COMPLEMENTARY & ALTERNATIVE THERAPIES

include mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout, and menhaden. They provide about 1 gram of omega-3 fatty acids in about 3.5 ounces of fish. often contain small amounts of vitamin E to prevent spoilage. Fish oil is used for a wide range of conditions. It is most often used for conditions related to the heart and blood system. Some people use fish oil to lower blood pressure or triglyceride levels (fats related to cholesterol). Ironically, taking too much fish oil can actually increase the risk of stroke. Eating broiled or baked fish appears to reduce the risk of heart disease, but eating fried fish or fish sandwiches not only cancels out the benefits of fish oil, but may actually increase heart disease risk. Two of the most important omega-3 fatty acids contained in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

FISH OIL/OMEGA-3 FATTY ACIDS

 How does it work?

A lot of the benefit of fish oil seems to come from the omega-3 fatty acids that it contains. Interestingly, the body does not produce its own omega-3 fatty acids. Nor can the body make omega-3 fatty acids from omega-6 fatty acids, which are common in the Western diet. A lot of research has been done on EPA and DHA, two types of omega-3 acids that are often included in fish oil supplements.

These fatty acids also prevent the blood from clotting easily. this might make fish oil helpful for some heart conditions.

Effective for: High triglycerides. High triglycerides are associated with heart disease and untreated diabetes. Now researchers believe that fish oil, though not as effective as gemfibrozil, can reduce triglyceride levels by 20% to 50%.
Possibly Effective for: High blood pressure. The omega-3 fatty acids in fish oil seem to be able to expand blood vessels.

 Stroke. Moderate fish consumption (once or twice a week) seems to lower the risk of having a stroke by as much as 27%. However, eating fish doesnt lower stroke risk in people who are already taking aspirin for prevention. On the other hand, very high fish consumption (more than 46 grams of fish per day) seems to increase stroke risk, perhaps even double it. Hardening of the arteries (atherosclerosis). Fish oil seems to slow or slightly reverse the progress of atherosclerosis in the arteries serving the heart (coronary arteries), but not in the arteries that bring blood up the neck to the head (carotid arteries). High cholesterol. There is interest in using fish oil in combination with statin drugs for some people with high cholesterol. Scientists think fish oil may lower cholesterol by keeping it from being absorbed in the intestine. There is some evidence that using vitamin B12 along with fish oil might boost their ability to lower cholesterol.

FISH OIL Side Effects & Safety

Fish oil is LIKELY SAFE for most people when taken in low doses (3 grams or less per day). There are some safety concerns when fish oil is taken in high doses. Taking more than 3 grams per day might keep blood from clotting and can increase the chance of bleeding. High doses of fish oil might also reduce the immune systems activity.

Only take high doses of fish oil while under medical supervision.
Fish oil can cause side effects including belching, bad breath, heartburn, nausea, loose stools, rash, and nosebleeds. Taking fish oil supplements with meals or freezing them can often decrease these side effects. Consuming large amounts of fish oil from some DIETARY sources is POSSIBLY UNSAFE.

Special Precautions & Warnings: Fish or seafood allergy: Some people who are allergic to seafood such as fish might also be allergic to fish oil supplements. There is no reliable information showing how likely people with seafood allergy are to have an allergic reaction to fish oil; however, until more is known advise patients allergic to seafood to avoid or use fish oil supplements cautiously.

High blood pressure: Fish oil can lower blood pressure and might cause blood pressure to drop too low in people who are being treated with blood pressure-lowering medications. An implanted defibrillator (a surgically placed device to prevent irregular heartbeat): Some, but not all, research suggests that fish oil might increase the risk of irregular heartbeat in patients with an implanted defibrillator. Stay on the safe side by avoiding fish oil supplements.

 FISH OIL Interactions

Moderate Interaction
Birth control pills
might decrease the effectiveness of fish oils by reducing these fat levels in the blood.

Medications for high blood pressure

cause your blood pressure to go too low.

Orlistat
There is some concern that orlistat might also decrease absorption of fish oil when they are taken together. To avoid this potential interaction take orlistat and fish oil at least 2 hours apart.

Minor Interaction
Medications that slow blood clotting
Might increase the chances of bruising and bleeding.

FISH OIL Dosing BY MOUTH: For high triglycerides: 1-4 grams/day of fish oil. For high blood pressure: Either 4 grams of fish oil or fish oil providing 2.04 grams of EPA and 1.4 grams of DHA per day. For atrial fibrillation (one of the chambers of the heart doesnt empty properly and this increases the risk of blood clot formation leading to stroke): Eating tuna or baked or broiled fish providing omega-3 fatty acids (fish oil) one or more times per week seems to reduce the risk of atrial fibrillation in patients aged 65 or older compared to consuming fish once per month or less. But there is no benefit from eating fried fish or a fish sandwich.

