine is broken down into homocysteine which in
turn is broken down into cysteine (which is harmless), or
sometimes actually turned back into methionine again. But in
order to be turned back into methionine, an enzyme is needed
requiring vitamin B12 as a cofactor and folic acid as a
substrate. Homocysteine may also be broken down into cysteine,
but this enzymatic reaction requires vitamin B6.
This
may seem confusing to you but the important thing to remember
is the simple fact that in order for homocysteine levels to
remain in a safe range, you must have adequate levels of folic
acid, vitamin B6, and vitamin B12. Elevated homocysteine
levels in our blood are primarily the result of a nutritional
deficiency of folic acid, vitamin B12, and vitamin B6. When
these nutrients are given in supplementation for just pennies
a day, our homocysteine levels will fall back into a safe
range the majority of the time.
Other Causes of
Inflammation
Other causes of inflammation in the
arteries are brought about by excessive free radicals produced
by high blood pressure, diabetes, cigarette smoke,
hyperinsulinemia (elevated insulin levels in the blood), fatty
meals, and possibly some infectious agents (usually bacteria
from gum disease). All of these conditions can either be
eliminated or significantly reduced through lifestyle changes
and nutritional supplements.
My clinical approach to
protecting patients who either already have cardiovascular
disease or for those wanting to prevent this disease is the
same—the goal is to reduce or eliminate all causes of
inflammation in the arteries. Initially an evaluation must be
made all of my patients, males over 35 years of age and
females over 40 years of age, for risk factors (see
below).
Evaluation for the Risk of Cardiovascular
Disease
- Complete history and physical
- Chemistry profile, which should include a general screen
for diabetes, kidney, liver, and thyroid function, along
with a lipid profile
- Other lab work should include a highly-sensitive CRP (hs
C-Reactive Protein, which measures the inflammation in the
arteries), homocysteine level (ideally this level should
remain below 7), and fibrinogen level.
- An exercise stress test with echocardiogram is
recommended for those patients who are already having
concerns about chest discomfort (seek medical advice from
the attending physician about whether this test is indicated
or not)
- Cardiac calcification score—(ultra-fast CT imaging of
the heart) this is a test that can determine how much
micro-calcification is present in the coronary arteries.
This provides an indirect indication of the amount of plaque
already present in one’s coronary arteries. Because the
first sign of heart disease over one-third of the time is
sudden death, I like to find out whether my patients who may
have some risk factors for heart disease actually have some
evidence of plaque in the arteries already.
Nutritional Supplement Recommendations
I recommend that all my patients take the basic nutritional
support I refer to as cellular
nutrition. This foundational regime provides all the
necessary micronutrients to the cell at ideal levels (not RDA
levels) for significant health benefits as documented in the
medical literature. When the cell is given maximum support, it
can then determine what it does and does not need. Over a
six-month period each cell is able to not only overcome
nutritional deficiencies but also to optimize
ALL the nutrients, which are needed to combat oxidative
stress.
The synergistic affect of providing all the nutrients
needed by one’s body at the most advantageous levels results
in optimizing and rebuilding the body’s natural immune system,
antioxidant, and repair systems back to their fullest fighting
potential against disease.
Minimal support for Cellular
Nutrition:
My minimal recommendation for creating cellular
nutrition is to simply take Usana’s Mega Antioxidant and
Chelated Minerals, called "The Essentials" at their
recommended doses (3 of each daily). The Essentials offers the
cell ALL of the antioxidants, B-cofactors, and antioxidant
minerals needed by the cell at ideal levels. In order to
achieve the best results, I recommend taking 1 Mega
Antioxidant and 1 Chelated Mineral with each meal.
Nutritionals should always be taken with food because of
better absorption and better tolerance. However, as a
physician, I realize that compliance with taking supplements
three times a day is a major issue. Therefore, if you tend to
frequently forget the lunchtime dose, I suggest taking the
supplements twice daily: taking 2 Mega Antioxidants and 1
Chelated Mineral in the morning with breakfast and 1 Mega
Antioxidant and 2 Chelated Minerals in the evening with the
evening meal.
Optimal support for Cellular
Nutrition:
For the most favorable results for basic cellular
nutrition, I also recommend adding to the Usana Essentials
either OptOmega (2 tsps daily) or BiOmega-3 (4 capsules
daily), which provides the essential fats and Fibergy, which
assures the individual is receiving the additional fiber his
or her body needs. I also recommend adding Active Calcium (4
tablets daily) to provide additional calcium, magnesium, and
vitamin D that our bodies need. These recommendations provide
all the nutrients at their ideal levels creating the cellular
nutrition I recommend in my book, What Your Doctor Doesn’t
Know About Nutritional Medicine May Be Killing You.
