Stroke and Cerebrovascular Disease-3

Stroke and Cerebrovascular Disease
Nutrients That Increase Glutathione
Glutathione is the major cellular antioxidant and has a central role in the antioxidant systems that help the body respond to oxidative insults. When glutathione levels are low, oxidative stress is more likely to occur (Thomas JA 2006). Deficiency in glutathione has been associated with atherosclerosis (Morrison JA et al 1999), and evidence indicates that increasing glutathione levels through diet or supplementation may reverse endothelial damage by enhancing nitric oxide production (Prasad A et al 1999). A number of nutrients have been shown to improve glutathione levels:

N-acetylcysteine.
N-acetylcysteine (NAC) is an antioxidant that helps overcome oxidative stress and enhance glutathione levels (Jiang B et al 1999; Vasdev S et al 1997, 1996; Meister A et al 1986; Lu Q et al 2001). Moreover, NAC lowers homocysteine and lipoprotein that can lead to atherosclerotic changes and helps reverse platelet aggregation that can result in blood clots (Gavish D et al 1991; Wiklund O et al 1996; Bostom AG et al 1996; Hultberg B et al 1997; Horowitz JD 1991).
Garlic.
Garlic has a long history of medicinal use. It supplies a component of glutathione metabolism, and it is an antioxidant that helps reduce damage from free radicals. Studies have demonstrated that garlic also slightly lowers cholesterol and has antiplatelet effects that help prevent blood clots (Barrett S 2006; Chang HS et al 2005).
Selenium.
Selenium is a metallic and essential trace element required for glutathione peroxidase. Deficiencies in selenium can produce oxidative stress as well as other stresses that make people vulnerable to infection or disease. It has also been shown to protect against the effects of cerebral ischemia (Ansari MA et al 2004; Schweizer U et al 2004).
DHEA and Stroke
Dihydroepiandrosterone (DHEA) is the most abundant adrenal androgen in the body. It can be converted into both testosterone and estrogen, and many studies have shown that DHEA levels decline as people age. In recent years, researchers have investigated the relationship between DHEA levels and cerebrovascular disease, found compelling evidence that low levels of DHEA are associated with cerebrovascular disease, and even identified DHEA as a possible therapy for the treatment of ischemic stroke.

In one study, researchers hypothesized that DHEA functions as a neuroprotective agent that protects the central nervous system and brain against a variety of insults. After performing the study on rabbits, they found that DHEA, at a daily dose of 50 mg/kg, was able to significantly reduce the damaging effects of ischemia. Perhaps better yet, the protective effect of DHEA was durable, meaning that it lasted more than four days.

Life Extension Foundation Recommendations
Life Extension believes that the best approach to stroke is to take aggressive steps to reduce the risk of stroke. This includes blood testing to monitor critical markers of vascular risk, such as cholesterol levels, C-reactive protein, homocysteine, and others. As you can see from the chart below, Life Extension’s recommended ranges for risk factors are somewhat below the suggested standard ranges often used by conventional medicine. These reference ranges were designed for a “normal” person, and considering that heart disease and stroke are the first and third leading causes of death in the United States, we think that average isn’t good enough. For more information on blood testing visit website.

The following dietary supplements may help improve endothelial function and cerebral blood flow and reduce the risk of stroke:

L-arginine—1800 to 9000 milligrams (mg) daily
Acetyl-L-carnitine—1000 mg daily
Propionyl-L-carnitine—1000 mg daily
Vinpocetine—15 to 25 mg daily
CDP-choline—250 mg daily
Potassium—99 mg daily or more, based on blood test results
Calcium—1200 to 1500 mg daily, with 800 international units (IU) vitamin D3
Magnesium—500 mg daily
Omega 3 (from fish oil)—1400 mg daily EPA and 1000 mg daily DHA
CoQ10—100 to 200 mg daily
Green tea—725 mg daily. A decaffeinated form is available for people sensitive to caffeine.
Beta-carotene—10,000 to 25,000 IU daily
Vitamin C—2000 mg daily
Vitamin E—400 IU daily (alpha tocopherol) and 200 mg daily gamma tocopherol)
NAC—600 mg daily
Garlic—600 to 1200 mg daily
Selenium—200 micrograms (mcg) daily
Vitamin B6—250 mg daily
Vitamin B12—300 to 500 mcg daily
Folate (folic acid)—800 mcg daily
DHEA—15 to 75 mg daily, followed by blood testing at 3 to 6 weeks to make sure optimal blood levels are maintained


Cerebrovascular Disease and Stroke Safety Caveats
An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Acetyl-L-Carnitine
Acetyl-L-carnitine can cause gastrointestinal symptoms such as nausea and diarrhea.
Calcium

Do not take calcium if you have hypercalcemia.
Do not take calcium if you form calcium-containing kidney stones.
Ingesting calcium without food can increase the risk of kidney stones in women and possibly men.
Calcium can cause gastrointestinal symptoms such as constipation, bloating, gas, and flatulence.
Large doses of calcium carbonate (12 grams or more daily or 5 grams or more of elemental calcium daily) can cause milk-alkali syndrome, nephrocalcinosis, or renal insufficiency.

