CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 4, July/August 2010
244
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The Sinatra Solution. Metabolic Cardiology
Stephen T Sinatra, MD, FACC
Basic Health Publications Inc, 2005
ISBN 1-59120-158-6
With less self-aggrandisement, this book might have carried an alterna-
tive title
You and your Mitochondria
, with a subtitle such as
Take Care of
your Mitochondria, and your Body Will Take Care of the Rest!
The term ‘mitochondrion’ comes from the Greek [mitos
=
thread,
and chondrion
=
granule]. Every nucleated cell in our bodies contains
mitochondria, sometimes – as in cardiomyocytes – thousands per cell,
and these organelles produce the energy in the form of ATP for all our
vital functions.
The author nicely expresses his gratitude to all of his patients who
allowed him the freedom to treat them by means that were, and prob-
ably still are in the eyes of many clinicians, somewhat experimental,
unconventional and unorthodox. His reported success in terms of much
improved health in many of those of his patients who were crippled by
their poor cardiovascular status and who were not responding to conven-
tional pharmacotherapy, provides much of the raison d’être for the text.
Persons who have had recent senior-school biology will readily
understand most of the chapters. However the more technical ones such
as Chapter 3, which carries the caption ‘ATP: The Miracle of Life’, and
some sections of the subsequent chapters which deal in detail with what
he has enticingly called the ‘awesome foursome’ i.e. d-ribose, l-carni-
tine, coenzyme-Q10 and magnesium, may not be too digestible for those
whose human biochemistry is somewhat rusty! For such persons the
book is a good tutorial.
Nevertheless, the gist of the author’s message will emerge very
clearly – and I would compress it along these lines:
•
•
Without mitochondria we would not be who we are.
•
•
Without healthy mitochondria we are not what we should be.
•
•
Mitochondria need d-ribose, l-carnitine, co-enzyme Q10, along with
adequate magnesium, as very fundamental essentials for their proper
function/survival.
•
•
Many seriously dysfunctional cardiovascular conditions, along with
a host of other metabolic and ‘low-energy’ syndromes, as well as
statin-induced myalgias, are improved and corrected by ensuring a
good intake of these fundamental mitochondrial nutrients.
•
•
Recommendations for appropriate supplementation with these
biochemicals are provided, and case histories of seriously ill
patients illuminate the benefits of careful use of these supplemental
biochemicals.
•
•
Conventional cardiovascular medications are by no means eschewed,
but while they address the signs/symptoms of the disorders, the basic
energy defect must be corrected. The reminder that cardiac diastole
is far more energy demanding than systole, helps explain ‘diastolic
failure’.
There is no doubt that the current medical literature supports amply
all the major contentions of the author. Big-Pharma doesn’t ‘sell’ these
concepts to practitioners, and it is a sad reflection on our profession that
it takes popularisation-type efforts and publications such as this one to
spread such vital messages.
Unfortunately, there is no mention of the vast population of persons
with mitochondrial cytopathy, particularly those who are HIV positive,
including those receiving ARVs. Indeed it must be realised that much of
the ‘íllness’, morbidity and mortality of HIV-positive persons is related
to the loss and severely sub-optimal function of their mitochondria.
In closing, I would without temerity, propose that in 2010 there is
overwhelming justification to expand the ‘awesome foursome’ to found
the ‘livesome fivesome’, by adding the essentiality of adequate vitamin
D to his regimen, and I doubt that the well-informed Dr Sinatra would
gainsay this. This remains a readable book for stimulating interest in, and
for providing the rationale for, looking after our vital mitochondria, so
that they may look after us.
John Straughan
Book Review
