Updated: Mar 15
It is estimated that 5.7 million adults in the United States have heart failure (1), and an estimated $30.7 billion dollars a year is spent on its treatment. (2) Statistics like these are very common in the healthcare world. Many people would think that this means that it is just a very common condition, that is expensive to treat, and that is just the way it is. But when I see statistics like this, I know that it means the condition being discussed has been misunderstood and the approaches to treatment being utilized are severely off base.
So, let’s try and understand it first. Once we understand it, we can address it appropriately. It is thought that heart failure is when the heart is not performing its job of pumping the blood as well as it should be. This idea supposedly explains the symptoms of heart failure, which include the congestion of fluid in the lungs and retention of fluid in the body, reduction of blood delivery to the body resulting in dizziness and fatigue, irregular heartbeats, and weight gain. If blood is not getting moved around the body effectively then these symptoms make sense. But is it the hearts fault?
I would argue no. The main reason being that the hearts’ job is not actually to pump the blood around the body. I have explained this in detail in my previous blog post called “Is the Heart Really a Pump?”. Once we understand that the heart is not solely responsible for the movement of blood, we can stop seeing the heart as the problem in heart failure and look for the real reason these symptoms are present. While the heart does provide some motion of blood when it is in the area of the heart itself, the main mechanism by which the blood moves through the body has to do with the water component of the blood.
Water has the ability to hold energy, and when it does it will form what is called exclusion zone water on the inner lining of our arteries. (3) When this happens, it creates an energy gradient that propels the blood through the arteries and veins. This creates the majority of our blood flow. (This has been proven but I cannot cite it just yet as it has not quite been published and the research authors have asked that I not discuss it in detail until it is published).
With the movement of the blood taken care of, the heart can focus on what it is designed to do, which is create a stop gap for blood so that it stays balanced between the arteries and veins, as well as to vortex (or swirl) the blood, which is one of the ways to energize the water in the blood. Knowing all this, it will now make more sense when I tell you that heart failure occurs when water in the blood is not energized and therefore not able to propel itself through the blood vessels.
When this happens, the heart is forced to be more of a pump that it is designed to be. This results in the characteristic rounding out of the heart seen in heart failure where it is shaped more like a basketball instead of the normal football-like shape. The heart is shaped more like a football because when it contracts it does so in a twisting motion, spirally vortexing the blood with each contraction. In heart failure the heart expands to be more like the shape of a basketball due to it being forced to act more like a pressure propulsion pump because the blood is not moving on its own. This youtube video is an excellent explanation of this concept of the spiral orientation of the heart muscle, though the doctors in the film are not aware the that heart is not a pump.
So, the cause of heart failure is not a dysfunctional heart, instead it is a breakdown of the mechanisms that allow blood to self-propel itself. In other words, water that is not sufficiently energized. The natural question is what causes this to happen. Ultimately, it is a lack of exposing the body to things that energize the water in it. Some things that energize the water are contact with the Earth (grounding), eating foods/water that have energized water in it (whole foods/spring water), vortexing the water in the presence of oxygen (like the heart does), and exposure to infrared light (sunlight).
Thinking about these things it is clear to me that heart failure happens when humans remove themselves from the environment that they evolved in. In nature humans would be exposed to those things on a daily basis but in our modern lives it just doesn’t happen as much, especially as we age and often times become less active spending less time outdoors. While this is the main driving factor to heart failure, there are instances when someone could have damaged heart tissue from a toxin exposure or previous heart attack that make them more susceptible to heart failure.
Now for the good stuff. Knowing what is driving heart failure we can know take steps to address it. Aside from doing the things mentioned above, that humans are lacking in their modern environments, I believe the best combination of treatment for heart failure is a ketogenic diet, balancing the autonomic nervous system, and infrared sauna therapy.
I have written about how the preferred fuel source of the heart is fatty acids and ketones and that even in the presence of glucose the heart will choose to burn fat and ketones. (4,5) I cannot help but wonder if the high carbohydrate diets of modern day are not only deficient in foods that contain energized water but are also forcing the heart to burn more glucose than it would like. The heart is more efficient when burning fats, (6) and burning glucose will create an inefficient heart that is more susceptible to heart failure int eh event that the heart is forced to do more pumping that it would like.
