The Extreme Importance Of Iron, Folic Acid, and Thiamin In Arrhythmia, Enlarged Heart, Heart Failure, Weak Heart Muscle
The purpose of red blood cells is to pick up molecules of oxygen from the lungs (and drop off carbon dioxide) and deliver the oxygen to cells of the body (and pick up carbon dioxide from cells) including heart muscle cells. According to the National Institutes of Health (NIH), "If you don't have enough red blood cells, your heart has to work harder to move oxygen-rich blood through your body. This can lead to irregular heartbeats called arrhythmias, heart murmur, an enlarged heart, and even heart failure."NIH Quote (6th ¶, .gov)
Red blood cells without enough iron can't pick up enough oxygen and therefore iron deficiency is effectively the same as not enough red blood cells and therefore iron deficiency can lead to weak heart muscle, irregular heartbeat, heart murmur, enlarged heart, and even heart failure or make these conditions worse if they already exist.Iron and Fatal Arrhythmia - find "Conclusion" (.gov)
Iron Deficiency Anemia - first 2 lines (.gov)
Iron Reference Ranges - find "Normal Results" (.gov)
Low Iron Level May Increase Blood Clot Risk (.gov)
Red blood cells contain hemoglobin molecules each of which contain 4 "heme group" molecules each of which contains one atom of iron. Heme group molecules (see model below) are shaped a little like a warped disc (colored white in image) with several oxygen atoms bonded to the edge of the disk (colored red). At the center of a heme group is an atom of iron (colored yellow). In the model the iron atom has picked up a molecule of inhaled oxygen (O2).
Inhaled oxygen usually is not shown in 2 dimensional diagrams of heme group molecules because inhaled oxygen (O2) is not part of the heme group. Heme groups react with inhaled oxygen. Inhaled oxygen molecules bond directly to iron atoms, therefore an iron deficiency becomes an oxygen deficiency. Lack of oxygen weakness the heart causing it to over work to do it's normal amount of work, which leads to arrhythmias, heart murmur, enlarged heart, and heart failure.Iron Oxygen Image Source (funded by .govs)
Concentration Of O2 In Healthy Blood Equal To Air
Iron deficiency, folic acid deficiency, and B-12 deficiency each, on their own, can prevent the body from making enough red blood cells, causing the heart to work harder than it normally would. (B-12 may keep INR raised some, best to take it once a month (body stores B-12), have coumadin dosage adjusted.)Folic Acid Deficiency Anemia - first line (.gov)
B-12 Deficiency Anemia - First line (.gov)
Other Causes Of Low RBC Count (.gov)
Iron supplementing can save you from pretty low red blood cell count. While time is being bought with iron supplementing, it takes a couple of weeks for folic acid to raise red blood cell count to normal. Taking folic acid during an iron deficiency may make iron deficiency worse - same amount of iron spread over more red blood cells, and if iron deficiency is significant enough fewer new red blood cells or no new red blood cells will be made even if folic acid is taken.
How Do Hospitals and Doctors Handle Nutritional Deficiencies Affecting The Heart?
The condition "heart failure" is not a heart attack. Heart failure is loss of heart muscle strength causing the heart to over work causes swelling of the heart and causing blood to pool in the heart. Weak heart muscle is caused by one or more of lack of oxygen in heart muscle, lack of one or more of certain nutrients, and disease of heart muscle.
So what are the chances doctors and hospitals would measure your iron and folic acid level and if you have deficiencies of these nutrients correct the deficiencies? The older you are the more likely you will be prescribed an oxygen machine 24/7 (which maximizes the little iron your body has), procrit (contains no iron nor folic acid) to raise red blood cell count some how, and more of a diuretic. Some diuretics cause a thiamin deficiency. Thiamin is necessary for cells, including heart cells, to make energy; it's the "spark" of the Krebs cycle. According to The American Journal Of Medicine, "... long-term furosemide therapy may be associated with clinically significant thiamine deficiency .... and contribute to impaired cardiac performance in patients with CHF. This deficit may be prevented or corrected by appropriate thiamine supplements." (Thiamin HCL is useless, use thiamin mononitrate, don't take too much.) And for these medical methods and expenses you get a much shorter and unhappier life.Heart Muscle Swelling Of Thiamin Deficiency (Beriberi) Observed With CMR (MRI of the Heart) (.gov)
The Many Needs Of Thiamin In Heart Failure (.gov)
Thiamine Deficiency, Lasix (furosemide), Heart Failure (.gov)
Thiamin Deficiency and Lasix (.gov)
Lasix And Digoxin Inhibit Thiamine Uptake In Cardiac Cells (.gov)
Improved Left Ventricular Function After Thiamine (.gov)
Correction of iron, folic acid, and thiamin deficiencies will make the heart stronger and more efficient. This can cause the normal diuretic dosage to be too much, causing blood pressure to drop too low, requiring a lower diuretic dosage. A reduction in diuretic dosage may be needed more than once. As helpful as iron, folic acid, and thiamin are, taking more of these nutrients than the body can use will cause problems.
Real World Results Of Correction Of Iron, Folic Acid, and Thiamin Deficiencies
Factually, at least 5 times my own mother (who has kidney disease) left the hospital prescribed 325mg of iron sulphate a day and an oxygen machine 24/7 and 5 times she got off the oxygen a week after stopping the iron sulphate and restarting a much better form of iron hospitals don't have, ionic iron (2,000 ppm).
