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Every year, we write at least one column listing our top supplements for heart health. We try to do this without looking back at what we’ve written before. But when we finally do reread what we wrote the previous year, we’re always amused to find that the list doesn’t change that much.
So here’s this year’s list of superstar heart supplements. A good supplement plan isn’t the only thing you’ll need — far from it — but it’s a great addition to a heart-healthy lifestyle. These supplements are an excellent place to start.
The heart needs a lot of energy. It never takes a vacation and beats approximately 86,400 times a day, day after day, year after year. Coenzyme Q10 (CoQ10) literally “recharges” the energy production factories—known as mitochondria—in the cells. It’s needed to generate the “bitcoin” of cellular energy, ATP. The cells use ATP to power everything you do. ATP is needed to pump your blood, burn fat, snore, digest food, dance the rhumba, blink your eyes—every single operation in your body requires ATP, and CoQ10 helps make it. Ubiquinol, the active form of CoQ10, has been shown to be better absorbed and utilized by the body.
Pantethine, the active form of pantothenic acid, is the most important component of CoQ10, and some research supports its use for lowering high cholesterol levels. Look for products featuring Pantesin, a proprietary form of pantethine that has been clinically studied and shown to help promote healthy cholesterol levels.
Omega-3 fatty acids are found in plant foods such as flaxseeds and animal foods such as coldwater fish. Flaxseed oil has some marvelous properties—there’s a lot of good research on flax oil and cancer, for example. But for heart health, fish oil has a heavier research pedigree. Fish oil has been shown to reduce the risk of having a heart attack or a stroke. It has been shown to improve insulin sensitivity. And it helps decrease the risk of sudden cardiac death.
But for me, the most important action of omega-3s is that they are anti-inflammatory. Inflammation either causes, promotes, or amplifies just about every degenerative disease known—including heart disease. And low levels of omega-3s have been associated with everything from heart disease to ADHD. That’s why I recommend omega-3 supplements for everyone, including children.
Magnesium is the ultimate “anti-stress” nutrient. It basically calms things down, functioning as a kind of “relaxer.” It relaxes (dilates) the arteries, which lowers blood pressure and makes it a lot easier for the heart to pump blood. It improves sleep, which in turn lowers stress. It helps lower blood sugar, a major concern of diabetes and metabolic syndrome, both of which wildly increase the risk of heart disease.
According to surveys, almost no one gets enough magnesium. One easy (and fun) way to get your magnesium is to take a relaxing magnesium bath (powders and flakes are now available and can be easily added to a warm bath).
Niacin is accepted even by mainstream doctors because it lowers cholesterol. But its real value is that it lowers Lp(a), an independent risk factor for heart disease and heart attacks. It also raises HDL cholesterol, specifically HDL-2 cholesterol, which is the most beneficial of the HDL subclasses. The only problem with niacin is the dreaded niacin flush, which is why a lot of people don’t take it. Sustained-release niacin was introduced to remedy this problem, but there’s only one problem: it doesn’t work. For this reason, avoid sustained-release versions.
D-ribose is another of the components of ATP, that cellular energy molecule we talked about earlier. Without D-ribose, you’ve got no ATP. Without ATP, you’ve got no energy to do anything, including basic metabolic functions. When the heart is stressed, it can’t make enough D-ribose to replace lost energy quickly.
D-ribose stores are “tissue-specific”—the heart can’t “borrow” D-ribose from the liver. It has to have its own stash. My co-author on The Great Cholesterol Myth, cardiologist Steven Sinatra, MD, recommends 5 grams a day as a starting point for cardiovascular disease prevention, athletes, and people who engage in strenuous activity.
L-carnitine is like a shuttle bus that transports fatty acids into the mitochondria—little energy plants within the cells—where those fatty acids can be burned for energy. Because the heart gets 60 percent of its energy from fat, it’s very important that the body has enough L-carnitine to shuttle the fatty acids into the heart’s muscle cells. A number of studies have shown that L-carnitine can improve exercise endurance in heart patients, and in some research, carnitine actually improved survival rates in heart patients.
