Continued: Reply to Ian

Hi Ian, you last wrote:

"OK. Many thanks again Erling - that's certainly laying it all out. Up to now I have concentrated on simply diet and lifestyle changes to moderate the beast, and have achieved a good deal in that regard. I have been "saving up" the onslaught of supplements for study in due course. I was soon going to begin playing around with various permutations, but now, thinking about it, when I start, I think I might go straight to duplicating your whole supplement regime in one "packet"!!! I mean, like I said before, one thing we know for sure is that you're not taking anything which makes it worse!!! (Although there will always be individual idiosyncracy).

Just one last question (I promise): Right at the end you mention additional "Daily multivitamin and multimineral capsules", which presumably introduce further separate components. Could you please specify which brands/doses of "daily multivitamin and multimineral capsules"? And I take it, from the way you have listed things, that all components of those multivits and multimins are things which you ingest ADDITIONAL to the other supplements you have separately listed? If not, grateful if you could specify which of the earlier supplements you are counting from within the multivits/multimins - wouldn't want to poison anyone with a double dose!"
======================================
Please keep asking - this is important. The posted article 'Essential Nutrient' (http://en.wikipedia.org/wiki/Essential_nutrient) is a valuable general guide to the body's needs for health, beyond this forum's specific recommendations for Afib - e.g. that Essential Nutrient list doesn't include the amino acid taurine as it is not incorporated into proteins, but it may well be essential for treating arrhythmia. It's impossible to know if my intake contains all of that, so the good multi-B vitamin*, the good multi-mineral*, and an attempted "good" diet, plus Dr. Cooney's "methylating" nutrients, hopefully comes at least close - and of course a high dietary K to Na ratio has turned out to be extremely important: biophysicist Richard Moore, MD, PhD's medical science wisdom is at the beginning of CR Session 72 (http://www.afibbers.org/conference/session72.pdf)

The 6 year period between my move to Denver, CO / change of domestic water and onset of palpitations may, or may not, be causally linked to the Afib - that's impossible to know. By then my body had aged 6 years, and by the time of outright Afib had aged 10 years - meaning 10 additional years of a Standard American Diet (SAD): low dietary magnesium, high sodium/ low potassium, inadequate complete protein (amino acids), too much sugar, not enough co-factor vitamins, minerals etc. It's interesting that NSR was gained with only dietary improvements/ supplements aimed at maximizing cells' membranes integrity and energy production (ATP), plus high dose magnesium aimed at reversing an assumed Mg deficiency. Had I known then about SAD, fluoride/ low Mg/ high Ca in the water, and their combined effects on cardiac rhythm, and made appropriate changes, it's certain that NSR would have been achieved much, much sooner than 7 years! - probably within a year at most! Thus the constant emphasis on nutrition in this debilitating malady. Proper nutrition heals not only cardiac cells' performance and rhythm, but also that of all 50 trillion body cells. The down-side of a surgical "fix" is that it can only eliminate, or re-direct, so-called "errant" electrical signals. At age 83 I sometimes wonder about the massive amounts of errant signals that must be emanating from my PV region that my atria are obviously not responding to.

Be well!

Erling

* The multi-B vitamins that I presently use:
Natural Factors B-100 mg. [www.iherb.com]

The multi-minerals that I'm using:
Bluebonnet Nutrition, Iron Free Chelated Multi Minerals. [www.iherb.com]

Thanks Erling for your continued nutritional reminders and advice.

I'd to emphasize the Taurine element that's so very important in a nutritional protocol for afibbers. Taurine is part of the original Essential Trio... magnesium, potassium and taurine ...and should not be overlooked. Taurine acts like a traffic cop - monitoring what goes in and out of cells.
Now that we have the inside track on potassium/sodium connection (CR 72)... this becomes even more relevant because of taurine's function.

Following are various links and a few clips from previous posts just to remind us all that taurine continues to be important for afibbers and shouldn't be forgotten. Some people need more than others; some don't find it to be useful. Once again, biochemical individuality at work.

Be sure to follow the various links to past posts.

