Fish Oil: Summary of studies related to bipolar
 

Hi,
Waves mentioned the two fatty acids in fish oil in other thread. That inspired this post here.

This page was updated Jan 1, 2011. It has a chart showing of studies the past ten years.

http://www.psycheducation.org/depres...ds/Omega-3.htm

Fish oil contains fatty acids: EPA (eicosapentaenoic) and DHA (docusahexaenoic)




Three Risks



M

Youtube video on Consumer Reports and Fish Oil in Prescription Form
 

1.
Prescription Fish Oil
http://www.youtube.com/watch?v=5H04t08PkiU

2.
Here is a page that states what is in the prescription pills.

http://www.omegavia.com/prescription-fish-oil-pill1/

M

OmegaBrite is the version used in the Stoll studies.

It is mostly EPA.

Since then DHA has become more popular. But if you want the Stoll product (his wife was the CEO of that Company originally)
That is the one to get.

http://www.omegabrite.com/

I am not sure if now after many years, Stoll is involved with this company. But he and his wife were, and this is what was used in his studies, back then.

OmegaBrite
 

Hi, Mrs. D.
Thank you. I used to order that one but lost track of the name in a move and then a computer crash.
I will wait until the weather cools here in Florida. I only order supplements online during late fall and winter months. Otherwise, the stuff is cooked before it gets to me.

M

found it - from "All In The Mind" - August 20th 2011
 

Here is a transcript from a show/interview with three scientists, mediated by Natasha Mitchell. the discussion (link below) touches on many issues regarding inflammation, depression and the development of other pathologies.

It states that we still lack well-designed studies with sufficiently large sample populations is to prove or disprove any definitive role of Omega-3 fatty acids in depression and inflammation. It discusses an inconclusive study on gestating women given DHA on the basis that depletion could occur due to fetal development. It also indicates that EPA seems to be more effective in treating depression, but indicates a need to differentiate between sub-types of depression and to discover which of these respond to treatment with Omega-3's.

This last part was the most interesting to me. anyway here is the link and some excerpts:

An inflammatory story: Depression and immunity
ALL IN THE MIND - 20 August 2011

they start in with fatty acids about half way down.

you have to click on "SHOW TRANSCRIPT" to see the article text.

~ waves ~

Dear Waves,

This is useful information.
Today I took two capsules that I have had in the fridge for a few months. They have slightly more EPA than DHE.

M

Since EFAs are called ESSENTIAL fatty acids, the bottom line is that we cannot live without them.

Whether they will cure or control a condition already present, is very difficult to prove, because of the many variables people have when chosen for study subjects. Nutritional studies are always difficult to substantiate.

But since we cannot live without EFA's ...a certain amount daily should be in your food choices, and if not, you need to supplement them. There are global benefits besides psychiatric ones... strengthening the membranes lining your lungs, your retina, your stomach (they can help prevent and control GERD)
and improving immune functions to reduce overactivity and autoimmune reactions.... EFAs should be a considered part of your diet and or supplement routine IMO.

For what it is worth, the higher DHA types (we used Carlson's DHA) enabled my son to go off Ritalin and clonidine for his ADHD. So I started using EFAs in our home over a decade ago!
I have a thread about them on our Vitamin forum.
I used to get flamed constantly when I posted this information on BT... by the internet bullies who used to post there BTW.

http://neurotalk.psychcentral.com/showthread.php?t=6092

aren't fatty acids good for our ph balance, skin and heart? Your input is always appreciated mrs d!!!!!!!
bizi

Yes, Bizi,
I think they bring down inflammation too.

M

inflammation and EFAs
 

the inflammation thing is a little complex.

Fatty acids are used in the synthesis of prostaglandins - these are substances our body makes which are responsible for pro-inflammatory and anti-inflammatory response.

There are basically 3 types, one of which tends to have anti-inflammatory type actions while the other two have different types of primarily pro-inflammatory type actions.

prostaglandins are derived from fatty acids, some of which can be synthesized in the body. a deficit in dietary intake of essential fatty acids can cause the body to have an imbalance of what it needs to make the prostaglandins in "balanced" way. this can also happen if we get enough, but our intake is skewed.

