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Long post, any help is appreciated. Young Affiber - new diagnosis, had it for many years

Posted by beardman 
I am a 35 year old male who has had his battles with weight, but currently sit at about 240. I exercise 5-10 hours a week and have been training to become a police officer for the past year or so (not much hiring around here). My workouts at times increased upwards of 20 hours a week.

Every 6 months I need to renew my medical approval forms and since I wasn't due for a full physical my GP decided that an EKG would be a good measuring block for the sign-off. At that time is when I was diagnosed with AFIB (March 2018)

My resting pulse is about 50 and my blood pressure is right around 105/70. All of my blood tests are more or less right down the middle expect for my vitamin D which is through the floor (~13). My cholesterol is on the lower side (114 total/46 HDL/57 LDL/40 Triglycerides) and my Thyroid panel is normal, Magnesium RBC is 4.8. My stress test was good and my echo-cardiogram was normal. My CHA2DS2–VASc score is 0. I have completed an in home sleep study that came back inconclusive since I only breath through my mouth (broke my nose a few times as a kid and have almost no ability to breath through the left nostril). In lab sleep study is very cost prohibitive, especially considering the fact that I dont't think I have sleep apnea. I don't snore, have a neck smaller than 16.5" and my afib has never triggered during sleep, 95% of the time it is during exercise.

I don't drink alcohol at all, no smoking, no recreational drug use, no coffee or other caffeine at all. I have been eating a vegan diet for the past few years and prior to that a vegetarian diet since 2009. I have recently started eating a vegetarian/keto diet in hopes of perhaps controlling the afib, but it would not appear to be Vagal based as it doesn't seem to ever happen when I eat.

I have now seen 3 different cardiologists, an electrophysiologist, a naturopath (MD), an acupuncturist and a chiropractor. The cardiologists can't seem to agree on what drugs they want me on although all of them want me to cease martial arts training (about 5 hours/week) and put me on a blood thinner. The electrophysiologist wants me on Pradaxa (only one with a reversal agent per my request), Flecainide 100MG and Diltiazem 120MG for 30 days (after he wanted to electrocardiovert me). I have explained to all of the doctors that I seem to convert myself back to normal rhythm and have no symptoms, but they have all wanted to convert me medically in some way shape or form.

I really have zero interest in being on pharmaceuticals for the next 40+ years and am having a tough time convincing myself why it would be a good idea to take my 0%-0.2% stroke risk with my CHA2DS2–VASc score of 0 and increase that with things like blood thinners or the cardioversion. I do understand that they are trying to prevent remodeling etc, but the only other thing that they seem to be able to agree on is that I have probably had this since I was a teenager (looking back I do remember times that my heart was racing like crazy for no reason). If my heart was going to remodel, wouldn't that already have happened?

I can tell, based on my apple watch readings of HRV that this has at least been happening since August of 2017. I also now have a Kardia monitor so I can tell when I am in and out of NSR.

I have started taking large doses of Taurine (15grams/day) and Arginine (6 grams/day) along with Curcum-Evail (1gram/day) and Magnesium.
I have been able to extend my days of NSR from 1 up to about a 4-5 and have reduced the amount of time out of NSR as well. Previously I would be out of rhythm for 2-3 weeks at a time, now it is usually only a day or two, sometimes just a few hours. When I am out of NSR. Usually my heart rate is still under 100 BPM, but there are times when it seems to fly off the handle and spike up above 200BPM.

I know I am way on the end of the bell curve here and all of the studies that I have read about are studying the majority, 60+ years old. I don't want to follow the flowchart as it doesn't seem like it applies to me.

I am not sure what I am asking for other than maybe to touch base with someone in a similar situation, perhaps to find some sort of supplement/diet/?? mixture that works. I have tried all the natural methods to convert to NSR, but the only ones that sometimes work for me are an ice cold shower or exercising (which is also what usually triggers me to go out of NSR as well).

Thank you in advance for reading through all of my mumbling and again, I very much appreciate any insight.
Hey Beardman,

As chronic fitness can bring on afib, perhaps figuring out your minimum effective dose on exercise would be in order and use fasting/adjustment of macros to control your weight rather than cardio. The magnesium supplement is good. From Dr. Carolyn Dean, you'd like your RBC mag in the 6-6.5 range. If not there, I'd suggest increasing your supplement to near bowel tolerance.

Check out Patrick McKeown's book Oxygen Advantage <[oxygenadvantage.com] (he's also got lots of podcasts so you can see where this is going) and pay attention to using only nasal breathing all the time, especially during exercise. If you have to open your mouth, stop till your breathing is controlled, then exercise at a pace where you can breathe through your nose. Over time, what you can do will increase. This will keep you from overstressing your body.

