Two herbs used in the traditional medicine of India (Ayurveda) to treat people with cardiomyopathy and congestive heart failure have recently been supported by a small amount of clinical research. Arjun (Terminalia arjuna) has been shown to significantly improve the signs and symptoms of cardiomyopathy, as well as the objective measurements of heart function.⁴ In a clinical trial, people with dilated congestive cardiomyopathy (DCM) and severe heart failure took 500 mg of arjun extract three times daily. After two weeks, significant improvement in heart function was observed, an effect that continued over the course of approximately two years.⁵ The arjun used in this study was concentrated, but not standardized for any particular constituent. Commercial preparations are sometimes standardized to contain 1% arjunolic acid.

People with dilated congestive cardiomyopathy (DCM) have been shown to be deficient in coenzyme Q10.⁶ Most studies using coenzyme Q10 in the treatment of cardiomyopathy have demonstrated positive results, including improved quality of life, heart function tests, and survival rates.^7,8,9 Coenzyme Q10 also has been shown to improve cardiac function in people with hypertrophic cardiomyopathy—a less common form of cardiomyopathy.¹⁰ A few studies, however, have found no benefit from CoQ10 supplementation in treating people with cardiomyopathy.^11,12 Despite a lack of consistency in the outcomes of published research, many doctors recommend that 100 to 150 mg be taken each day, with meals.

Another Ayurvedic herb, coleus, contains forskolin, a substance that may help dilate blood vessels and improve the forcefulness with which the heart pumps blood.¹³ Recent clinical studies indicate that forskolin improves heart function in people with cardiomyopathy and congestive heart failure.^14,15 A preliminary trial found that forskolin reduced blood pressure and improved heart function in people with cardiomyopathy. These trials used intravenous injections of isolated forskolin. It is unknown whether oral coleus extracts would have the same effect. While many doctors and practitioners of herbal medicine would recommend 200 to 600 mg per day of a coleus extract containing 10% forskolin, these amounts are extrapolations and have yet to be confirmed by direct clinical research.

Dan shen (Salvia miltiorrhiza), a Chinese herb, has been traditionally used to treat angina and coronary artery disease. Some studies suggest that dan shen may improve the force of heart contractions and coronary circulation, and may prevent damage to the heart muscle that might lead to cardiomyopathy.^16,17,18 However, no clinical trials of dan shen for DCM have been reported. Doctors expert in Chinese herbal medicine typically recommend 1 to 6 grams per day of dried root.

Deficiency of L-carnitine, an amino acid, is associated with the development of some forms of cardiomyopathy.¹⁹ Inherited forms of cardiomyopathy seen in children may be the most responsive to therapy with L-carnitine.^20,21 Whether carnitine supplementation helps the average person with cardiomyopathy remains unknown. Nonetheless, some doctors recommend 1 to 3 grams of carnitine per day for adults of average weight.

Several veterinary studies have demonstrated benefits from supplementation with taurine, another amino acid, in animals with cardiomyopathy. Most of these studies showed taurine deficiency to be a cause of cardiomyopathy. Taurine supplementation in animals with DCM has resulted in improvement of symptoms and survival rates.^22,23 However, clinical studies in humans are lacking; thus, despite a good safety record, the benefits of taurine supplementation in people with any form of cardiomyopathy remain speculative. When taurine supplements are used by doctors to treat people with other conditions, 2 grams taken three times per day for a total of 6 grams per day is often recommended.