It is a tricky business because there is not, in every case, a single metabolic pathway by which a fatty acide can be metabolized. The body will "choose" different metabolic pathways based on what it has available but also the proportions of what it has available, and accordingly, produce different quantities of the different types of prostaglandins. This process is affected by other nutrients necessary for metabolism of certain EFA's - eg, Magnesium, Zinc, Vit C and B complex... probably others. Deficiency in these, no matter if you are getting all the right EFA's, can produce an imbalance in prostaglandins.

An excessively high dietary intake of meat and dairy for example, will generally provide too many omega-6 ESSENTIAL fatty acids. These are not per se "bad for you." What is bad is a disproportionate intake of these.

FWIW, EPA, which is found in fish oil, is one of the building blocks for anti-inflammatory type prostaglandins. However what the article i posted tells us is, taking more of it might not help, unless you aren't getting enough of it. Now it is true that eating habits in our current society have been skewed towards high meat consumption (high Omega-6 source), so that most of us get have a much too high ratio of Omega-6:Omega-3s.. To make things worse, many of us lack required "assistive" nutrients for the processing of Omega-3's to produce our nice anti-inflammatory prostaglandins, because we do not eat our share of veggies!

i apologize to anyone fully knowledgeable about the precise biochemical processes involved for the gross oversimplification for the purposes of illustration.

i apologize to anyone in difficulty reading, if i have made this too complicated. Unfortunately it IS quite complicated.

~ waves ~

I believe the main dietary skewing factor is SUGAR and high glycemic carbs. This stimulates excessive insulin release, which then favors PGE2 formation.

Meat and dairy are primarily saturated fat providers, which is neutral to formation of the the various prostaglandins.

What really provides Omega-6s are polyunsaturated oils.
Peanut oil, safflower, CORN (a biggie),sunflower, soybean etc. Most vegetables contain adequate Omega-6 content so we don't really need to supplement this when trying to balance with the Omega-3s. The average person who consumes fried food and does not supplement flax in the diet, can have ratios of 1:20 or higher of Omega-3: 6. Some ADHD kids can have even higher ratios it has been found in testing.

Eating fast food and fried food will quickly skew you to the inflammatory side as well.

The Zone diet was formulated to balance protein, carbs, and fat so that the EFA chemistry is as anti-inflammatory as possible.
Dr. Sears PhD. explains this in detail in his many books.
"Enter the Zone" was his first one, and now there are others.

Dear MrsD

From everything i have read, there are indeed many, many, skewing factors. ;) I was not aware of the "sugar" one - although i have my doubts (for now, in opinion only) as to it being the "main" one. My reasoning here is that the other skewing factors wil not necessarily go away if you take away the sugar. Chemically, the metabolic routes do vary based on the proportions of the individual EFA's available, i cannot be more specific than that without a reference but unfortunately i do not have them anywhere near... :( i apologize for that. Also, the body simply cannot use supplements correctly to make PGE2 if it doesn't have ALL the building blocks!

I will however look into the sugar influence further - thank you for pointing it out as well as the observations on ADHD where i suspect there may be organic differences as well, but again, i would have to look into that.

Mostly, I wanted to describe the process of prostaglandin synthesis in order to point out that the question is not as simple as take extra this or extra that, and to dispel generic notions regarding what a single EFA can do. Unfortunately when folks talk nutrients, a simple answer of this kind is often sought but in this case it really cannot be distilled so simply.

i want to encourage folks to consider the big picture and to realize that the big picture is different for each person.

~ waves ~

Well, for us, following the recommendations by Dr. Sears, my son was able to function better without his Ritalin and manage to go to the college of his choice which earlier seemed not a viable option.

I reversed my asthma, and long standing GERD (although I still have my GI congential twisted problem and a hiatal hernia), and improved my skin tone considerably by following the Zone diet. I no longer need daily medications for either of these past painful issues.

Removing trans fats, consuming more Omega-3s (which today is easier because of smart foods available) and reducing carbs and sugar, avoiding fried foods-- all were highly successful.

We all still take our fish oil (I've switched myself to Krill oil), consume more flax products (Smart Balance helps with this).
Buy Omega-3 enriched eggs. We use magnesium to support the EFA chemistry. I find today, I am pretty balanced and can take less supplemental fish oil. Hubby won't eat the enriched peanut butter so he still takes fish oil and flax oil. One a day.

