Complementary Alternative Cardiovascular Medicine

Chapter 7 / Nutrachemicals and CVD 113
(strength and endurance) in patients with CHF. There was no reported
change in the ejection fractions. Andrews et al. (54) studied the effects
of creatine supplementation (20 g/d) in patients with CHF (n = 10), compared
with the placebo group (n = 10). The creatine group showed a
significant increase in skeletal muscle endurance and an improvement in
the metabolic responses to exercise in muscle groups, which were
impaired because of CHF.
Trade names: Creatine Fuel (Twin Lab), Muscle Power (Mason Vitamins),
Creatine Booster (Champion Nutrition), Power Creatine (Champion
Nutrition), Crea-Tek (Iron Tek), Creavescent (GEN), Phosphagen
(GNC), Creatigen (Bricker Labs), Perfect Creatine (Nature’s Best), and
Xtra Advantage Creatine Serum (Muscle Marketing USA)
Adverse reactions: Nausea, vomiting, diarrhea, rashes, fatigue, seizure,
migraine, polymyositis, anxiety, nervousness, myopathy, and atrial
fibrillation
Contraindications: Renal failure or renal disorders, such as nephritic
syndrome
Usual dosage: Loading dose of 20 g followed by 2 g/d
GLUTATHIONE
Glutathione is typically used as a collective term to refer to the tripeptide
L--glutamyl-L-cysteinylglycine in both its reduced and its dimeric
forms. It is primarily synthesized in the liver. Glutathione is involved in
DNA synthesis and repair, protein and prostaglandin synthesis, amino
acid transport, prevention of oxidative cell damage, and enzyme activation.
It is present in fruits, vegetables, and meat products, but body levels
do not correlate with dietary intake.
Role in CVD
Glutathione is a potent antioxidant agent that reduces inactivation of
endothelial-derived NO and enhances NO activity (55). Atherosclerosis
of coronary and peripheral circulation is associated with reduced NO
basal and stimulated activity. Low total serum glutathione (tGSH) levels
have been reported in male offspring of parents with premature CHD,
suggesting that it as a significant independent predictor of parental CHD
(56). Prasad et al. (57) have demonstrated that glutathione supplementation
resulted in improved human endothelial function. Its infusion also
suppresses the vasoconstrictor response of epicardial vessels to acetylcholine
of patients with spastic angina. This phenomenon of enhanced
NO bioavailability by glutathione or related thiol substances suggests a
potential role for this nutrachemical supplement.