Hello mrsd,

Thank you for starting this thread.

I decided to respond here to your comment about EFA in the other thread, Errors in Pathology..., to keep it all together.

As I mentioned on the other thread, in May this year I finally found a doctor who has an interest in nutritional medicine; he takes a holistic approach. He was the first to accept that my vitamin B12 deficiency was not "all in the mind". The first test that my new doctor ordered for me was Essential Fatty Acids.

The results, from ARL Pathology in Melbourne, are presented as % of total and ratios, rather than absolute quantities. Here is a link for an example of their reports: http://www.arlaus.com.au/Sample/EFA%20Plasma.pdf

Unfortunately, ARL has the usual policy of refusing to communicate with patients, so I have not been able to discuss my report with them; they ignored my Email request for some technical information. They do have useful general information on their web site. This is a link to their article on EFA: http://www.arlaus.com.au/clinical_gu...FA%20Guide.pdf

Some of my EFA levels were so abnormal that we repeated the test on new samples a few weeks later. The results were almost identical, giving me more confidence that ARL could at least repeat their tests.

The Summary showed that:

• Total Saturated % was high
• Total Monounsaturated was normal
• Total n3 was very low
• Total n6 was low
• Ratio n3/n6 was low

This does not necessarily mean that I have too much saturated fat; these are ratios. For me it far more likely to mean that the "good" n6 and n3 fats are too low. I am unlikely to eat too much saturated fat, because I am a vegetarian, with a revulsion for animal fat; even the milk for my breakfast cereal is low fat. I am very slim, weighing 64 kg, with a BMI of 22. I have no evidence of CAD (angiogram), have low cholesterol and triglycerides and low BP for a 54 year old male (120/70).

Perhaps this might explain my revulsion for fatty food:

I will only include actual % here where it is significant.

The detailed section of the report for the n6 acids shows:

• LA, the shortest n6 acid, borderline low
• The four longer n6 acids normal or borderline low

This is unusual because most people, especially vegetarians, are reported to consume too much n6 fats. I am apparently not eating quite enough LA, although what I do consume is being converted to the longer chain n6 acids. I just need to eat more LA; simple.

The detailed section of the report for the n3 acids shows:

• ALA, the shortest n3 acid, at 0.6% was borderline high (Reference Range 0.3 - 0.6%)
• EPA at 0.3% was borderline low (Reference Range 0.3 - 0.9%)
• DPA at 0.3% was borderline low (Reference Range 0.4 - 0.7%)
• DHA at 0.3% was very significantly low (Reference Range 1.5 to 3.2%)

Now, this is a really interesting, and worrying, result. I am apparently consuming enough ALA but it is not being converted to the longer chain n3 acids. The worst case is DHA, where I am way below the reference range. Assuming a normal frequency distribution for DHA, I fit in the bottom one in 100,000 of the population.

As you said, males only covert a few % of ALA to DHA. The most likely explanation for my DHA deficiency is conversion fault, rather than inadequate ALA intake.

Rather than immediately commence EPA and DHA supplements, I have decided to see if it really is a conversion problem. Here is my three-step plan:

1. Walnut Therapy

For the past four weeks I have been adding six walnuts (12 halves) per day to my food intake. This is the amount recommended by experts to increase ALA to normal levels. I will have my EFA checked again in another two weeks.

I expect to see an increase in both LA and ALA. In fact, my LA should come up to normal because walnuts contain large amounts of LA as well as ALA. I also expect to see ALA increase above the normal range. Whether or not there is sufficient conversion to push EPA and DHA up into the normal range is unknown. I also expect to see my LDL to decrease and HDL to increase, further reducing cardiac risk.

2. Linseed Therapy (you might call it Flaxseed)

If walnut therapy fails to improve DHA, then I will add a tablespoon of ground linseeds (flaxseeds) to my breakfast cereal each day. That should definitely push my ALA way above normal, although my body will presumably be able to regulate it to some extent. Once again, there is no certainty that it will be converted to DHA.

3. DHA Supplements

If walnut and linseed therapy fails to increase DHA and EPA to acceptable levels, I have no option but to take supplements.

This is not so easy for vegetarians or vegans because most of the available supplements are derived from oily fish (yuk!).

Another problem with most supplements, affecting carnivores as well, is the risk of heavy-metal poisoning. So, I will leave it to others to eat their mercury flavoured juice squeezed from bodies of oily fish!

Fortunately, there are now non-animal DHA/EPA supplements commercially available. I imported a three-month supply of "V-Pure" DHA/EPA vegan capsules from Switzerland; they arrived very promptly. These contain oil from farmed algae, and are claimed to be free of heavy metals. You can find the suppler at this link: http://www.water4.net/index.htm

I cannot comment on the effectiveness of the V-Pure product because I am still in the "Walnut Therapy" stage of investigation. I expect the capsules to push my DHA and EPA levels well into the normal range. I will let you know the results.

Paul