Hawthorn (Crataegus oxyacantha)

Hawthorn, also known as Maybush, is a thorny shrub found on hillsides and in sunlit woodsey areas throughout the world. Over centuries, all parts of the plant have been used to prepare foods, beverages, and medicines. In folk medicine, Hawthorn was used for the treatment of diarrhea, insomnia, and asthma. In China, it has been used to treat digestive problems, high cholesterol, poor circulation, and shortness of breath. During the early 1800s, doctors in North America used Hawthorn for heart conditions, circulatory, and respiratory disorders.

Hawthorn has a rich supply of flavonoids (antioxidants that protect cells from damage) and anti-inflammatory properties, which are important to heart health. It plays a role in helping dilate blood vessels, improves blood flow to the heart, and can lower blood pressure. In Europe, Hawthorn is regarded as a safe and effective treatment for early-stage heart disease. It is used to promote the health of the circulatory system and in patients with angina, high blood pressure, and congestive heart failure. In studies, patients with heart failure who took Hawthorn showed improvement in clinical symptoms and sense of wellbeing.

Hawthorn heart

Hawthorn is available as tea, capsule, tincture, and standardized extract found in prescription drugs, over-the-counter medication, standardized herbal medicine, or dietary supplements. Before taking Hawthorn, especially if you suspect or have a heart or lung condition, consult with a FUnctional medicine / Integrative holistic medical professional.

 

Resources
Hawthorn. Complementary and Alternative Medicine Guide. University of Maryland Medical Center Online. https://umm.edu/health/medical/altmed/herb/hawthorn
Johnson, Rebecca L. & Foster, Steven et al., National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. (National Geographic Society. (2010, 2014), 123-125.
Hawthorn Berry (Crateagus Oxycanthus): Health Benefits. http://www.herbwisdom.com/herb-hawthorn-berry.html
Mars, Bridgitte & Fiedler, Chrystle. Home Reference Guide to Holistic Health & Healing. (Beverly, MA: Fair Winds Press. 2015.), 189.
Dahmer, S., Scott, E. “Health Effects of Hawthorne,” Amer Family Phys. (Feb 15, 2010) 81:4, 465-468. Accessed: Dec. 09, 2015: http://www.aafp.org/afp/2010/0215/p465.html
Chang, W., Dao, J., and Shao, Z. “Hawthorn: Potential Roles in Cardiovascular Disease.” American Jnl. Chinese Medicine (January 2005) 33:01, pp. 1-10. DOI: 10.1142/S0192415X05002606. http://www.worldscientific.com/doi/abs/10.1142/S0192415X05002606?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
ie Wang, Xingjiang Xiong, and Bo Feng, “Effect of Crataegus Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 149363, 16 pages, 2013. doi:10.1155/2013/149363.
http://www.hindawi.com/journals/ecam/2013/149363/
Image attribution: morisfoto/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

 

February 7th, 2016

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February 7th, 2016

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Mighty Pomegranate (Punica granatum)

Pomegranate

Inside a lumpy, thick-skinned pomegranate you’ll find a treasure of jewel-like arils-ruby seeds surrounded by sacs of flavorful juice. Pomegranate is both richly sweet and tart and exceptionally refreshing. Savor the flavor by eating the arils by the spoonful, adding them to salads or to a bowl of Greek yogurt. Any way you choose, you’ll reap the health benefits of this exotic fruit.

Pomegranate is native to the mountainous regions along the Caspian Sea, near northern Iraq and northwest Iran. For centuries, cultures around the world have used all parts of the tree—roots, bark, flowers, peel, seed and seed oil—medicinally to treat a range of health concerns, from digestive disorders and dysentery, to fever and heart ailments. In the West, the fruit and seed are typically used in medicinal preparations. Modern research indicates that pomegranate may be beneficial for reducing risk and supporting treatment for arthritis, certain types of cancers, erectile dysfunction, and heart disease.

A compound found only in pomegranates called punicalagin is beneficial to the heart and blood vessels. Punicalagin is responsible for pomegranate’s antioxidant effects. In fact, pomegranate has more antioxidant power than red wine and green tea! Preliminary research shows that drinking unsweetened pomegranate juice helps lower cholesterol, lower blood pressure, improve blood flow to the heart, and may help protect against the formation of blockages in the arteries. Further research is needed to determine how much pomegranate juice (or as a nutritional supplement) is beneficial for different people and for different health concerns.

