Diary of a Doctor: Heart Health

Hawthorn: Fruit for The Heart

The Hawthorn (Crataegus oxyacantha) is a fruit-bearing shrub or small tree with a long history as a medicinal substance. Hawthorn Berry has been used for centuries as a heart and cardiovascular tonic herb. It has also been used for the treatment of digestive ailments, shortness of breath, kidney stones, and cardiovascular disorders.

Cardiovascular Benefits of Hawthorn

Today, Hawthorn is used primarily for its cardiovascular benefits. Research has shown that Hawthorn's positive cardiovascular effects are due to its ability to strengthen the integrity of blood vessel walls and increase coronary blood flow in the heart muscle and cardiac output while also improving the heart’s utilization of oxygen.

Clinical studies have found that standardized extracts of Hawthorn flower, leaf, and fruit show promise as adjunctive agents for the treatment of left ventricular heart dysfunction commonly associated with congestive heart failure.

How Hawthorn Works in your Heart

Hawthorn improves left ventricular performance (the heart muscle’s ability to pump blood to the body), as measured by ejection fraction (the percentage of blood pumped out of your heart with each beat). Other trials consistently demonstrate the ability of Hawthorn solid extracts to improve exercise tolerance and symptoms of mild to moderate heart failure.

Reviews of placebo-controlled trials have reported both subjective and objective improvement in patients with mild forms of heart failure (New York Heart Association classes I through III). Other studies of Hawthorn in patients with heart failure have revealed improvement in clinical symptoms with better output of blood from the heart into circulation and patients' subjective sense of well-being.

The Benefit of Flavonoids

The active components of this slow-acting cardiotonic agent are thought to be its flavonoids and oligomeric procyanidins (vitexin). These are the substances that make the fruit so red and the flowers pink. These flavonoid molecules are some of the strongest known antioxidants and have been shown to have specific affinity for the heart and cardiovascular tissues.

Hawthorn (Crataegus) Extracts and Supplements

Hawthorn Extract: Vital Nutrients Hawthorn Extract is concentrated and standardized for its active flavonoid constituents. It is used to support the health of the cardiovascular system, including the protection and preservation of heart tissue. Hawthorne also is a tonifier of blood vessels and arterial walls. This is a standardized extract of leaf and flower in capsule form delivering 1.8 - 2% vitexin per capsule. Studies show this to be a clinically effective concentration at one to two capsules twice daily.

Cratoxy: Scientific Botanicals CRATOXY is a solid extract of Hawthorn Berry which has been used for centuries for heart and cardiovascular support. Concentrated into a molasses-like syrup, Cratoxy allows you to ingest therapeutic levels of Hawthorn Berry without taking pills… and it tastes great too! We commonly suggest ½ tsp., two to three times daily.

CardioBlend: The key elements in Vitanica CardioBlend, including Hawthorn Berry, help to support healthy blood cholesterol levels, healthy cholesterol ratios, balanced nutritional supplementation, and strengthened heart muscle tissue. Suggested use is two capsules twice daily.

Q10 Plus: Thorne Q10 Plus is a combination of coenzyme Q10, hawthorne (Crataegus oxycantha), potassium, taurine, and magnesium, providing the heart muscle with the nutrients needed for optimal functioning. Suggested use is three capsules one to two times daily.

We'd like to hear from you. Please send us an email and let us know if there is something in this article that works for you. We value your input and would like to exchange ideas with you.

I have been asked many times, “If you had to chose only one nutritional supplement to take to improve your overall health and prevent disease, which one would that be.” My answer is: A pure, stabilized, pharmaceutical-grade fish oil from wild salmon, anchovies, sardines or Arctic cod with added vitamin E.

Benefits of Fish Oil and EPA/DHA

There has been an extensive amount of medical and scientific literature published over the past 35 years testifying to the MANY health benefits of ingesting fish oil and its active omega-3 fatty acid components EPA and DHA. It is clear that ingesting 1,000 mg or more of EPA daily with its associated DHA can play a crucial role in preventing and possibly reversing numerous disorders such as cardiovascular disease (atherosclerosis, heart attack, stroke, heart failure, angina); depression; autoimmune inflammatory disorders; and cancers such as breast, prostate, and colon cancers. Many clinical trials have further demonstrated fish oil supplementation to be effective in the treatment of inflammatory bowel disease (Crohn’s Disease and Ulcerative Colitis), Rheumatoid arthritis and other autoimmune arthritic disorders such as Lupus, diabetes, Raynoud’s disease, peripheral vascular disease, and some degenerative neurologic disorders.

EPA and DHA have also been shown to be biologically essential, natural anti-inflammatory compounds critical to cell development and function that are now severely deficient in the common human diet. In fact, we humans evolved on a diet rich in omega-3 fatty acids with a common ratio of 1:1 omega-3 fats to omega-6 fats. However, due to our change in diet to one of more processed foods, that healthy ratio is now deteriorated to a ratio 1:10 and in some cases 1:25. This unhealthy ratio promotes the development of inflammation, cellular dysfunction and the accelerated development of degenerative disorders and aging.