Chronic fitness is a common path to afib for those who are younger.

George
Thank you very much for the insight. I will check out the podcasts and try increasing my magnesium dosage. Nasal breathing is extremely difficult for me, but I will try it out. I did see and ENT specialist who gave me a surgical option, but she told me the only way that would be approved was if I failed using a CPAP machine.
BeardMan:

Welcome to our Forum.

You say your weight is 240. How tall are you? 240 can look like an NFL Linebacker, or an average overweight guy. Do you liift Weights?

As for your Meds you want to avoid:

100mg Flec and 120mg Diltiazem are low doses for 240lb Guy.
Also your frequency of AFIB episodes will have the Dr's calling for Blood Thinners. If you can get down to 1 or 2 short Episodes every several months your Doctors should be more willing to talk about stopping the Pradaxa.

I agree, if you are Converting on your own, then why do the Cardioversion. The time to do a cardioversion would be if you went 3-4 days to a week or so, and it looked like you were not going to Self-Convert. In my own Case, I know that if I don't Convert within 48 hours, then I will need a Cardioversion, so at about 24 hours into my episodes, I start making arrangements to get Cardioverted. The problem with letting it go on and on, is that the longer you are in AFIB, the more remodeling occurs, and Stroke Risk also increases. Also Heart Rates constantly above 100 can lead to a wearing out or weakening of the Heart Muscle (Tachy-Cardia Induced CardioMyopathy).



Edited 2 time(s). Last edit at 06/04/2018 07:57AM by The Anti-Fib.
I am 6’ tall and do lift so I am in fairly good shape, but not a pro athlete. I am trying to grind that down to 225 at least, but we will see.

I was prescribed the blood thinners, but they want me to stop any martial arts in order to do so. That really isn’t of interest to me at all. I haven’t taken any of the prescribed pharmaceuticals at all. I am not trying to be thick headed, I just really would rather go the way of supplements and a natural remedy if at all possible.
I'm 44, diagnosed at 41, so it's not crazy for younger folks to have AF. Plenty do.

What form of magnesium are you taking? You want to use the amino-acid chelated form for the best bioavailability in oral consumption. We loos for the Albion TRAACS label. Taurine is also good, but 15g/day might be a bit too much. Is there a need for that? I take 2g/day for comparison purposes.

I agree with you on the drugs. I wouldn't want to go down the path of decades of pharmaceuticals, and the simple truth is there's about ZERO chance they will work for that amount of time.
I waa originally only taking 2,000 mg of Taurine, but read a study regarding line Afib and super doses that I will track down and post.

This is the Magnesium that I am taking. Mother Earth Minerals Angstrom Minerals, Magnesium-8 ozs
Beardman,

When I was first diagnosed with afib, I had been having episodes for the previous 5 years (didn't know what it was and the Dr's didn't find anything), then caught on an EKG. Then I was on meds for next 6 years until I was successfully ablated 11 years ago (it all began in 1996 at age 51). I didn't know of this web site at the time and did what my cardiologist suggested (didn't see an electrophysiologist until my ablation).

I led a VERY active lifestyle (bleeding risk) and my Dr. was concerned about bleeding with Coumadin, so she prescribed Plavix. Not the norm by far, but I still see that it can be used with someone with a 1 or 0 CHAD score. At least it may be an option if bleeding risks are high enough with the current blood thinners and your activity. Others may disagree, but????

I had more that 200 afib episodes over the 11 years of my afib, and no stroke.
Here is a link to the study showing high levels of Taurine

Study
Interesting.

Certainly a vegetarian/vegan diet would be low in taurine. Given its low cost, too, one certainly won’t go bankrupt with supplementation in the 10’s of grams per day. Let us know how it works out!
Beardman... in the recent "Taurine - Reminder and Update" post... there was a notation that said - among the many benefits of taurine ...by regulating cellular calcium, taurine not only improves heart-muscle contraction but also prevents it from becoming over-irritable, which can lead to arrhythmia. Blaylock June 2009.
[www.afibbers.org]

If your diet contains a lot of calcium, then the taurine will help, but it's best to limit calcium as it competes with magnesium... and the heart needs an abundance of magnesium compared to small amounts of calcium for muscle activity.

In another segment on dosing the higher dosing was mentioned and related to the Eby study where they used very high doses. However, it's almost always suggested that the best approach to higher dosing is to start with lower doses and increase incrementally so you know the lowest effective dose... rather than risking overload which puts extra work on the body to manage. Fortunately, taurine is known to be safe - even in large doses... according to Dr. Blaylock's report.

