Atkins Diabetes Revolution (39 page)

Important note:
It has been observed in clinical practice that a few individuals experience elevated blood pressure while taking vitaminE. If your blood pressure goes up while taking a high dose, cut back.

B VITAMINS

Although you need all the B vitamins to keep your heart healthy, three of them are particularly important for heart health, especially for people with blood sugar problems. The first is folic acid, also known as fo- late. Folic acid could save your life.

The reason is a little complex. One of the normal by-products of metabolizing the amino acid methionine is a substance called homo- cysteine. Statistically speaking, a high level of homocysteine in your blood is associated with an increased risk of heart disease from clogged arteries. That can automatically raise the risk of death from heart disease for those individuals who have a tendency toward high homocysteine levels. If you have high homocysteine levels
and
diabetes, your risk is about 2.5 times greater.
6

People with diabetes and elevated homocysteine are more likely to have complications such as kidney disease and eye problems.
7
Another study showed that lowering homocysteine improves blood sugar control.
8
The commonly used diabetes drug metformin (Glucophage), in some instances, may also raise your homocysteine level.
9

Fortunately,you can take positive steps to bring your homocysteine level down if it’s too high.(Your doctor can do a blood test to find out.) First, getting your blood sugar down almost always also brings down your homocysteine.
10
Second, folic acid supplements, along with vita- min B
₆
(pyridoxine) and vitamin B
₁₂
(cobalamin),contribute to lowering homocysteine levels by helping your body form the enzymes that break it down.
11
To lower homocysteine, Dr. Atkins used 2,000 mcg to 4,000 mcg (2 mg to 4 mg) a day of folic acid, along with 50 mg of vitamin B
₆
and 500 mcg to 1,000 mcg of vitamin B
₁₂
. To get your homocysteine under control with such doses, however, work with your doctor because follow-up blood monitoring for homocysteine will be needed until the optimum level is reached. Dr. Atkins’ goal was a homocysteine blood level of 8 µmol/L or below. Another important reason to review this with your physician is that, in some women, additional folic acid can have a mild estrogenic effect, which may need to be monitored. These nutrients have been helpful for patients with neuropathies.A good example of the effectiveness of the use of B vita- mins in lowering homocysteine levels was Martha N., who saw Dr. Atkins for weight management and to reduce some of the five medications she was taking, including those for elevated triglycerides—hers had been as high as 700. Interestingly, although she had a number of cardiovascular risk factors, she never had her homocysteine level tested. On her initial visit her homocysteine level was 20.6. After two months with additional supplementation of B
₆
,B
₁₂
, and folic acid, her level dropped to 8.8.

Another valuable B vitamin for heart health is niacin, also known as vitamin B
₃
. Long before statin drugs appeared on the scene, doctors used large doses of niacin to help bring down LDL cholesterol and triglycerides and to raise HDL cholesterol.
12
This treatment was improved by the development of a form of niacin called inositol hexanicotinate (IHN), which works well without the unpleasant flushing side effect that can result from large doses of niacin. If you want to try IHN to improve your lipid profile, you must work with a nutritionally oriented physician to find the right dose, monitor your progress, and check your liver function. Dr. Atkins usually prescribed 500 mg to 1,500 mg per day in divided doses.

One problem with niacin and IHN is that they might raise your blood sugar a bit if you have diabetes.
13
For patients with elevated blood sugars, Dr. Atkins usually prescribed a slightly lower dose of IHN and the higher dose range for chromium (check Chapter 20 for more information on this mineral). Blood sugar elevation does not happen to everyone, but be sure to monitor your blood sugar. The combination therapy he used is just as effective as a larger dose of IHN alone for improving cholesterol levels.

Pantethine, a form of the B vitamin pantothenic acid, can also be helpful for improving your lipid profile, particularly total cholesterol and LDL.
14
Pantethine can be very effective with minimal side effects. (Some patients get diarrhea, but this usually goes away if the dose is reduced.) Dr. Atkins found that his patients usually benefited most from taking two or three 450 mg capsules of mega-pantethine a day. If that formulation isn’t available, take three to six tablets daily of a standard pantethine complex supplement.

MAGNESIUM

If you have the metabolic syndrome, prediabetes, or diabetes, your magnesium levels are likely to be low, as we explained in Chapter 20. That’s not just bad for your blood sugar, however—it’s also bad for your blood pressure and your heart. Low levels of magnesium can cause heart arrhythmias (irregular heartbeat) and may also make your blood “stickier”and more likely to form clots.
15
,
16

Magnesium can have a major impact on your blood pressure. When you’re low on magnesium—as many people with hypertension are—the walls of your blood vessels tighten up, which raises your blood pressure. Magnesium helps the blood vessels relax, which brings your blood pressure down.
17
For treating high blood pressure, Dr. Atkins used 500 mg a day of magnesium orotate in three or four divided doses. He preferred this form of magnesium, as it is generally well absorbed. Alternatively, use magnesium taurate in doses of three to four a day.

Important note:
If you have kidney disease,you must discuss magnesium supplements with your doctor before you try them.

