Dr. Sean X. Hesler, ND

Thyroid, adrenals, anemia, stress, infections…oh my! When most health-savvy people think of fatigue, they think of these causes. While these are very common causes of fatigue in my patients, as a whole-patient Naturopathic Physician, I always consider my patients’ cardiovascular health as KEY to their energy levels! Reduced circulation is traditionally considered to be a root cause of disease, in multiple systems of medicine dating back thousands of years. Although the modern concept of cardiovascular disease focuses on frank diseases of the heart and vessels (which can be deadly!), optimizing circulation benefits health far beyond the treatment of hypertension, angina, etc. To understand why, let’s first dive into how your cardiovascular system works.

Movement of Blood

The heart is a muscular organ – beating about once per second at rest, and triple that in a workout, it works every second of your life to keep oxygen flowing to every cell in your body. Arteries carry blood away from the heart (Arteries Away!) to the organs and tissues, which then sends blood back into the heart through the veins (VeINs). Think like a plumber to imagine areas where problems can creep in – buildup in the plumbing of the vessels decreases blood flow, and several problems with the pump (valve disease, energy production in the muscle).  Without the proper flow of oxygen, nutrients, and removal of wastes, cells suffer and energy production decreases.

Beyond Cholesterol ~Here are some tests to ask your doctor to order and interpret to gauge your cardiovascular risk:


Heart medications and fatigue

Patients taking medication(s) for cardiovascular disease may experience increased energy from improving aspects of their cardiovascular health, but some of these medications sometimes CAUSE fatigue!

Beta blockers (these end in -olol, ie metoprolol) are used for hypertension and heart failure. They essentially block your sympathetic nervous system from stimulating your heart and vessels, resulting in a decrease in blood pressure and heart rate to spare fatigued heart muscle and tight arteries. But, they also prevent the more energetic effects of your nervous system. Your heart will not increase its out put to meet the increased demands of exercise. They can also interfere with your deeper sleep cycles. Beta blockers can be life-saving medications, so if the side effects are a problem for you, discuss with your doctor ways to reduce your blood pressure and your need for these medications – stopping them cold-turkey is dangerous!

Statin medications reduce cholesterol and inflammation by blocking the mevalonate pathway.Unfortunately, this pathway also produces an essential compound called ubiquinone (CoQ10) which is vital for energy production in every cell of your body. Yes, it’s true – you produce your own CoQ10 without supplements! Almost 1 in 3 people complain of muscle pain from taking statins, and some patients cut down on their energy-producing exercise routine as a result.

Improving your cardiovascular care: the foundations

Staying healthy in our modern world is increasingly challenging. Stress, poor diet, toxic exposure and a sedentary lifestyle all harm vessel function and contribute to atherosclerosis. Worst of all, smoking kills more people through its cardiovascular harm than its contribution to lung cancers.

  • Food and hydration are vitally important. Eating whole foods with a focus on plants (especially vegetables and eating a rainbow of colorful fruits) has been shown to not only reduce the risk of heart attacks and stroke, but also improves blood flow in numerous studies. Nuts, seeds, fish, avocados and olive oil are all good sources of heart-healthy fats needed to keep inflammation low throughout the body. Hibiscus tea (known traditionally as Jamaica) is my favorite addition to patients’ diets to reduce blood pressure and help insulin resistance (which contributes to diabetes).
  • Toxins in our air, food and water contribute to oxidation and inflammation on a daily basis. Studies show an increased risk of not only lung conditions but also heart disease in cities with more fine particulate pollution in the air – drive with your vehicle set to recirculate air, take off your shoes when you enter your house and use HEPA filtration in your vacuum and air purifiers in your home. Depending on your water supply (check https://www.ewg.org/tapwater), at least an activated carbon filter and at most Reverse Osmosis may be necessary to remove contaminants from your water and you should then replenish minerals in your water. Eat organic when possible, but consult the Environmental Working Group’s annually-updated Dirty Dozen and Clean 15 (https://www.ewg.org/foodnews/dirty-dozen.php) to learn which foods are most conventionally toxic and therefore important to eat organic!
  • Exercise is a good stress for your heart – the challenge increases the strength of the muscle just like weight lifting for your skeletal muscles! I recommend my patients engage in a resistance training program and also High-Intensity Interval Training, which is even more challenging on the heart, speeds metabolism for weight loss and improves resilience to stress!
  • Emotional stress takes a heavy toll on the nervous system. The dominance of sympathetic fight-or-flight over parasympathetic rest-and-digest has become a common pattern in our culture, but it is the OPPOSITE of what we need for energy! Hydrotherapy, belly breathing, mindfulness techniques, and Cognitive Behavioral Therapy journaling have all been essential in helping my patients tune their minds and bodies for optimal balance.

Specific Naturopathic considerations for improving energy through cardiovascular optimization

Beyond the foundations, we can boost cardiovascular function more specifically through supplementation. In my patients suffering from heart disease, improvements in fatigue happen quickly.

  • Magnesium is key for producing cellular energy and allowing muscles to relax properly, including in the vessels. Deficiency is the norm and supplementing with 250-500mg elemental Magnesium can drop elevated blood pressure, increase cardiac output in congestive heart failure, assist in regulating cardiac arrhythmias and help relaxation and sleep. I teach my Naturopathic medical students that it is the most important mineral!
  • 3 mitochondrial nutrients are helpful for energy and strengthening the heart. L-Carnitine is essential for burning fats for energy, especially – it works best when taken daily 1500-3000mg. Alpha Lipoic Acid acts as an antioxidant and detoxifier to the mitochondria, boosting cardiac function and keeping vessels clean at 200-600mg daily. Beyond treating statin side effects, CoQ10 supplementation is great for patients with fatigue from cardiovascular complaints at 200-300mg of crystal-free ubiquinone.
  • In some cases, the Western and Eastern views of the heart overlap. I work with burned-out students and professionals who suffer more from mental fatigue and insomnia – in Chinese Medicine a common pattern called Heart Blood Deficiency ties these together and the herbal formula Gui Pi Tang (Ginseng and Longan, Restore The Spleen) helps these patients come back for optimal cognitive performance and mental endurance!
  • And last but not least, spend some time in the sauna! Research has shown that sauna therapy is a workout for the heart, and patients also benefit from sweating out toxins from extended heat sessions!
  • Relax and enjoy the traditional (and now scientifically-validated) benefits!

Dr. Sean X. Hesler, ND received the 2018 AANP President’s Award and the 2011 SCNM Alumni Award for Community Service for his commitment to global and community health throughout his career. Alongside his wife, Dr. Sarah Preston Hesler, he co-founded the MamaBaby Haiti birth center in 2010. Dr. Hesler currently serves as Executive Director of Naturopaths Without Borders (NWB), a not-for-profit organization operating in Haiti, Mexico, Thailand and Phoenix. In addition to presenting at conferences and universities around the United States, Dr. Sean also see patients privately at Phoenix Natural Family Medicine in Tempe, AZ (www.phxnfm.com) and Regenerative Health Group in Mesa, AZ (www.regenerativehealthgroup.com).

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