Recommendations for Managing Heart Failure and High Blood Pressure - #48819

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Hello Doctors I am a 64-year-old man with heart failure and high blood pressure. I am not taking any medication to lower my blood pressure. My average blood pressure is 138/86, and my pulse is 68 bpm. My current weight is 60 kg, down from 74 kg, and my height is 175 cm. Based on the analyses and tests mentioned below, what are your recommendations I am now on Gokshuradi Guggulu , Punarnavadi Mandur , Ashwagandha Cnurna and Shatavari churna Best Regards ALI Hematocrit % 0.44 Hemoglobin 157.0 g/dL MCH 30.4 pg MCHC 358.0 g/dL MCV 84.7 Fl Erythrocyte distribution width % 13.30 Erythrocytes 5.18 10*6/ Leukocytes 3.80 10*3/ Platelet mean volume 11.1 Platelets in blood by Automated count 122 10*3/ Urine Alb/Creat Ratio 73.02 Creatinine in serum 84.0 Fasting glucose 6.10 nmol/ Urea nitrogen 3.80 mmol/L Basophils %0.0 Basophils/100 leukocytes in blood by Automated count 1.2 Lymphocytes in blood by Automated count 0.9 Lymphocytes/100 leukocytes 47.7 Eosinophils %0.0 Eosinophils/100 leukocytes in blood 0.7 Monocytes 0.2 Monocytes/100 leukocytes in blood 8.7 Neutrophils 0.8 Neutrophils /100 leukocytes in blood by Automated count 41.7 Chloride 101.0 Cholesterol in HDL 2.38 Cholesterol in LDL 2.94 Hemoglobin A1c % 5.00 Alanine aminotransferase 22.0 U/L Alkaline phosphatase 85 U/L Aspartate aminotransferase 27.00U/L Albumin in serum or plasma 45.0 g/L Bilirubin. Direct 6.33 Gamma glutamyl transferase 36 U/L Bilirubin. indirect 13.49 Protein in serum or plasma 73 g/Dl Bilirubin. Total 19.82 Potassium 4.01 Sodium 138 mmol/ Cholesterol 6.24 mg/dL Abdominal Ultrasound Examination Revealed 12- MAR-25 LIVER: Normal size with homogeneous echo pattern and smooth surface. No venous congestion. No focal lesions GALL BLADDER: is contracted over multiple intra-luminal stones largest is measuring about 9mm …. chronic calcular cholecystitis CBD: is dilated measuring about 12 mm with minimal intra hepatic biliary radical dilatation the distal end of CBD is masked by gases SPLEEN: Normal size PANCREAS: is normal showing no gross lesion RIGHT KIDNEY: shows few renal gravels. Otherwise, normal site size and outline. Normal parenchymal tissue thickness and echogenicity. No backpressure. No masses or sizable stones LEFT KIDNEY: shows few renal gravels. Otherwise, normal site size and outline. Normal parenchymal tissue thickness and echogenicity. No backpressure. No masses or sizable stones URINARY BLADDER: Normal urine filling. No detectable wall thickening, masses, stones or diverticula PROSTATE: Normal size parenchymal concretion. No focal lesions Normal appearance of the seminal vesicle

How long have you been experiencing heart failure symptoms?:

- More than 6 months

Have you noticed any specific triggers for your high blood pressure?:

- No specific triggers

How is your overall energy level during the day?:

