A friend of mine, Avery, who is in his late 60 sixties, had a heart attack just over 4 months ago in late April 2024 and had a single stent placed (percutaneous transluminal coronary angioplasty (PTCA) ) to alleviate the blockage and return normal blood flow to the heart and was simultaneously diagnosed with having a medical condition called an "enlarged aorta" or " aortic aneurysm" (AA) that measured 4.5 cm in diameter. For context, an average AA in a 75-year-old man is said to be 4.1 to 4.2 cm, and for women it is 3.6 to 3.7 cm, as discussed here:
Here is a relevant quote from the link:
Normal aorta grows slowly with age. From the Framingham Heart Study (echo sub-study), aorta diameter increases 0.1 cm per 10 years at the aortic root after the age of 25 [22]. Similar rate of growth is also observed for the tubular portion of the ascending aorta [23]. By the age of 75, normal ascending aorta diameter is approximately 3.6–3.7 cm for women (BSA: 1.95 m2) and 4.1–4.2 cm for men (BSA: 2.35 m2).
Given the above quote, it is clear that Avery's AA was quite enlarged beyond that seen in men older than himself. He told me that the men in his family had a history of various forms of heart disease and related complications.
The cardiologist told him about the AA for the first time at the first office visit after the stent was placed. His doctor told him that they spotted the AA because the top of the aorta was visible when they ran the CT scan in the hospital to try and locate the heart blockage. His cardiologist must have thought it might be better not to mention the AA while he was still in the hospital and waited for the first follow up visit instead to let Avery know about it.
His cardiologist said that although the stent had restored blood flow to the heart, the 4.5 cm AA was worrisome for a person of his age of late sixties. His cardiologist also told Avery that they currently have no treatment to shrink an AA, but could do surgery if the AA continued to enlarge and that if the AA got to 5.5 cm, they would have to do the surgery without delay because the potential for rupture would be significantly greater. Rupture of the aorta can result in fairly quick death because the aorta is relatively large and the bleed out would be fairly quick. He told me that his cardiologist had him schedule another CT scan to see if the whole aorta was enlarged similarly to the upper section of the aorta in order to see if he might need that surgery soon.
Needless to say, my friend was worried. He contacted me once his cardiologist mentioned the AA and asked if I could suggest any supplements that might be beneficial for his aorta. I told him that I could suggest 6 or 7 supplements that might help improve the status of his aorta based on animal studies. These are what I suggested for him, with his cardiologist's approval being required before he could start taking them:
Supplements for an Enlarged Aorta
1. Melatonin Lotion (ML) as discussed here: https://www.earthclinic.com/supplements/topical-melatonin-pain-relief-success-stories.html
Application to abdominal area front and back applied sparingly up to twice a day.
2. Quercetin - 1000 mg/day
3. Berberine - 1500 mg/day in three divided doses of 500 mg each
4. Zinc Sulfate - 50 mg
5. Fish Oil - 3 grams / day - Do not use with blood thinners.
6. Selenium - As L- Selenomethionine at 200 mcg/day
7. Ubiquinol - 800 mg/day
I suggested that he use at least three of the seven supplements and told him that at a minimum they should significantly slow or stop the enlargement of the aorta, but that doctors maintain that shrinkage of an AA is not possible using supplements. I went over each supplement with him and explained how each may be able to help based on study literature and also explained about potential side effects.
Avery chose to use 4 of the 7 supplements: melatonin lotion applied sparingly at least once up to two times a day to the abdomen, quercetin at 1000 mg/day, zinc sulfate at 50 mg/day, and selenium (L-Selenomethionine) at 200 mcg/day.
He chose not to use fish oil because his cardiologist put him on a couple of blood thinners and fish oil also has blood thinning effects. He chose not to use berberine because it requires 3 times per day dosing and he wasn't sure if he would be able to take it on time everyday. He chose not to use Ubiquinol because he decided he just wanted to use four supplements. I told him that if any of the four supplements were problematic for him, he could select a replacement from the remaining 3 supplements.
I told him he would have to get his cardiologist's approval in order to make sure the four supplements would be safe for him and also be compatible with all of his medications. He said he would talk to his cardiologist about whether he could take them or not. He told me later that his cardiologist was very reluctant, but told him he could, but not to exceed the label recommended dosing levels.
He made the melatonin lotion himself as described in the melatonin link above and started on the four supplements as soon as he got them and that was around June 2, 2024. He tolerated the supplements very well with no apparent problems. He had the second CT scan done on August 5th so he was taking his supplement regimen for just over 2 months when he had the second CT scan done. He went to his cardiologist to get his CT scan results on August 29, 2024. At this visit his cardiologist said all of his current tests looked good including the second CT scan. He said the results from the scan of the whole aorta showed that the aorta had reduced in size from the original 4.5 centimeters to 3.8 centimeters! The cardiologist acted as though this was normal and then he told Avery that the reason for the size difference was because the first test was done with an ultrasound/echocardiogram and he said they are not as accurate as a CT scan. Avery reminded the doctor that the first test was done with a CT scan in the hospital and further reminded the doctor that he had said that the CT scan was how they found the AA in the first place. He said the doctor looked perplexed at first then said that he was going to look up the record right then and he confirmed that yes, the first CT scan was how they first found and measured the AA. He said, well this is good! Avery then reminded the cardiologist that he had told him that AA's don't shrink and the doctor had no answer, but said this is very good! Avery mentioned that he had been taking supplements for the aorta and the doctor looked at him like he was crazy and basically concluded the visit then and said he would schedule another appointment and CT scan to see Avery again in 6 months.
