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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by Cam W. on June 25, 2001, at 12:47:26
In reply to Re: Omega-3 fish oil in psychiatry. » Cam W., posted by Chris A. on June 25, 2001, at 12:15:56
Chris - The Stoll article that everyone refers to is from the May, 1999, Archives of General Psychiatry. I do not believe it is available free online, but any university medical library should have it in the stacks and it can be copied. There is a commentary on this study by Joe Calabrese, in the same issue. Also, I have looked for, but not found the follow-up letters to the article (I have them at work). - Cam
Posted by Sulpicia on June 25, 2001, at 15:20:03
In reply to Re: Omega-3 fish oil in psychiatry., posted by eoflaherty on June 25, 2001, at 12:34:31
> >First, apologies for my earlier cranky response. Current grad school workload is killing me.
References for essential fatty acids:
Drevon, C.A., Baksaas, I. & Krokan [edd.] Omega-3 Fatty Acids: Metabolism and Biological Effects Basel (1993)
Nettleton, J.A. Omega-3 Fatty Acids and Health New York (1995)Essential fatty acids and mental health:
Smith, R.S. "The macrophage theory of depression" Medical Hypotheses 35 (1991) 298-306
Weissman, M.M. et al. "Cross-national epidemiology of major depression and bipolar disorder" J Am Med Assoc 276 (1996) 293-299
Maes, M., Smith, R.S. "Fatty acids, cytokines, and major depression" Biol Psychiatry 43 (1998) 313-314
Hibbeln, J.R. and Edwards, R.W. have some interesting papers from the NIH Workshop on Omega-3: Essential Fatty Acids and Psychiatric Diseases - I'm not sure if they've been published yet but are available from the authors if you check the workshop web site.
Between the bibliographies in the books and articles, most of the important papers should be covered.The Paleolithic diet and problems with the modern western diet:
Eaton, S.B., Konner, M. "Paleolithic nutrition: a consideration of its nature and current implications" N Engl J Med 312 (1985) 283-289
Eaton, S.B. "Humans, lipids, and evolution" Lipids 10 (1992) 814-820
Eaton, S.B., Eaton, S.B. III, Konner, M. "Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications" European J Clinical Nutrition 51 (1997) 207-216Hominid ancestry and enviroment is in the Cambridge Ancient History, Vol. 1, pt. 1 Prolegomena and Prehistory Cambridge (1981), tho probably any standard textbook on physical anthropology/archaeology would do just as well.
No more grumpy posts. I promise.
S.
Posted by shelliR on June 25, 2001, at 16:35:16
In reply to Re: Omega-3 fish oil in psychiatry., posted by eoflaherty on June 25, 2001, at 12:34:31
> >It looks as if it very difficult to get it in adequate quantities except from fish oil.It might be possible in newborns using ALA from vegetable sources such as flax oil but in adults the conversion of this to EPA and DHA seems to be poor.
>
>
Do you have any references to support the above statement? I'm not saying you are incorrect, just would like to know where you have read or learned that the conversion of flax oil to EPA and DHA are poor? Especially since I eat 1/4 cup a day!shelli
Posted by Neal on June 25, 2001, at 16:43:43
In reply to Re: Omega-3 fish oil in psychiatry., posted by Cam W. on June 25, 2001, at 10:11:02
A little off topic but, I've read some articles recently citing some studies about Omega-3 and the risk of stroke. Omega-3 seemed to have a favorable effect for stroke.
Posted by gilbert on June 25, 2001, at 20:10:20
In reply to Re: Omega-3 fish oil in general health, posted by Neal on June 25, 2001, at 16:43:43
Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals. Until the FDA starts to regulate the health food stores and supplements the quality assurance is scant. It also appears to prey on peoples wishes to control their own destiny by doctoring themselves instead of having trained professionsals tell them things they simply do not want to hear. I think we have gone back to the days of selling elixer from the back of the carny wagons it just is mass marketed and packaged and sold at GNC now.
Gil
Posted by Elizabeth on June 26, 2001, at 1:53:30
In reply to Re: Omega-3 fish oil in general health, posted by gilbert on June 25, 2001, at 20:10:20
> Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals.
Nutritional supplementation is very different from "homeopathy." Although "homeopathic medicine" is almost certainly quackery, it is true that some people can benefit from taking supplements such as folate and omega-3's. It is possible to get standardised supplements (although the "food supplement" industry is not regulated nearly as strictly as the "pharmaceutical" industry is). This is why, if you're going to try "food supplements," it's important to investigate the reliability of different brands.
There are some drugs that can cause vitamin or mineral depletion; for example, the anti-TB drug isoniazid (INH) carries a high risk of pyridoxal phosphate (vitamin B6) deficiency. When I found out I'd been exposed to TB (positive skin test, but normal chest x-ray), I took isoniazid for 6 months. My doctor said I should take the B6 supplements that the pharmacy carried rather than random over-the-counter B6 supplements. I don't know whether OTC vitamin and mineral supplements are really all that unreliable, but plant extracts (like St. John's wort) and other supplements (amino acids, inositol, SAMe, etc.) definitely can vary depending on the brand.
I mentioned OmegaBrite because the typical health-food store fish oil supplements that I've come across did not seem to have anything close to the amount of EFAs that the preliminary studies on mood disorders have found effective. Stoll is very well respected in academic medical circles as a clinician, a teacher, and a researcher, and I know that he and a number of other doctors (in the Boston area at least) have been impressed with the effects of omega-3's. The theoretical basis for this treatment is sound as well, as far as anyone can tell.
