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ABOUT CONSTITUTIONAL MEDICINE
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The treatment of palpitations and arrhythmias with a natural approach takes time and commitment, but if the person is ready to put in the work, then past experience suggests that it is highly likely they will get an excellent result. I've been in full-time practice since 1989 in Christchurch. Given how common and distressing a problem it is, many people have come in with palpitations or arrhythmias in that time. Each case is different and needs an individualised approach, but there is also much common ground between people and there are some general suggestions given later in this article that may have the potential to benefit anyone. Firstly, from the clinic files, the following two cases histories are shown to illustrate one practitioner's approach to this common and distressing condition.
Barry was in his mid-60s when he first came to see me. His primary concern was arrhythmia and the reason his case immediately came to mind when I thought about who to write about is that he was affected so very badly by them. If this is a problem that you have, or you have been learning about it for someone you care for, you probably already know that many types of arrhythmias are said to be harmless, even though they are recognised as having the potential to cause much stress to the sufferer. Barry's arrhythmia was not one of the benign ones that can be left alone, and he had been treated with an aggressive regimen of drug therapies for some years including calcium channel blockers, beta-blockers, anti-coagulants and anti-arrhythmia specific medications. His history was one of constantly changing and trying different medications as he frequently had side-effects, including several drugs that caused the arrhythmia to increase! My records show that he had been admitted as an out-patient to Christchurch hospital 3 times over the last 2 years for a cardioversion (a process that involves shocking the heart back to rhythm) and, at the time of our meeting, he was scheduled for a 4th procedure, something he was keen to avoid as he frankly detested the whole process even though he was heavily sedated each time. Described as 'more English than England', Christchurch, New Zealand, is in many ways a conservative city. Certainly, much of the older population would never dream of stepping outside of the mainstream, entirely tax-funded medical system unless they were in a very bad way and had practically exhausted all the conventional options first. It has been a wonderfully challenging journey to work with such people, especially when not only are they coming to you as a last resort, but they are also expecting you to have worked some kind of magic before they turn up for their 2nd visit! Barry turned up with his wife, a list of medications, and a mood of frustration that was barely contained. As much as he was projecting his anger and frustration into the appointment, I was careful not to take any of it personally. He was not angry with me, as gruff as he was being, he was angry with his own body and he was angry with his doctors and his drugs. The first rule of medicine is 'do no harm' the second is 'treat the cause'. Why did Barry have arrhythmias in the first place? It turned out that he had a much longer history of high blood pressure and had been on a beta-blocker for this for nearly 15 years, long before his heart went out of rhythm. It was also apparent that Barry had the metabolic syndrome. I'll say something more about that shortly but, for now, this was evident from a group of signs, namely the high blood pressure, along with elevated cholesterol, a round belly, a tendency to sore joints and signs of congestion on his tongue and in his pulse. Arrhythmia was the worst of Barry's problems, but it was not the first of them. If we were to have any real chance of helping him, we had to work at a much deeper level than trying to find a magic herb or herbs to correct his mis-firing heart. Once we had established some open communication around this, and I was sure that he was ready to do the work and would not give up too soon or at the first hurdle (in which case I would have preferred to not even begin), we got started with the following
We make our own tinctures from organic dried herbs, so it might be important that you understand that the optimal dose range will vary with different preparations made by different companies or practitioners, The above liquid extracts were combined into a formula to make 540mls. This will just fit in to a 500ml amber pharm round bottle and is enough to last 4 weeks, if taken at the maximum safe and effective dose of 10mls twice a day, which is what I prescribed. Hawthorn & Motherwort are talked about in the general recommendations. Dandelion, Barberry & Celandine are three of the best herbs in all Nature to help activate the liver and cleanse the blood.
We import dried, concentrated extracts of Hawthorn berry and Reishi mushroom and send them to a local company to be processed into capsules. I used the leaf extract in the formula but added the berry of Hawthorn for its own distinct benefits for strengthening the heart, whilst Reishi mushroom conveys calming and nourishing properties. In a case like this, I used the maximum effective dose possible meaning we started on 4 capsules twice a day.
