I recall sitting through three or four hours of continuous lectures on topics foreign to me such as leaky gut syndrome, or dysbiosis (microbial imbalances in the body) and the ultimate surprise of all: the connection between the gut and the immune system. Why I had never heard about this material in either medical school or in my three years of internal medicine training. Because it seemed so off from my beaten path, I just said to myself, “No problem. I'll just refer patients with these issues out.”

But then I thought, “To whom am I going to refer these patients?” The truth was, I didn't know anyone who was equipped to handle these issues. All the gastroenterologists whom I knew were well versed in diagnosing patients with structural disease of the gastro-intestinal tract. Such physicians were very qualified in performing endoscopies and colonoscopies, and in diagnosing and treating those with peptic ulcer disease and colon cancer. However, they were not prepared to manage patients with functional disease of the GI Tract. They were completely non-integrative in their approach. So, it quickly became obvious to me that it would become my duty to manage such patients as a board-certified, anti-aging medical specialist. I never looked back from that point on. Indeed, this has become a pet peeve of mine in helping my patients achieve optimal health and wellness.

Let’s take a simple example of those with acid reflux, a disorder of increasing magnitude, affecting persons of all ages and genders. A common remedy is prescribing proton pump inhibitors with drugs such as Prevacid, Nexium and Aciphex among others. Now, these drugs are quite useful in treating erosive gastritis and the symptoms of severe acid reflux, but are generally only indicated for eight weeks duration. In reality, these same drugs are prescribed to many patients on a chronic basis. Side effects include, most notably, malabsorption of calcium. Most folks know how important calcium is in preventing osteoporosis. I don’t care how much calcium a patient takes in the form of supplements. They will never achieve a level high enough to combat osteoporosis as long as they remain on proton pump inhibitors. There are many other side effects including an increased incidence in community acquired pneumonia in the elderly population in those taking proton pump inhibitors on a chronic nature.Gut flora : from Wikipedia

There are viable alternatives to maintain a healthy GI tract, which can help guard against acid reflex. Digestive enzymes can make it easier for our food to be digested and consequently improve gut motility. Probiotics help to maintain a healthy colon. We now know a lot about the protective nature of our intestinal flora, the good bacteria that keep our gut functioning in a healthy manner. Unfortunately, disease and many commonly prescribed medications such as antibiotics can easily wipe out our flora and set us up for poor health.

Wall Street JournalFew people might know that 85 percent of neurotransmitters are made in the GI tract, and not in the brain. I wasn’t aware of this until three years ago. So, a healthy balance of serotonin, dopamine, GABA (gamma-aminobutyric acid) and the like which can affect both brain function and mood depends on healthy gut function. Moreover, nearly 90 percent of the immune system emanates from the gut. Obviously, this is extremely important in helping guard against common infections, cancer and autoimmune disorders.

So, even though I am best known as a cardiologist and an anti-aging medical specialist, I take most pride in being known as the “Medical Advocate,” since my goal is always to motivate my patients, my readers and my audiences to get in the driver’s seat when it come to their health--so that they, in turn, can become their own best medical advocate. My interest in gut health is paramount to our well-being. Therefore, we dedicate April and May as “Digestion Health Months” here at HeartWise to promote healthy gut function in everyone.

Dr. Elkin is a board-certified internist, cardiologist and anti-aging medical specialist.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2012

I always plan a new year by setting forth goals. Then, I formulate a plan to actually accomplish them. The plan is not a stagnant tool, as I review it regularly and make necessary changes to get closer to my goals. Formulating the plan takes research and support from family and friends. This is absolutely necessary for success. Remember that old adage: “Failing to plan is planning to fail.”

Click Arrow at Site to ListenThere are financial goals, personal goals, career goals, athletic goals and social goals. The one I cherish above all are goals related to health and wellness. Without our health, we really have nothing. I have too often seen cases where one’s health only became a priority once they were stricken with a life-threatening illness.

I’ve been branded the “medical advocate” because I don’t stop at being a health advocate to my patients. I go one major step further. I encourage each individual to become his or her own medical advocate. After all, no one knows your body better than you. I encourage my patients to read, ask questions and seek more than one medical opinion on issues that are not simply black or white. My wish is for my patients to take the driver’s seat when it comes to their health, and learn about various options available to them. By becoming their own medical advocate, communication between patient and physician is enhanced, which will lead to better outcomes.

One very common health goal is exercise. To avoid regular exercise is clearly an anathema to health, akin to smoking a pack of cigarettes a day. Research shows regular physical activity is critical to prevention of chronic diseases and prevention of falls. It aids mobility, social interaction and emotional and cognitive health. For maintenance of memory as we age, exercise is one of the greatest strategies available to us by increasing blood flow to the brain.

Data as late as 2009 speak of these grim facts: Less than 20 percent of the adult population engages in recommended frequent exercise to achieve health benefits.

Data show more than 50 percent of people who start an exercise program give up before the end of 12 months. Nearly half those individuals who purchase home-exercise equipment eventually use it as a clothes hanger. Surveys show 69 percent of men in the United States consider themselves physically fit. In reality, 13 percent of men in the country are physically fit.

Aerobic activity, nicknamed “cardio,” and resistance training are important components of an exercise regimen. Aerobic exercise, such as walking, running, cycling and swimming, is important for a healthy heart and brain. It is useful for weight control. But what is not commonly known is that the calorie burn from performing cardio occurs during the activity. It tapers off quickly once the exercise is completed.

Weight training is more vital as we age. I am a competitive bodybuilder on the national level, but strength training for the non-competitor will garner health benefits.

