The heart is an incredible organ. Weighing in at 10.5 ounces, it sustains our life for as long as we live. In its ceaseless work, it beats more than 100,000 times per day to drive blood through more than 60,000 miles of blood vessels. It supplies blood to the 75 trillion cells in our body. The heart works harder than any other organ in our body. The heart is capable of beating normally until about 120 years in humans. Yet we obviously do not have enough respect for it. Heart disease is the number one killer of human beings.

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The heart uses a lot of mitochondria to put out the energy it does; it is well known that heart muscle is one of the most mitochonrdrial dense tissues in our body. Taking care of the heart is complex and this means taking care of the mitochondria. Per gram of tissue, the heart uses the most oxygen of any organ in the body. And we consume about 2 pounds of oxygen per day (6 when exercising). The heart constantly runs on the verge of oxygen starvation, thus the metabolic needs of heart muscle cells are immense. Mitochondria produce ATP within the cells, and ATP is essential for myocardial cellular integrity and function. However, in ischemic heart disease, ATP levels can be reduced, with supply not meeting demand. As we age, stress on the heart accumulates. Heart disease is the leading cause of death in the United States. We just don’t do a good enough job at taking care of our hearts. Although many of the therapies developed in recent decades have markedly improved life expectancy, adverse cardiovascular events such as ventricular arrhythmias and angina attacks still occur frequently after an acute myocardial infarction (heart attack).

Optimizing the fuel for the heart cells is one way that you can take care of your heart. Imagine the cells of the heart as a battery which uses huge amounts of energy. There are certain nutrients the heart needs for optimal function that are often missing from today’s diet: Ribose, Coenzyme Q10, Carnitine, Creatine, and Magnesium. All of these nutrients have been scientifically proven to improve heart function in synergistic ways. Scientific support for the vitamin and cofactor mitochondrial therapies is accumulating.

In a sense you can think of these supplements as organic nutrition for the heart. Studies suggest that in athlete’s hearts, especially when they push extreme limits such as in endurance sports, the heart enlarges and resembles a mild type of failure. This is not unlike the heart failure resembling patients with congestive heart. It’s just that we are young and the cells can recover. But it is well known that the athletes heart can eventually go into failure.

Let’s go over each nutrient individually:


Carnitine (L-carnitine) is a non-essential organic acid that is synthesized in the body from lysine and methionine and is mainly found in red meats and dairy products. It is also widely available as an over-the-counter nutritional supplement which is claimed to improve energy, weight loss, and athletic performance. Its potential role in treating heart disease was first reported in the late 1970s. Carnitine plays a critical role in the process of beta oxidation of fatty acids inside of the mitochondria. Carnitine actually transfers fatty acids across the cell membrane. It should be remembered that the heart, liver, and kidneys largely depend on beta oxidation. Our diet provides about 75% of carnitine while only 25% is actually made in the body. This makes it a semi-essential nutrient. Carnitine is mostly stored in skeletal muscle. It is important to remember that the synthesis of carnitine is highly dependent on adequate amounts of vitamin C in the body. Carnitine also plays a role in the production of acetylcholine, an important neurotransmitter. Carnitine comes from animal products. Carnitine reduces red blood cell fragility, erythropoietin resistance, enhances bone marrow, and is very important in fat energy metabolism.

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Elderly people may suffer from a relative carnitine deficiency (inadequacy). Serum levels of carnitine tend to increase until approximately the age of 70, after which they decline for unknown reasons. The decline is correlated with lean body mass. It has been shown that supplementation with 2 grams of carnitine per day is associated with less fatigue and a better body composition in the elderly and can increase muscle function.

During ischemic events carnitine levels are depleted. Investigators sought to determine the effects of targeting cardiac metabolic pathways using carnitine to improve free fatty acid levels and glucose oxidation in these patients. By performing a systematic review and meta-analysis of the available studies published over several decades, carnitine was shown to be beneficial. In patients experiencing an acute myocardial infarction. Carnitine significantly improves cardiac health in patients after a heart attack, in a study published in the Mayo Clinic Proceedings. Their findings, based on the analysis of controlled trials, associate carnitine with significant reduction in death from all causes and a highly significant reduction in ventricular arrhythmias and chest pain (angina) following a heart attack.