Optimizers
It is critical that you know the necessity of adding
optimizers to your foundational cellular nutrition for optimal
results. Patients who are suffering from a chronic
degenerative disease or illness are under more oxidative
stress than the average healthy individual. Therefore, adding
potent Optimizers to the basic cellular nutrition offers you
the best chance to bring this oxidative stress back under
control. The synergy and increased potency created by this
approach to nutritional medicine is why I’m able to get such
consistent results in my patients.
However, to suit each individual’s unique needs, I always
offer both an optimal and a minimal plan for cellular
nutrition and for adding Optimizers. Obviously, one’s
improvement will be quicker and more consistent with the
optimal recommendations; however, a minimal regime can still
produce significant clinical results.
Recommended Optimizers:
Optimal:
- Proflavanol 90*--3 tablets daily
- Coquinone 30—2 capsules daily
Minimal:
- Proflavanol 90—2 tablets daily
*Proflavanol 90 is equal to 3 Proflavanol
C
Optimal Recommendations
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Active
Calcium |
1 |
1 |
2 |
| Proflavanol
90 |
1 |
1 |
1 |
| Coquinone
30 |
1 |
|
1 |
| Optomega |
2
tsps. |
|
|
| Biomega-3 (an
option instead of Optomega) |
1 |
1 |
2 |
*Adding at least one serving of
Fibergy daily will enhance these
recommendations.
Minimal Recommendation
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Proflavanol
90 |
1 |
|
1 |
If you are frequently going to miss taking your lunchtime
dose, it is better to simply take your nutritionals twice
daily. I recommend taking 2 Mega Antioxidants, 1 Chelated
Mineral in the morning with breakfast and then taking 1 Mega
Antioxidant, 2 Chelated Minerals in the evening. You should
try to divide up your Active Calcium, essential fats, and
Optimizers equally as possible between the AM and PM
dose.
Consider a Power Shake
USANA has a fantastic line of nutritionally balanced drinks
that many of my patients consume as a meal substitute. In
fact, I personally start every morning with 2 scoops of
Fibergy, 2 scoops of Soyomax, and 2 teaspoonfuls of OptOmega.
This provides me with a perfect, balanced, unpolluted meal to
start my day. It allows me the opportunity to supplement my
diet with soy protein; extra needed fiber, and essential fat.
This meal is also a low-glycemic meal, which will not spike my
blood sugar. Likewise, many USANA associates are using their
imaginations to create exceptionally tasting meals with
Fibergy and OptOmega. By blending in frozen, whole fruit for
added flavor they are creating a variety of great tasting
drinks.
Isn’t it remarkable that by simply taking USANA Essentials,
Active Calcium and a power drink (remember, to consider this
part of your food budget, since it is replacing an entire
meal), the body is supplied with complete, and balanced cellular
nutrition for every cell in the body? The synergy that is
created, especially when adding needed Optimizers is
phenomenal. Remember, the underlying problem is oxidative
stress NOT a nutritional deficiency.
Why I recommend USANA Products
USANA strictly follows pharmaceutical-grade Good
Manufacturing Practices (GMP). This means they not only
purchase pharmaceutical-grade raw products, but also
manufacture the products according to tough
pharmaceutical-quality guidelines. In addition, USANA Health
Sciences follows USP guidelines for potency, uniformity, and
dissolution of the tablet. In a nutshell, USANA manufactures
their products to the strict standards of over-the-counter
drugs even though not required to do so—assuring all of their
customers and associates that what is on the label is actually
in the tablet.
Usana's essentials are complete and balanced and provides
the cellular nutrition that I strongly recommend in my book,
What Your Doctor Doesn't Know About Nutritional Medicine May
Be Killing You. This improves compliance and makes taking
these advanced levels of nutritional supplements
easier.
Starting Your USANA Nutritional Program
Over eighty percent of my patients are able to start the
USANA Nutritional Program with absolutely no set backs while
beginning to experience the health benefits of high-quality
nutritional supplements immediately. Please keep in mind these
supplements are extremely potent and optimal levels of
nutrients are being provided that the body has never had
before. The body is therefore able to finally rid itself of
toxins, which have been accumulating for years (called
detoxification). This is especially true in those who are
suffering from a serious illness and are taking a significant
amount of medication. It is important to understand the
possible signs and symptoms of detoxification so that you can
deal with them confidently and properly.
Detoxification:
The most common detoxification reaction is muscle aches
and/or mild headache. These symptoms will usually pass within
a few weeks. If the discomfort is not unbearable, I simply
have my patients continue their program as I have prescribed.
However, occasionally there is a more severe reaction. The
patient is not in danger, rather, the amounts of nutrients are
just too much too fast. In this case, I have my patients quit
their supplements for a few days until the reaction subsides.
