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Fish oil: clinical considerations
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Research News:Anti-inflammatory, modulation of gene transcription, and
many other benefits: Fish oil has a wide range of applications, proven
effectiveness, and record of safety that is second to none; no other single
treatment is as effective for such a wide range of conditions. Positive results
have been documented in clinical trials in patients with hypertension,
hypercholesterolemia, various types of joint pain, mental depression, diabetes,
bipolar illness, ulcerative colitis, Crohn’s disease, schizophrenia and various
other conditions, particularly inflammatory and neurologic diseases. Rather than
being specific for any one disease, the provision of EPA and DHA via
supplementation with fish oil quite simply makes the body work better by
supplying the long-chain omega-3 fatty acids that are necessary for proper
physiologic function but which are commonly deficient in our modern diets.
Benefits include reduction in harmful 2-series pro-inflammatory and
pain-enhancing eicosanoids, increased production of 3-series eicosanoids,
modulation of gene transcription, and enhancement of cell membranes with the
general result of increased receptor sensitivity and thus improved intercellular
communication and improved efficiency of cell membrane signal transduction.
§ Clinical benefits: EPA supplementation has proven beneficial for patients with
lupus,[1] cancer[2], borderline personality disorder[3], mental
depression[4],[5],[6], schizophrenia[7], and osteoporosis (when used with GLA).[8]
DHA appears essential for optimal cognitive function in infants and adults, and
DHA in fish oil provides some protection against thrombosis, arrhythmia,
cardiovascular death, Alzheimer’s disease[9], otitis media (when used with
nutritional supplementation[10]), and coronary restenosis following
angioplasty.[11] Supplementation with DHA (often in the form of fish oil, which
includes EPA) has been shown to benefit patients with bipolar disorder[12],
Crohn’s disease[13], rheumatoid arthritis[14],[15],[16], lupus[17],
cardiovascular disease[18], psoriasis[19], and cancer.[20] DHA appears to have
an “anti-stress” benefit manifested by 30% reductions in norepinephrine and
improved resilience to psychoemotional stress.[21],[22] Supplementation with
EPA+DHA in fish oil is extremely safe and reduces all-cause mortality.[23]
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[1] Duffy EM, Meenagh GK, McMillan SA, Strain JJ, Hannigan BM, Bell AL. The
clinical effect of dietary supplementation with omega-3 fish oils and/or copper
in systemic lupus erythematosus. J Rheumatol. 2004 Aug;31(8):1551-6
[2] Wigmore SJ, Barber MD, Ross JA, Tisdale MJ, Fearon KC. Effect of oral
eicosapentaenoic acid on weight loss in patients with pancreatic cancer. Nutr
Cancer. 2000;36(2):177-84
[3] Zanarini MC, Frankenburg FR. omega-3 Fatty acid treatment of women with
borderline personality disorder: a double-blind, placebo-controlled pilot study.
Am J Psychiatry. 2003 Jan;160(1):167-9
[4] Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to
maintenance medication treatment for recurrent unipolar depressive disorder. Am
J Psychiatry. 2002 Mar;159(3):477-9
[5] Puri BK, Counsell SJ, Hamilton G, Richardson AJ, Horrobin
DF.Eicosapentaenoic acid in treatment-resistant depression associated with
symptom remission, structural brain changes and reduced neuronal phospholipid
turnover. Int J Clin Pract. 2001 Oct;55(8):560-3
[6] Peet M, Horrobin DF.A dose-ranging study of the effects of ethyl-eicosapentaenoate
in patients with ongoing depression despite apparently adequate treatment with
standard drugs. Arch Gen Psychiatry. 2002 Oct;59(10):913-9
[7] Emsley R, Myburgh C, Oosthuizen P, van Rensburg SJ. Randomized,
placebo-controlled study of ethyl-eicosapentaenoic acid as supplemental
treatment in schizophrenia. Am J Psychiatry. 2002 Sep;159(9):1596-8
[8] Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Calcium,
gamma-linolenic acid and eicosapentaenoic acid supplementation in senile
osteoporosis. Aging (Milano). 1998 Oct;10(5):385-94
[9] Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid (DHA).