Read on:

New readers, especially, need to become aware of the beneficial effects that adding taurine supplements can offer to most afibbers especially regarding prolonging the refractory period.

Start by reading the original January '04 post, What About Taurine?
<[www.afibbers.com]>

It’s important to become conversant with the influence taurine has on keeping potassium in heart cells in that potassium prolongs the refractory period. Refractory period: The rest period following a contraction of the heart muscle. The cell does not respond to stimulation during this period. (this is good.)

ABNORMAL ELECTROPHYSIOLOGY OF LAF
How does Mg (and K) deficiency actually cause AF? Muscle cells (skeletal, smooth and cardiac) contract during
depolarization (excitation phase) and relax during repolarization. During a portion of the relaxation phase, the
cell is immune to further stimulation (refractory period)(75). AF requires a shortened atrial effective refractory
period (AERP), enhanced atrial dispersion of refractoriness, slow conduction velocity and a trigger (increased
PACs)(78). Dispersion of refractoriness is nothing more than a measure of how much variability in AERP exists
between atrial muscle cells. (continue at this link to PCs article on Magnesium and Potassium in the Conference Room
[www.afibbers.org] Session 14A page 7)

Reference to Taurine in Potassium thread and response by PC
[www.afibbers.com] (1/11/04)

(From PC) "I didn't (and still don't) know much about taurine before reading Durlach. I tried to summarize my meager knowledge of this important amino acid in my article in the Proceedings of the CR, Session 14A. I've duplicated some of it below."

"Jean Durlach, M.D., Editor-in-Chief, Magnesium Research, President of the International Society for the Development of Research on Magnesium, and author of Magnesium in Clinical Practice, ... Catecholamines and insulin favor cellular influx of taurine. Taurine is a powerful membrane stabilizer. It also chelates Ca, a Mg antagonist, facilitates maintenance of intracellular K and opposes the undesirable cellular effects of insulin and catecholamines(13). Taurine plays an important role in Mg deficiency. Ingestion of monosodium glutamate (MSG) can lead to taurine deficiency, since glutamate competes with cysteine (required to make taurine) for cellular uptake(46)."

13. Magnesium in Clinical Practice, Jean Durlach, Section I, Elements of Magnesium Biology, pp 1-39, John Libbey & Company, 1985.
[www.mgwater.com]

Excellent article explaining afib and refractory periods: [www.medscape.com]

In March of '08, more details regarding taurine were offered…
<[www.afibbers.org]>

Current studies offering more reasons to consider taurine as important for arrhythmias.

Taurine calms adrenaline and is useful for seizures or arrhythmias.(1)

FromThe Healing Nutrients Within (2)
by Eric Braverman, MD

It known that both taurine and magnesium are depleted in arrhythmia and may be useful in treating some types of it. Sebring and Huxtable found that intravenous administration of taurine prevented arrhythmias caused by the digitalis commonly used to treat heartfailure. (3)

Taurine was also found to inhibit the drop in potassium levels inside heart cells which can cause electrical instability and thus, arrhythmias

Findings have been mixed with regard to taurine’s role in other types of arrhythmias. It has been found to prevent supraventricular beats and arrhythmias due to epinephrine (adrenaline), intravenous potassium and heart stimulants such as digitalis.

According to a Japanese study, taurine can also promote the pumping action of the heart. Taurine alone may be better than low-dose coenzyme Q10 for congestive heart disease. At our clinic, we recommend up to several grams of taurine daily plus 30 mg. of CoQ10.

In cardiomyopathy patients, taurine is thought to help lower blood pressure slightly and prevent deterioration.

A study by Azuma and colleagues in Japan has had a major impact on the treatment of heart disease. In this double-blind study using taurine to treat congestive heart failure, they found that 4 grams of oral taurine a day for four weeks brought improvement to 19 out of 24 patients. The only side effect of the treatment was a tendency to produce loose stools. Taurine content naturally increases in failing hearts which is thought to be the body’s attempt at metabolic correction.