Co-enzyme CoQ10

Co-enzyme CoQ10 (Coq10) occurs naturally in the body and is essential to survival. CoQ10 works as an electron carrier in the mitochondria, the powerhouse of the cells, to produce energy; it is also a powerful antioxidant. CoQ10 is a molecule found in the mitochondria and exists in significant quantities in our brains, heart, liver, kidneys, and muscle. There are several diseases connected with decreased CoQ10 levels such as heart attacks, depression, male infertility, Parkinson’s, and fibromyalgia. CoQ10 can enhance blood flow and decrease oxidized LDL (bad cholesterol). Several pharmaceuticals can actually deplete the levels of CoQ10 in tissues such as statins.


Coenzyme CoQ10 is said to decrease all-cause mortality by half, according to the results of a multicentre randomized double blind trial presented at the Heart Failure 2013 congress. It is the first molecule to improve heart failure mortality in over a decade. CoQ10 levels are decreased in the heart muscle of patients with heart failure, with the deficiency becoming more pronounced as heart failure severity worsens. Statins are used to treat many patients with heart failure because they block the synthesis of cholesterol, but these drugs also block the synthesis of CoQ10, which further decreases levels in the body. Double blind controlled trials have shown that CoQ10 improves symptoms, functional capacity and quality of life in patients with heart failure with no side effects. To date, no trials have been statistically powered to address effects on survival.

CoQ10 has a remarkable safety profile and many options exist for supplementation. CoQ10 can be extracted from animals, synthesized by bacteria, or just completely synthesized. CoQ10 is poorly absorbed from the intestines. And it is said that grapefruit juice greatly increases the absorption of CoQ10. CoQ10 is also sold over the counter as a food supplement. Natural ways to take CoQ10 include organ meats such as heart, liver and kidney. Another less known organ meat is brain, somewhat taboo in this country, but it is consumed in many parts of the world. The reason is because brain tissue is the most mitochondrial rich organ in the body (because it uses the most energy). Also fatty fish such as sardines and mackerel are good sources of CoQ10. Vegetable sources include spinach, broccoli, and cauliflower. Egg yolks contain more CoQ10 than the white, another reason to eat the yolk. Other vegetable sources include oils, peanuts, and soybeans, however all of these sources must be consumed in excess of amounts making it difficult to get a significant amount of CoQ10 from non-animal sources.


Ribose (D-ribose) is a simple sugar and a key component of genetic material and vitamin B2 to (riboflavin). Bitmain B2 is important in building mitochondria. Your body actually makes ribose, and it is found in plants and animal foods as well. Ribose is mainly found in meats, dairy, and eggs (albeit in low doses). Certain vegetables like spinach, broccoli, and asparagus also contain significant amounts of ribose. Finally, most processed foods have ribose artificially added to meet certain government standards.

We know from research that an infusion of ribose increases the synthesis rate of nucleic acids, ATP, and vitamins. Thus the rationale that supplemental ribose may help in instances where energy consumption is increased, such as a heart attack and/or exercise. Studies using cardiac and exercise models show that patients improve with ribose.

When the heart is starving for oxygen, as can occur with a heart attack or angina, it loses much of its ATP, and the ATP levels remain low for several days, even after blood flow is reestablished. Scientists have found that supplying supplemental ribose helps to restore the hearts normal ATP levels and diastolic function. Clinical trials have shown that ribose supplementation improves ischemic threshold and enhances diastolic function in congestive heart failure. Human clinical trials have also found similar benefits from ribose. A recent study showed that daily doses of ribose enabled patients with stable severe coronary artery disease to increase their “ischemic threshold,” reflected in their ability to exercise longer with fewer symptoms or potential electrocardiographic changes.

Ribose differs from other sugars because it does not increase insulin or glucose levels like other sugars such as maltodextrin. Even more, ribose is effective in loading the muscles with glycogen. However, most studies suggest that large doses are necessary to do this. Another interesting caveat about ribose is that it may help with certain pain disorders which goes along with diseases such as congestive heart failure. A practical point about ribose when taken in significant amounts while fasting, may cause you to become hypoglycemic. There are many ribose supplements available on the market, be sure to ask for a quality brand.


Creatine affects the expression of over 250 genes in the body. Creatine is a naturally-occurring organic acid (protein building block) that’s found in meat and fish. It is made by the human body in the liver, kidneys, and pancreas. It combines with phosphate inside of the mitochondria. Interestingly, not everyone responds equally to creatine supplementation. It is thought that genetic differences in the metabolism of creatine are responsible. Creatine must undergo methylation, and many genes affect one’s ability to methylate molecules. Furthermore, men, black race, and Hispanics have a higher capacity to synthesize creatine in their cells than others. This all brings up the point that people should consider DNA tests such as 23 and me and/or DNA fit to assess their ability to metabolize creatine.