To further help the cleansing process we used a special tea. The details, for anyone who would like to know the recipe and instructions are found here
The first step in the healing journey comes from Nature. We come to a point where we are unable to fix ourselves and then these ancient allies, the herbs, can help us to get well. The next step is the 'work'. It is what the patient does to help themselves. Underlying all the old ways of healing is an understanding that living organisms have the ability to self-repair, unless something is getting in the way. The 'work' is usually doing something to remove the obstacles that are getting in the way of that innate, self-healing intelligence. Barry was from the Tiger constitution. I will say something about that further on too, but why I mention it now is that, like many Tigers, he was born with a genetic disposition to develop the metabolic syndrome and it was this that was the underlying root of many of his problems, including the health of his heart. Barry complied enthusiastically with the whole program. I am sure he came in with quite a lot of scepticism, after all his condition had steadily deteriorated despite numerous interventions by specialist cardiologists, what would a herbalist be able to do? But he was an intelligent man who could understand and make the connections between having the metabolic syndrome, developing high blood pressure and central obesity and then getting heart problems from taking drugs to treat the symptoms instead of changing his diet to treat the cause. On his 2nd visit the notes say that his arrhythmias were substantially reduced. When I asked him to give a percentage (I always do this to get as honest a feedback as possible) he said they were over 50% better. He felt better in himself, considerably less soreness in his body, sleeping better and having more energy. I wrote down that his wife made the comment 'he is so much easier to live with!' I had advised them to read up on the metabolic syndrome and get ready to start the ketogenic diet with researching recipes, getting in ingredients etc. The article that they had to read is found here Barry and his wife, who was keen to do it with him as she wanted to lose some weight herself, engaged enthusiastically with the ketogenic diet. My notes show that I saw Barry two further times, two months later and then a final visit, three months after that. The last time I saw him he was completely drug free for the first time in many years. He had lost over 20kgs and was exercising daily. His blood pressure was normal, his cholesterol levels were normal (we have a certified machine in the clinic that measures the difference kinds of cholesterol. Best of all, his heart was beating strongly and regularly, no arrhythmias whatsoever. He had become a fit, healthy man, drug-free, eating well and looking after himself. I mentioned that I thought of recounting Barry's case because he was so badly affected by arrhythmia. I also want to say that this kind of improvement in a person who gets to the roots of their troubles is not unusual. People can get better from almost anything, so long as they treat the cause and work with the healing power of Nature. Barry had reduced his herbal program to taking everything just once a day after the 2nd visit. On the last visit I was happy to advise him that he didn't need to stay on anything but should come back and get more herbs or come and see me again if any of his troubles returned. This was over 6 years ago, and I see that he hasn't needed to come back, which is exactly what we want.
Liz was in her early 50s when she came in a highly distressed condition with the primary symptom of both palpitations and arrhythmias. She had not been to a cardiologist but had been told by her GP that her arrhythmia was not a dangerous one and this was my sense of it too. I listened to her heart for quite a while and made some recordings with an electronic stethoscope that I use to record all my patient's heart-beats when the first come in. Her heartbeat was really all over the place in terms of a stable rhythm. I did also believe that she was not in any physical danger from what was happening, but that equally she was clearly and understandably being much disturbed by what she could feel. I chose Liz's case to share because I got to know her well from treating her over a reasonable time frame, plus she is a good example to counterbalance the case of Barry as described above. It is important to recognise that some arrhythmias are dangerous but that many are completely benign and do not at all indicate an increased likelihood of a stroke, heart-attack or anything of the sort. It's reassuring for the patient to hear this, especially from more than one source, but it doesn't stop the stress of experiencing arrhythmias or palpitations. It is essential that anyone reading this understand that our brains are 'hard-wired' to react to any kind of disturbance to the heart with a marked increase in nervous tension. It doesn't matter how well you can rationalise what is happening, if you feel your heart beating out of rhythm (arrhythmia), or you feel it beating more strongly than you should for whatever you are doing at the time (palpitations), then it will make you tense up. The more it happens and the stronger you feel it, the tenser it will make you. In Liz's case the symptoms were pretty bad, and she had reached a severe state of anxiety. Liz described her sleep as 'shocking', she said she was awake much more than she was asleep at night and that when she did wake up it was often with a panic attack which she attributed to the palpitations more than anything else. She said she would wake up out of deep and exhausted sleep with her heart pounding and said that it could take her hours to get back to sleep. Liz was anti taking drugs. She had been prescribed sleeping pills, anti-depressants and beta-blockers, and had tried all three of them at different stages but had hated how they made her feel, hence coming to see me. Her history gave some insight into the roots of what was wrong. She had experienced severe menorrhagia (heavy periods) in her early 40s and had a hysterectomy at 44. She had retained her ovaries and thought that she went into perimenopause fairly soon after this time as she had experienced some months of recurrent hot flushes that had then gradually subsided and she assumed that was that. She was a little hazy on when the arrhythmias and subsequent palpitations first started but guessed it was in her late 40s. They had then progressively increased in frequency and intensity until about 18 months before we met, which is when her sleep began to be seriously disrupted, and then things continued to escalate from there. I believe that the underlying cause for her heart disturbance was a hormonal one. The hysterectomy had somewhat thrown things out of kilter, but she had actually entered perimenopause proper in her late 40s when the heart disturbances began. Her hormones, the great regulators of the body, were in a state of change and her sleep, her circulation and her heart were being thrown out of balance. Liz was an EB (Elephant-Butterfly) constitution, I will introduce this subject further a little later, suffice to say here that the 'sensitive' aspect of the EB can especially struggle with hormonal imbalance and, as well as finding some ways to ease her symptoms, one underlying priority was to help her navigate 'the change' of menopause more smoothly. To this end we made up the following treatment plan
Dosage 10mls twice a day.
