Is Metformin Contraindicated In Congestive Heart Failure?

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Congestive Heart Failure - congestive heart failure - Explained - MADE EASY end of life- end of life Symptoms, Causes, and Treatment Subscribe My Channel to Stay Updated What is congestive heart failure? Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart coronary artery disease or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently. What is left sided Congestive Heart Failure - congestive heart failure - end of life? Left-side heart failure occurs when the left ventricle does not pump efficiently, and your body does not receive enough oxygen-rich blood. The blood instead backs up into your lungs, causing shortness of breath and fluid accumulation. What is a left ventricular failure? Systolic failure: The left ventricle loses its ability to contract normally. The heart can't pump with enough force to push enough blood into circulation. Diastolic failure also called diastolic dysfunction: The left ventricle loses its ability to relax normally because the muscle has become stiff What is left ventricular systolic dysfunction? Systolic and diastolic. Similarly, a distinction is frequently made between systolic and diastolic heart failure. This is somewhat arbitrary and many patients with heart failure have evidence of both. Left ventricular systolic dysfunction is usually defined as an LV ejection fraction (_)40% on echocardiography. Heart failure affects nearly 6 million Americans. Roughly 670,000 people are diagnosed with heart failure each year. It is the leading cause of hospitalization in people older than age 65. What Is Heart Failure? Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition. What Causes Congestive Heart Failure - congestive heart failure - end of life? Heart failure is caused by many conditions that damage the heart muscle, including: Coronary artery disease. Coronary artery disease, a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients. Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly. Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse. Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once. Congestive Heart Failure - congestive h In an effort to prevent further heart damage: Stop smoking or chewing tobacco. Reach and maintain your healthy weight. Control high blood pressure, cholesterol levels, and diabetes. Exercise regularly. Do not drink alcohol. Have surgery or other procedures to treat your heart failure as recommended. What Medications Should I Avoid if I Have Heart Failure? There are several different types of medications that are best avoided in those with heart failure including: Nonsteroidal anti-inflammatory medications such as Motrin or Aleve. For relief of aches, pains, or fever take Tylenol instead. Some antiarrhythmic agents Most calcium channel blockers if you have systolic heart failure If you are taking any of these drugs, discuss them with your doctor. It is important to know the names of your medications, what they are used for, and how often and at what times you take them. Subscribe my Channel Here to get more videos daily https://www.youtube.com/channel/UCf40... Facebook Page https://www.facebook.com/oceanofvideos Website http://www.oceanofentertainment.blogs... Google + https://plus.google.com/u/0/102343539... Twitter @malikakmal70086

Use Of Metformin In Chronic Kidney Disease, Congestive Heart Failure, And Chronic Liver Disease - Curr Med Issues

EVIDENCE-BASED MEDICINE: SUMMARY OF STUDY Year : 2017 | Volume : 15 | Issue : 3 | Page : 240-242 Use of metformin in chronic kidney disease, congestive heart failure, and chronic liver disease Source of Support: None, Conflict of Interest: None . Use of metformin in chronic kidney disease, congestive heart failure, and chronic liver disease. Curr Med Issues 2017;15:240-2 . Use of metformin in chronic kidney disease, congestive heart failure, and chronic liver disease. Curr Med Issues [serial online] 2017 [cited2018 Mar 28];15:240-2. Available from: Source: This is a summary of the study: Clinical Outcomes of Metformin Use in Populations with Chronic Kidney Disease, Congestive Heart Failure, or Chronic Liver Disease: A Systematic Review. Authors: Crowley MJ, Diamantidis CJ, McDuffie JR, Cameron CB, Stanifer JW, Mock CK, et al. Ann Intern Med. 2017 Feb 7;166(3):191-200. doi: 10.7326/M16-1901. Summary prepared by Dr. Ajay Kumar Mishra, Christian Medical College, Vellore, Tamil Nadu, India. Clinical Question: Is metformin safe for use in individuals with chronic kidney disease, congestive heart failure, or chronic liver disease? Authors' conclusion: With appropriate dose optimization, Continue reading >>

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  1. lucullus

    low carb causing my fasting blood sugar to rise?

    A few months ago I had a fasting blood sugar test which showed signs of pre diabetes. I went on a strick diet for 4 weeks and lost 22lbs. I had another checkup and they told me there was no signs of diabetes. HBA1C was 5.4 and fasting blood was 99. I assumed all was well and went back to normal diet. Three weeks later I noticed my fasting level where 110-125 over a few days. I went straight on to a low carb restricted calorie diet, that's about 12 days ago.
    I have been consuming about 1400-1600 calories with around 130g carbs. Nearly All foods being low glycemic index. I thought I would add fasting days to my diet also. So I had one day on 650 calories. I have been doing about 1.5 to 2 hours of walking per day, plus either 1 hr bike or 1 hour gym. Since the fasting day (5 days ago) my fasting blood sugars have risen quite dramatically. My fasting blood sugar is averaging 145 and before bed I have scores as high as 175. I have lost around 12 lbs in the last 12 days. My BMI is currently 26.7 down from 30.2. My waist measurement is less than half my height 191cm versus 94 cm
    It appears that by loosing approx 34 lbs in total. I have managed to go from pre diabetic to full diabetes. I am very concerned can anyone give we a reason why my blood sugars are rising when I am eating such a low calorie low carb diet. It like my pancreas just decided to stop producing insulin. When a few weeks into the start of first part of my diet it was producing normal amounts. 72.3 pmol/l. My wife has said my breath has started to smell a bit worse last few days?