Pharmacol Res. 1999 Sep;40(3):211-25
[10] Linday LA, Dolitsky JN, Shindledecker RD, Pippenger CE. Lemon-flavored cod
liver oil and a multivitamin-mineral supplement for the secondary prevention of
otitis media in young children: pilot research. Ann Otol Rhinol Laryngol. 2002
Jul;111(7 Pt 1):642-52
[11] Bairati I, Roy L, Meyer F. Double-blind, randomized, controlled trial of
fish oil supplements in prevention of recurrence of stenosis after coronary
angioplasty. Circulation. 1992 Mar;85(3):950-6
[12] Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK,
Marangell LB. Omega 3 fatty acids in bipolar disorder: a preliminary
double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1999
May;56(5):407-12
[13] Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of
an enteric-coated fish-oil preparation on relapses in Crohn's disease. N Engl J
Med. 1996 Jun 13;334(24):1557-60
[14] Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek
R, Forth W. Anti-inflammatory effects of a low arachidonic acid diet and fish
oil in patients with rheumatoid arthritis. Rheumatol Int. 2003 Jan;23(1):27-36
[15] Lau CS, Morley KD, Belch JJ. Effects of fish oil supplementation on
non-steroidal anti-inflammatory drug requirement in patients with mild
rheumatoid arthritis--a double-blind placebo controlled study. Br J Rheumatol.
1993 Nov;32(11):982-9
[16] Kremer JM, Jubiz W, Michalek A, Rynes RI, Bartholomew LE, Bigaouette J,
Timchalk M, Beeler D, Lininger L. Fish-oil fatty acid supplementation in active
rheumatoid arthritis. A double-blinded, controlled, crossover study. Ann Intern
Med. 1987 Apr;106(4):497-503
[17] Walton AJ, Snaith ML, Locniskar M, Cumberland AG, Morrow WJ, Isenberg DA.
Dietary fish oil and the severity of symptoms in patients with systemic lupus
erythematosus. Ann Rheum Dis. 1991 Jul;50(7):463-6
[18] “The recent GISSI (Gruppo Italiano per lo Studio della Sopravvivenza
nell'Infarto miocardico)-Prevention study of 11,324 patients showed a 45%
decrease in risk of sudden cardiac death and a 20% reduction in all-cause
mortality in the group taking 850 mg/d of omega-3 fatty acids.” O'Keefe JH Jr,
Harris WS. From Inuit to implementation: omega-3 fatty acids come of age. Mayo
Clin Proc. 2000 Jun;75(6):607-14
[19] Bittiner SB, Tucker WF, Cartwright I, Bleehen SS. A double-blind,
randomised, placebo-controlled trial of fish oil in psoriasis. Lancet.
1988;1(8582):378-80
[20] Gogos CA, Ginopoulos P, Salsa B, Apostolidou E, Zoumbos NC, Kalfarentzos F.
Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore
immunodeficiency and prolong survival for severely ill patients with generalized
malignancy: a randomized control trial. Cancer. 1998 Jan 15;82(2):395-402
[21] Hamazaki T, Itomura M, Sawazaki S, Nagao Y. Anti-stress effects of DHA.
Biofactors. 2000;13(1-4):41-5
[22] Sawazaki S, Hamazaki T, Yazawa K, Kobayashi M. The effect of
docosahexaenoic acid on plasma catecholamine concentrations and glucose
tolerance during long-lasting psychological stress: a double-blind
placebo-controlled study. J Nutr Sci Vitaminol (Tokyo). 1999 Oct;45(5):655-65
[23] O'Keefe JH Jr, Harris WS. From Inuit to implementation: omega-3 fatty acids
come of age. Mayo Clin Proc. 2000 Jun;75(6):607-14
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Dr Vasquez's Comments:
This is an excerpt from my textbook "Chiropractic and Naturopathic
Mastery of Common Clinical Disorders" which is available from
OptimalHealthResearch.com
(website with clinical information designed for doctors) and also from
OptimalHealthNutrition.com
in our selection of books.
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