When buying pomegranate, don’t shy away from a fruit that isn’t perfectly round or feels heavy. Unusual shape, and weight indicate a fruit that is plump with arils and juice. Pomegranates do not sweeten once picked, so you’ll want to avoid fruits that look dried out.

Resources
Johnson, Rebecca L. & Foster, Steven et al., National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. (National Geographic Society. (2010, 2014), 249-251.
Swanson, H. Super Natural Cooking: Five Ways to Incorporate Whole and Natural Ingredients Into Your Cooking. (2007), 80. Ten Speed Press: Berkeley, CA.
Pomegranates and Health. (Recipes and other Resources) http://pomegranates.org/index.php?c=3
Medline Plus. Pomegranate. https://www.nlm.nih.gov/medlineplus/druginfo/natural/392.html
National Center for Complementary and Integrative Health. Pomegranate. https://nccih.nih.gov/health/pomegranate/at-a-glance
Basu, A., Penugonda, K. “Pomegranate juice: a heart-healthy fruit juice.” Nutr Rev. (2009) Jan: 67(1):49-56. doi: 10.1111/j.1753-4887.2008.00133.x. Accessed on: Dec 8, 2015. http://www.medicatrix.be/download/grenade_protecteur_cardiovasculaire.pdf
Stowe, C.B., “The effects of pomegranate juice consumption on blood pressure and cardiovascular health.” Complement Ther Clinical Pract., (2011, May), 17(2):113-5. doi: 10.1016/j.ctcp.2010.09.004. Available from: http://www.ctcpjournal.com/article/S1744-3881(10)00076-9/abstract
Sumner Michael D., Elliot-Eller, M. et al., “Effects of Pomegranate Juice Consumption on Myocardial Perfusion in Patients With Coronary Heart Disease.”: Amer Jnl of Cardiology. (2005) 810-814. Date Accessed: Dec 08, 2015: http://www.ornishspectrum.com/wp-content/uploads/Effects-of-Pomegranate-Juice-Consumption-on-Myocardial.pdf
Seeram NP, Aviram M, Zhang Y, et al., “Comparison of antioxidant potency of commonly consumed polyphenol-rich beverages in the United States.” J Agric Food Chem (2008), 56:1415-1422. Accessed on Dec 08, 2015: http://www.pubfacts.com/detail/18220345/Comparison-of-antioxidant-potency-of-commonly-consumed-polyphenol-rich-beverages-in-the-United-State
Aviram M, Rosenblat M, Gaitini D, et al. “Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation.” Clin Nutr (2004). 23(3):423-33. Date Accessed: Dec 08, 2015: http://www.wonderfulpomegranateresearch.com/media/pdf/health/HH_2004_Aviram_ClinNutr_PJ_Consump_3Years_Carotid_021.pdf
Image attribution:
Geo-grafika/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

February 7th, 2016

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Heart stethoscopeLong before the ancient Greek surgeon Galen carried out meticulous dissections of the heart, the Egyptians wrote about health and disease in relation to how the heart “speaks in vessels” with the rest of the body. Today, physicians may not associate the heart with the soul (or soul mates), but many credit early Egyptian medical knowledge of the heart as a precursor to modern cardiology.

 

The Heart: Powerful, but VulnerableHeart stethoscope

A key element of a healthy body is a healthy heart. The heart is the center of our cardiovascular system and beats an average of 100,000 times per day supplying oxygen rich blood to the whole body. Every day we make choices that have a profound affect on the health of this vital organ. Most heart disease (HD) is linked to inflammatory risk factors such as lack of exercise, obesity, smoking, stress, and poor eating habits.

One major condition that can develop with these risk factors is Hypertension, also known as high blood pressure. Often called the ‘silent killer’, Hypertension can cause significant damage throughout the cardiovascular and other body systems and ultimately results in over 80 million deaths each year.

The Silent Killer

Blood pressure is the amount of pressure exerted on the inside of blood vessels as the heart pumps the blood through the body. When there is resistance in the vessels, the pressure rises and hypertension results. The longer hypertension goes undetected and/or uncontrolled, the greater the damage to blood vessels and other organs. Hypertension can lead to heart attack, stroke, ruptured blood vessels, kidney disease or failure, and heart failure.

Warning signs for high blood pressure are rare but can include headaches, blurred vision, light-headedness, shortness of breath and nosebleeds. However, there are typically no warning signs or symptoms for hypertension, which is why it is called the silent killer.

Hypertension is diagnosed by looking at 2 numbers in your BP reading: Systolic pressure (the top number) is the pressure in your arteries when the heart beats (contracts). Diastolic pressure (bottom number) represents the pressure in your arteries between beats.