Dosage 4 capsules at night before sleep. Ok to take a 2nd dose of 4 capsules in the night if needed. Safe, potent and fast-acting herbs to help treat anxiety and poor sleep.
Dosage 4 capsules once a day in the morning. Tonic herbs to help her adrenal glands to navigate the perimenopausal change.
Dosage to work up from 2 capsules twice a day. The method to use Cayenne to help 'equalise the circulation' is described further below under general recommendations.
Make and take a cup of Tonic tea in the morning. For anyone interested, the recipe and instructions for this tea are found here (coming soon)
Make and take a cup of Relaxing tea in the evening. Ok to make more if desired, recipe and instructions found here (coming soon)
To take as freely and frequently as desired, this formula and exactly how to use it along with a relaxing breathing exercise is discussed in detail in the article on anxiety linked below.
The above prescription obviously contains a lot of medicine, and if, as with a prescription of pharmaceutical drugs, we were expecting Liz to have to keep using this treatment indefinitely, then it would be too much to countenance. However, working with the old ways is like going on a healing journey where there is a clear destination. We can pull out all the stops with a comprehensive treatment program so long as we have a reasonable expectation that it should be able to help and that the patient will be perfectly able to reduce their prescription when they are on their way to getting well and will be able to completely stop all of it when they are fully better. Liz was in an acute crisis when we first met. The last thing I will do in such situations is to hold back and, not only did I give her the strongest herbal program I could formulate, but equally, we jumped into the deep end of the work too. It must be understood that, for many people, arrhythmias and palpitations can quickly become a kind of self-perpetuating and self-aggravating condition. The worse a person feels with them the more they happen, the more they happen the worse they feel. Many people would rather take very strong drugs, and put up with some heinous side-effects from them, than to keep experiencing arrhythmias or palpitations on an increasingly frequent basis. Liz's crisis was as much from the stress she was in as with whatever was happening to her physically and hormonally. To be sure of a good result as quickly as possible we had to meet the anxiety and stress head on. There are certain approaches that are reliably seen to help in this area. The relaxing herbal formula mentioned above is a crucial intervention, something the patient can use as freely as frequently as they need. Likewise, the breathing technique to get out of panic attacks and hyperventilation. Practicing 'worry-time' to sort out her mental 'in-box'. All the steps that needed to be taken to treat the mind as much as the body were needed and Liz did them all. I won't go into further detail here but for any reader that has cause to go into it further, the detailed article on anxiety is found here The eventual outcome of Liz's case was excellent, she made a complete recovery and, lest any wrong impression is being given here with this 2nd of two success stories, i.e. an impression of fast or easy fixes, I want to be 100% clear that this case, like many others, was not in the least fast or easy! We were able to reduce her treatment program after not too long and her heart symptoms were all but gone within 3 months, but she worked hard on herself for much longer; on her nerves, her thinking, and her emotions. When I first met Liz, she had been an insomniac and in acute anxiety for a year and half, and she was about as easy to be around as high-voltage live electricity! I grew to like Liz very much for her willingness to be honest with herself and her courage and readiness to do whatever it took to get well. Denial is the enemy in this work. If a person is ready to face the truth of their situation and what it is that they need to do to get well, then they will usually go through a transformative process. The 'Butterfly' analogy to the EB works on more than one level. Liz went through more than just a hormonal change, she re-evaluated her life choices, her path and her passions, and eventually came out of the crisis a changed woman, with a great deal of inner strength.
