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- Hello Everyone: Here is the promised newsletter on dosages of essential omega 3 fatty acids. Actually there is another set of essential fatty acids called omega 6 fatty acids, but I won’t have room to discuss them in this newsletter. Most of the vegetable oils are omega 6 fatty acids, and we usually get enough of them, though often now in the wrong form (hydrogenated, or otherwise tortured into unnatural forms by the food industry). So for now – back to the omega 3 fatty acids. These are the fish oils, and seeds and nuts, such as flax seeds and walnuts which contain the omega 3’s. One must eat quite a lot of cold water ocean fish, seeds and nuts to get enough. Speculation on the diets of healthy populations living near the ocean in the past proposes that those folks probably had about 5 times the omega 6’s as omega 3’s. Now in the US with solid fats like shortening and margarine in heavy use, and questionably informed consumers pushing for a move to vegetable oils instead of lard and animal fats for restaurant frying, the estimate is the average US citizen eats about 30 times the omega 6 fatty acid as omega 3. That’s way too much omega 6. The need for more omega 3 FA’s is known to the health-conscious public, so most people I see as patients are taking an omega 3 supplement. The largest mistake by far that I see is – these people are not taking enough to do any good. Omega 3 FA’s are not a micro- nutrient, where all a person needs is a few milligrams, or even just a few micrograms. The minimum requirement for just mere prevention of heart and vascular problems, cell membrane health, and anti-inflammatory balancing is 1000 mg. a day. Since most capsules of fish oil contain 1000 mg. of fish oil, most people believe they are getting 1000 mg. of omega 3’s from one capsule. I invite you to look at the detailed back label of your fish oil. You will probably see that of that 1000 mg. of fish oil 180 mg. of it is EPA and 120 mg of it is DHA. Those are the only part that is omega 3 oils – the rest is just, well, oil. So each capsule you are taking has only 300 mg of actual omega 3 in it. If you are taking Carlsen’s, or Nordic Naturals, or ProOmega ( or others) these are high potency fish oils, often molecularly distilled to remove some of the fishy taste, often batch tested for mercury (which is somewhat of a danger), and each one of these capsules will contain 400mg. or more of omega 3’s, and be labeled as such. In other words, if you are taking a standard fish oil capsule, your minimum dosage to get any effective amount is 4 capsules daily. If you are using one of the high potency, high quality ones (which I strongly recommend) then you can get by with 3 a day. As to the danger of mercury in the fish oil supplements, a study was done 7-8 years ago in which a large number of brands of fish oil were gleaned off health food store and supermarket shelves, and tested for mercury. The content was quite low in all but the very cheapest of the fish oils. I do still suggest the higher potency, distilled ones because some people find the appropriate dose of fish oil absolutely intolerable because of the after taste that it can have. It does help to take the fish oil, and then eat quite a bit of food afterwards – it seems to help somewhat with the repeating and repeating of the fishy taste., but taking a molecularly distilled brand solves the problem for almost everyone. So far we’ve talked only about preventive dosages, though I think pre-existing arthritis responds quite well to this dose range. (Or at least, mine did.) If someone has glaucoma, and wants a lowering of the pressure from omega 3’s, then it takes 2000 mg., or some articles say up to 6,000 mg. of omega 3 a day. There are articles recommending up to 8,000 mg. a day for heart disease. At these doses, one of fish oils benefits can become a hazard. Fish oil prevents platelets from clumping together, so it prevents abnormal clotting from closing off arteries accidentally. A degree of this is helpful in people with narrowed arteries from advanced cardiovascular disease. However, it is possible to bleed excessively from failure of the platelets to clump when they should. I personally never recommend doses that high in the 6,000 and above range, and even at the 4000 mg. per day range, I warn people about potential bleeding, and sometimes perform a simple test called a “bleeding time” in the office to see how easily the blood clots. The truly effective omega 3 fatty acids in the human system are the EPA and DHA that are in fish oil. However, some people are allergic to fish, or are dedicated vegans and do not want to take an animal by-product of any type. For those folks, there are algae sources of EPA and DHA which work great. There are other sources, but the web site I have memorized is www.vegan-essentials.com. The more I have studied the effects of omega 3’s (EPA and DHA) specifically, the more it appears that the human body was designed to eat either fish or algae, and we don’t fare well without it. The other obvious option to fish would seem to be flax, chia, hemp seed, or walnut oils. These products all contain high amounts of an omega 3 FA called alpha linolenic acid (ALA). Twenty years ago, the nutritional industry was across the board (me included) suggesting that people take flax oil. Chia was not even on the radar screen yet, and