Large doses of taurine, in the range of 2 grams a day appear to help congestive heart failure by acting as a diuretic and causing sodium and water to be excreted. Taurine also acts as a heart stimulant like digitalis, yet maybe safer than conventional treatments which do not nourish the heart muscle.

Some patients with mitral valve prolapse (MVP) have been found to have depressed levels of heart muscle taurine. This inborn error underscores taurine’s importance in the heart an suggests there may be some cases of the common diagnosis of MVP that respond to taurine therapy.

Add the notes on dosing again here from the original and add links to that post and any other updates.

Twenty years ago in 1988, the role of taurine was expressed by magnesium researcher, Jean Durlach, and is especially relevant to this discussion on the benefits of taurine for afibbers.
These different negative effects of the adrenalin-insulin couple in regulation of the cellular effects of magnesium disturbances make the role of taurine all the more important. Moreover, it is doubtless not by chance that adrenalin and insulin favor cellular influx of taurine. This would appear rather to be a regulatory mechanism.

Taurine seems in fact able to oppose the undesirable cellular effects of the adrenalin-insulin couple (Fig. 7) . Taurine appears to be a powerful membrane stabilizer (81, 82, 84, 88, 361, 398, 401, 626, 627, 1138, 1139) whose effects at physiologic doses are comparable to those of magnesium. They appear to be achieved more by a para-cellular action on the physico-chemical structure of the membrane than by a cellular route, that is to say, essentially by means of membrane ATPases (84). This action on membranes must facilitate the maintenance of potassium levels in the cell (Fig 7).

It is therefore possible that the organism deficient in magnesium can try non-specifically to balance the membrane changes secondary to Mg2+ deficit by mobilizing the stabilizing capacity of taurine. But it is also possible that the action of taurine on the cell membrane seeks to keep Mg2+ an essentially intracellular cation, in the cell. Taurine would then be acting like a true "magnesium sparing" hormone (361, 398).

Taurine also appears to be able to chelate calcium. It can thus oppose the effects of calcium overload in the cell, the major mediator of the biochemical consequences of magnesium deficit, an effect enhanced by changes in its subcellular distribution during magnesium deficiency (401). This action must also contribute to the reduction in levels of cyclic GMP since guanylate cyclase in vivo is often Ca2+ activated (Fig. 7) (402b).
Source: <[www.mgwater.com]>

There are many current research findings on benefits of taurine. Do a Pubmed search for “taurine” Following are a few:

Taurine supplementation modulates glucose homeostasis and islet function.
J Nutr Biochem. 2008 Aug 15. [Epub ahead of print]
[www.ncbi.nlm.nih.gov]

Taurine induces anti-anxiety by activating strychnine-sensitive glycine receptor in vivo
Ann Nutr Metab. 2007;51(4):379-86. Epub 2007 Aug 29
[www.ncbi.nlm.nih.gov]

(protects against fluoride toxicity)
Taurine provides antioxidant defense against NaF-induced cytotoxicity in murine hepatocytes.
Pathophysiology. 2008 Aug 1. [Epub ahead of print]
[www.ncbi.nlm.nih.gov]

Benefit Taurine for Heart Tissue
The function of taurine in the cardiac vascular system is extensive, and the mechanism is complicated. Taurine protects cardiac cells from injury caused by ischemia. Taurine helps prevent endothelial dysfunction caused by hyperglycemia, hypercholesterolemia, smoking and homocysteine; suppresses the proliferation and calcification in vascular smooth muscle cells, promotes metabolism and excretion of cholesterol in animal models of hyperlipidemia.

Taurine mainly acts inside the cell. However, taurine transport system becomes aberrant in pathological myocardial and vascular tissues. In addition, taurine improves cardiovascular function in fructose-induced hypertension and an iron-overload murine animal models.
[www.raysahelian.com]

(1) Interview on “Stress & the Heart” with Alan Sosin, MD, practices at The Institute for Progressive Medicine in Irvine, California. He may be reached by phone 949-753-8889

(2)Braverman, E. The Healing Nutrients Within… etc

(3) ibid – pp. Arrhythmia pp. 135-136


Taurine Revisited
<[www.afibbers.org]>
September 10, 2008

I recently heard a comment in a nutritional product review which helps explain why we don’t need to worry about taking taurine singly or worry about the risk of unbalancing our amino acids.

