Nutrition. Vitamins. You.
Omega 3s and the Heart! Dr. Claire Arcidiacono, ND Omega 3s are something that everyone has heard of. In fact many nutritionists including myself consider them to be essential to a healthy daily vitamin regimen. But many people I talk to ask a few …
The Benefits of Beets Hx Dr. Claire Arcidiacono, ND Everyone has heard about beets. Beet powder, beet chews and even beet juice! It’s everywhere you look! But what really are the benefits of using beet supplements? Why is the tart cherry in the Beets …
Congestive Heart Failure
Dr. Claire Arcidiacono, ND
Our next topic is something that may seem uncommon but is actually more common than you would think. This is congestive heart failure. When people refer to having a “weak heart” they are referring to congestive heart failure. What is congestive heart failure? Basically what happens when you have Congestive heart failure or CHF for short is the heart is unable to pump blood throughout the body. Over time blood and fluids start to build up in different parts of the body. The 3 types of CHF are left sided, right sided, and high output failure.
What causes our heart to fail? There are a number of situations that can cause our heart to fail. Recreational drug use, including tobacco use as well as certain medications can lead to heart failure. Having a family history of CHF also places you at risk of CHF. Having a personal history of high blood pressure, coronary artery disease, diabetes and having a past heart attack all increase risk of CHF. Additionally being over 65 increases risk of heart failure. Having an enlarged heart known as cardiomyopathy can also increase risk of CHF. There are congenital heart disorders which are present at birth that over time can cause CHF. Having a history of arrhythmia is also a risk factory. Life style risk factors that can increase our risk of heart failure include alcohol use, BMI over 30, being inactive and eating a diet high in saturated fat and salt. Lastly having a history of rheumatic fever can overtime increase the risk of developing heart failure.
Heart failure is broken down into 4 stages. These stages start with high risk of developing heart failure and end with having advanced heart failure. Other conditions that can affect heart function include chronic lung disease, thyroid disorders, anemia and even kidney disease. It is important to address these concerns to help keep our heart working as well as possible.
What are the classic signs of heart failure? While not everyone will experience these symptoms it is important to know what you may experience especially as the disorder gets worse over time. Now as I said the most common symptoms are swelling in the ankles, legs abdomen and even a bloated or heart stomach. This swelling occurs due to the hearts inability to pump fluids and gets worse as the heart fails to do its job. Because of the buildup of fluid in the body there may be weight gain without any change in diet. There may also be nausea. Our ability to breath can be impacted with a feeling of shortness of breath or SOB. You may also wake up with a feeling of SOB. There may also be a chronic dry cough. There can be chest pain and heart palpitations. As fluid builds up there may be a need to urinate at night. Lastly you will experience fatigue that gets worse over time.
Unfortunately, chronic heart failure gets worse over time. Because of the hearts inability to pump blood throughout the body there are some series complications that can occur. This includes a buildup of fluid in the lungs which can lead to pulmonary hypertension. There may also be kidney damage, liver damage and even heart valve damage. CHF can even lead to an irregular heartbeat. Due to nausea there may be malnutrition. Lastly, over time CHF can lead to sudden cardiac arrest. Heart failure has to be taken seriously. While there is no cure there are certain things that can help improve our hearts function. (1, 2)
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What is a Myocardial infarction or Heart Attack? Dr. Claire Arcidiacono, ND What exactly is a myocardial infarction or MI? Well in layman’s terms, it is what is known as a heart attack. But what exactly happens during a heart attack? Basically during a …
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Written by Dr.Claire Arcidiacono, ND
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Last week we finished our conversation about lupus. Today we will be discussing gout. Gout will be the last condition specific blog in this series on joints. What exactly is gout? Basically, gout is a form of inflammatory arthritis in the joints. This arthritis is interesting because it is associated with uric acid build up in the joints. This uric acid causes the joints to become inflamed and this inflammation is what leads to the joint damage and pain. (1) Please see picture for exactly what this looks like. † (2)
Symptoms of gout may sound familiar, interestingly gout usually starts in the joint of the big toe. As the condition progresses more and more joints become involved. Like other inflammatory disorders in gout the joints will be red, tender, swollen and even warm to the touch. In addition to joint pain the buildup of uric acid can also cause the buildup of crystals in the kidneys leading to what is known as urate nephropathy. In addition to these symptoms’ gout can also lead to systemic symptoms such as fatigue and even a high fever. † (3)
The symptoms of gout are caused by the buildup of uric acid crystals. Therefore, anything that increases the uric acid levels in the body will increase the risk of developing gout. Diet is a very well-known risk factor for gout. A diet high in alcohol, meat, seafood and sugar can increase the uric acid in the body and thus can increase gout risk. (4) Another well-known diet-based risk factor for gout is a diet that is high in purines which can increase uric acid. Purines are a part of every cell and break down into uric acid. Because they are found everywhere it is impossible to eliminate them entirely. It is possible to try and limit the foods that have a very high purine content. (5) These foods include but are not limited to anchovies, shrimp, mushrooms, seaweed and organ meats. (6) Some research has indicated that potatoes as well as chicken can increase the risk of developing gout. (7) As a result of the fact that gout occurs when uric acid builds up anyone that has kidneys that do not excrete the uric acid properly is at a higher risk of developing gout. † (8)
Certain genes have been found to increase the risk of developing gout. Therefore, anyone with a family history of gout may want to reduce their other risk factors for the disease. † (9)
Gout is associated with certain medications as well as certain chronic conditions. For example, diuretics, niacin, aspirin, ACE inhibitors as well as Beta blockers and even some chemotherapy may increase the risk of gout. (10) Interestingly with excessive vitamin D (blood work showing vitamin D over 80) there is an increased risk of gout. (11) A few examples of chronic conditions that are associated with gout include but are not limited to the following: metabolic syndrome, kidney failure, organ transplant recipients, those exposed to lead and those who are obese/overweight. † (12)
Other triggers that can lead to a gout flare up can include rapid changes in the weather. Additionally, trauma, surgery and having sleep apnea increase the risk of gout. † (13)
While having high uric acid on blood work or hyperuricemia is considered to be a classic sign of gout not everyone with gout has this classic sign. In fact, up to 50% of people with gout never develop high uric acid on blood work. (14) In order to diagnose gout uric acid crystals are found in the synovial fluid of the joints. (15) Other conditions that should be ruled out can include but are not limited to pseudo-gout, RA, psoriatic arthritis and rheumatism. † (16)
ICYMI:PSORIATIC ARTHRITIS>>READ NOW!
The goals of working with gout include stopping the acute attack or flare up that is occurring right now and then from there we work on lowering the uric acid. By lowering the uric acid, we can reduce the risk of a flare up in the future. Now I know some people might think that they only need to work on gout during a flare up but it’s important to work to reduce the uric acid levels regardless of flare up status. Each gout “attack” or flare up increases the risk of damaging the joint. This can lead to destruction of the joint surface and even cause the joint to become deformed. Lastly in 30% of those with untreated gout something called tophi can occur. This is basically a buildup of uric acid that most commonly occurs on the ear, olecranon process and the Achilles. † (17) Please see the attached picture (18) †
To help reduce uric acid and thus reduce the risk of gout the following have been found to be helpful:
Next week we will be discussing how to heal from surgical based interventions. †
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