• Normal blood pressure is below 120/80
• Prehypertension is 120 – 139 systolic or 80 – 89 diastolic.
• Hypertension is 140/90 or higher

The Potassium Secret for a Healthy Heart
You’ve no doubt heard the best thing to do when you have hypertension is to reduce the amount of salt/sodium in your diet. Did you know the average adult needs 4,700 mg of potassium daily compared to only 200 mg of sodium. Unfortunately for most of us, our eating habits give us way too much sodium – 3,300 mg a day – and not nearly enough potassium. This imbalance can increase your risk of developing hypertension.

What’s truly important for your heart, and a more accurate strategy to prevent high blood pressure, is to balance the relationship between potassium and sodium (salt) in your daily diet. Proper sodium-potassium balance is necessary for nerve transmission, muscle contraction, fluid balance, and the optimal health of all the cells in your body. In regard to the heart, potassium is particularly important for regulating heart rhythm and maintaining blood pressure.

By reducing your sodium intake, you are often correcting the sodium-potassium imbalance without realizing it. To further support your heart health, eat more potassium-rich foods such as sweet potato, spinach, banana, peas, legumes, apricots, avocados, halibut and molasses.

More Healthy Heart Tips & Heart-Healthy Diet Do’s:

  • Eat a variety of fresh fruits and dark green veggies daily.
  • Use plant-based oils for cooking.
  • Eat mindfully, not on-the-run.
  • Reduce or eliminate packaged foods, sugar, and red meat.
  • Walk, No Need to Run: 30 minutes of daily, brisk walking lowers your risk for hypertension.
  • Be Calm: Learn to manage stress with healthy coping techniques, such as, deep breathing, yoga, meditation, gratitude journaling, and getting quality sleep.
  • Supplemental Support: Nutritional supplements shown to support heart health include Hawthorn, CoQ10, Essential Fatty Acids (Omega 3), Magnesium, Garlic and B-vitamins. Always speak with your Integrative/ Functional Medicine physician as to which forms of these supplements and what doses are optimal for you as all forms are not equal in efficacy or quality. Supplements you might have heard about—Natto-K (nattokinase), Guggul, or Niacin—should not be taken without the supervision of your health practitioner.

Because some blood pressure medications affect the potassium level in the body, be sure and discuss the best strategy for making this adjustment with your Functional Medicine Physician /Integrative Holistic Doctor.

Resources:
Murray, M. “Hypertension” as cited in Pizzorno, Joseph E. (2013). Textbook of Natural Medicine. St. Louis, MO Elsevier. (chapter 174), 1475-1485.
Johnson, R.L., S. Foster, Low Dog, T. and Kiefer, D. “Plants and the Heart” in National Geographic Guide to Medicinal Herbs: The World’s Most Effective Healing Plants. Washington, D.C.: National Geographic, 2012. 100-101.
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2013 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 1999-2013, through the Vital Statistics Cooperative Program. Accessed on December 11, 2015.: http://wonder.cdc.gov/ucd-icd10.html
Mayo Clinic. “High Blood Pressure- Hypertension.” Updated November 10, 2015. http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580
National Heart, Lung & Blood Institute. “Risk Factors for High Blood Pressure.” Updated September 2015. http://www.nhlbi.nih.gov/health/health-topics/topics/hbp/atrisk
Lelong, H., Galan, P. et al., “Relationship Between Nutrition and Blood Pressure: A Cross-Sectional Analysis from the NutriNet-Santé Study, a French Web-based Cohort Study” Am J Hypertens first published online September 3, 2014 doi:10.1093/ajh/hpu164. Accessed on Dec 21, 2015: http://ajh.oxfordjournals.org/content/early/2014/09/03/ajh.hpu164
Study above cited in Time magazine article, accessed on Dec 21, 2015: http://time.com/3313332/salt-and-blood-pressure/
Appel, L.J., Brands, M.W., et al., American Heart Association. “Scientific Statement: Dietary Approaches to Prevent and Treat Hypertension.” Updated January 2014. http://dx.doi.org/10.1161/01.HYP.0000202568.01167.B6
American Heart Association. “Learn more about heart disease and high blood pressure.” Accessed on December 11, 2015. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/High-Blood-Pressure-or-Hypertension_UCM_002020_SubHomePage.jsp
American Heart Association. “Walk, Don’t Run Your Way to a Healthy Heart.” Accessed on December 11, 2015.
http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/Walking/Walk-Dont-Run-Your-Way-to-a-Healthy-Heart_UCM_452926_Article.jsp#.Vop0pDYwcrg
Also see:
http://www.heart.org/HEARTORG/Conditions/Conditions_UCM_001087_SubHomePage.jsp
American Heart Association. “Walking Can Lower Risk of Heart Related Conditions” Accessed on December 11, 2015.
http://newsroom.heart.org/news/walking-can-lower-risk-of-heart-related-conditions-as-much-as-running
American Heart Association. “Potassium and high blood pressure.” Last Updated August 04, 2014. Accessed on December 11, 2015.
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Potassium-and-High-Blood-Pressure_UCM_303243_Article.jsp#.Vopz2DYwcrg
Harvard School of Public Health. “Shifting the Balance of Sodium and Potassium in Your Diet.” Accessed on December 11, 2015. http://www.hsph.harvard.edu/nutritionsource/sodium-potassium-balance/
Linus Pauling Institute: Micronutrient Information Center. “Sodium (Chloride).” Last Reviewed 2008. Accessed on December 11, 2015. http://lpi.oregonstate.edu/mic/minerals/sodium
Linus Pauling Institute: Micronutrient Information Center. “Potassium.” Last Reviewed 2010. Accessed on December 11, 2015. http://lpi.oregonstate.edu/mic/minerals/potassium
Image attribution:
lola1960/bigstockphoto.com
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