Choline
Do not take choline if you have primary genetic trimethylaminuria.
Choline can cause fishy body odor, excessive perspiration, hypotension (low blood pressure), depression, and gastrointestinal symptoms such as nausea and diarrhea.
Coenzyme Q10

See your doctor and monitor your blood glucose level frequently if you take CoQ10 and have diabetes. Several clinical reports suggest that taking CoQ10 may improve glycemic control and the function of beta cells in people who have type 2 diabetes.
Statin drugs (such as lovastatin, simvastatin, and pravastatin) are known to decrease CoQ10 levels.

DHEA
Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss.
EPA/DHA

Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Folic acid

Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.
Daily doses of more than 1 milligram of folic acid can precipitate or exacerbate the neurological damage caused by a vitamin B12 deficiency.
Garlic

Garlic has blood-thinning, anticlotting properties.
Discontinue using garlic before any surgical procedure.
Garlic can cause headache, muscle pain, fatigue, vertigo, watery eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.
Ingesting large amounts of garlic can cause bad breath and body odor.
Green Tea

Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or warfarin can increase the risk of bleeding.
Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
Green tea extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea, headache, muscle tension, sleep disturbances, and rapid heartbeat.
L-Arginine

Do not take L-arginine if you have the rare genetic disorder argininemia.
Consult your doctor before taking L-arginine if you have cancer. L-arginine can stimulate growth hormone.
Consult your doctor before taking L-arginine if you have kidney failure or liver failure.
Consult your doctor before taking L-arginine if you have herpes simplex. L-arginine may increase the possibility of recurrence.
Magnesium

Do not take magnesium if you have kidney failure or myasthenia gravis.
NAC

NAC clearance is reduced in people who have chronic liver disease.
Do not take NAC if you have a history of kidney stones (particularly cystine stones).
NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes.
Consult your doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal barrier.
NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea.

Potassium
Do not take potassium if you have hyperkalemia (a greater-than-normal concentration of potassium in the blood).
Consult your doctor before taking potassium for potassium deficiency.
Potassium can cause rash and gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
Selenium

High doses of selenium (1000 micrograms or more daily) for prolonged periods may cause adverse reactions.
High doses of selenium taken for prolonged periods may cause chronic selenium poisoning. Symptoms include loss of hair and nails or brittle hair and nails.
Selenium can cause rash, breath that smells like garlic, fatigue, irritability, and nausea and vomiting.

Vinpocetine
Do not take vinpocetine if you have a history of allergic or hypersensitivity reactions to any vinca alkaloids.
Consult your doctor before taking vinpocetine if you take warfarin (Coumadin). Have your international normalized ratio monitored frequently by your doctor if you take vinpocetine and warfarin.
Consult your doctor before taking vinpocetine if you have low blood pressure (including transient low blood pressure or orthostatic hypotension). Prolonged use of vinpocetine may lead to slight reductions in systolic and diastolic blood pressures.
Vinpocetine can cause temporary rapid heartbeat, pressure headache, facial flushing, dizziness, insomnia, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea.

Vitamin A
Do not take vitamin A if you have hypervitaminosis A.
Do not take vitamin A if you take retinoids or retinoid analogues (such as acitretin, all-trans-retinoic acid, bexarotene, etretinate, and isotretinoin). Vitamin A can add to the toxicity of these drugs.
Do not take large amounts of vitamin A. Taking large amounts of vitamin A may cause acute or chronic toxicity. Early signs and symptoms of chronic toxicity include dry, rough skin; cracked lips; sparse, coarse hair; and loss of hair from the eyebrows. Later signs and symptoms of toxicity include irritability, headache, pseudotumor cerebri (benign intracranial hypertension), elevated serum liver enzymes, reversible noncirrhotic portal high blood pressure, fibrosis and cirrhosis of the liver, and death from liver failure.
Vitamin B6

Do not take 5 milligrams or more of vitamin B6 daily if you are being treated with levodopa, unless you are taking carbidopa at the same time.
Vitamin B12 (Cyanocobalamin)

Do not take cyanocobalamin if you have Leber's optic atrophy.

Vitamin C
Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.

Vitamin D
Do not take vitamin D if you have hypercalcemia.
Consult your doctor before taking vitamin D if you are taking digoxin or any cardiac glycoside.
Only take large doses of vitamin D (2000 international units or 50 micrograms or more daily) if prescribed by your doctor.
See your doctor frequently if you take vitamin D and thiazides or if you take large doses of vitamin D. You may develop hypercalcemia.
Chronic large doses (95 micrograms or 3800 international units or more daily) of vitamin D can cause hypercalcemia.

Vitamin E
Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
Discontinue using vitamin E 1 month before any surgical procedure.