I agree with you that your history of vegan/vegetarian eating has most likely left you very low in taurine so the supplementing should help.

I'll be interested in your progress reports.

Jackie
I will try to keep this up to date as things progress. I am going to try adding potassium in as well incrementally to see if that helps.

The only sure fire way I have been able to snap back into NSR is to workout/train at martial arts.
Beardman, Tall guy here too, 6 3 225, 64 yrs young. 2010 first episode, 1 yr since my last. Have your ND do an adrenal test. Cheap and easy saliva test. May not be your issue, but a good one to rule out and easy to treat with some good natural supplements. I had 12 episodes in 2 months and was lined up for an ablation. ND got report back 1 week before EP blade sharpening, and found high cortisol levels at night, (most episodes occur then), and very low daytime. Canceled EP, 3 weeks of supplements, and feel like I never had this condition before. Worth a shot. Hawk
I’m actually going back this afternoon for the spot test results. What supplements did your doc put you on and what dosages. I’d love to share with the doc.
beardman.... on adding the potassium.... be very cautious as that can make afib worse if your intracellular stores of magnesium are not optimal. Since you are vegetarian, you may already have enough potassium... so again....be very cautious.

Jackie
Beard, One is DHEA 10mg, along with 1 with Ashwanganda, etc, daytime and 2 at night, one is Seriphos, Most GPs know about this one. It is mostly anti anxiety supplement.[www.naturalhealthyconcepts.com]
Jackie, excellent advice. Potassium is most readily available in daily diet. Beard works out and most likely drinks alot of water, so thats a huge plus for releasing Pot into the blood stream.
Yes - true enough... but it's better to be forewarned than learn about it after the fact.

Too much water is risky for afibbers as well.

Jackie
Getting too much water doesnt seem like it would be an issue. Whats that connection?
I am drinking somewhere in the range of 200oz of water a day. I used to drink ~80-100 oz of Powerade zero and 100 oz of water in addition, but cut that out because of the art sweeteners.

Some of the drs have suggested that is too much while others are not concerned at all. Electrolytes are fine based on blood tests though.
Too much water will flush electrolytes.

Let me try to do a crash course in "Electrolytes 101":

The primary electrolytes OUTSIDE your cells (extracellular) are sodium (Na+) and calcium (Ca2+).

The primary electrolytes INSIDE your cells (intracellular) are potassium (K+) and magnesium (Mg2+).

The balance of Na+ and K+ in intracellular fluid is roughly constant. That means when Na+ comes in, K+ comes out.

Muscles work by voltage-gated ion channels in the cell membrane opening and closing to either allow influx of Na+ and outflux of K+ or vice-versa. The concentration gradient of K+ and Na+ across a cell membrane creates the "membrane potential" - literally a voltage. Rising voltage will then open the calcium channels. When Ca2+ enters a cell (and this is a REALLY small amount), it causes the proteins in the cell to "curl up", contracting the cell. This is how our muscles get tight and move our bones via ligaments. The heart works the same way, it's just autonomous and doesn't require nerve synapses firing to initiate the motion.

So here's a plausible scenario - you're working out a lot. Moving muscles and pushing electrolytes across the cell membranes. You drink lots of water. Your kidneys are very good at regulating the electrolyte levels in your blood (extracellular fluid). If they didn't, we'd all be very sick or dead. So, you've pushed K+ into your blood and had lots of fluids. Your kidneys will dump K+. You repeat this process, thus creating a long-term, downward trend in K+ (and Mg2+ also, as it "follows" K+ for lack of a better term). If you measure serum (blood) level of electrolytes, chances are they will measure fine. All that means is your kidneys are working. But what you can't measure (easily, anyway) is how much K+ and Mg2+ is still left in the cells themselves. Serum levels will continue to measure fine until you've seriously depleted the intracellular levels. By that time, you may well be experiencing symptoms like muscle cramps, random twitching and, yes, even a-fib.

Lesson over. smiling smiley

None of this means working out is bad for you. It simply makes the case for careful electrolyte supplementation. Get them (K+/Mg2+) into your body, into your cells where they belong and try the best you can not to do things that cause your body to excrete them.
So my Adrenocortex test came back. My Cortisol levels are elevated slightly, but my DHEA numbers are way above max level (dr said too much of a good thing). Between that and some other tests being out of whack a bit he suggested a few other supplements.