 For preventing and reversing the progression of hardening of the arteries: 6 grams/day of fish oil for the first three months, followed by 3 grams/day thereafter. For combined high triglycerides and high cholesterol: Fish oil providing EPA 1800-2160 mg and DHA 1200-1440 mg combined with garlic powder 900-1200 mg/day has been used to lower total cholesterol, LDL, triglycerides, and the ratios of total cholesterol to HDL, and LDL to HDL.

HAWTHORN
Hawthorn is a plant. The leaves, berries, and flowers of hawthorn are used to make medicine. Hawthorn is used for diseases of the heart and blood vessels such as congestive heart failure (CHF), chest pain, and irregular heartbeat. It is also used to treat both low blood pressure and high blood pressure, hardening of the arteries (atherosclerosis), and high cholesterol. You will find hawthorn among the ingredients in candied fruit slices, jam, jelly, and wine. Before taking hawthorn, talk with your healthcare professional if you take any medications. It has major interactions with several prescription medications.

How does it work? Hawthorn can help improve the amount of blood pumped out of the heart during contractions, widen the blood vessels, and increase the transmission of nerve signals. Hawthorn seems to cause relaxing of the blood vessels farther from the heart. It seems that this effect is due to a component in hawthorn called proanthocyanidin. It seems to lower accumulation of fats in the liver and the aorta (the largest artery in the body, located near the heart). Hawthorn fruit extract may lower cholesterol by increasing the excretion of bile, reducing the formation of cholesterol, and enhancing the receptors for LDLs. It also seems to have antioxidant activity.

Possibly Effective for: Treating heart failure symptoms when a standard form Possibly Ineffective for: Heart failure. seem to improve some heart failure symptoms in some people with mild to moderate heart failure. However, some research shows that these products may actually worsen heart failure and increase the risk of death or hospitalization.

Insufficient Evidence for: Decreased heart function. Blood circulation problems. Heart disease. Irregular heartbeat (arrhythmias). High blood pressure. Low blood pressure. High cholesterol.

 Hawthorn is POSSIBLY SAFE for most adults when used at recommended doses short-term (up to 16 weeks). It is not known whether hawthorn is safe when used long-term. In some people, hawthorn can cause nausea, stomach upset, fatigue, sweating, headache, dizziness, palpitations, nosebleeds, insomnia, agitation, and other problems.
Special Precautions & Warnings: Pregnancy and breast-feeding: Not enough is known about the use of hawthorn during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Heart disease: Hawthorn can interact with many prescription drugs used to treat heart disease. If you have a heart condition, dont use hawthorn without the recommendation of your healthcare provider.

 Major Interaction
Digoxin (Lanoxin)
might increase the effects of digoxin and increase the risk of side effects. Do not take hawthorn if you are taking digoxin (Lanoxin) without talking to your healthcare professional.

Medications for high blood pressure (Beta-blockers)

Taking hawthorn along with medication for high blood pressure might cause your blood pressure to go too low.

Medications for high blood pressure (Calcium channel blockers)

Taking hawthorn along with medication for high blood pressure might cause your blood pressure to go too low.

Medications for male sexual dysfunction (Phosphodiesterase-5 Inhibitors)

Taking hawthorn along with medications for male sexual dysfunction might cause your blood pressure to go too low.

Medications that increase blood flow to the heart (Nitrates)

Taking hawthorn with medications that also increase blood flow to the heart might increase the chance of dizziness and lightheadedness.

DOSING BY MOUTH: For heart failure, some specific hawthorn products have been used in doses of 160 mg to 1800 mg divided and taken in 2-3 doses daily. These doses have been shown to improve symptoms of heart failure in some people, but they have also been shown to increase the risk of death or being hospitalized due to heart failure.

Alfalfa

HERBS THAT PROMOTE BLOOD CLOTTING

One of these herbs is alfalfa, which contains vitamins, minerals and eight essential amino acids as well as vitamin K. Alfalfa is so effective at promoting blood clotting that it can interfere with the action of the anticoagulant warfarin brand name Coumadin.

Yarrow
Yarrow was named for the mythical Greek hero Achilles, who used the plant to heal his soldiers bleeding wounds. It was traditionally used for wounds and minor bleeding. Certified Chinese Herbalist Lisl Meredith Huebner reports that yarrow, Achillea millefolium, is effective for stopping bleeding. It can be used to stop a nose bleed or bleeding cut. You should chew a fresh leaf and apply it to the wound.