We rarely get sick any more. I don't need asthma inhalers anymore but keep one as a rescue. Typically it expires without being used even.

It took a bit of getting used to...but we did it. I find others less enthusiastic about changing diet enough to improve health, so supplements are easier for those types of folks.

Today at my age I am favoring antioxidants more heavily than before.

Dear MrsD

i am glad for your hard-earned success, and do not get me wrong, i appreciate your sharing your experiences with us. :hug::hug::hug:
It is true, many folks won't even consider changing their diet... even though i do agree that is the best way to go.

Anyway, kudos to all of you :Tip-Hat:
and best wishes for your continued good health!

~ waves ~

For people interested in this topic, I'd recommend going to the source...one of the first lay published information on the subject was by Dr. Sears.

Over a decade ago when I found this information, it was still only on research studies for the most part. Doctors were totally clueless (and many still are) about EFA chemistry. They were prescribing NSAIDs commonly then, and did not even know how they worked, in relation to EFA chemistries.

In the book, Enter the Zone, there are two chemistry chapters. A friend of mine was given this book recommendation by her sleep apnea doctor... and she did not understand any of it so gave it to me to interpret for her. One of the chapters is complex, in detail. The second one is more general language for the layman. I was very piqued by this book, and decided to look for confirmation. Lo and behold I found Dr. Rudin's book published earlier at our library! His focuses on psychiatric use of EFAs in medicine. Since then, he has a new edition out.
This is his newer edition:
http://www.amazon.com/Omega-3-Oils-P...5910034&sr=8-7

He explains the subject well also. Armed with both experts, I then went on the net (which was new to us, with our first computer, back in the late 90's) and found the studies on PubMed. Dr. Simopoulous MD also wrote a book... which I bought that was based on her research and various papers.

http://www.amazon.com/Omega-Diet-Lif.../dp/0060930233

So when I refer to this subject I go back to the experts. I have found many many discussions and websites on EFAs over the last decade, and because of the extremely complex nature of the subject some information is reported on those sites in slightly different formats from the original work.

To this day many doctors do not know or understand anything about this chemistry. They prescribe the drugs that interfere with it, cause terrible side effects, and do no counsel their patients on how to balance their lifestyle to minimize those effects. Steroids are a prime example, of a drug family that skews the chemistry. When the Cox-2 inhibitors hit the market this lack of understanding was taken advantage of by the Big Pharma who KNEW heart effects were possible and concealed this from doctors. That was the center of the controversy!
Cox-2 prostaglandins are inflammatory molecules... but NOT ALL OF THEM ARE. One which is produced by the kidney is a potent vasodilator necessary to maintaining vascular tone. When it is blocked (prostacyclin) arteries clamp down, and lead to heart attacks/stroke in some people. This was the Vioxx controversy leading to the removal of Vioxx and from sale in US. It illustrates the misuse and blatant ignoring of the chemistry to make billions of dollars. And illustrates that even the doctors fell for it all! Pfizer paid over a Billion dollars in fines for misleading Bextra promotion:
http://money.cnn.com/2009/09/02/news...cnnw/index.htm

I long for the day when doctors are trained properly in how the body really works, so that when drugs come out, the can use them skillfully and help people rather than the reverse.

kinda getting more and more off topic here but...
 

I should like to add, just as a general note, that many drugs - including of course psych drugs - deplete some nutrients (body uses them up to "process" the drug), or inhibit their absorption.

When a person maintains an otherwise "ideal" diet, yet is taking such drugs, nutrient depletion can grossly affect other organic functions (including but not limited to prostaglandin synthesis).

In these cases, supplementation with the depleted nutrients is probably a good idea - but one needs to find out what, if any nutrients are affected. In the case of inhibited absorption, there are a variety of issues... oral supplements do not always "work" and or at best may have to be taken well away from the medicine.

This is a toughie because, how do you know... most doctors do not know of the depletion... and it can be hard to convince them to test for it. It was a long time before i found out (and thanks MrsD - you pretty well clued me into this) Depakote was draining me of certain things... i started supplements to compensate but some issues with it still remain murky.