February 7th, 2016

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heart-disease
Most people have their blood pressure, heart rate, lipid profile, fasting blood sugar, and even vitamin D levels measured during their yearly physical. Your physician may do an EKG or a stress test. All of these tests may be “normal,” but there are other significant risk factors for metabolic issues that contribute to cardiovascular disease, that may be completely missed unless more testing is done.
Below is a list of some easily run lab tests and calculations which give insight into risk for insulin resistance, metabolic syndrome, inflammation and risk for future coronary heart disease. In my opinion, these tests should most certainly be a part of any patient’s assessment for metabolic disorders and development of heart disease:

1. Triglyceride to HDL ratio

This is a simple measure of insulin resistance, risk for diabetes mellitus type 2 and cardiovascular disease. A ratio less than 3.0 is considered normal, and more than or equal to 3.0 is suggestive of insulin resistance. An elevated ratio should prompt counseling the patient about therapeutic lifestyle change with close follow-up of metabolic markers for prevention of development of diabetes, hypertension and coronary artery disease.

2. Fasting insulin levels (and, if possible, two-hour postprandial insulin levels)

Usually at the yearly physical your physician will measure fasting blood sugar, and may even measure hemoglobin A1c levels, which are markers for pre-diabetes and diabetes. In my opinion, abnormalities in these are late developments. Insulin is a hormone produced by cells in the pancreas; it’s responsible for regulating blood sugar levels and for promoting uptake of glucose into the cells for use as energy or for storage as fat. Measuring insulin levels two hours after a glucose load may be the first indication of metabolic problems in your handling of sugar (or carbs).
Sometimes a two-hour insulin measurement may be difficult, so in my practice I measure fasting insulin levels, which are the second measure to go up. These two can be early markers of insulin resistance, much before fasting blood sugar starts going up. Excessive insulin levels lead to increased serum triglyceride levels, decreased serum HDL (good cholesterol) levels, increase in levels of the small dense LDL (the plaque-promoting form of bad cholesterol) particles. Insulin resistance is a risk factor for hyperlipidemia, diabetes, hypertension, all of which contribute to atherosclerosis and plaque formation, which in turn is a risk factor for heart disease development. I encourage my patients to work toward a fasting insulin level of at least less than 6 microunits per mL (ideal is 4). Obviously diet is the key for reducing Insulin levels, but for patients who need additional short or long term support, I use a supplement known as Blood Sugar Support which have all the key factors to support blood sugar and insulin levels. It has helped many of my patients.