  2. Nan OH

    Hello and welcome
    For many people 130 grams of carbohydrates is not a low carb diet. Your extra fasting may be causing your liver to release stored glucose and that is raising your numbers. For me, if my Blood Glucose Level is 150 or higher I can not do heavy work outs. Well I could not, my health has changed due to other conditions and I can no longer work out at all.
    It is debated whether there is actually a pre-diabetes. When you notice that carbohydrates are giving you problems, they will almost always give you problems. We can control but we can not stop our inability to use our bodies' insulin.
    How often are you testing? I know test strips are expensive but since you are trying to figure this out you may want to test when you get up, one hour and two hours after each meal and then at bed time.
    Has your doctor run any test to rule out the possibility that you could be a Type One diabetic?

  3. AnnC

    You've made a lot of changes to your diet in the past 12 days, without waiting for each change to take effect. If eating the first 'strict diet' brought your HbA1c back into non-diabetic ranges while maintaining normal insulin production, is there any reason why you can't go back to eating that diet?

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What is HEART FAILURE? What does HEART FAILURE mean? HEART FAILURE meaning & explanation. Heart failure (HF), often referred to as congestive heart failure (CHF), occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the body's needs. Signs and symptoms commonly include shortness of breath, excessive tiredness, and leg swelling. The shortness of breath is usually worse with exercise, while lying down, and may wake the person at night. A limited ability to exercise is also a common feature. Chest pain, including angina, does not typically occur due to heart failure. Common causes of heart failure include coronary artery disease including a previous myocardial infarction (heart attack), high blood pressure, atrial fibrillation, valvular heart disease, excess alcohol use, infection, and cardiomyopathy of an unknown cause. These cause heart failure by changing either the structure or the functioning of the heart. There are two main types of heart failure: heart failure due to left ventricular dysfunction and heart failure with normal ejection fraction depending on whether the ability of the left ventricle to contract is affected, or the heart's ability to relax. The severity of disease is usually graded by the degree of problems with exercise. Heart failure is not the same as myocardial infarction (in which part of the heart muscle dies) or cardiac arrest (in which blood flow stops altogether). Other diseases that may have symptoms similar to heart failure include obesity, kidney failure, liver problems, anemia and thyroid disease. The condition is diagnosed based on the history of the symptoms and a physical examination with confirmation by echocardiography. Blood tests, electrocardiography, and chest radiography may be useful to determine the underlying cause. Treatment depends on the severity and cause of the disease. In people with chronic stable mild heart failure, treatment commonly consists of lifestyle modifications such as stopping smoking, physical exercise, and dietary changes, as well as medications. In those with heart failure due to left ventricular dysfunction, angiotensin converting enzyme inhibitors or angiotensin receptor blockers along with beta blockers are recommended. For those with severe disease, aldosterone antagonists, or hydralazine with a nitrate may be used. Diuretics are useful for preventing fluid retention. Sometimes, depending on the cause, an implanted device such as a pacemaker or an implantable cardiac defibrillator may be recommended. In some moderate or severe cases cardiac resynchronization therapy (CRT) may be suggested or cardiac contractility modulation may be of benefit. A ventricular assist device or occasionally a heart transplant may be recommended in those with severe disease despite all other measures. Heart failure is a common, costly, and potentially fatal condition. In developed countries, around 2% of adults have heart failure and in those over the age of 65, this increases to 610%. In the year after diagnosis the risk of death is about 35% after which it decreases to below 10% each year. This is similar to the risks with a number of types of cancer. In the United Kingdom the disease is the reason for 5% of emergency hospital admissions. Heart failure has been known since ancient times with the Ebers papyrus commenting on it around 1550 BCE.