In early February 2012 she left the hospital prescribed 325 mg of iron sulphate, oxygen 24/7, total of 120mg a day and 40 more mg a day of the diuretic than she normally was taking, and prescribed the drug procrit to raise her red blood cell count. When she got home she stopped the iron sulphate and restarted the ionic iron and started folic acid for the first time. A week after leaving the hospital she got off the 24/7 oxygen. Nine days after leaving the hospital her primary care doctor lowered her lasix 20mg because the diuretic was pushing her blood pressure too low. Sixteen days after leaving the hospital her kidney doctor lowered her lasix another 20 mg because the diuretic was pushing her blood pressure too low and stopped the procrit shots at home (which hadn't started yet) because her red blood cell count was normal.Serious Iron Deficiency, Kidney Disease, find “Conclusion” (.gov)
Find On Their Site "Using Procrit Can Lead To Death Or Other Serious Side Effects"
In mid April she increased her thiamin dosage due to fatigue and severe apathy. At the end of May her kidney doctor lowered her diuretic dosage another 40 mg because it was pushing her blood pressure too low. A week later she stopped taking the diuretic (the last 40 mg) on her own because her blood pressure was already fairly low at the time of the next dose.
According to the NIH, "Wet beriberi [significant thiamin deficiency] manifests as cardiac impairment with peripheral vasodilation, cardiomyopathy, congestive heart failure, edema, tachycardia, peripheral neuritis...."Quote On Thiamin Deficiency, find "Wet Beriberi" (.gov)
Doctors will tell you that beriberi doesn't occur in normal people. It does occur in normal people, especially those who eat poorly and/or have inefficient biochemistry, like the elderly and those who drink coffee.
In August her oximeter meter showed her oxygen level was low (92-94). Her oxygen level was rechecked with new batteries, the oximeter showed her oxygen level was still low. In mid August she decided to change her ionic iron dosage from one day on two days off (every third day) to every other day (so iron should be started days before starting folic acid). On August 21 her cardiologist was surprised to find she was off lasix for the last 2 1/2 months but did not have her restart lasix because her blood pressure, pulse (while on diltiazem for atrial fibrillation) were fine and her oxygen level was 97. On August 27, 2012 her primary care doctor said her "heart failure is in remission".Oximeters And Iron
She's been taking zinc about 5 to 7 times a week for at least 2 years and was likely a necessary part of her heart failure correction (see next link). Speaking of weak hearts and nutrition, exercising to strengthen the heart during deficiencies of nutrients needed for a healthy heart is dangerous. As far as your heart is concerned, exercise is work.Replenishing Zinc Improves Cardiac Function (.gov)
Protective Role Of Intracellular Zinc (.gov)
Heart Failure Diagram
Weak Muscles/Stiff Muscles Of Heart Failure (.gov)
What Is Heart Failure (.gov)
Looking back a couple of years later, for 8 months or so before her heart failure correction was under way, she developed just about an obsession with eating ice (pica), which is usually caused by iron deficiency. More iron was tried several times but each time the extra iron made her tired and weak. Since she was getting plenty of iron, it looks like the ice eating was caused by folic acid deficiency, or is near obsessive ice eating a symptom of low red blood cell count?
Figuring out how much iron is needed may take some work, it may be a heaping 1/32 tsp every other day, 3rd day, 4th day, or 5th day, or 6th day, etc. depending on health, vitamin C intake, red meat consumption. Red meat is high in iron. For some the body will make use of higher doses of iron during an iron deficiency but once the iron deficiency is corrected the same dose may be an overdose. Buying a home use oximeter and keeping oxygen between 96 and 98 will help prevent getting too little and too much iron. Iron in red blood cells bonds to oxygen in the lungs and brings the oxygen to all cells of the body - if you know what your oxygen level is, then you know your iron level (although certain illnesses keep oxygen low regardless of iron intake, e.g. illnesses of the lung). Two hundred to four hundred mcg of folic acid is likely enough to keep serum folic acid normal.Oximeters And Iron
Symptoms To Avoid
Pale complexion can be caused a serious iron deficiency (which causes lack of oxygen) and also folic acid deficiency. (Oximeter readings can be thrown off by holding breath, usually due to pain or anxiety.) Anything that weakens the heart, including potassium deficiency, way too much potassium, and possibly zinc deficiency can cause pale complexion. Pain and being cold for an extended period can cause a pale complexion. Zinc deficiency can, and often does, cause being cold for an extended period. It's very important to figure out the root cause(s) of pale complexion. Iron deficiency causes fatigue, pale complexion, breathing more frequently than would normally would be needed, more frequent asthma attacks, lower oximeter readings, especially during activity, dizziness. Longer term iron deficiency causes brittle nails and white portion of the eye tinted blue. Folic acid deficiency causes fatigue, pale or gray complexion ("pallor"), headache, sore mouth. Zinc deficiency significant enough to cause pale complexion will likely cause inability to keep warm. Those that always have this symptom likely always have a zinc deficiency. Zinc definitely helps prevent pneumonia and other infections.Iron Deficiency - find "pale" (.gov)
Too Much Potassium - find "pale" (.gov)
Folic Acid Deficiency - find "Pallor" (.gov)
Folic acid deficiency, like other B-vitamin deficiencies, can cause a lot of "moodiness" (a euphemism). Correction of folic acid will temporarily (a couple of weeks or more) raise moods higher than what they will normally be (in the context of healthy folic acid level). The temporarily raised moods from folic acid deficiency correction may temporarily cause normal dosage of Xanax to be too much xanax requiring. Folic acid may temporarily lower xanax needs by as much as 40%. Too much xanax causes excess sleeping, confusion, irritability, moodiness and can push blood pressure too low.