hemp is still not suitable for public conversations. A lot of this flax seed excitement came about from animal (mostly rat) experiments showing that (ALA) could be easily converted to EPA and DHA by means of two different enzymes. Well once again rats proved not to be people – the delta 5 and delta 6 desaturase enzymes with which rats come fully equipped to make this essential conversion to EPA and DHA turn out to be scarce and fairly ineffective in humans. We can do some conversion of ALA to EPA, but there is a huge risk of becoming DHA deficient by relying on flax seed alone for omega 3’s. . And it is DHA which makes up a brain. DHA is truly important in children. Concern about DHA needs in babies years ago led most manufacturers of soy based baby formulas to add DHA to their product. Since soy contains no DHA, there was actually a lowering of IQ shown in babies who were being fed DHA deficient soy formula. Though I am not a fan of flax seed as a sole source of omega 3 FA’s, it does have lignans and products that are useful for a healthy gut, and it is not a “bad” food – it is just an inadequate source of usable omega 3 FA’s for humans. This ALA part is the topic that I wanted to research that delayed the production of this newsletter. I know 10 years ago the best understanding out there was that the human body had no known use for ALA as such, but only for the EPA into which we can convert it. That still is the case. The information I found that was new to me was the potential for DHA deficiency. There is still a sad lack of research in this area. I personally have a sense that walnuts may have some intrinsic quality that aids in the conversion process, or another component that is also anti-inflammatory. My own experience with flax seed was that while I was on it, an old broken knee was getting more and more arthritis, and beginning to somewhat cripple my movements. When I switched to an appropriate dose of fish oil, within two weeks, I had almost no pain in the knee, though it does still pop a lot. In the last few years I have experimented a bit with making walnuts a substantial part of my diet, and actually noticed some improvement in my arthritis in one of my fingers, that the fish oil is not helping. So – there are so many questions research has yet to answer. One question I would like to answer is whether fish oil can solve the problem of the “aspirin resistant” people, who can take aspirin or even Plavix in largish doses and not get any reduction in their platelet clumping. There is a new blood test out that may just allow me to do a little research of my own, depending on the cost of the blood test. I lost a friend about 1 ½ years ago to blood clots that were unstoppable by his excellent cardiologist because of aspirin resistance. I didn’t get a chance to try to help him out with fish oil (or other supplements), and at that time there was no blood test available to me to test the effects of the fish oil. Now let me add two more things. Rather than saying “we are what we eat” we should say “we are what we absorb.” For us to absorb any fat, we must have bile, and adequate amounts of it. Some people have poorly functioning gall bladders, or have had their gall bladder removed. Now, if your gall bladder has been removed, you still have a trickle of bile going into the small intestine all the time, straight from the liver. But the way the gall bladder is meant to work is that it stores quantities of bile. Then when we eat a normal diet, containing some protein, and some carbs, and some fats, a hormone trigger in the upper duodenum tells the gall bladder to squeeze all that bile out onto the food. The bile salts turn the fat into tiny particles (micels) that can be absorbed and used. Without adequate bile, we simply do not absorb fatty acids well. So there are some people who take large amounts of good fatty acid supplements, and it does nothing but make their stool float (oil floats on top of water, remember). Their skin will remain dry, their joints tender, and their inflammatory balance off kilter. We have ways of testing this in the office, some by just asking the right questions, some by testing levels of fat soluble vitamins in the blood stream, or the amount of fat in the stool. These people will need to take bile salts with their fatty acid supplement, or fatty meals, or make sure they are properly absorbed. The other additional piece of advice – if you still notice dry skin, and other evidence of fatty acid deficiency despite doing everything else right, you might try taking biotin. It is one of the B vitamins, and one of its jobs is to help the cells themselves absorb the fatty acids. Ordinarily adequate amounts of biotin are made by the healthy bacteria in the gut, but there are some people who need to take an additional 5000-10,000 mcg of it to fully utilize their fatty acids. People who have had gut problems, a colostomy, lots of antibiotic use, or other reason to have inadequate beneficial gut flora probably need to take biotin. It helps the hair and nails too. Well that’s it for May (Yeh,…. I know.) But this fatty acid topic gets so very complicated! And for all of you who’ve checked on me or asked, yes, I am doing much better, getting past that recurrence of chronic fatigue syndrome. Still not 100% but getting close. Thanks for caring! Until next time, Alice
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