Hypertrophic cardiomyopathy and sodium bicarbonate

Nathan

Dagobah Resident
FOTCM Member
It took me a year to figure this out, but I've finally been diagnosed with hypertrophic obstructive cardiomyopathy (HOCM).

This is a condition that occurs in 1 in 500 people. In my case specifically, it's where the wall of the heart's left ventricle is thickened, narrowing the passage for blood to be flowing freely from the heart out into the body. It also spits a little blood back into my right ventricle, which is a little inefficient to say the least. This means that when I moderately exert myself (such as walking up a reasonable incline), I get out of breath a lot more quickly than a person without my condition. This symptom first occurred in my mid 30s.

Anyway, I'm posting this because I've recently had sodium bicarbonate on two occasions (just a single dose each time) with the intention of starting a sodium bicarbonate protocol. My pH levels are normally 5 pH, which is very acidic. I never had the chance to continue the protocol (first, I lacked the pH strips, secondly I would have interfered with my cardiologist's tests). But even after those two single doses, which were months apart, I was surprised to discover they improved my condition while walking up inclines by a good 50%. In each instance, this lasted approximately 3 days and then tapered off over a few more days.

So that's interesting.

Testing with bicarbonate soda

I'd like to test this properly, and @nicklebleu suggested I first post here to check with @Gaby, given her background as a heart surgeon, to make sure I'm not doing anything foolish. Because that wouldn't be the first time. :)

Yesterday, I was given a month's prescription of Atenolol (50mg per day), a beta-blocker that will lower my heart rate and allow it to pump blood through more efficiently. (It's worth noting that people with metabolic acidosis are advised not to take Atenolol, which is a little concerning since I never thought to mention my pH levels to my cardiologist.) Nonetheless, I took my first dose of Atenolol this morning and observed no side effects so far.

Next week, for 24 hours, I'll be wired up with a Holter monitor (portable ECG) to keep an eye on my heart while medicated to ensure there are no issues. With that in mind, I think it's best to go ahead and complete the month's supply of Atenolol and observe the results.

But after the month is done, what I'd like to do is take nothing for 1-2 weeks, reach a baseline, and then commence a sodium bicarbonate regimen with daily pH testing--with NO Atenolololol. My aim here would be to get my pH levels from 5.0 into the optimal range (7.0 to 7.5 pH), which I have yet to ever do, and see if there are any improvements with my breathlessness symptom, as there appeared to be the last two times. Maybe there won't be any improvements, but I want to test this properly.

I assume that the appropriate sodium bicarbonate dosage is dictated by testing pH levels, so I suppose I'd be ceasing doses when I hit the desired pH level, and resuming when the pH level slips. As a result, it shouldn't take long to figure out the correct frequency of dosage. Of course, if I'm wrong on anything here, please correct me!

It seems the general medical advice is that continued use of sodium bicarbonate may lead to metabolic alkalosis and heart problems, which I assume would be the case if you went out of the optimal 7-7.5 pH range and into the 8-9 range, where you're too alkaline.

@Gaby, would a sodium bicarbonate protocol be safe for me to test after I've finished my medication? I don't want to test both at once.

And if you have any other suggestions or warnings, I'll gladly take heed.

So far, I've had an ECG (which picked up a heart murmur), a stress ECG on a treadmill, a chest X-ray, and an ultrasound. No irregularities or arrhythmia. But it was the ultrasound that picked up the thickened left ventricle. I also have a cardiac MRI booked, apparently to confirm my condition.

Interestingly, I found one study here:

Sodium bicarbonate supplementation prevents cardiac hypertrophy in male rats exposed to high intensity swim exercise via inhibition of lactate dehydrogenase activity

How I made it to this diagnosis

I've had this "breathlessness during mild exertion" symptom since 2016, with no other symptoms, which I originally put down to being unfit. But when I took a video game writing job in Malta (just before the COVID hysteria hit), I was walking up and down hills to get to work. I noticed even after six months that my cardiovascular fitness was NOT improving. That's when I had to admit something was off.

