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I have been thoroughly enjoying NOT having to go to Seattle every single week for chemotherapy treatments. The past few months have been a breath of fresh air for me. I still go in every 3 weeks for a couple hours to check in with my oncologist, my naturopathic doctor, and receive an infusion of Herceptin, a HER2+ targeted anti-body medication. In addition to this, I am taking a relatively new oral targeted HER2+ medication daily. Of course, almost no medication is free from side effects and these two are no exception (at least for me).
Herceptin (in the past) has caused my heart function, more specifically, my ejection fraction (EF), to drop. What exactly is ejection fraction?
Ejection fraction (EF) is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. An ejection fraction of 60 percent means that 60 percent of the total amount of blood in the left ventricle is pushed out with each heartbeat.American Heart Association
A normal ejection fraction is anywhere from 50-70%. In my case, I should have had an echocardiogram to measure my EF BEFORE my first Herceptin infusion but I didn’t have one until after. Even then, my EF was 65%. It slowly and continually dropped down to about 41%, if memory serves me correctly. I was taken off Herceptin (and Perjeta) until my EF rose back up closer to my baseline 65%. Every time I’ve been put back on Herceptin, my EF lowers. This is dangerous as it shows the heart muscle is literally weakening and weak heart muscles can lead to heart failure and heart attacks. Couple that fact with my family history of heart disease (both maternal and paternal) and if I’m not careful, I could very well die from heart failure before cancer.
Thankfully, my naturopathic doctors prescribe a few supplements that help strengthen the heart muscle. This has caused me EF to rise back up as long as I’m taking those supplements. If I slack off on taking them, my EF lowers again. Being physically active daily also strengthens the heart muscle and I am grateful that I am strong and well enough to be physically active. Even taking the time for a 10-20 minute walk daily has been associated with a DRASTIC reduction in risk for cancers, heart disease, and other diseases. The walk doesn’t even have to be a brisk walk! Interestingly enough, walking reduces hormone levels that are associated with with a higher risk of endometrial and breast cancers! However, there was a time when various chemo side effects limited my physical activity so I relied heavily on my supplements and nutrition to strengthen my heart and the rest of my body and I know that someone reading this may find themselves in the same boat.
So…what on earth do I take? For inquiring minds, the supplements that I take for this are COq10, Hawthorne Berry Extract, fruit anthocyanins, and fish oil. Below, I’ll address each supplement, link articles explaining how it helps heart function, and give you one or more links to the supplements I have used or would use if I couldn’t get specific ones from my Naturopath.
As always NONE of what I write is meant to be medical advice. I am sharing my journey and what I have used. It is up to you to do your research and consult with your appropriate medical advisors to make any medial decisions.
Coenzyme Q10 (CoQ10) is an endogenously synthesised and diet-supplied lipid-soluble cofactor that functions in the mitochondrial inner membrane to transfer electrons from complexes I and II to complex III. In addition, its redox activity enables CoQ10 to act as a membrane antioxidant. In patients with congestive heart failure, myocardial CoQ10 content tends to decline as the degree of heart failure worsens. A number of controlled pilot trials with supplemental CoQ10 in heart failure found improvements in functional parameters such as ejection fraction, stroke volume and cardiac output, without side effects. Subsequent meta-analyses have confirmed these findings, although the magnitude of benefit tends to be less notable in patients with severe heart failure, or within the context of ACE inhibitor therapy.DiNicolantonio JJ, Bhutani J, McCarty MF, et al
Coenzyme Q10 for the treatment of heart failure: a review of the literature
Open Heart 2015;2:e000326. doi: 10.1136/openhrt-2015-000326
More simply put, COQ10 is an antioxidant. It seems to decline alongside heart failure (is it the case of the the chicken or the egg) but when patients are given supplemental COq10, their heart function generally improves. Our hearts need adequate COq10 to function properly!
Here are a few more links to medical journal articles about the benefits of COq10 and lowered EF:
I personally, have taken a number of various COq10 supplements. Of these, I can’t say that a specific one worked better than the others so I will link each one. I typically use the brand that my naturopaths recommend and while they are not the cheapest brands, remember that you pay for quality so a cheaper brand may not be the same quality and therefore may not be as effective.
