Supplementation with Essential Fatty Acids
By Alice R. Laule, M.D.
The two basic classes of EFA’s are omega 3 and omega 6 fatty acids. They are
so-named because of their biochemical structure, which I won’t go into in
detail. All the EFA’s are “polyunsaturated” fats — which means they have a lot
of double bonds between carbon atoms. That makes them rather fragile. These are
fats that should not be heated when extracted from their source, because the
double bonds break and create “free radicals,” which are harmful to living
things.
The omega 3 fatty acids can be consumed in three different forms,
alpha-linolenic acid (ALA), eicosapentanoic acid (EPA), and dicosahexanoic acid
(DHA).
I still see a great deal of information pushing flaxseed oil, which contains a
great deal of ALA, in the nutritional literature. Flax, and other seed oils,
high in ALA, have been touted as a wonderful way to get your omega 3 EFA’s.
However, ALA is only useful to us insofar as we can convert it to EPA or DHA. A
lot of studies get done on rats first, and only later on humans. The rat
studies showed that dietary ALA was wonderful! Rats utilized the ALA well, and
they seemed to thrive. Only a few years later did we realize that humans
convert flax seed oil to the essential EPA and DHA very poorly. Only about 10% of ALA is converted by humans. New information has come
to light, as well, that ALA seems to worsen prostate cancer. Even the rats got
larger prostates on flaxseed! As a consequence, I do not recommend flax seed
oil very often. I do sometimes recommend ground flax seeds for their tonic
effect (because of lignins) on the gut, since there is less ALA to disturb the
prostate in this whole, ground food than there is in the extracted oil.
I have my own flax seed oil story to share. For years, based on advice of
nutritional literature I was reading, I had taken flax seed oil. In the
meantime, I was also beginning to have increasing arthritis in my right knee
where I had previously broken my knee cap. I couldn’t get up from a deep knee
bend any more — at least not gracefully and not without groaning with pain.
When I read about our inability to convert ALA to the more strongly anti-inflammatory
EPA and DHA, I switched myself to fish oil. Within two weeks my knee no longer
hurt. It still pops a little bit now and then, but has no pain. I acquired
another seed oil recently and reduced my intake of fish oil, to add the seed
oil. Within 6-8 weeks, my knee hurt again (and several other
joints that had never hurt in my life.) Needless to
say, I’m back on fish oil. My joints are better, and I won’t switch to a seed
oil again.
Now, about fish oil — not all fish oil is created equal. I have been taking a
fairly high quality fish oil with good quality control, guaranteed to have no
mercury contamination. When I was out of town and forgot my fish oil, I bought
a cheaper brand. Both bottles say that the capsule contains 1000 mg. of fish oil.
But the cheaper one had only 180 mg. of EPA and 120 mg. of DHA. I was taking 4
capsules a day, and not getting relief from my joint pain. The more expensive
brand contains 690 mg. of total omega 3 fatty acids. Three of those a day got
rid of my joint pain. I have now located a product that is even more rich in
omega 3 EFA’s. The recommended daily amount of fish oil is enough to get
1000-4000 mg. of total omega 3 EFA’s. The most common mistake I see in people
taking fish oil is that they will take one capsule a day. In most brands that
means a mere 300 mg. of EFA’s, which is not enough to have any salutary effect.
Besides joint pain, what else are we accomplishing by taking fish oil (or
eating a lot of cold water ocean fish)? Omega 3 oils reduce all sorts of
inflammation, be it asthma, skin disorders, or inflammatory bowel disease. Some
studies indicate they lower breast cancer risk. Blood pressure, and
cholesterol ratios improve. Bones are stronger in those who get plenty of omega
3 fish oil. For children, the DHA is essential for healthy brain growth.
Nursing mother’s will have more DHA in their breast milk if they ingest plenty
of it themselves. Treatment of ADHD with fish oil has been successful, as have
trials of omega 3 fish oil for depression, even as severe as the depression is
in bipolar syndrome.
People who intake plenty of omega 3 fatty acids tend to have less obesity. The
EFA’s actually are a stimulus to the hypothalmos letting us know that we are
full. I have not seen a study reported to this effect, but it seems natural to
suppose that taking a couple fish oil capsules early in the course of a meal
might reduce the portion size a person would eat, and thus help them reduce
weight.
There are recent studies that show the omega 3 oils are even helpful in macular
degeneration. They lower the intraocular pressure in people with glaucoma or
ocular hypertension, although it takes 4,000-6,000 mg. of fish oil to
accomplish this. I often also recommend them to people who have had a tendency
to form blood clots, as they will thin the blood.
The contraindication to taking large doses of omega 3 fatty acids relates to
their ability to reduce platelets activation of blood clotting. Anyone who
bruises easily, is on blood thinners, or has trouble with deficient blood
clotting should be very cautious and take only low doses of supplemental omega
3’s, no more than 1000 mg. These folks probably should stick to eating fish,
not taking supplements, for their EFA’s.
Remember, to get all these good effects above the usual dose is 1,000—4,000 mg
not just of fish oil, but of the EPA and DHA that the fish oil contains. That
means taking quite a few capsules of the stuff. Some people will get gas, or even
diarrhea, and of course that dreaded repeating of the fishy taste. The purer
the brand, I find, the less people have a problem with burping, gas, or
diarrhea. It also helps to take them first, and then eat something. After
taking fish oil as a supplement for a few weeks, the burping is often less
intense.
Well, I didn’t even get to the omega 6 EFA’s—I thought we might be going
through three newsletters with this topic. Next time, cod liver oil, and omega
6’s.
Stay healthy.
Alice R. Laule, M.D.