Vitamin K actually comes in two main “flavors,” K1 and K2. Most people know of vitamin K because it’s involved in clotting, something that’s necessary if you’re not going to bleed to death from a paper cut! But clotting is a property of vitamin K1.
Vitamin K2 has a whole different resume. It’s important for the heart, because it helps get calcium into the bones where it belongs, and helps it stay out of the arteries, where it doesn’t. For its ability to help prevent calcification in the arteries (what my parents used to call “hardening of the arteries”), it’s a very important supplement for heart health. Vitamin K2 is found in some foods like natto, egg yolks, liver, and other organ meats, but many people don’t eat enough of those foods to get much K2 from food. The trend in supplements is combining vitamin K with vitamin D for comprehensive cardiovascular and bone health.
Nattokinase is extracted from the traditional fermented soy food natto, believed by many researchers to contribute to the low incidence of coronary heart disease in Japan. It provides a unique, powerful, and safe way to eliminate clots, or reduce the tendency to form clots, and thus decrease the risk of heart attack and stroke.
Here’s how it works: Your body naturally produces fibrin, a fibrous protein formed from fibrinogen. Fibrin is both good and bad. Its clot-forming action is immediately activated when bleeding occurs, so that’s a good thing. But excess fibrin activity can produce consistently thick blood, and that’s a big problem.
If blood clots in an already narrowed blood vessel, you’re basically screwed. So if you can dissolve the clotted material, you can open arteries and improve blood flow. If you reduce the clot even just a tiny bit, you get a significant blood flow boost. Nattokinase is a natural blood thinner. It can literally turn your blood from the consistency of ketchup to the consistency of red wine! Do not take if you are already on prescription blood thinners.
Vitamin C is one of the most powerful antioxidants in the world, and because heart disease is initiated by oxidative damage (damage caused by free radicals), any help you can get in the antioxidant department is a good thing. And the evidence is not just theoretical: A large 2011 study published in the American Heart Journal found that the lower the level of vitamin C in the blood, the higher the risk for heart failure. Take 1,000–2,000 mg per day.
Worth knowing: Vitamin C is extremely safe, and side effects are rare because the body can’t store the vitamin.(In some cases, doses exceeding 2,000 mg a day can lead to a little harmless stomach upset and diarrhea.) The bigger danger is the fact that vitamin C increases the amount of iron absorbed from foods. People with hemochromatosis, an inherited condition in which too much iron builds up in the bloodstream, should not take more than 100 mg of supplemental vitamin C.
This extract from the Indian spice turmeric has multiple benefits, not the least of which is that it’s highly anti-inflammatory. Scientific research has demonstrated its anti-inflammatory, antioxidant, anti-thrombotic, and cardio-vascular-protective effects. Curcumin also reduces oxidized LDL cholesterol. In animal studies, it was shown to protect the lining of the artery walls from damage caused by homocysteine.
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Garlic is a global remedy. More than 1,200 (and counting) pharmacological studies have been done on garlic, and the findings are pretty impressive. In addition to lowering lipids and preventing blood coagulation, it has antihypertensive, antioxidant, antimicrobial, and antiviral properties. Garlic has been shown to lower triglyceride levels. It can also reduce plaque, making it a powerful agent for cardiovascular health.
In one study, subjects receiving 900 mg of garlic powder for four years in a randomized, double-blinded, placebo-controlled study had a regression in their plaque volume of 2.6 percent; meanwhile, a matched group of subjects given a placebo (an inert substance) saw their plaque increase over the same time period by 15.6 percent!
One of the active ingredients in garlic—allicin—also has significant antiplatelet activity. That means it helps prevent platelets in the blood from sticking together. To understand how important that is, consider that many heart attacks and strokes are caused by spontaneous clots in the blood vessels. The anticoagulant effect of garlic is an important health benefit. For supplements, talk to you doctor if you are taking a blood thinner.