Risks from Polution and Poor Manufacturing Practices

Clearly, consuming a diet rich in oily fish or alternatively, supplementing with fish oils is one of the most important steps one can take to ensure optimal health while reducing the risks of cardiovascular disease and other degenerative and inflammatory disorders. However, pollution of our fresh and saltwater resources has taken its toll and a growing number of various fish species have been shown to contain large amounts of mercury and other industrial pollutants such as PCBs. According to research done at Harvard University by doctors Mozzaffarian and Rimm and reported in the October 18th, 2006 issue of the Journal of the American Medical Association, the fish shown to be the greatest risk for mercury and other toxin exposures are shark (particularly shark liver oil), swordfish, golden bass, tuna and king mackerel.

In March of 2010, a lawsuit was filed in California Superior Court targeting eight supplement manufacturers or distributors of fish oil supplements commonly available on the retail market. These companies purportedly sold fish oil, shark oil, fish liver oil and shark liver oil supplements that have PCB contamination above the so-called “safe harbor” limits set for human PCB consumption under California’s Proposition 65. That law requires companies to warn consumers about contaminant exposures. As reported by Reuters and CBS News, “defendants included the world's largest producer of commercial omega-3 fish oil, Houston-based Omega Protein, as well as drug stores Rite Aid Corp and CVS Caremark Corp. Also named as defendants were General Nutrition Corp, a subsidiary of GNC Acquisition Holdings Corp, Now Health Group Inc, Pharmavite LLC, the maker of the NatureMade brand of supplements, Solgar Inc and TwinLab Corp.” According to the lawsuit, two citizen environmentalists and the Mateel Environmental Justice Foundation, found that “levels of PCBs in supplements in popular fish oil products varied wildly, from about 12 nanograms per recommended dose in the best performer to more than 850 nanograms in the worst performer - a factor of 70.” PCBs have been listed as known carcinogens and reproductive toxins in California for 26 years. This makes them subject to California’s label warning requirements.

The Best Fish and Fish Oil for Consumption and Supplementation

According to doctors Mozzaffarian and Rimm from their Harvard University study as well as other medical research, the safest fish to consume and use for fish oil supplementation known to be good sources of EPA and DHA and low in mercury and other contaminants are anchovies, herring, wild salmon, sardines, wild trout and arctic cod. Fresh, wild pacific salmon is an excellent source of safe fish oil as is fish oil from anchovies, sardines, mackerel and Arctic cod for ensuring your daily needs for EPA and DHA are met. Also, only fresh, highly purified, pharmaceutical-grade fish oils that are molecularly distilled in an oxygen-free environment, independently assessed for toxins and rancidity, and stabilized with vitamin E should be consumed. This level of quality control, unfortunately, adds a bit to the cost. Therefore, cheap, low-quality fish oils especially from shark, shark liver and king mackerel should be avoided as they are unstable and may contain significant amounts of mercury, undesirable oxidation products and PCBs as shown in the California law suit and scientific studies.

Fish oil versus flax oil

There is considerable evidence that fish and fish oils are beneficial to heart health, reduce the risk of cancer, and benefit mental health. The “active” components of fish oils are eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Both are members of the omega-3 group of essential fatty acids. EPA and DHA are found exclusively in marine mammals and fatty, saltwater fish such as anchovies, herring, sardines, salmon, mackerel, and Arctic cod to name a few. Alpha-linolenic acid (ALA) is another omega-3 fatty acid. It is found in various plants, seeds and true nuts such as walnuts. Flaxseeds and flaxseed oil contain a large amount of ALA but also contain other omega-6 fatty acids. ALA can be converted to EPA in the body (in the liver). EPA, in turn, can be converted to DHA.

There has been some controversy as to the benefit of consuming ALA over EPA and DHA. However the scientific research has shown that, gram for gram, the health benefits from taking EPA and DHA far outweigh those for ALA. This is primarily due to the time and extent of conversion needed in the body to make ALA into EPA. The fish have done that for us. In research done at the National Institutes of Health and reported in the August, 2001 issue of the Journal of Lipid Research, the researchers conclude that ALA is not a viable source of EPA and DHA and cannot replace fish and fish oils in the diet. Apparently, a tablespoon of flax oil would only result in the synthesis of about 30 mg of EPA – far less than the recommended minimal daily intake of 220 mg.

Take-aways: A daily dose of fish oil reaps many benefits

If I had to chose only one nutritional supplement to take to improve overall health and prevent disease, I would select a pure, stabilized, pharmaceutical-grade fish oil from wild salmon, anchovies, sardines or Arctic cod with added vitamin E. When selecting fish oil, check to make sure that it is from fish low in mercury and other contaminants (i.e., anchovies, herring, wild salmon, sardines, wild trout and arctic cod). Also, make sure that your fish oil is a fresh, highly purified, pharmaceutical-grade fish oil that is molecularly distilled in an oxygen-free environment, independently assessed for toxins and rancidity, and stabilized with vitamin E.