3. High-sensitivity C-reactive protein (hsCRP)

CRP is produced in the liver in response to nonspecific inflammation in the body. The high-sensitivity CRP is an assay which detects low levels of CRP specific to inflammation in the blood stream i.e., vascular inflammation, which could be the cause for development and progression of heart disease. Standard lipid tests do not test for inflammation, and this marker can be easily tested through your local labs. Even if your lipid profile is normal and you do not have other cardiovascular disease risk factors like hypertension or obesity or diabetes, if this marker is elevated, it is cause for concern. If somebody has already had a cardiac event like a heart attack or stroke, and this marker stays chronically elevated, it could be predictive of a high risk for future repeat heart attack or stroke. The therapeutic goal for hs-CRP is less than 0.7 mg/L, preferably as near to 0 as possible. I like to repeat this a few times to be sure it is actually staying high.
A word of caution with hs-CRP: though a marker of inflammation, it can also be a marker for infection and acute injury, so if you’ve had any recent surgery or procedure; have a respiratory, gum or other infection; or have the flu, please wait until your symptoms are resolved before testing, as this marker will be elevated due to that acute event.

4. Red blood cell magnesium levels

Red blood cell magnesium levels are the best way to assess magnesium status. Clinical signs of magnesium deficiency could be fatigue, weakness, muscle cramps, seizures, numbness and tingling in the extremities, mood and sleep issues, irregular heartbeats and also spasms in the arteries which feed the heart, contributing to heart attacks. Magnesium supplementation may reduce the risk of coronary heart disease, so try to keep levels at the high end of the lab range, though I monitor clinically more often. The form of magnesium I use is a very highly absorbable chelate.

5. Homocysteine levels

Homocysteine is a toxic amino acid and elevated levels can be a risk factor for development of cardiovascular disease and stroke. Elevated homocysteine levels damage LDL cholesterol, causing its oxidation. Oxidized LDL leads to plaque formation in the coronary arteries. Homocysteine is produced as an intermediate in the metabolism of amino acids methionine and cysteine. Activated forms of vitamin B12 and folate are needed for the conversion of homocysteine into methionine, so elevated homocysteine can be one of the indicators of deficiency in these important vitamins (remember that there are drugs like Methotrexate and acid blockers like Nexium which block the metabolism or absorption of these vitamins and may cause elevations in homocysteine levels). Serum homocysteine is great screening test for patients who are at a risk for cardiovascular disease and stroke, especially when there is a family history but no other known risk factors. Strive to keep levels around 8 micromoles/L. If elevated Homocysteine levels are due to a genetic variation in key enzymes of the methylation pathway then supplementation will usually be required long-term with frequent (every 3 months) monitoring of levels.

6. Ferritin levels

Ferritin is an iron-containing protein produced in the liver, and signifies the stored form of iron. Ferritin can also be a marker of inflammation. Moderate elevation of ferritin may lead to a 2-3 times increased risk for development of diabetes. Though the normal range in your lab for ferritin can be from 12-150 ng/mL in women and 12-300 ng/mL in males, studies have shown high ferritin levels increase cardiovascular risk. Lowering the iron stores to near optimal level of between 70-80ng/mL will improve outcomes in cardiovascular disease including reduced risk for heart attacks, strokes and also improve life expectancy. As a side note, I don’t think that ferritin levels less than 50ng/mL are in any way normal (even though your lab may show it in the normal range) and reasons for low iron stores must be looked into.

7. Testosterone levels (in males only — no correlation with heart disease has been found in women)

In males, testosterone deficiency has been associated with a high risk for cardiovascular disease. In elderly males, lower free testosterone level has been shown to be associated with a high prevalence of cardiovascular disease. If your total and free testosterone levels are low, work within integrative or a functional medicine physician to find out why that is the case. Replacing testosterone may not be the only answer. Certain natural supplements like Zinc, Magnesium, L-carnitine, B vitamins especially B6 can help support Testosterone levels naturally.
Males should try to keep testosterone levels between 350-600ng/dl. Remember, more is not always better with testosterone therapy if you need it, and always seek out a physician well versed in male hormonal replacement therapies, or someone who can help guide you to support your body’s hormone production naturally!

8. Testing for chronic infections

Many pathogenic bugs have been shown to have a significant correlation with development of coronary heart disease as well as acute coronary syndromes (heart attacks). Some of these are herpes simplex virus, cytomegalovirus, and H. pylori. Ask your physician to test for antibodies to these bugs through your local laboratories. Since most of your immune system is in the gut, taking a multistrain good quality probiotic can be a great first step.
Print out and take this list to your physician to help them better evaluate your risk for heart disease, or find a functional medicine physician who is well versed in managing and counseling patients with metabolic disorders!
Dr. Manisha Ghei first wrote this article for  Mind Body Green
The information offered by this blog is presented for educational purposes. Nothing contained within should be construed as nor is intended to be used for medical diagnosis or treatment. This information should not be used in place of the advice of your physician or other qualified health care provider. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of any information contained within this blog.

September 20th, 2015

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