From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.nutrition
Subject: Re: acetyl-L-carnitine, L-carnitine, or propionyl-L-carnitine?
Date: 26 Aug 1998 22:39:08 GMT

In <6s2016$rrv$1@netnews.upenn.edu> @assets.wharton.upenn.edu ()
writes:

>Anyone ever heard of reversing severe mitral regurgitation, somehow
>building back the organization of the leaflets? fibroblasts?
>
>Don't see or hear anything in medicine or alternative medicine.
>
>Any rumors or ideas? The point of this all is to avoid heart surgery,
>
>which seems inevitable, so far, from all those in any field. The window
>of opportunity before surgery appears to be only two months.
>
>Adam Sundor


   All I can suggest is don't suddenly start vitamin E, which will
increase your afterload and make your mitral regurgitation problem much
worse.

   Valve problems are intractable mechanical things.  You don't fix
them with diet, any more than you fix blown valves in your car by
changing your oil more often.  If you need the surgery, get it done.
Just make sure you get it done by a guy who does valve replacement a
lot, and not just a sideline for bypasses.  Specialize, specialize!
That's the key to surviving surgery.

                                         Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med.nutrition
Subject: Re: acetyl-L-carnitine, L-carnitine, or propionyl-L-carnitine?
Date: 27 Aug 1998 09:16:46 GMT

In <6s2uov$sl9$1@netnews.upenn.edu> @assets.wharton.upenn.edu ()
writes:
>
>On 26 Aug 1998 22:39:08 GMT; sbharris@ix.netcom.com wrote:
>
>:    All I can suggest is don't suddenly start vitamin E, which will
>: increase your afterload and make your mitral regurgitation problem much
>: worse.
>
>Taking 400 IU in Twinlab's Daily Two with another 400 or 800 at times
>then would be increasing vitamin E?

Yep.  If you have lots of regurgitation, probably not a good idea to
take more than 50 IU of vitamin E.


> Don't understand how this increases
>afterload at all.


    I don't think anyone knows the mechanism.  Perhaps E sops up nitric
oxide, which keeps blood pressure down.  But what happens is that when
starting vitamin E at high doses, systemic vessels clamp down for a
while, and blood pressure goes up a bit.  Most people tolerate this
fine.  People who have your problem sometimes don't.


>  Is vitamin E working like jogging would, increase
>oxydative stress and mechanical stress?  Or thinning the blood like fish
>oils might?  Or causing the heart to pump stronger increasing the
>afterload that way?

    None of these.  It directly increases systemic vascular resistance.


> Would vitamin C ameliorate this after-effect of
>vitamin E?

    No.


>I gather by afterloading, you mean the back-wash into the atrium?

    Yes, that will happen.  As more blood cannot go forward, more will
go backward through the mitral valve which isn't working.  That, you do
not want (since it causes atrial damage).

> If so,
>then jogging and vitamin E are not too wise?

    In early exercise, peripheral resistance actually drops, as muscle
vessels dilate.  This is okay.  But after the exercise is brisk enough,
increased cardiac output raises pressure again.  The point where this
happens is different with each person.  You'll have to see how much
aerobic exercise you tolerate before your blood pressure starts to
climb.



>  It's a very good suggestion
>to not aggravate an already very bad mitral regurgitation since that
>reduces the chance or repair and increases the chance of replacement.
>
>Adam Sundor