Many benefits come from regular weight training:

1.) A greater degree of fat burning occurs with weight training vs. cardio exercise. Resistance training builds muscle; cardio does not. With more muscle mass, metabolism greatly increases, thereby burning fat even while one is sedentary. Research shows regular resistance training can increase metabolic rate by 15 percent. Weight training will keep one’s metabolism running like a furnace. The result is improved body composition or improved muscle-to-fat ratio.

2.) Enhanced muscle mass reduces risk of injury. Weight training is the best exercise to protect against osteoporosis. Strong muscles as well as active muscles pull on ligaments and bones, thereby greatly aiding in laying down new bone on an ongoing basis.

3.) Regular strength training helps guard against insulin resistance, which is rampant in our society and is often a precursor to Type 2 Diabetes. It can help keep blood pressure under control and increase gastro-intestinal transit time, which may help guard against colonic polyps and colon cancer.

4.) Increasing muscle mass has a beneficial role both cosmetically and physically. Folks with enhanced muscle mass look healthier and age better with less loss of facial muscle mass. Regular weight training will minimize this age-related loss in muscle mass.

5.) Muscle mass is vital for successful aging. To maintain the ability to live independently, one needs to have enough strength to be able to open a jar or shut a window. These independent daily activities require strength.

6.) Weight training greatly aids in balance and coordination.

Let’s use the first month of this New Year to make new goals that will positively affect health and wellness. By being in charge of one’s health and wellness, one can expect to be their own medical advocate. It’s a wonderful feeling of self-empowerment.

Dr. Elkin is a board-certified internist, cardiologist and anti-aging medical specialist.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements.
©Howard Elkin MD FACC, 2012

I previously mentioned what is commonly referred to as the “awesome foursome” a term so coined by my mentor and friend Stephen Sinatra, MD, a well known integrative cardiologist on the East coast. These four nutritional supplements can treat the gamut of heart disease, from coronary disease to heart failure. Each of these naturally occurring supplements work in the mitochondria of the heart cell, sometimes referred to as the energy powerhouses of the cell. Here lies the difference between the medications commonly prescribed and such supplements. Drugs treat symptoms. They are mandatory in most cases of heart failure. They remove excess fluid and decrease the stress load on the heart, but they do not provide any nutritional support or energy boost. By supplying nutrients to the mitochondria of the heart cell, energy in the form of ATP can be produced. 

CO-ENZYME Q 10
This is like a vitamin which is produced within the body, but the production declines with age and with heart disease. A diseased heart lacks adequate amounts of CoQ10 which results in impaired energy production. CoQ10 production is also suppressed by commonly used drugs such as statins and beta blockers. CoQ10 is a co-factor and plays an important role in what’s called the electron transport chain within the mitochondria. This chain is vital for the production of ATP, an immediate source of energy. The nutrient also doubles as a free radical scavenger, which is extremely important when you consider the fact that ATP or energy production generates a significant amount of free radicals which, if left unchecked, could lead to chronic inflammation and premature aging. So CoQ10 is important in protecting against oxidative stress caused by too many free radicals and inflammatory damage.

L-CARNITINE
L-carnitine is an amino-acid–like compound, a break-down product of protein, found primarily in meat, especially lamb. The body can also make it. It is an important transport compound, and it carries fatty acids within the cell to the mitochondria. This transport allows energy in the form of ATP to be produced. This function is vital since the heart obtains 60 per cent of its fuel from fat. Equally important, this compound carries out wastes from the mitochondria. A diseased heart needs all the energy boosting possible. Supplementing with L-carnitine can make a significant difference for patients suffering from heart disease.

D-RIBOSE
This compound is a simple sugar and serves as the energy substrate for not only the heart cell, but for every cell in the body. You may have an ample supply of CoQ10 and L-carnitine, but without this major building block for ATP production, energy repletion in diseased hearts will always be impaired. Unlike sucrose (table sugar) or glucose which are 6-carbon sugars, d-ribose is a 5-carbon sugar which the body processes differently. In most cases this compound can be safely taken by diabetics without upsetting their glucose metabolism.

MAGNESIUM
More than half of all Americans may be deficient in magnesium, a critical mineral. Most patients with heart disease are depleted, especially diabetics and postmenopausal women. Magnesium plays an important role in more than three hundred enzymatic reactions in the body, including the generation of cellular energy and muscle relaxation. It is important to remember that as we age our hearts get stiffer and this impairment of muscle relaxation can lead to inadequate filling of the heart. Inadequate cardiac filling, even in the face of normal pumping action can still lead to heart failure. Magnesium can play an important role here. There are many other vital functions for this magnesium as well, both cardiac and extra-cardiac.

*********************************************************************************

There is a role for other supplements with regard to the cardiovascular system, but these four are extremely useful in energy production for diseased hearts. It is important to remember that these do not replace pharmaceutical products of known efficacy. However when appropriately supplemented along with a healthy diet, they may make a major difference in cellular energy while improving quality of life in those suffering from heart failure.

Dr. Elkin is a board-certified internist, cardiologist and anti-aging medical specialist.

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this blog. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements.
©Howard Elkin MD FACC, 2012

When someone famous succumbs, interest is sparked and people from all over become engaged in conversation. “How did this happen and how long had it been going on?” are common questions raised. Elizabeth Taylor, the glamorous queen of American movies, and equally famous humanitarian, died late March of congestive heart failure. Known for her seemingly countless illnesses and hospitalizations, she always seemed to pull through and survive. The truth of the matter is that she began suffering from heart failure as early as 2004. Suddenly this diagnosis became a buzz world around the western world.