TAURINE

The amino acid taurine is another valuable supplement for treating high blood pressure and helping your heart.
18
It acts as a natural diuretic, which helps your body excrete excess fluid.
19
That, in turn, lowers your blood pressure and puts less strain on your heart. Taurine has been shown to enhance immunity and protect against oxidative stress.
20
It’s usually available in 500 mg tablets. The usual dose range is 1,500 mg to 3,000 mg a day in three divided doses.

Important note:
Amino acids such as taurine can have powerful effects, especially in the presence of medications such as diuretics, and should be used only under the supervision of a nutritionally oriented physician. Health care professionals differ in their opinions on the use of individual amino acids for therapeutic effect.

ESSENTIAL FATTY ACIDS

Omega-3 fatty acids are extremely helpful for preventing heart disease (as discussed in Chapter 8) in people with diabetes, mostly by lowering their triglyceride levels and blood pressure. Eating cold-water fish twice a week gives you a lot of the benefits of the omega-3s,in addition to providing high-quality protein and some nice variety in your diet. Taking omega-3 capsules can boost that benefit—especially if you don’t like eating fish. (Flaxseed oil is another source of omega-3.) There is solid evidence to show that supplemental omega-3 helps your blood pressure.
21
In addition to its blood-pressure-lowering effect, omega-3 supplementation was found to reduce triglycerides without adverse effects on glucose metabolism.
22
–
25

To obtain all the omega-3 fatty acids, including eicosapentenoic acid (EPA) and docosahexanoic acid (DHA), which are found only in fish oil, we recommend taking a soft gel containing 600 mg total. Dosage can range from two to six soft gels per day. If triglycerides are significantly elevated or inflammation markers are high, the higher dose range may be needed until lab results fall to the optimum level. If you currently take any prescription medications to thin your blood, discuss omega-3 supplements with your doctor first.

It’s important to balance your intake of omega-3 and omega-6 fatty acids. For supplements of omega-6 (also called gamma linolenic acid or GLA),Dr.Atkins used borage oil in 240 mg soft gels; the dose ranges from one to three capsules daily. Atkins Formula Essential Oils combines the essential fatty acids in the optimal balance. A table listing all of the nutrients in Atkins Essential Oils follows.

ESSENTIAL OILS FORMULA

COENZYME Q
₁₀

One of the worst things about statin drugs, the
de rigueur
prescription for people with high cholesterol, is that they interfere with your production of coenzyme Q
₁₀
(ubiquinone or CoQ
₁₀
). Because you need CoQ
₁₀
to create energy in your mitochondria, the tiny power plants found in all your cells, a shortage of it can lead to fatigue and muscle weakness. That’s more than just a minor side effect—it can be a real problem when it comes to your heart, a powerful muscle that has more mitochondria per cell than any other part of your body. The last thing you want to take is a drug that weakens your heart, yet statin drugs are being liberally prescribed as a way to
help
your heart.
26
Dr. Atkins believed that this self-defeating paradox would soon be recognized, when people who have been taking statin drugs for years start showing the signs of heart failure, cardiomyopathy, arrhythmias, and other problems caused by insufficient amounts of CoQ
₁₀
. What the medical establishment will say then should be interesting to observe.

Even without statin drugs, your production of CoQ
₁₀
naturally drops off a bit as you get older. Dr. Atkins routinely prescribed CoQ
₁₀
for all of his patients who were at risk for heart disease. He also found CoQ
₁₀
to be effective for lowering high blood pressure. The usual dose is 100 mg three times per day; in some cases he recommended a higher dose.

For ease in designing your supplement regimen,Atkins makes supplements that support the needs of those with blood sugar imbalances and address blood sugar imbalances and cardiovascular health. You have already seen the formulations of Atkins Basic 3 (page 247) and Essential Oils Formula (page 267).For information on specialized formulations, go to www.atkins.com/shop.

You’ve learned about two of the major aspects of the Atkins Blood Sugar Control Program—diet and supplements.Now it’s time to learn about the all-important third leg of the program: exercise.

WHAT’S YOUR HEART HEALTH SUPPLEMENT IQ?

How do different supplements help keep your heart healthy? Check your knowledge with this quiz.

1. Vitamin C helps your heart by:

1. preventing scurvy
   
2. improving digestion
   
3. relaxing blood vessels
   

2. Vitamin E helps your heart by:

1. preventing cholesterol oxidation
   
2. building strong bones
   
3. making your heart beat slower
   

3. Folic acid,vitamin B
₆
,and vitamin B
₁₂
are valuable for:

1. lowering A1C levels
   
2. lowering homocysteine
   
3. lowering blood pressure
   

4. Niacin or IHN can help:

1. lower cholesterol
   
2. lower blood pressure
   
3. lower blood sugar
   

5. Magnesium can help:

1. lower cholesterol
   
2. lower blood pressure
   
3. manage blood sugar
   

6. Omega-3 fatty acids help your heart by:

1. lowering triglycerides
   
2. lowering blood pressure
   
3. improving blood flow
   

7. Taurine helps the heart by:

1. lowering blood pressure
   
2. increasing loss of excess fluid
   
3. decreasing oxidative stress