There is no such thing as L-taurine – taurine is not an exact amino acid – there is no L structure, it is just taurine.

Taurine functions as a regulator of electrolytes and is extremely important in sodium/potassium pump function and helps regulate the proper electrolyte flow inside and outside of the cell along with other nutrients, medications and for cell communication.

Taurine is extremely important in preventing arrhythmia as it enhances parasympathetic tone. If patients are on high doses of magnesium and don’t seem to utilize it well and still have symptoms of magnesium deficiency,or get diarrhea easily from high dose magnesium, consider adding taurine to the regimen to help with better magnesium utilization…. even if it is the Albion chelated form because it obviously is not getting absorbed through the gut into the blood stream.

Taurine is safe in high doses. Has an unbelievable amount of functions and is probably one of the most complicated nutrients to understand.

Many doctors use 1 - 10 grams dosage; very safe.

Taurine helps with anxiety and helps neurotransmitters work better.

Is a natural diuretic (as is vitamin B6). Vitamin B6 is a natural calcium channel blocker and taurine has similar functions which is why both help lower blood pressure – naturally. (and would be useful in arrhythmia treatment as well)

Useful for
Anxiety
Arrhythmias
Asthma
Bloating including PMS bloating
Edema – especially important nutrient for edema and so would be extremely important for congestive heart failure (4 – 6 grams a day)
Epilepsy
Diabetes - helps insulin to work better
Hypertension - Taurine in doses of 1 – 4 grams is appropriate for lowering blood pressure.
Taurine will not lower blood pressure if it is already low but will help in those with hypertension.

Taurine calms adrenaline and is useful for seizures or arrhythmias.(1)

Typical taurine dose – 1 – 4 grams a day spread throughout the day

Taken at night will probably cause increased nocturnal urination

===

Original - What About Taurine?
<[www.afibbers.org]>

Taurine Revisited
<[www.afibbers.org]>

Taurine and L-Arginine
<[www.afibbers.org]> 5/7 08

Dose of Taurine
<[www.afibbers.org]>

Magnesium, Potassium, Taurine – Useful Clips – FYI potassium, taurine – useful clips -- FYI
<[www.afibbers.org]> 7/25/07

Taurine
<[www.afibbers.org]>

Do I need taurine?
<[www.afibbers.org]>

====
Taurine Deficiency
7-28-20
<[www.afibbers.org]>

The results of a comprehensive metabolic profile type of test that was ordered by my FM MD are in and were just reviewed to have a look at nutritional status and some key points. These results were mostly improved over the original baseline which I had a number of years ago….. but hat’s not the not the topic of this post.

Of interest was my taurine level which was flagged as ‘high. I take a daily dose of about 1500 mg. (sometimes twice that if I remember) so this was not a surprise.

In the Interpretive Guideline Commentary provided with the results and under Taurine, these (selected) statements are of interest:

Taurine is measured to be elevated in the urine which is consistent with excess dietary intake or with urinary wasting due to poor renal conservation. Excessive dietary intake of taurine-rich sources like seafood (especially shellfish) and from liver and organ meats may elevate plasma blood levels as may consumption of taurine-supplemented sports and stimulant drinks. Urinary wasting can be secondary to generally increased renal clearance or nephritic syndromes. Wasting can also occur when the similarly-structured amino acid, beta alanine is elevated or is present in kidney tubules. In molybdenum deficiency or sulfite oxidase impairment, elevated urine taurine results as a mode of sulfur excretion.

Renal wasting of taurine can be medically significant if it affects one or more of taurine’s many important functions:

- Conjugation of cholesterol (as cholyl-coenzyme A) to form taurocholic acid, an important component of bile and a major utilization of cholesterol.

- Mediation of the flux of electrolyte elements at the plasma membrane of cells.Deficient taurine may result in increased cellular calcium and sodium and reduced magnesium.

