The case of the froggy heart

Colin was a trim, middle-aged man who obviously took care of his body. His short-sleeved shirt revealed strongly muscled arms, and the almost inevitable paunchy bulge that even skinny men sport so often was not in evidence. I couldn’t pinpoint any obvious reason for his visit. “My wife insisted I should come to see you,” be began. “I’m sure she’s worrying unduly but I can understand her concern. Just last week a friend of ours in his early 40s fell dead from his bike with a heart attack. He was much fitter than I like to think I am and spent a lot more time working out in a gym and exercising generally.”

“Tell me why your wife is concerned?” I prompted. Colin sprawled back in his chair and began: “For some years I’ve been experiencing a peculiar feeling in my chest. It only happens occasionally and it feels as if I’ve got a frog in my chest.” My eyes must have widened because he quickly added. “It’s hard to describe. But it’s as if my heart had turned into a frog and kicked its hind legs.”

On my advice, Colin immediately made an appointment with his GP to request a referral to a cardiologist. Almost nine weeks later, he returned. “I’ve been diagnosed with premature ventricular contractions (PVC),” he told me.

PVC is also referred to as extra systolic beats and they are surprisingly common. The extra beats disrupt the heart’s normal rhythm and, occasionally, trigger bouts of tachycardia, or very rapid heartbeats. Sometimes the best way to restore equilibrium is simply to lie flat on the nearest comfortable surface and breathe slowly and calmly. The cardiologist had reassured Colin that there was no cause for concern and felt that no treatment was needed at this time. “However,” Colin resumed, “my wife insisted I check with you to see if you had any additional advice.”

PVC has always intrigued me. Many years ago I saw an elderly lady who had recently been hospitalised with a dissecting thoracoabdominal aneurysm. She was not a candidate suitable for surgery and had been discharged with a total of 12 prescriptions to control blood pressure. She told me that a GP had diagnosed her with extra systoles at 35. His comment at the time had been, “We don’t know what causes this problem. We know there’s something wrong somewhere, but the cause is a mystery.” The PVC and bouts of tachycardia had continued until her collapse at 73, when she was diagnosed with one of the largest aneurysms ever seen. Bearing this, and other cases of PVC in mind, I suggested some very specific tests. Colin was only too happy to comply.

The results confirmed my suspicions:

• Colin’s copper levels were disturbingly low
• His zinc reading was on the high side
• He was slightly anaemic
• Copper-superoxide dismutase enzyme activity was decreased
• Liver ATP was raised
• Physical examination revealed a number of well-entrenched fungal infections

When questioned, it quickly became obvious that the major component of Colin’s diet was a variety of fruits: in season, out of season, tropical, exotic and dried. Some years previously, he had read a well-known publication extolling the merits of eating a high-fruit diet but Colin had taken it many steps further.

His father and older brother had both undergone surgery for prostate cancer. Colin had assiduously studied internet information on the topic and decided to dose himself rather heavily with zinc tablets. His aim was to avoid a similar situation. He had been taking a zinc supplement for almost six years. When I explained that too much zinc and not enough copper could be related to his anaemia, he was startled. “Could that explain why I always tire easily?” he asked. “No matter how much I work out, my stamina never improves or matches my expectations. Sometimes I feel like a mouse stuck on a treadmill — the harder I try, the less headway I seem to make. I look fit but I don’t feel fit.”

“I think the main problem is that, although you are trying to achieve a number of good things, you’re not getting the balance right,” I explained.

Fresh fruit is a good food choice but I asked Colin to consider the following facts: Fructose is metabolised differently from other sources of sugar. The metabolism of fructose was discussed in the American Journal of Clinical Nutrition, where it was reported that, compared to glucose, fructose was preferentially metabolised in the liver. Fructose intolerance can vary widely from one person to the next but, commonly, interference with copper metabolism features high on the list of side-effects. Fructose has been implicated in a number of studies as a suspected contributor to nearly all the recognised signs and symptoms of insulin resistance.

Each of us has a unique genetic background. Pale-skinned Caucasians evolved in a cool to temperate climate where tropical and exotic sweet fruits were unknown. My father in the UK grew apples, peaches, plums and many different berries. I had never seen a mango until we came to Australia. In-season fruits produced a quick glut, shared by neighbours, then disappeared for the best part of another year. Our ancestors would rarely have eaten fruits out of season because of storage difficulties, lack of refrigeration and mould attack etc.

Our ancestors would have subsisted largely on what we today refer as the Palaeolithic diet: mainly vegetable matter, nuts and roots, with seasonal fruits and a portion of meat where tribal warriors concluded a successful hunt.

Radical changes were made to Colin’s meal plans and he agreed to switch from supplementary zinc to reliable food sources: black pumpkin seeds, unsweetened ginger, biodynamic eggs and fresh blueberries. Colin’s copper intake was fortified by raw, whole (non-pareil) almonds, avocadoes, broccoli, legumes, mushrooms and buckwheat.

By the end of three months, Colin reported that he had experienced no further PVC issues. Tests showed that his anaemia had reverted to well within normal blood count range. After six more months, it appeared that the PVC had disappeared completely. Interestingly, Colin’s cholesterol, which had always been stuck on the high end of normal for years, fell back to mid-range during this time. A year later, Colin’s copper reading had risen to normal. To date, some six years later, Colin remains well and his exercise tolerance has improved to indefatigable.