Drugs That Should Be Avoided Or Used With Caution In Patients With Heart Failure

INTRODUCTION A number of medications that are in common clinical use are relatively or absolutely contraindicated in patients with heart failure (HF), either because they can cause exacerbations of HF or because there is a higher risk of adverse reactions in such patients (table 1) [1]. Drug-induced exacerbation or decompensation of established HF is a relatively common occurrence. Its prevention requires frequent reassessment and meticulous management of often complex medication regimens. Utilization of these drugs is common in patients with HF. In a study from Denmark, 34 percent of patients received at least one nonsteroid anti-inflammatory agent or cyclooxygenase-2 inhibitor after discharge for first hospitalization for HF [2]. Use of some of these drugs may be increasing. As an example, a review of Medicare beneficiaries hospitalized with the diagnoses of HF and diabetes mellitus found that the proportion using metformin and/or a thiazolidinedione increased from 13.5 percent in 1998 to 1999 to 24.4 percent in 2000 to 2001 [3]. Management of patients with HF is discussed separately. (See "Overview of the therapy of heart failure with reduced ejection fraction" and "Treatment an Continue reading >>

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  1. RachelZen

    Okay I have water fasted several times before, no worries I simply avoid being "too close" to anyone. In past relationships they know that my breath is pleasant most of the time,except around fasting time.
    This is a first date/meeting with a new guy.We'll probably go for a walk or see a show. I've already postponed before because of work(2 weeks already) and I don't want him to think I'm not interested in getting together. What can I do to NOT turn him completely off with my breath.I'm a kisser, but not sure during fasting.lol. This is day 2 of 10-14 day fast.Any ideas or suggestions?

  2. TheFastDoctor

    TheFastDoctor replied the topic: Re:Fasting Breath (yikes) and first date
    The "Smell" in your breath when you fast is primarily Ketones. When you break down fat, you make glycerol and ketones. The latter has a peculiar smell. It is volatile, so when you breath out, it will be in your breath. You could MASK it with a more potent smell, but you cannot hide it. Your own olfactory nerve accommodates after a while so you are blissfully unaware of the smell yourself.
    I can think of no way to get around this "problem" other than to be honest. Tell the guy you are fasting, and why, and that this causes your fat to be turned into Acetone, HydroxyButyric acid and now I forgot what the third ketone is.. and that you are breathing it out.
    We who know what fasting is all about, love the smell of ketones. But other people often don't, largely due to ignorance.
    Honesty is the best policy.
    All my posts are "generic", based on my opinions and experiences only and are not intended to replace the advice of your own licensed medical practitioner.

  3. RachelZen

    I'm clear on why breath smells.Yes, he already knows I'm fasting That's why we're not going to dinner.With so many life long fasters on the board I thought someone might have a breath masking tip to share. My old standby is constant tongue brushing with baking soda and if I really, really need to - a breath mint. Any other suggestions.

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Risk factors for CKD, Measures to prevent CKD, CKD as a risk factor for Heart Attack.

Metformin Reduces Mortality In Ckd, Chf, And Cld

FDA label update will increase drug use in persons with historical contraindications or precautions. From 1950 to 1995, we only had 1 class of drugs for type 2 diabetes. Then in 1994, metformin was approved. And it has become the cornerstone therapy for patients with type 2 diabetes. There was and still is a warning of possible lactic acidosis. However, because phenformin was withdrawn due to lactic acidosis in 1977, the FDA put a boxed warning on metformin stating that it should not be used in patients with chronic kidney disease (CKD), to avoid accumulation of the drug, which could possibly lead to lactic acidosis. There was also a warning concerning individuals who may accumulate lactate such as patients with congestive heart failure (CHF) and chronic liver disease (CLD). However, over the years, individuals who had CKD, CHF, or CLD were on metformin. This present study looked at these patients to see if metformin conferred any benefit relative to their chronic diseases. The researchers reviewed five observational studies with a total of 33,442 patients with moderate to severe CKD. In the metformin-treated groups, all-cause mortality was reduced by 33% (HR, 0.77). They looked at Continue reading >>

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  1. Bobhes

    What is the best time of the day to check blood ketone levels? I've heard that upon rising is a bad time because the body produces glucose overnight while you sleep. I've heard others say mid afternoon and still others at night at the end of the day.

    Please unconfuse this confused keto novice. Thanks in advance!

  2. Shortstuff

    I've been testing three times a day, just out of curiosity.
    Can't keep doing it as the test strips are so expensive, but interesting to gauge things properly.

  3. MaryAnn


    I've heard that upon rising is a bad time because the body produces glucose overnight while you sleep.
    I've heard this too. But I'm doing an N=1 experiment and my blood ketone readings are higher in the AM (generally).

    Not fasting *approx 5 hrs after eating Ketones: 3.9

    Not fasting (mid afternoon) Ketones: 1.4

    Not Fasting (approx 5 hrs after eating) Ketones 2.0

    Not Fasting (approx 3.5 hrs after eating) Ketones 1.6

    Fasting Ketones 3.3

    Fasting Ketones 2.9

    Fasting but a few hours (3) after ACV Ketones 2.8

    Fasting Ketones 3.6

    Not Fasting 2.2

    Not fasting means in the afternoon and at least after 1 meal. My first reading was the highest and it was in the afternoon. These are all separate day measurements. I haven't done the test in the AM and the PM (only because of cost). Will try that next.

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