- Moderate

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Dr. Sara Garg

I am someone who believes Ayurveda isn’t just some old system — it’s alive, and actually still works when you use it the way it's meant to be used. My practice mostly revolves around proper Ayurvedic diagnosis (rogi & roga pariksha types), Panchakarma therapies, and ya also a lot of work with herbal medicine — not just prescribing but sometimes preparing stuff myself when needed. I really like that hands-on part actually, like knowing where the herbs came from and how they're processed... changes everything. One of the things I pay a lot of attention to is how a person's lifestyle is playing into their condition. Food, sleep, bowel habits, even small emotional patterns that people don't even realize are affecting their digestion or immunity — I look at all of it before jumping to treatment. Dietary therapy isn’t just telling people to eat less fried food lol. It’s more about timing, combinations, seasonal influence, and what suits their prakriti. That kind of detail takes time, and sometimes patients don’t get why it matters at first.. but slowly it clicks. Panchakarma — I do it when I feel it's needed. Doesn’t suit everyone all the time, but in the right case, it really clears the stuck layers. But again, it's not magic — people need to prep properly and follow instructions. That's where strong communication matters. I make it a point to explain everything without dumping too much Sanskrit unless they’re curious. I also try to keep things simple, like I don’t want patients feeling intimidated or overwhelmed with 10 things at once. We go step by step — sometimes slow, sometimes quick depending on the case. There’s no “one protocol fits all” in Ayurveda and frankly I get bored doing same thing again and again. Whether it’s a fever that won’t go or long-term fatigue or gut mess — I usually go deep into what's behind it. Surface-level fixes don’t last. I rather take the time than rush into wrong herbs. It’s more work, ya, but makes a diff in long run.

1 hour ago

Thank you, Ali, for sharing your detailed information. I’ve reviewed your labs, imaging, and clinical history carefully
While seeing your parameters-
- Your blood pressure is 138/86 mmHg, which is slightly above normal (prehypertension/mild hypertension).
- You have heart failure (duration >6 months). The fact that your weight has dropped from 74 kg to 60 kg is significant — that’s ~19% weight loss, which may reflect muscle loss, nutritional deficiency, or worsening heart failure.
- Pulse is normal at 68 bpm, which is reassuring.
- Serum creatinine: 84 μmol/L – normal
- Urea nitrogen: 3.8 mmol/L – normal
- Urine albumin/creatinine ratio: 73 mg/g – elevated (microalbuminuria), which indicates kidney stress, possibly due to hypertension or heart failure.
- Leukocytes: 3.8 × 10³/μL – slightly low, may indicate mild immunosuppression or nutritional deficiency
- Platelets: 122 × 10³/μL – mildly low
- Other indices (Hb, Hct, RBCs) are normal.
- Chronic calculous cholecystitis (gallstones) with dilated CBD – this requires specialist evaluation, especially before considering surgery.
- Cholesterol: 6.24 mmol/L – slightly elevated
- HDL: 2.38 mmol/L, LDL: 2.94 mmol/L – reasonable
- HbA1c: 5% – normal
- Electrolytes, liver enzymes, and pancreas are essentially normal.
- Kidney imaging shows minor stones, no obstruction.
You are currently on:
- Gokshuradi Guggulu – supports kidneys, urinary system
- Punarnavadi Mandur – supports heart, anemia, edema
- Ashwagandha Churna – supports strength, immunity, stress, and heart function
- Shatavari Churna – supports general vitality and digestion
✨With low platelets and WBCs, Guggulu and Mandur can sometimes affect liver and hematology, so monitoring is important.
Advice from my side-
Continue with heart medicine as earlier prescribed.
- Gokshuradi Guggulu: 250–500 mg twice daily after meals with warm water or milk
- Punarnavadi Mandur: 1 tablet (250 mg) twice daily after meals with lukewarm water
- Ashwagandha Churna: 3–5 g with warm milk at night
- Shatavari Churna: 3–5 g with warm milk or water, preferably at night
Notes:
Avoid high salt, processed foods, and excess oil/fat — critical for heart failure.
Monitor weight, edema, urine output, and fatigue daily.
If you notice sudden swelling, breathlessness, or rapid weight gain, seek emergency care
Monitoring and Investigations are must -
- Repeat CBC, kidney function, liver enzymes every 3 months
- Blood pressure monitoring daily
- Gallbladder and CBD follow-up with gastroenterologist
- Echocardiogram (if not done recently) to assess heart function
Lifestyle Advice
- Light walking or yoga if tolerated
- Adequate hydration, but avoid excessive fluids if heart failure causes swelling
- Gentle strength training to prevent muscle loss
Tq

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