I mentioned above that Barry was a Tiger constitution and that Liz was an Elephant/Buttterfly. This ancient way of understanding our differences, according to how we are naturally either hotter or cooler, and at the same time dryer or damper, underpins much of the understanding and approach of what kinds of foods, herbs etc, will best help a person. Some health problems clearly affect some constitutions more than others and, for what it is worth, my personal observation is that the dryer constitutions are more prone to experiencing the disturbance of arrhythmias and palpitations but there will, of course, be plenty of exceptions to this. In any case, if you or someone you care for are having troubles with arrhythmias or palpitations, you may find it helpful to learn more about the general subject of the constitutions starting here, and look into working out which constitution you are by going here
After getting a sense of whether a person is naturally cooler or hotter, dryer or damper, the next level of knowledge to take the kind of personal approach that can be essential to a great result is to look into the healing cycle. There are four stages in the cycle; cleansing, activation, nourishment and rest. This is a fascinating subject in itself and understanding it can give great insight into what needs to be done to treat the cause and help healing happen naturally. Barry needed help with cleansing his body and then activating his metabolism. Liz needed help with relaxing her nervous system and nourishing her hormones. Before I put the link for anyone who wants to learn more, I want to say that I fully recognise that many people are not ready to take the kinds of steps you see being talked about in the case histories above or in the general recommendations below. They would rather use prescription drugs and get on with their lives with as little disturbance to their habits as possible. Yes, probably, if there are underlying issues that aren't being dealt with, there will be further trouble to come, but none of us are getting out of this alive no matter what we do and I deeply believe that people should choose their own paths as much as they possibly can. So, these old ways are not for everyone but, that said, I can also say that, if a person is ready to let Nature in and work on the causes of what's stopping them get well, then it can be seen that they can get better from just about anything. To learn more about the cycle of healing read here
I trust that the above examples have illustrated that the holistic treatment of arrhythmias or palpitations requires an individualised approach that works alongside the person wherever they are at and, as mentioned at the beginning, if your condition is very bad or you know you need some guidance in person, then I hope you will be able to find a good herbalist who will get involved and guide you to getting and doing whatever you need to get well. However, it also may be that the condition is not so severe, or even that it is but you just don't have the option of working with a holistic practitioner. In these instances, I want to share some general suggestions, starting with some special medicines from Nature that are both safe and likely to help anyone that uses them patiently and correctly.
At the top of the list for anyone who is troubled by arrhythmias or palpitations. must be Hawthorn. No matter their condition or age, if I meet a person who has any kind of problem with their heart then I will almost certainly use Hawthorn. Not only is it one of the safest of all herbs, so you can give it to absolutely anyone, but it is also one of the most reliable. It is a proven fact, verified by thousands of years of traditional use along with many modern scientific tests, that Hawthorn does two things; it strengthens the heart muscle and it improves blood flow through the heart. It is important to use Hawthorn in a strong enough dosage to be sure of these effects. You can see the kinds of amounts I use from the two case histories above. These are at the high end of the dose range but they are entirely safe and, as Hawthorn is readily available and economic to use in generous amounts, it is recommended to find a good quality product that conveys high doses of Hawthorn and to use it with confidence. Then, having a good product, you must be prepared to be patient with it. I suggest to take it for at least 3 months before stopping because it will feed and nourish your heart and that is not a job to be rushed! To read more of my thoughts about Hawthorn or to learn more about its history and science etc. read here
The second herb that I can recommend to anyone with arrhythmias or palpitations has the distinctive name of Motherwort. Motherwort's Latin name Leonurus cardiaca (cardiac for heart) shows how it has been used since ancient times for heart troubles and, especially so, for functional heart disturbances, such as occur with arrhythmias or palpitations. Again, dosage is critical. You don't need so much of it as you do with Hawthorn, and its effects are somewhat more fast-acting, but it still needs to be taken at a level that the body, to learn more about it, read here
I am sure that both Hawthorn and Motherwort are appropriate, safe, and worth using for anyone who is being troubled by arrhythmias or palpitations. Cayenne is a third herb that may be generally recommended but may only be of much benefit to someone from one of the cooler constitutions; i.e. a 'Bear' or an 'EB'. That said, it is a powerful herb that has been seen to help some particularly difficult conditions. The only way to know for sure in the case of Cayenne is to take a 'try and see' approach, and it won't take too long to figure out if it is the right herb for you. In the matter of giving it a 'trial', you must be crystal clear that you may need to find an optimal dose to truly benefit from it. I cannot advise you on any product without seeing you in person so, what follows is merely by way of example whereby in our clinic we capsules with nothing in them but pure Cayenne powder and we start people on about 2 or 3 capsules a day and then advise them to see how their body feels with it and to be prepared to add a capsule every couple of days to see if they get an improved effect or whether their body tells them it has had enough. The maximum dose we go to is 4 capsules twice a day. The gradual build-up of the dose is both to check for tolerance and also to see at what level it might be starting to help. If you are taking too much you then you may get some excess feelings of 'heat' in your body. This may be a literal feeling of being too hot or it may feel like a kind of agitation, like you are being too stimulated. If this happens it does not necessarily mean it is the wrong herb for you, just that you are having a little too much of it. Go back to a smaller dose and continue to observe to see if it is actually helping the palpitations or arrhythmias overall, more about this process and about Cayenne in general here