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Creatine is an energy substrate serving as a reservoir for high energy. It is known that an increase in creatine via food or supplementation, promotes the regeneration of ATP. Creatine donates a phosphate group that can be used to generate ATP. Phosphocreatine is stored in the brain and muscles, where it is used for energy. During high-intensity, short-duration exercise, such as lifting weights or sprinting, phosphocreatine is rapidly converted into ATP, a major source of energy within the human body.

In studies of people with heart failure, those who took creatine in addition to receiving standard medical care, increased the amount of exercise they could do before becoming fatigued, compared to those who took placebo. Getting tired easily is one of the major symptoms of heart failure. One study of 20 people with heart failure found that short-term creatine supplementation in addition to standard medication helped to increase body weight and improved muscle strength. To be fair, some other studies showed no improvement.


Preliminary studies suggest that creatine supplements may help lower levels of triglycerides (fats in the blood) in men and women with high concentrations of triglycerides. Creatine has also been reported to help lower levels of homocysteine. Homocysteine is associated with heart disease, including heart attack and stroke. This is a good thing when blood coagulation systems are out of whack.

Creatine has many effects on the central nervous system and it is known to increase focus. It is also interesting that neurons possess the ability to manufacture creatine. There are many studies showing that creatine increases cognition, this is especially true in strict vegetarians. There are even studies showing that creatine may exert anticancer effects.

Creatine is a very well researched molecule that is remarkably safe; it accumulates in organs such as brain, heart and skeletal muscle. Many companies make excellent creatine. Creatine can be consumed by eating animal products such as chicken, fish, and beef. Many research studies show that supplementation of 5 grams of creatine per day is more than adequate for most individuals.


Forty percent of all people in the USA are said to be magnesium deficient. Magnesium is involved in hundreds of reactions in the body, everything from your hormones to your heart beat to your humerus. Magnesium is involved in ATP formation, the transmission of nerve impulses, heart and blood vessel function, temperature, detoxification reactions, muscles and healthy bones, and insulin sensitivity. You need to check a RBC magnesium to really know your levels of magnesium in the body. A regular serum magnesium will not be low unless you are very sick, basically at the end of life, or you are a severe alcoholic and / or malnourished. Ideally, you can get sufficient amounts of magnesium and other minerals from food, but research strongly shows that 40% of Americans are deficient in magnesium. It is better to think of magnesium deficiency as an inadequacy. As actual vitamin and mineral deficiencies are quite rare nowadays, which is why we should refer to mineral inadequacies.

Magnesium has many important roles in your body. For example, ATP must be bound to a magnesium molecule to be biologically active. Glutathione requires magnesium and is therefore important in helping to prevent damage from toxins, chemicals, heavy metals, and others. Magnesium drives over 300 enzymatic and physiologic reactions. It is involved in DNA and RNA synthesis. Magnesium profoundly affects blood pressure, yet you almost never hear of health practitioners suggesting magnesium to treat their high blood pressure. Magnesium supplements have a small but significant effect on lowering blood pressure, according to a study in this month’s Journal of the American Heart Association.

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The main food sources of magnesium are plants. Nuts, seeds, and legumes all contain magnesium. However, nuts and seeds contain phytic acid as well as some enzyme inhibitors which interfere with the absorption of magnesium. The reason that plants contain so much magnesium is because plants contain chlorophyll, a protein that contains magnesium at its center. This is analogous to hemoglobin and iron. Plants utilize the energy from the sun through chlorophyll and magnesium to convert it into energy. Green leafy vegetables such as spinach and Swiss chard are excellent sources of magnesium. Avocados are also a good source. Juicing your vegetables provides a lot of magnesium. It is said that those who often crave chocolate may have a magnesium inadequacy.

There are many different types of magnesium supplements on the market. A well-known magnesium supplement is magnesium citrate. It has a good bio availability Magnesium citrate is often used in bowel prep solutions for colonoscopies as it pulls water into the lumen of the intestine lines, thus dehydrating the body. Magnesium aspartate is an amino acid chelated magnesium. Aspartate is critical for cellular energy production and is thought to have a positive effect on energy depletion depleting processes such as exercise and fatigue.

Athletes may require extra magnesium as they have a greater need to magnesium loss through sweating. This occurs in hot and humid conditions than it is well-known that a lack of magnesium may be one of the cause of cramping.

Magnesium is a critical mineral for heart health, which is why everyone needs to be sure they are getting enough magnesium.



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