Conditions:
Angina

Principal Proposed Treatments
  • L-Carnitine and L-Propionyl-Carnitine
Other Proposed Treatments
  • Arginine, Glutamine, Coenzyme Q10 (CoQ10), Magnesium, Hawthorn, Khella, Coleus forskohlii, Vitamin E

Essentially, angina is a muscle cramp in the heart—the one muscle that cannot take a rest. It develops when the heart muscle does not receive enough oxygen for its needs.

People usually experience angina as a squeezing chest pain, similar to a heavy weight or a tight band, accompanied by sweating, shortness of breath, and possibly pain radiating into the left arm or neck. Usually, angina is brought on by exercise—the more rapidly the heart pumps, the more oxygen it needs. Atherosclerosis (hardening of the arteries) is the most common cause of angina.

Conventional treatment for angina is very effective. Drugs that expand (dilate) the heart's arteries, such as nitroglycerin, can give immediate relief. Other drugs help over the long term by making the heart's work easier. Surgical treatments (such as angioplasty and coronary artery bypass grafting) physically widen the blood vessels that feed the heart.

To prevent heart attacks, current recommendations suggest that most people take daily doses of aspirin, make lifestyle changes such as diet and exercise to lower cholesterol, and reduce other factors that accelerate atherosclerosis.

Principal Proposed Treatments for Angina

Angina is a serious disease that absolutely requires conventional medical evaluation and supervision. No one should self-treat for angina. However, alternative treatments can provide a useful adjunct to standard medical care when monitored by an appropriate health-care professional. We intentionally do not give dosages in this section as they should be individualized by your physician; however, you can find general guidelines in the separate articles on each substance.

L-Carnitine

The vitamin-like substance L-carnitine might be a good addition to standard therapy for angina. Carnitine plays a role in the cellular production of energy. Although carnitine does not address the cause of angina, it appears to help the heart produce energy more efficiently, thereby enabling it to get by with less oxygen.

In one controlled study, 200 individuals with angina (the exercise-induced variety) received either a daily dose of L-carnitine or were left untreated.¹  All the study participants continued to take their usual medication for angina. Those taking carnitine showed improvement in several measures of heart function, including a significantly greater ability to exercise without chest pain. They were also able to reduce the dosage of some of their heart medications (under medical supervision) as their symptoms decreased.

Unfortunately, the results of the study just described can't be fully trusted, because it didn't use a double-blind placebo-controlled design. A smaller trial that did use a double-blind placebo-controlled format evaluated 52 individuals with angina.² The results showed that daily use of L-carnitine significantly improved symptoms as compared to placebo.

Other studies (both single- and double-blind) used a special form of L-carnitine called L-propionyl-carnitine, and found evidence of benefit.^3–6 Consult with your physician regarding dosage and specific safety issues.

Other Proposed Treatments for Angina

Preliminary evidence suggests that the amino acids arginine^7,14 and glutamine¹⁵ might improve exercise tolerance in angina. Coenzyme Q₁₀ (CoQ₁₀) is best known as a treatment for congestive heart failure, but it may offer benefits in angina as well.⁸Magnesium has also shown some promise.⁹N-acetyl cysteine may be helpful when taken along with the drug nitroglycerin, but severe headaches may develop.^10,11,12 The herbs hawthorn, khella, and Coleus forskohlii are often recommended by herbalists, but as yet there is no meaingful evidence that they work. Vitamin E has been found only slightly effective at best for angina, and beta-carotene may actually increase angina.¹³

Last reviewed April 2002 by Medical Review Board

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