Lastly is the extract from Wild Cherry bark. This can be a tremendous ally for some people who suffer from arrhythmias or palpitations because, whilst it is mostly used these days for severe and unrelenting coughs, it also has a uniquely calming action on the muscle of the heart, something that was once upon a time one of its chief uses. It is vital to obtain Wild Cherry from a reputable source as this is a herb that can easily lose its potency if not prepared from fresh and high-grade material but, assuming it is a good extract, there are some intriguing ingredients within Wild Cherry that relieve spasm and agitation within the chest, especially the lungs and heart. More on this potentially important herb for arrhythmias or palpitations here
I realise that not everyone is well enough to do any kind of exercise, let alone the kind that I am going to generally recommend however, most people can do something and if you understand why it can help you will be much more likely to try. We all know that exercise is good for us, and everyone instinctively understands that their heart-rate is inseparably connected to how much physical effort their work or exercise requires. What is less well known, but can also instinctively be understood, is that the muscle of the heart, at any age, responds very positively to being made to work. In fact, the heart thrives on exercise and needs it in order to remain healthy and strong. On the contrary, when a person stops being physically active, if they become sedentary, the heart loses its 'tone', it moves less blood with each beat and it beats with less strength. We need to keep exercising to keep our hearts healthy, but it can be consistently observed that the majority of people who are experiencing distress from irregular heartbeats, arrhythmias or palpitations, become anxious about stressing their hearts further with vigorous exercise and so reduce their level or intensity of exercise accordingly. It's an understandable reaction. The 'hard-wiring' that we have to worry about any untoward sensation in our hearts makes us to want to do whatever we can to minimise that disturbance. But this is a mistake, reducing activity does not improve the health of the heart, if anything it may make the arrhythmias or palpitations worse, because they are 'functional disturbances' and the function of the heart is very much affected by how fit and active we are. Regularly doing exercise to the point of elevating the heart-rate is not the easiest advice to take at the best of times, and it can be hard to accept that it will truly help, and not do any harm, when a person has arrhythmias or palpitations, but I have only ever see it be of benefit and I believe it can be relied on help, to at least some degree. The question of 'what to do?' is best answered by the person who has to do the work! If it is enough to make you puff, then you are doing enough. You don't have to actually feel your pulse to know if you have elevated your heart-rate. If you need to significantly increase the speed and depth of your breathing, then you have definitely got your heart working a lot harder. Do whatever you like, whatever best suits you. There is no one right form of exercise any more than there is one right form of diet. The main thing is to be quite firm with yourself if becoming more aware of your heart beat whilst you exercise temporarily makes you more uncomfortable and you fall prey to a feeling of anxiety that tells you to stop. This is an unfortunate by-product of both arrhythmias and palpitations, that they make people feel very anxious about their hearts. Becoming less active will make things worse and, just as surely, becoming more active will make things better. But you might have to 'feel worse before you get better, as you rewire your brain to interpret a hard-working heart as a good thing, a sign of life, and nothing whatsoever that is putting you at risk.
My last comments are to briefly reinforce a theme that has been referred to several times throughout this article and it comes from recognising the considerable impact arrhythmias and palpitations have on the mental health of the person who is suffering from them. I have worked with many people with these conditions, so I feel I have some understanding of how severely they can impact on a person but truly, unless a person has experienced arrhythmias or palpitations for themselves, it may be impossible for them to grasp just how great is their ability to disturb a person's peace of mind. The subject of stress and how we can deal such difficult feelings as anxiety is a big one and not one to over-simplify. If you who are reading this know that this is a core issue, and that it will need attention if you are to become well, then at this point I want to make two further referrals. The first is to the article on anxiety that I linked above when I was talking about Liz. Again, this is here. The second is to suggest that you might like to read another chapter called 'emotional healing'. This goes into some depth on the difficult feelings, including anxiety, that many of us have to struggle with and what it is that I have seen to best help. It is not an approach that will suit everyone, especially as, rather counter-intuitively, it shows the way of going into our difficult feelings rather than trying to find a way out of them! The introduction to this chapter starts here
Please understand that I cannot personally advise you without seeing you in my clinic. |
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