And the doctors? Oh yes, i asked... CLUELESS. Sigh, just another example of when will the "ones who should guide us" be properly informed to do so in the best way. And if the drug pushers - oops! i mean pharm co's - know this stuff, you can bet they don't tell anyone ... shhhhh... wouldn't want to make their med look too toxic. no skin off their back if you can't absorb folic acid, right? besides nobody needs that stuff anyway unless you plan to get pregnant. (<<--- WARNING: SARCASM)

~ waves ~

There is even now an app for smart phones on depletions!

http://itunes.apple.com/us/app/nutri...432547190?mt=8

I haven't tried it since I don't have one of these phones so I can't say it is a complete as the reference I use, by Ross and Pelton.

But yes, Depakote depletes carnitine primarily and folic acid.

It is interesting that there is a drug RX in US for treating depression that is nutrient responsive. It is called Deplin, and has 7.5mg of methylfolate in it (this is the activated form of folic acid).

There are people with MTHFR genetic mutation (approx 10% of humans) who cannot methylate folic acid, and hence cannot use it properly. The methylfolate bypasses that error.

lol that's great MrsD... i can't afford a smartphone though.

i don't take carnitine because the body makes it - and i believe i get enough of the essential amino acids. ;) Vit C is needed for synthesis and i made sure that is in my supplements, as i might not get enough of that.

on Depakote (VPA) i seem to recall Selenium as a depletee also, and possibly a couple other things? again haplessly lost the reference. this one is NOT in the garage either it was a on the net... sigh. i bought supps that included those things so, i'm ok but argh, now i wish i could remember or at least find the article again. i am a mess. my supps will not tell us because they include complementary nutrients also. i'm thinking Zinc may also be depleted? but i wouldn't swear by it.

i take a little Mg but that's coz i found early in my life that it helped with occasional bouts of tics and lessens my startle reflex to a passable level. I really can't remember if that's also involved with VPA because that's an a priori requirement for me... i pilot the amount i take based on my startle reflex.:rolleyes:

well now i'm thinking..............

if there is an app for smartphones, there is a database. and if there is a database, there is probably a website for depletions somewhere. we have to find it. if there isn't... WE CAN MAKE ONE. but most of all, if this collection of info exists in form of an app, why don't the doctors KNOW this stuff or look it up when prescribing!!! this is so infuriating!!! :mad:

~ waves ~

There is one website I have found:

http://www.chiro.org/nutrition/ABSTR...orticosteroids

I am not sure how complete that one is either.

The reference I use only gives two things for Depakote.
The carnitine and folate. (however it was written in 2001)

The Side Effects Bible...a newer book lists:
B12
VitD
Melatonin
Sodium
Selenium

in addition to carnitine and folate.

I don't know where that list comes from...however. Some anticonvulsants are thrown together based on the other drugs in that family.
The reference I use only is based on Medline papers published.

So I did a PubMed search on valproic acid B12 depletion and got no hits.

However, Depakote does block methylation of epigenetic DNA and that is a theory on how it helps bipolar.

Both B12 and folic acid have to be methylated to be useful in the body, so maybe this methylation issue is why those show up on the second list.

Vit D loss is listed for almost all anticonvulsants, because some have shown this interaction, so it is extrapolated to all.

The zinc may be the same. Zinc has always be recommended for hair loss, and Depakote does cause this in women. So shrinks have recommended this intervention. But I think in women the Depakote is really changing hormonal status and that is known to cause hair loss in women. Depakote is very hard on the sex hormones for both sexes! That IS documented.

Yes.

This is good, Waves.

M

Thanks MrsD for doing that checking. and yes, i ran into "grouped" AED lists too... sigh.

regarding the folate, the deal was different. it is not a direct depletion due to drug metabolims. what i read - and i only found it in one place... you can kill me now i don't know if have it but i have to go to pdoc's - is that its absorption is inhibited by depakote. so if one were on depakote for a lenghy period, their folate tissue stores would gradually become depleted.

Mari... thanks. i am glad you foudn that helpful. :) :hug:

i have to run

~ waves ~

Deplin
 

Thanks. Mrs. D.

I found a diagram.

http://www.deplin.com/DeplinFacts,HowItWorks

M

pdocs
 

Hi,

My first guess to that is that pdocs are a little bit lazy.

Perhaps also they don't trust the supplements as they are not regulated as to dose, quality, . .

M