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Presentation on theme: "COMPLEMENTARY AND ALTERNATIVE TREATMENT IN CV DISEASE."— Presentation transcript:


2 DEFINITIONS Complementary: Enhances treatments currently used Alternative: Replaces treatment currently used.

3 OBJECTIVES Explain what works, or might work Explain what does not work and may harm Have the courage to explain the difference

4 IMPORTANCE OF HERBAL MEDICATIONS 1/3 of what we use began as herbal medications. Digitalis from the foxglove plant Aspirin from willow bark Statins from red rice yeast.

5 DIET AS AN HERBAL THERAPY Grains Vegetables Fruits Oils, Olive, Canola, Peanut, Soy etc. Milk and cheese Meat and beans Discretionary

6 SUPLEMENTS FOR HIGH CHOLESTEROL Fish Oil Red Rice Yeast Artichoke Leaf Niacin Garlic Fiber

7 FISH OIL Omega 3 Fatty Acids DHA and EPA Fatty fish-Salmon, Mackerel, Lake trout Lowers Triglycerides but not LDL or TC Fish Burp Lovaza May elevate glucose.

8 RED YEAST RICE Ferment rice with yeast-Monascus purpureus Asian digestive tonic Monacolin K=Lovastatin Highly variable levels of Monacolin and potential muscle injury.

9 PLANT STEROLS Sterols and Stanols=Phytochemicals Lower LDL 10% reduction in LDL Very effective when added to a statin. Block intestinal absorption

10 SOLUBLE FIBER Psyllium=Metamucil Oats, Barley,Apples, Broccoli, Beans Binds with bile acids, removes bile acid and makes the liver convert more cholesterol into bile acids. Use only if you cannot get enough from your diet.

11 GARLIC Little evidence for significant cholesterol lowering Small reduction in TC. Increased risk of bleeding with coumadin.

12 NIACIN Vitamin B6 Lower triglycerides and raise HDL May cause flushing Hepatotoxic, especially OC varieties Stick to Niaspan. Take after aspirin and with a meal.

13 ARTICHOKE LEAF Plant, Cynara scolymus contains antioxidants Very Small effect on cholesterol Not recommended.

14 BOTTOM LINE Applies to all C and A treaatment Even if its natural it still can have serious side effects-Kava Kave, Yohimbine. Natural does not mean safe Make sure it will not diminish or increase the effectiveness or risk of what you are on. Tell your doctor what you are taking.

15 VITAMIN A Liver, eggs, fortified foods, Carrots (foods that contain b carotene) Essential for night vision, skin Women 700 mcg Men 900 mcg Toxic in higher doses (3000 mcg)

16 VITAMIN C Ascorbic acid-citrus fruits and juices Promotes healty gums and teeth, Antioxidant Women- 75 mg Men-90 mg Smokers need 35mg more Tissue levels do not change above 250mg

17 VITAMIN D Milk and fish and fortified foods. Body produces in response to sunlight. Bone density Can be tested Adults 19-50 200 IU Adults 51-70 400 IU Maine 1000 iu a day in winter

18 VITAMIN E Nuts, vegetable oils, whole grains Antioxidant Ask MD if you are taking aspirin or coumadin

19 VITAMIN K Green vegetables Bacteria in the gut produce most of what we need Essential for blood clotting Women 90 mcg Men 120 mcg Suplements are not recommended.

20 THIAMIN (B1) Whole and fortified grains, beans, wheat germ Needed for the conversion of carbohydrates into energy Women 1.1mg Men 1.2 mg Supplements are not necessary.

21 RIBOFLAVIN (B2) Dairy products, red meat Helps convert carbohydrates into energy Red cell production Women 1.1mg Men 1.3 Supplements are not necessary

22 NIACIN (B3) Nuts, grains, red meat, fish Aids in the release of energy May be prescribed to reduce cholesterol and triglycerides. Women 14 mg Men-16mg May cause flushing, gout, liver damage in high doses.

23 VITAMIN B6 Pyridoxine Grains, bananas, meat Maintains reactions in proteins and amino acids. Immune function. Adults 1.3-1.7 mg In large doses can cause neurological disorders

24 FOLIC ACID (B9) Leafy greens, beans, citrus fruit Important in the synthesis of DNA Aids normal growth and development Adults 400 mg Do not exceed 1000 mg

25 VITAMIN B12 Cobalamin Liver, Beef, poultry Essential to RBC development Maintains the nervous system Adults 2.4 mcg No benefits from megadoses.

26 PANOTHENIC ACID Whole grains, beans, milk Vital for metabolism. Adults 5 mg Supplements are not necessary

27 BIOTIN Peanuts, eggs, milk Important in metabolism Adults 30 mcg Supplements not recommended If you are concerned take a good multivitamin.

28 DRUGS TO AVOID St John’s wort-hypertension Ginseng-hypertension, reduces effect of warfarin, hypoglycemia Ginko biloba-bleeding risk, seizures Hawthorn berry-potentiates cardiac glycosides and nitrates Saw palmeto-bleeding, hepatitis, floppy iris

29 DRUGS TO AVOID Yohimbine-hypertension, kidney disease Licorice-hypertension, dig toxicity Black cohosh BOTTOM LINE-check with you doctor before trying any herbal product.

30 PROBLEMS WITH HERBALS Lack of scientific evidence and safety Lack of regulatory oversight Lack of quality control Public misinformation Lack of knowledge of the interactions by patients and providers. Underreporting of adverse reactions

31 WHAT DO I TAKE? I eat a healthy balanced diet I am very active I take my blood pressure pill I take my multivitamin I take fish oil I take vitamin d and calcium I take one aspirin.

32 I ALSO Try to exercise regularly Do Pilates Do Yoga Meditate Bucket list-more exercise, tai-chi, more fly fishing and sailing. More family time.

33 QUESTIONS One at a time No I do not support supplements with multiple components claiming to make one young, sexy, and physically vibrant More than 5-8 bottles on the shelf is a waste of your money.


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