~Stroke and Cerebrovascular Disease, Part 4 - Life Extension Recommendations

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, call 1-800-544-4440.

Blood Test

Standard Range

Life Extension’s Optimal Range

Fibrinogen

Up to 460 mg/dL

Less than 300 mg/dL

C-reactive protein

Up to 4.9 mg/L

Less than 0.55 mg/L (men)
Less than 1.5 mg/L (women)

Homocysteine

Up to 15 mmol/L

Under 7 mmol/L

Cholesterol

Up to 199 mg/dL

Between 180–220 mg/dL

LDL

Up to 100 mg/dL

Less than 100 mg/dL

HDL

No lower than 35 md/dL

More than 50 mg/dL

Triglycerides

Up to 199 mg/dL

Less than 100 mg/dL



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.


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