Q: Is it true that hawthorn can cure congestive heart failure?

Dan Lukaczer: No, but hawthorn (Crataegus oxyacantha) has been shown to increase survival time and improve quality of life for those with congestive heart failure (CHF). A patient with CHF is unable to efficiently pump blood out of his heart, often because of weak and dilated heart chambers. As a result, congestion may occur in the lungs or the circulatory system, giving rise to a variety of symptoms such as shortness of breath and edema (swelling caused by fluid buildup). CHF is a difficult condition to treat and one whose five-year survival rate is less than 50 percent. Hawthorn is thought to better these odds by actually improving circulation in the heart itself.

One of the most impressive studies of hawthorn involved 3,600 patients. The subjects were treated three times a day with 300 mg of hawthorn standardized to 2.2 percent flavonoids (Phytotherapie, 1998, vol. 19). Although it was an observational study and not a placebo-controlled trial—researchers gave all patients the same treatment—the eight-week results were impressive: Heart palpitations dropped from an average of 40 percent to 18 percent, edema was reduced from 50 percent to 13 percent and the overall symptom score was lowered from nine to three. The authors note that hawthorn provided a significant overall benefit for patients with CHF symptoms.

Q: I try to use only natural sweeteners. I like honey but find it inconvenient. Any suggestions?

Lukaczer: My best suggestion for an easy-to-carry sweetener is stevia, generally available at natural products stores in powder form or in small squeeze bottles. This extract, sold as a dietary supplement, comes from the leaves of a South American shrub, Stevia rebaudiana. The leaves contain a small amount of stevioside, a carbohydrate reported to be approximately 300 times sweeter than sucrose (table sugar). It is widely used in Brazil and Japan as a noncaloric sweetening agent. Other components of the leaf may actually help the body maintain blood-sugar levels. The data on this health benefit are not all in, but it does appear to be an excellent, easy-to-use sweetener.

Q: Can L-carnitine help reverse Alzheimer's disease?

Lukaczer: There's a possibility it may slow Alzheimer's, but reversing the neurodegenerative condition is less likely. Many nutrients have been examined for their potential to promote brain health in older adults (see "Sustain Your Brain"). One of the most extensively researched nutrients is the amino acid acetyl-L-carnitine. Although the research is far from conclusive, acetyl-L-carnitine's effect on individuals with Alzheimer's does suggest that this form of L-carnitine may slow the disease's progression. For example, in 1998, a double-blind, placebo-controlled trial at 24 outpatient sites across the United States examined 334 subjects diagnosed with probable Alzheimer's disease (International Psychogeriatrics, 1998, vol. 10, no. 2). The results showed that a 1-g dose of acetyl-L-carnitine three times a day provided statistically significant benefit in slowing the cognitive decline in those patients with early disease onset—age 61 or younger. Although more research is needed, preliminary work clearly suggests that acetyl-L-carnitine may slow the progression of Alzheimer's disease, specifically in younger patients.

Dan Lukaczer, ND is director of clinical services at the Functional Medicine Research Center, a division of HealthComm International Inc., in Gig Harbor, Wash.