- Increased resistance to aggregation of blood platelets and decreased thromboxane release of aggregation does occur.

- Sparing of magnesium – globally.

Urinary magnesium wasting can result from taurine insufficiency. Magnesium deficiency may cause fatigue, depression, muscle tremor and hypertension.

Taurine strongly influences neuronal concentrations and activities of GABA and glutamic acid.

Pathologies attributed to taurine insufficiency include”
biliary insufficiency, fat malabsorption (steatorrhea),cardiac arrhythmia, congestive heart failure, poor vision, retinal degeneration, granulomatous disorder of neutrophils, immune dysfunction, enhanced inflammatory responses to xenobiotics, convulsions and seizures.

The uncommon condition of overall taurine excess (hypertaurinura with hypertaurinemia) usually is insufficiency of sulfite oxidase activity, possibly due to molybdenum deficiency.

This is extremely relevant for those who are having trouble optimizing IC magnesium stores and who are not also taking supplemental taurine on a regular basis.

Jackie
====

Many thanks Erling. Do you take 1 caplet of the Multimineral per day, or 1 serve (2 caplets) per day? Depending upon this you are taking 500mg Ca + 250mg Mg Chelate, or, 1000mg Ca + 500mg Mg Chelate, per day, respectively. And whether it's 1 or 2 caps/day, is this Magnesium (in the Multimin) additional to the 500mg of Mg you have already listed (ie overall Tot then = 750 or 1000mg/day), or is this the Mg you already listed (ie overall Tot = 500mg)?

You have also separately listed 50mg of Zn/day and 800mcg of Folic Acid/day. Are these amounts additional to those in the Multimin and Multivit-B (ie, overall Tots would then be up to 75mg Zn/day, 1200mcg Folic Acid/day)? With that information, all will be clear!

The Calcium is interesting, whether it's 500 or 1000 per day, plus dairy as you mention, plus Ca in your other food. I've found that one thing which definitely helps me is low Ca. Once again, individual variation.

Hi Ian, (note again: this is only about me, I'm not at all strict about this, in fact pretty sloppy, so don't take this as recommendations).

>"Do you take 1 caplet of the Multimineral per day, or 1 serve (2 caplets) per day?"

I take 1 multi-mineral caplet per day.

>"Depending upon this you are taking 500mg Ca + 250mg Mg Chelate, or, 1000mg Ca + 500mg Mg Chelate, per day, respectively."

I take 500 mg Ca per day in the caplet. The 250 mg Mg in the caplet is mostly Mg oxide, so I don't count it.

>"And whether it's 1 or 2 caps/day, is this Magnesium (in the Multimin) additional to the 500mg of Mg you have already listed (ie overall total then = 750 or 1000mg/day), or is this the Mg you already listed (ie overall Tot = 500mg)?"

Yes, I assume the total Mg to be 500 mg per day from the Albion form.

>"You have also separately listed 50mg of Zn/day and 800mcg of Folic Acid/day. Are these amounts additional to those in the Multimin and Multivit-B (ie, overall totals would then be up to 75mg Zn/day, 1200mcg Folic Acid/day)?"

That's correct: 75 mg Zn and 1200 mcg Folic acid per day.

>"The Calcium is interesting, whether it's 500 or 1000 per day, plus dairy as you mention, plus Ca in your other food. I've found that one thing which definitely helps me is low Ca. Once again, individual variation."

Calcium is a highly extracellular electrolyte, the "reference materials" agreeing that the IC : EC ratio is typically 1 : 10,000. This "towering tide" of calcium that "wants back in" is created and maintained by the Na/K pumps via the Na/Ca exchanger pumps. My suspicion is that if dietary Ca seems excitatory it is because of less-than-optimal performance of the Na/K pumps. Their performance requires optimal Mg-ATP and an optimal K-Na ratio, the bottom line of CR 72: [www.afibbers.org].

Best wishes, Ian!

Erling

Note that the list of essential nutrients contains no carbohydrates.

William