Since the hearts of people in heart failure are said to be inefficient, I think it makes sense to provide the heart with a the most efficient fuel source that we can. That would be fatty acids and ketones. (7,8) If the heart is starving for its preferred fuel source while also having to act as a pump more than it is designed to, you can imagine that is a recipe for an inefficient heart, heart failure. While the preferred fuel source of the heart is fatty acids and ketones normally, this seems to be even more true in the case of heart failure, as hearts in heart failure have been shown to have more of an affinity for ketones. (9,10) There has even been evidence of a ketogenic diet successfully treating heart failure in people with glucose storage disease. (11,12) A fat adapted, ketogenic physiology can provide clear benefits to those struggling with heart failure.
Next, we need to discuss the importance of balance in the autonomic nervous system. I have written a lot about the importance of this concerning the prevention of heart attacks in previous blogs, but it is important for people with heart failure as well. The autonomic nervous system is the system we have that interprets our environment and tells the body if it needs to have a stress response or a calm response in our current situation. Due to the unnatural stressors of the modern world, getting stuck in an imbalanced stress response is very common. This can result in more stress signals being sent to the heart, and the rest of the body, creating an imbalance. Sending stress signals to the heart too frequently can make the heart work harder. This doesn’t sound like a good thing for a heart already struggling in heart failure.
It has been shown that improvements in heart rate variability (the best marker we have of balance in the autonomic nervous system) can have a positive impact on the condition of people with heart failure. (13,14) In those studies, heart rate variability was improved using drugs called beta-blockers. These can have side effects though. Luckily, there are many ways to balance our autonomic nervous system balance without having to use a drug. Strategies like being in contact with nature (15), not suppressing feelings (16), being part of a community (17), practicing mindfulness (18), exposing your body to heat and cold (19,20), having sex (21), and having meaningful loving relationships (22) have all been shown to increase heart rate variability.
Now, I have saved the best for last, infrared sauna therapy. This one makes the most sense for treating heart failure because, as we discussed, heart failure is when the blood is not moving itself on its own because it is not energized enough to do so. Infrared light exposure is the most effective way to energize water in our bodies and ensure lack if blood flow does not happen. It makes sense that if the heart is being forced to pump more than it is designed to do, and we do something that makes it so that it doesn’t have to do this, then we should see improvement in the condition. There is an overwhelming amount of research showing this.
Studies have shown that infrared sauna therapy has positive effects on heart failure by decreasing the size of the abnormally expanded heart (23), reducing arrythmias (24), improving endothelial function (25), improving exercise tolerance (26), improving hemodynamic performance (27), increasing quality of life (28), and improving prognosis by reducing risk of heart attack. (29) It is a pretty impressive list of effects for people with heart failure. In my opinion infrared sauna therapy should be utilized in every cardiac heart failure rehab center in the world. I like the Relax Far Infrared Sauna (click here and use code DRHUSSEY for $100 off your sauna)
Lastly, I want to briefly discuss salt. Because of the fluid retention seen in people with heart failure, they are told that they need to avoid salt to prevent further fluid retention. However, there is really no evidence for this recommendation. (30, 31) Often times heart failure patients are given diuretics that make them eliminate glucose and large amount of water through their urine to address the fluid retention. I would rather them get on a ketogenic diet and start eliminating ketones through the urine, but let’s discuss the low salt recommendation.
The minerals in your body need to be dissolved in fluid. If you don’t get enough minerals your body will hold on to the ones you have by holding on to the fluid they are dissolved in to keep them in. Using this logic, avoiding salt (we’re talking sea salt which is full of minerals) would signal to the body that it needs to hold on to the minerals it has and actually cause more fluid retention
Conversely, if someone with heart failure was to eat more salt, that would signal to the body that it doesn’t need to hold on to minerals because a ready supply is coming in and therefore it can release some fluid. This is exactly what one study showed. Using a saline (salt) solution with a diuretic improved weight loss, preserved renal function, and decreased length of hospitalization, mortality and heart failure rehospitalization compared to using a diuretic alone. (32) Does this mean that those with heart failure should mega dose on salt, probably not. But they should most definitely not avoid it as that could make their fluid retention worse.
Hopefully now you have an understanding of the mechanisms of heart failure and you can see how the approach presented here makes more sense that the current medial approach. People with heart failure are a population that is not very well served in our modern medical model. But there is hope for those struggling with this condition and with the right strategies quality of life can be significantly improved.
Stay healthy out there!
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