The tests of concern were:
DHEA (955)
DHEA: Cortisol ratio/10,000 (2,705)
HS CRP (2.9), range 1.0-3.0
LP PLA2 ACTIVITY (147), range less than 123
FIBRINOGEN ANTIGEN (356H), range less than 350

The supplements suggested are:
Niavasc (niacin)
Nattokinaise
DHA from algae
Adrenatone
Carnitine Tartrate

I discussed the large doses of Taurine and L-Argentine as well. He agreed that they were high, generally suggesting 3grams/day to start. He also said that they wouldn’t really be doing any harm in the higher dosage. I will continue the large doses for now while I try these new supplements. Once I see how they impact things, I will possibly taper down the Taurine and L-Argentine.
Have you been checked for aldosteronism? That will cause potassium loss.
No, but my BP is 105/70 and my sodium levels are normal. Doesn’t that usually go along with high bp and High sodium levels too?
Unsure, I’m by no means an expert on endocrinology. It might make sense to at least ask the question. Another way to create a “pseudo”-aldosteronism is by eating a lot of licorice. Going off into the weeds a bit here, though.
In reference to drinking to much water, in addition to Electrolytes being Flushed, Many other things like Cortisol can also be over-excreted. The easiest way to tell if your over-hydrating is to look at your Urine Color, the lighter it is, the more hydrated you are. A more detailed test would be a 24-hour Urine test, that would measure the volume over 24 hour period.

I am wondering Beardman as active you are, have you been taking Anti-Inflammatories, either NSAID, (like Motrin), or Steriodal like Prednisone?
Adrenatone has a few of what is in Cortisol manager* in lower amounts. The C and B are virtually useless for mg amounts. Large doses of C, 3-5 grams, control adrenals also. I will get a list to compare later. Good start. Hope it works.
Prior to being diagnosed with Afib in the end of March I generally didn’t take anything, pain meds, cold medicine, vitamins, supplements, etc.

Now I am on a whole host of supplements, but still no pain meds.

Regarding the over hydration, I tried cutting back to 100oz/day for a week or so, but that only lead to symptoms of dehydration. I would always have a cotton mouth, felt slightly weaker and my urine turned very dark. I agree that I could be flushing the electrolytes, but instead of adding the Powerade zero back into my intake I figured the magnesium and potassium would be a better option. Thank you wolfpack for the detailed explanation above.
I've had AF paroxysmally for 17 years - starting at age 30. Apart from the weight issue and nasal breathing (and female!), my diet is similar to yours. However, you get a lot of AF episodes for shorter periods. (mine is generally 3 days long, approx every 2 months; I've been cardioverted lots, as well as self-reverting). Do you know how long your AF lasts?
From personal experience, and knowing how fundamental exercise and movement is to human's wellbeing, I would not reduce exercise. 5 hours is minimal. I have been an elite athlete/artist. There's evidence to show that rowers & triathletes can have higher risk of AF, and I have modified my intensity a bit. Mostly, I have experimented with how I start and stop exercise; my heart doesn't like going from complete rest to a full on sprint, or to lifting a heavy weight , so now I am careful to keep jogging before a big exertion, and afterwards. You may find you need to ease off intensity. But physical activity is so good for all body systems and mental health! Many AF folks find that exercise can put them back into NSR. For the first 5 years, it did for me.
I am curious about the precautions for excessive water intake.... good hydration can prevent AF , and lowers risk of stroke.
All the research I've done over the years prompts me to ask you to really consider your mouth breathing... apnea is such a risk for AF, even if you reckon you don't have it. And nasal breathing and close-mouth humming promotes formation of ___ (i forget the name), which has a regulating effect on heart rhythm.
It's crap to be told to take blood thinners. I take riveroxaban (xarelto) a few times a week, but if I think I might be about to trigger an AF episode, or if I am in AF, (I know precisely when i am in AF or NSR - i get v week) I am diligent with the blood thinners; a stroke is a far worse outcome. (and i have had TIA, alas my CHAD score is not zero!). If your risk is low, I'd be chugging the garlic ginger turmeric; they do thin the blood, it's just we don't have the mega RCT studies to back them up, like we do for the pharmaceuticals. And because they are plant-based, the blood thinning factors are variable, depending on where/how they are grown.
I'm curious how you go on Taurine etc. I'm about to start taurine. As for Mag, I use a Mag Citrate powder. Took me a few years to hone in on that form of Mg, and when I told my cardiologist that MagCitrate was most effective, he said "oh yeah, that's the most useful form for the heart". Needless to say, I was not impressed he hadn't stipulated that years prior.
Good luck.
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