Book Report

Book Report: The Sinatra Solution

The Sinatra Solution by Stephen T Sinatra

The notes I took from this book have become among my most often used as a starting point for a variety of patients.

With his decades of experience condensed and summarized into this package, it is highly recommended as a read to become familiar with a variety of metabolic process in the body. The heart is among the most sensetive to metabolic efficiency, who while focused on cardiology as his specialty, these concepts apply well to all body systems who rely on efficient energy production (hint: all!)

He begins by taking the reader through some impressive stats about ATP (Cellular energy currency) in the heart. The heart contains 700mg of ATP, but needs a minimum of 6,000 mg per day and continues to replenish 10,000 times. ATP is critical, and when this replenishment cycle breaks down, it is indicative of a malfunction

This is perhaps the quote I share most often:

It’s during this relaxation, or diastolic, phase that the heart refills with blood for the next contraction. The relaxation stage also depends on energy, and on the ability of the heart muscle to stretch without sagging, fill, and accommodate adequate blood volume (about 200–400 milliliters). A great deal more energy is required to relax the heart muscle than to force it to contract for two reasons. First, energy is needed to separate the bonds formed during contraction, which allows the muscle to return to its relaxed state. These bonds, called rigor bonds, will not break without the help of lots of energy. The second use of energy during relaxation is for the removal of calcium ions from the cell following contraction.

This failure to relax shows up as the bottom number of a blood pressure reading, if high it shows an energy shortage.

For actionable supplementation, he focused primarily on 4 different intervention points in particular.


It is involved in two steps of the mitochondrial energy production pathway. CoQ10 helps in ATP recycling and therefore energy production and resultant help with high blood pressure readings. It is an effective antioxidant and works to stabilize the membrane (structure=function, unstable membrane=suboptimal function). This can help reduce the formation of oxidized LDL cholesterol (involved in atherosclerosis) and can have a favorable effect on platelets. CoQ10 production is inhibited by statins, so he advocates for a higher replenishment in these cases. Further, beta blockers which are often given to cardiac patients also causes depletion.


Carnitine is made in the body from two amino acids, which vegetarians will likely be short on by meat avoidance. Its main job is to get fatty acids into the mitochondrial site of action needed to make energy. Fat produces a much higher yield of energy production, but if we are short on carnitine it isn’t getting into the cells causing a failover to glucose burn. It can also help remove lactic acid from the blood) excellent after strenuous exercise. Carnitine can also help scavenge iron, which we learned about previously how important that is.


Ribose is a sugar, but a very specialized one that is critical in energy recycling, and is found in every cell in the human body. It is produced on a glucose breakdown pathway that may not function ideally under metabolic stress. Ribose helps recycle used ATP and keep the pool up. Ribose production is not very fast so supplementing can help, as Dr. Sinatra describes.


Magnesium is involved in hundreds of biochemical processes, making it kind of important, to say the least. One unique one brought up here is in the ability fo Magnesium to help decrease triglycerides via an enzyme called lipoprotein lipase. It is also involved in ATP synthesis and recycling.

This short article doesn’t do the book justice. There are many protocols for aging, exercise, and cardiac diagnosis (again I have used these specifically in patients and myself on the exercise front). Please reach out if you are interested in following this approach or learning more!

This Book Report collection is meant to provide some of the best take-home points from the health and science genre I read. I will continue to go thru my notes of the 160+ and counting (as of January 2019) Kindle books I have on file. To view ALL the notes I saved on this one AND many others without a Book Report post yet, THAT IS ALSO SEARCHABLE, please click here.


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