Avery was really happy with these results! Although the reduction in size of the AA from 4.5 cm to 3.8 cm may not seem like much at just a 0.7 cm reduction in aortic diameter, it is very significant for two reasons. One, AAs do not shrink in size on their own and doctors have no medications that can shrink an AA. Two, the following quote from the first study link above said this :
Normal aorta grows slowly with age. From the Framingham Heart Study (echo sub-study), aorta diameter increases 0.1 cm per 10 years at the aortic root after the age of 25.
So the aorta only increases in diameter at the rate of 0.1 cm per 10 years once you reach the age of 25, so this shows exactly how significant a 0.7 cm reduction really is! The fact that Avery was able to significantly reverse the AA direction in just two months is also notable.
The following are links to animal studies that tend to support the use of the supplements that Avery used to try and improve the condition of his aorta:
MELATONIN
https://pubmed.ncbi.nlm.nih.gov/32329099/
Here is a relevant quote from the study :
Melatonin functions as an endogenous protective molecule in multiple vascular diseases, whereas its effects on thoracic aortic aneurysm and dissection (TAAD) and underlying mechanisms have not been reported. In this study, TAAD mouse model was successfully induced by β-aminopropionitrile fumarate (BAPN). We found that melatonin treatment remarkably prevented the deterioration of TAAD, evidenced by decreased incidence, ameliorated aneurysmal dilation and vascular stiffness, improved aortic morphology, and inhibited elastin degradation, macrophage infiltration, and matrix metalloproteinase expression. Moreover, melatonin blunted oxidative stress damage and vascular smooth muscle cell (VSMC) loss. Notably, BAPN induced a decrease in SIRT1 expression and activity of mouse aorta, whereas melatonin treatment reversed it. Further mechanistic study demonstrated that blocking SIRT1 signaling partially inhibited these beneficial effects of melatonin on TAAD. Additionally, the melatonin receptor was involved in this phenomenon. Our study is the first to report that melatonin exerts therapeutic effects against TAAD by reducing oxidative stress and VSMC loss via activation of SIRT1 signaling in a receptor-dependent manner, thus suggesting a novel therapeutic strategy for TAAD.
It is worth noting that melatonin lotion can remain active in our systems for 24 hours whereas oral melatonin is only active for about 5 hours. This makes melatonin lotion a better choice than oral melatonin, in my opinion.
QUERCETIN
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7582618/
Here is a relevant quote from the animal study :
In the present study, we suggested that quercetin administration might prevent atherosclerosis-related acute aortic syndromes, such as aortic aneurysm, dissection, and death from rupture, in mice. The preventive effect of quercetin against these conditions was attributable to its anti-inflammatory and endothelial cell-protective effects, which were independent of its blood pressure-lowering effect.
It is worth noting that, like melatonin, quercetin has a multitude of potential positive health effects beyond vascular benefits.
ZINC
Here is a relevant quote from the animal study :
The results showed that zinc supplementation significantly suppressed the CaCl2-induced expansion of the abdominal aortic diameter, as well as a preservation of medial elastin fibers in the aortas. Zinc supplementation also obviously attenuated infiltration of the macrophages and lymphocytes in the aortas. In addition, zinc reduced MMP-2 and MMP-9 production in the aortas. Most importantly, zinc treatment significantly induced A20 expression, along with inhibition of the NF-κB canonical signaling pathway in vitro in VSMCs and in vivo in rat AAA. This study demonstrated, for the first time, that zinc supplementation could prevent the development of rat experimental AAA by induction of A20-mediated inhibition of the NF-κB canonical signaling pathway.
Zinc has shown other heart health protective effects in multiple studies.
SELENIUM
https://www.sciencedirect.com/science/article/abs/pii/S1078588423008304
This animal study is a little different than the other studies because it shows that selenium deficiency promotes aortic enlargement or dilation. Here is a relevant study quote :
Se deficiency promoted dilatation of the aorta in AA model mice by increasing expression and activity of VSMC derived MMP-2, causing abnormal aggregation and proliferation of VSMCs in aortic media.
This suggests that keeping the selenium level a bit higher may be beneficial for AA preventive effects.
As you can see from the above studies, these four supplements had different methods of action and that often leads to synergy from the combination of supplements. Judging by the relatively quick and significant results that Avery had, it seems as though there may have been synergy involved.
So this is the regimen that Avery used to very significantly shrink his aortic aneurysm /enlarged aorta down to a more normal size in just two months. It is worth mentioning that these 4 supplements not only shrunk Avery's aorta, but they also are purported to help contribute to improving the integrity of the aorta itself, based on information within the studies linked to above. Both points are important in trying to deal with an AA. All seven supplements have very good safety profiles.
Avery said he plans to continue taking the four supplements because his cardiologist suggested that 3.5 cm would be a very good number to have. He said he will update me as he knows more, but his next appointment is 6 months away and he likely won't have any new information until then.
Art
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