Goldenrod
Goldenrod is used traditionally for internal bleeding, which implies it has the ability to stop bleeding, but the University of Maryland Medical Center cautions that it should not be used on an open wound. Herbs can cause side effects.

HERBS PREVENTING BLOOD CLOTTING

Herbal Treatments Certain herbs are considered anticoagulants, or substances that prevent your platelets from forming blood clots. According to Dr. William A. Mitchell Jr., a naturopathic doctor and author of "Plant Medicine in Practice," effective herbal anticoagulants include sweet clover, Dutch tonka beans, sweet vernal grass, sweet scented bedstraw, red clover, vanilla leaf, flaxseeds, white willow tree and ginger.

A Popular Herb
White willow, also known as willow bark, is a popular herb used to help prevent blood clots. The bark of the willow tree is used as an herbal medicine, and it contains a substance called salicin, which contains acetylsalicylic acid and works like aspirin to help prevent platelet aggregation.

Garlic
It is naturally antioxidant, anti-bacterial and antifungal. It is also considered a natural blood thinner and used by herbalists to lower blood pressure and cholesterol levels. A 2007 report published in "Molecular Nutrition and Food Research" said that garlic possesses plasma lipidlowering and anticoagulant properties. The authors concluded that taking garlic can help reduce the risk of atherosclerosis, or hardening of the arteries, by lowering blood cholesterol and triglycerides. Do not take garlic if you are taking any other blood thinners.

Turmeric
Turmeric is a root herb used both as a spice in curries and as an herbal remedy in Ayurvedic medicine. A 2007 study in "Advances in Experimental Medicine and Biology" showed that curcumin, the active ingredient in turmeric, may help reduce the risk of cardiovascular disease due to its cardioprotective, antiplatelet and anti-coagulant effects. Turmeric may interact with other prescription medications for cholesterol or high blood pressure.

Ginger
It contains both antioxidant and antiinflammatory properties, and has been shown to help lower blood pressure and cholesterol levels. However, a 2007 study from "Pharmacotherapy" found that taking ginger may interfere with other blood-thinning medications. The study, which evaluated patients on prescription blood thinners who also take natural supplements, showed that certain herbs increased bleeding when taken with warfarin.

Cayenne Pepper
Cayenne pepper, or capsicum, is a spice with potent medicinal properties. It has warming effects and acts as a vasodilator, increasing blood flow. Herbalists use it to improve digestion, stimulate circulation and treat chronic conditions such as migraines, heart disease, arthritis and fibromyalgia. Again, the findings showed that these natural supplements increased bleeding in patients on warfarin.

NATURAL LIPID-LOWERING AGENTS

Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points. Other studies, however, suggest that it may not be as beneficial as once thought. It may also have significant side effects and/or interactions with certain medications. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be consumed prior to surgery and should not be taken with blood-thinning drugs such as Coumadin (warfarin).

 Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. In clinical studies performed in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. The enthusiasm for using guggulipid as a cholesterol-lowering herbal agent, however, diminished after the publication of negative results from a clinical trial in the U.S.

 Red Yeast Rice: Red yeast rice has been found to lower cholesterol. Their effectiveness is questionable.

 Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several trials.

 Almonds Studies have found that eating just a quarter cup of almonds a day can lower your LDL by 4.4 percent, according to dietitian Leslie Bonci, who is also the director of sports nutrition at University of Pittsburgh Medical Center. Stick with a small serving and choose almonds that are dry roasted without oil.

 Oatmeal "The soluble fiber binds to the bile acids that are the precursor to the development of cholesterol and help flush it out," explains Bonci. It doesn't matter how you get your oats-those instant, just-add-water packets are just as good for you as traditional, slowcooked versions.

 Fish Omega-3 fatty acids are widely considered to be the best of the "good" fats, and the best place to find them is in fish-especially fatty fishes like salmon, halibut and tuna. According to Dorfman of the ADA, you want to get 1.5 to 3 grams per day of omega-3. A 4-ounce piece of salmon will give you close to 3 grams, and you can also get these fatty acids from walnuts.

 Red wine A glass of red wine, which contains flavanols, has been shown to have antiinflammatory properties that may help lower cholesterol and stave off heart disease. But in this case, more is definitely not better. "For women, the recommendation is one drink a day and for men it's two," says Bonci. More than that will, literally, dilute any potential benefits. These flavanols can also be found in red grape juice and dark cocoa.

 Soy Soybeans, soy nuts and edamame, plus any products made from soy (like tofu, soymilk, etc.) can help to reduce the production of new cholesterol. A little can go a long way-aim for about 25 grams of soy protein a day (the amount in a cup of edamame).