Hawthorn Berry Extract-
When researching Hawthorn Berry and the effect (positive or negative) it may have in people with heart failure, I discovered there have been an number of studies completed. Most looked very promising, showing a positive correlation between Hawthorn berry and improvement in heart functions. They also highlighted the fact that there don’t seem to be known herbal-drug reactions and no side effects. There were a few studies though where not much benefit was seen. HOWEVER, I found another paper that critiqued those studies because they only studied individuals with more severe heart failure and didn’t increase the Hawthorn dosage above what was used for patients with mild heart failure. As we know with any medication….dosage is EVERYTHING! So I will leave two links here (the first being the one that examined multiple past trials) and allow you to come to your own conclusions:
These are the hawthorne containing products I have used so far and each one seemed to be effective:
Wise Woman Herbals – Hawthorn Solid Extract *This may seem expensive for the amount but it is POTENT….1/8tsp is 0.9G so you are getting what you pay for.
Anthocyanins are flavonoids found in a large variety of foods. They are the most widely consumed flavonoid and are responsible for the beautiful red, purple, and blue coloring found in fruits, vegetables, grains, and flowers. Aside from coloring our plate, they provide a large array of health benefits such as protection against liver injuries, reduction of blood pressure, improvement of eyesight, suppression of proliferation of cancer cells, and cardiovascular disease prevention (Novotney 2012; Knczak and Zhang 2004). Anthocyanins have been used as traditional or folk medicine around the world. Only recently have we begun to research these health benefit claims.https://militaryfamilieslearningnetwork.org/2017/02/24/role-of-anthocyanins-in-cardiovascular-disease-prevention/
Here are a few medical journal articles on Anthocyanin and heart disease:
And a great article on the subject as well:
I personally take a mixture of Fruit Anthocyanin that cannot be purchased on Amazon and as far as I know, are only sold to Naturopaths in the Seattle area (such as my own naturopaths). Here is the link to the website. If I were reading this and couldn’t get this particular product, I’d probably buy one of the following from Amazon as the product I use contains organic Red Grape, Elderberry, Blueberry, Aronia Berry, Pomegranate, and Red Raspberry. Of course, EATING these berries and fruits is going to be an ideal way to get anthocyanin in your body but please make sure your fruits are organic and or pesticide free. Otherwise I think I would purchase these products and the powders/juices I would add to some sparkling water like I do with my fruit anthocyanin. It makes a very refreshing afternoon drink!
I’d like to add that when I add my anthocyanin to my sparkling water, I like to mix it in with a spoon but if I’m adding any kind of powder, I LOVE my battery operated frother. I have a very old version of this one and mine is YEARS old, used daily, multiple times a day for my fruit drink but also frothing milk for coffees, my kiddos’ powdered drinks, etc. I’d definitely recommend snagging one of those for yourself if you don’t already have one!
If you have heart failure or have recently had a heart attack, omega-3 fish oil supplements could be a beneficial addition to your medicine cabinet. Taking these supplements might slightly reduce your risk of dying of heart disease, according to a March 2017 scientific advisory from the American Heart Association (AHA) published in Circulation. Supplementing with omega-3s might also help to modestly lower the chances of hospitalization if you have heart failure.https://www.healthandwellnessalerts.berkeley.edu/topics/heart-health/fish-oil-supplements-and-your-heart/
I think we’ve all be told that fish oil is beneficial for heart disease. Of course, again Ideally we would get these omega fatty acids from fish in our diet but well, not everyone likes fish or you may not be able to source quality fish. I’m the girl that would LIVE on sushi if I could so it’s not typically a problem. However, I still supplement and I alternate between these two products. Why do I alternate? I feel it’s best to rotate products every now and again. Note that I look for fish oil from sustainably caught fish; many fish oils on the market are rancid and really probably not what you want to be putting in your body.
So, there you have it, a detailed post filled with the supplements I take and nutritional changes I make to increase my EF caused by my Herceptin! I’m due for another echocardiogram soon so I’ll be sure to update and let you know how my ticker is doing. I hope the information here is helpful to you.