Posted by Sulpicia on June 25, 2001, at 0:25:10
In reply to Omega-3 fish oil in psychiatry., posted by eoflaherty on June 24, 2001, at 17:24:15
> Phew -- sorry but what a mess!
A correct version of the reasoning behind the efficacy of fish oil -- specifically the essential fatty acids DHA [docosapenaetic acid sp?] and EPA [eicosapentaetic acid] in LIMITED psychiatric disorders can be found in Andrew Stoll, The Omega Nutrition Solution -- check Amazon.com for the full ref.
Some corrections: our ancestors didn't come from the sea, they came from semi-tropical rainforests -- and the sea has nothing to do with the argument here at all. In a nutshell, the paleolithic diet, especially the game, allowed our ancestors to have a diet much higher in important essential fatty acids, especially DHA and EPA. The modern diet by contrast is much lower in essential fatty acids and this situation is exacerbated by diets relatively high in saturated fats and trans fatty acids, the latter of which decreases or prevents the absorption of the essential fatty acids that we do eat.
Some research shows that indigenous populations with diets high in DHA and EPA have lower levels of depression, and other studies have correlated depression with low levels of DHA in the blood. there are some problems with these studies, especially the basic caveat about epidemiological studies per se, but there is an emerging body of research that suggests supplementation with EFA and DHA may help in certain psychiatric disorders.The real problem is that essential fatty acid metabolism is extremely complex.
To start with: people with bipolar disorder should consult Stoll's 1999 paper [sorry no citation, wrong computer tonigh] -- research has clearly demonstrated that bipolars must take EPA in dosages AT LEAST TWICE AS HIGH as the dose of DHA. They learned very early in the study that DHA alone or in ratios of less than 2:1 pitches bipolars into severe depression. And nobody stopped or lowered meds -- the study showed that the bipolars on supplements and meds had fewer incidences of destabilization.
The metabolic complexity comes into play very quicky once you start reading about essential fatty acids. For them to be metabolized at all, you have to exclude all trans fatty acids from your diet. Then you have to cope with the form of the supplement: esters are poorly absorbed unless consumed with a high fat meal so probably a de-esterated supplement is a good bet.
To assist the metabolism you also need gamma linolenic acid but only in small quantities --like a serving of steel cut oats once a day. Lots of alt. med enterprise has gotten into this research and since they want to sell things, they sell GLA supplements, usually evening primrose oil. The problem gets nasty right here: the whole point of taking EFA and DHA is to lower the level of arachidonic acid -- high levels of this depress blood levels of EPA and DHA and trigger off several classes of eicosaniods that increase inflammation, increase bad cholesterol, increase thromboxanes [blood clotting more likely] etc.
Lowering arachidonic acid does roughly [very] the opposite and this is why "eating fish" is supposed to be good for decreasing cholesterol, risk of stroke, and now, we think, helpful for depression.
GLA in small doses, along with DHA and EHA in a readily absorbable form lower arachidonic acid. High levels of GLA increase arachidonic acid and creates precisely the wrong result. Nobody knows the right amount either.
Tho many web sites that sell supplements will harp on the fact that they're totally safe and natural, and not drugs but food, but this is misleading and probably wrong. The essentail fatty acids taken as supplements are powerful bioactive substances and more is not better -- people with asthma should avoid them until research has a better understanding, and also people in treatment for cancer since if you get the beneficial effect of increasing EFA and DHA levels in the body, tumor necrosis factor decreases.I'm sorry I wrote a novel here and there is good research that backs up efficacy in some areas -- I guess I'm irritated because I've run across lots of places selling supplements without a clue of what they do. No, I'm not a med professional -- I've just finished looking at the metabolism and diet research for work I'm doing in another field.
I'll post some of the pertinent citations tomorrow so folks can judge for themselves.
and no doubt I misspelled several things...
S.
poster:Sulpicia
thread:67716
URL: http://www.dr-bob.org/babble/20010618/msgs/67760.html