I will then have them start back on their program but
initially at lower doses (approximately one third of the
recommended dose). Once they are tolerating this amount of
supplementation, I suggest slowly building up to the
recommended doses.
Some of my patients actually develop a "detox" skin rash
somewhere on their body. As you know, the skin is an important
route for ridding the body’s toxins. This rash is a dry, red
rash that looks almost like a mild sunburn. Some people
confuse this with an allergic reaction to the supplements.
This is not typically so. I have never seen an allergic
reaction to the USANA Essentials and can only recall a couple
of patients who reacted to Proflavanol because they were
actually allergic to grapes.
Patients may also experience some aspect of loose stools or
even diarrhea. This again is a common "detox" reaction because
the GI tract is another prime route for eliminating toxins
from the body. This symptom will usually diminish within a
couple of weeks. It is an important part of the detoxification
and healing process. Therefore, I usually encourage my
patients to continue the supplements as recommended unless
their bottom gets too sore. I will then again recommend lower
doses of the supplements until they feel better and then begin
adding the supplements back more slowly until the recommended
doses are reached. Diarrhea can be the result of the magnesium
in the Active Calcium or by the Proflavanol. Again, this is
usually a mild reaction and will improve over the first week
or two. However, some of my patients need to discontinue the
Active Calcium and/or the Proflavanol until this settles down.
I then have them slowly add back the Proflavanol and
eventually the Active Calcium.
Increasing dietary fiber may also increase the amount of
intestinal gas and the frequency of bowel movements. This will
improve with time as the body adjusts to the higher intake of
fiber, but is an important aspect of getting rid of the
toxins, which have accumulated in the body.
Natural Relaxation Response:
A small percentage of patients develop a natural relaxation
response when minerals are absorbed into their body. This is
of great concern to those patients who have just been told
that nutritional supplementation will help improve their
energy level. They take the supplements as recommended only to
find themselves more fatigued and dragging themselves through
their day. If you experience this response, I recommend that
you take all of your minerals (including the Active Calcium)
with a light bedtime snack. This allows you to take advantage
of your body’s response while getting a good night’s
sleep.
Stomach Upset:
A small percentage of patients have difficulty tolerating
vitamin C. It can cause an upset stomach that will usually
become evident a couple days after starting their nutritional
program. With USANA’s specially combined vitamin C into Poly
C, I have seen many of people who could not previously
tolerate any nutritional supplements do very well with USANA’s
Mega Antioxidant. However, if nausea is experienced, I suggest
taking one Mega Antioxidant with the largest meal. Once this
level of supplementation is better tolerated, I suggest slowly
adding another Mega Antioxidant to the next largest meal. I
anticipate building them up to the recommended level of
supplementation, but sometimes this is just not possible. For
those extremely sensitive, I advise using Body Rox (the
teenage dose of Antioxidants and Minerals) as the best
alternative option.
Taking Your Supplements with Your Medication
I am often asked, "Can I take my nutritionals with my
medication?" To this I respond with this question, "Can you
eat?" I hope my point is made gently but clearly—nutritional
supplements simply contain nutrients we should be getting from
our foods, but at levels we can no longer obtain from our
foods. If you can eat anything, you can also take nutritional
supplements. The only exception to this is for those taking
the medication, Coumadin (Warfarin), which blocks vitamin K in
the body as a way of thinning the blood. If a patient is on
Coumadin, I recommend he or she take the Canadian Essentials
and Canadian Active Calcium because they contain no vitamin K.
Also, patients who are on thyroid medication should take their
medication on an empty stomach at least 1 hour prior to meals
or prior to taking supplements. Thyroid medication should not
be taken with food or with supplements because calcium can
block the absorption of the medication.
Disclaimer
Every effort has been made to make this web site as
accurate as possible. The purpose of this site is to educate
and inform. As such it is based on scientific evidence and my
clinical training and experience. No individual should at any
time use the information found on this web site for
self-diagnosis, treatment, or justification in accepting or
declining any medical therapy for any health problems or
diseases. Any application of the advice herein is at the
reader’s own discretion and risk. Therefore, any individual
who has a specific health problem or is taking medications
must first seek advice from his or her personal physician or
healthcare provider before starting a nutritional supplement
program. Dr. Strand shall have neither liability nor
responsibility to any person or entity with respect to loss,
damage, or injury caused or alleged to be caused directly or
indirectly by the information contained in this web site. We
assume no responsibility for errors, inaccuracies, omissions,
or any inconsistency herein. Any slights of people, places, or
organizations are unintentional.
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© 1999, 2000, 2001,
2002, 2003, 2004 Ray D Strand, M.D. P.C.
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