My first instinct--and I was wrong, so always trust your instincts, guys 😉--was B12 deficiency. My mother was diagnosed with pernicious anemia and received B12 shots every six months. She also tested positive for the intrinsic factor antibody. So I went crazy on the blood work, but they found nothing abnormal. I did the full serum testing, the active B12 test, even the homocysteine and methylmalonic acid tests, which are more reliable indicators of B12 deficiency. Tested negative for the anti-gastric parietal cell antibody and the intrinsic factor antibody (the latter my mother tested positive on, although that test isn't particularly accurate to begin with).

My mother also has breathlessness symptoms when exerting herself, so it's highly likely she also has hypertrophic cardiomyopathy. There's a 50 percent chance that a parent with HCM will pass it down to their children. In fact, prior to her B12 deficiency diagnosis, she was misdiagnosed with asthma. Interestingly, her doctor recently stopped her B12 shots because her levels were extremely high, even six months after her last shot. So I'm starting to think they messed up that diagnosis too, and her real issue is the same as mine.
 
Before giving feedback, I will need to know if there was there a heart rhythm anomaly on the baseline EKG? If unsure, you can send the EKG to me on a PM. Sometimes the EKG is reported as normal when there's an anomaly that is considered benign.
 
A couple of years ago I was diagnosed with ventricular tachycardia. I was put on Cardicor 25mg. The onset that sent me to the ER, was due to dehydration combined with physical exertion and a hiatus hernia. Acidity might have also played a role, however, I have no idea what ph level I had at that time. Weight also plays a big role. I am big time overweight and a small thoracic cavity comparing to my overall built. What puzzles me is that the episodes seem to be random and that luckily for me they seem to stop by themselves or if I make myself sneeze.

Thinking about heredity, my grandmother (father line) had a 'chronic' shortness of breath and she died suddenly at 72 yrs old of myocardial infarction while she was walking on the street on her way to visit a friend. She was never diagnosed with any heart condition.
 
Hehe! Just remembered. Two weeks ago while at the doctor for flu, I tested negative for Covid, the doctor asked me about the vax and I said that I do not want the vax because of my tachycardia. She gave me a referral letter to a specialist cardiologist in order to 'confirm the safety' of taking the vax. Right.
 
Before giving feedback, I will need to know if there was there a heart rhythm anomaly on the baseline EKG? If unsure, you can send the EKG to me on a PM. Sometimes the EKG is reported as normal when there's an anomaly that is considered benign.

The cardiologist was clear to me about there being no irregularities, which he was happy about. But I would very much like to send you the EKG to be sure.

I won't be near a scanner to scan the EKG pages until Monday, but in the meantime, I could take photos with my phone or DSLR. Maybe I'll try that and see if they come up sharp and readable.

Thanks for your time, Gaby! Much appreciated.
 
Hehe! Just remembered. Two weeks ago while at the doctor for flu, I tested negative for Covid, the doctor asked me about the vax and I said that I do not want the vax because of my tachycardia. She gave me a referral letter to a specialist cardiologist in order to 'confirm the safety' of taking the vax. Right.

Speaking of that, @987baz spotted this yesterday:


New guidance for myocarditis and pericarditis after mRNA COVID-19 vaccines On 30 July the Australian Technical Advisory Group on Immunisation (ATAGI) and the Cardiac Society of Australia and New Zealand (CSANZ) released new guidance for myocarditis and pericarditis after mRNA COVID-19 vaccination. Clinicians should be alert to the possibility of adverse events in people including the small risk of myocarditis and pericarditis in people who have received mRNA COVID-19 vaccines. These conditions have been reported more commonly in males under 30 years of age after the second vaccine dose.

I highlighted that part in red because hypertrophic cardiomyopathy appears to be more common in people under 30, particularly men. Untreated HCM is one of the more common causes of death among young male athletes.
 
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