-elizabeth
Posted by mila on June 26, 2001, at 8:46:05
In reply to Re: Omega-3 fatty acids and other supplements » gilbert, posted by Elizabeth on June 26, 2001, at 1:53:30
Hi Elizabeth,
how much B6 were you taking with INH? (I have began INH treatment last Friday, also will last six months). It turns my liver into a huge hard stone. Was your test negative after the treatment? I was shocked when I accidentally discovered that I was infected last week. My arm was hugely swallen. I checked my familty, no one shows even 1 mm of induration.
mila
Posted by Jane D on June 26, 2001, at 12:23:49
In reply to Re:elizabeth, posted by mila on June 26, 2001, at 8:46:05
> how much B6 were you taking with INH? (I have began INH treatment last Friday, also will last six months). It turns my liver into a huge hard stone. Was your test negative after the treatment? I was shocked when I accidentally discovered that I was infected last week. My arm was hugely swallen. I checked my familty, no one shows even 1 mm of induration.
>
> milaMila - Is it possible that there was a false positive. There is a form of vaccination which will later produce a positive skin test. I don't know if this could apply to you. In the US it occurs in people who have immigrated from other countries where they use that form of vaccine. Unfortunately that's about all I know about it.
Jane
Posted by Ron Hill on June 26, 2001, at 12:50:38
In reply to Some reading apology:Omega-3 fish oil, posted by Sulpicia on June 25, 2001, at 15:20:03
S(L):
Thank you much for both of your posts in this thread. Very informative and I did not sense a grumpyness in your first post. In fact, I'm happy you were slightly "torqued" since the emotions gave you the energy to write a lengthy informative post.
- Ron
-------------------------------------------------> > >First, apologies for my earlier cranky response. Current grad school workload is killing me.
> References for essential fatty acids:
> Drevon, C.A., Baksaas, I. & Krokan [edd.] Omega-3 Fatty Acids: Metabolism and Biological Effects Basel (1993)
> Nettleton, J.A. Omega-3 Fatty Acids and Health New York (1995)
>
> Essential fatty acids and mental health:
> Smith, R.S. "The macrophage theory of depression" Medical Hypotheses 35 (1991) 298-306
> Weissman, M.M. et al. "Cross-national epidemiology of major depression and bipolar disorder" J Am Med Assoc 276 (1996) 293-299
> Maes, M., Smith, R.S. "Fatty acids, cytokines, and major depression" Biol Psychiatry 43 (1998) 313-314
>
> Hibbeln, J.R. and Edwards, R.W. have some interesting papers from the NIH Workshop on Omega-3: Essential Fatty Acids and Psychiatric Diseases - I'm not sure if they've been published yet but are available from the authors if you check the workshop web site.
> Between the bibliographies in the books and articles, most of the important papers should be covered.
>
> The Paleolithic diet and problems with the modern western diet:
> Eaton, S.B., Konner, M. "Paleolithic nutrition: a consideration of its nature and current implications" N Engl J Med 312 (1985) 283-289
> Eaton, S.B. "Humans, lipids, and evolution" Lipids 10 (1992) 814-820
> Eaton, S.B., Eaton, S.B. III, Konner, M. "Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications" European J Clinical Nutrition 51 (1997) 207-216
>
> Hominid ancestry and enviroment is in the Cambridge Ancient History, Vol. 1, pt. 1 Prolegomena and Prehistory Cambridge (1981), tho probably any standard textbook on physical anthropology/archaeology would do just as well.
>
> No more grumpy posts. I promise.
> S.
Posted by Ron Hill on June 26, 2001, at 13:19:16
In reply to Re: Omega-3 fish oil in general health, posted by gilbert on June 25, 2001, at 20:10:20
Gil,
I hear ya and your points have some validity. At the same time, I am not ready to throw the baby out with the wash when it comes to supplements. Via trial and error (pronounced "modern psychiatry"), I have found a few supplements that are very helpful augments to my BP II meds. Just my opinion.
-- Ron
----------------------------------------------> Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals. Until the FDA starts to regulate the health food stores and supplements the quality assurance is scant. It also appears to prey on peoples wishes to control their own destiny by doctoring themselves instead of having trained professionsals tell them things they simply do not want to hear. I think we have gone back to the days of selling elixer from the back of the carny wagons it just is mass marketed and packaged and sold at GNC now.
>
> Gil
Posted by eoflaherty on June 26, 2001, at 16:49:16
In reply to Re: Omega-3 fish oil in psychiatry. » eoflaherty, posted by lissa on June 24, 2001, at 21:44:13
>Stoll in his book "The Omega-3 Connection" (available from amazon.com)points out that he started researching in 93 for a better treatment for bipolar disorder and did an extensive search of the literature to find something suitable.He does not mention Donald Rudin at that point in his book but Rudin`s research suggested years earlier that psychiatric illness had a large omega-3 deficiency as a likely cause.
> I've been keeping up with the research on this too. For me, the fish oil did not work well, but I am glad you and your patients have found such success with it. Congratulations.
>
> My question for you is maybe a little off-topic. Not being a scientist or doctor, I am just wondering how researchers come up with these hypotheses. To say that the reason fish oil works is because our ancestors lived by the sea; to say they have lower incidences of mental disorders and some forms of cancer is because they eat fish; for an African doctor to travel to New York and hypothesize that his subsequent depression was caused by changes in light -- well, it all seems far-fetched to me and I wonder how they get funding. I'm not mocking their efforts, sometimes I guess this is how science works.
>
> As for me, I find my moods correlate highly with changes in barometric pressure. If I were to hypothesize about the Japanese, then, say, I'd say they have lower incidences of mental disorders because most live at low altitude near the coast where the barometric pressure tends to be higher (I correlate low and falling pressure with low moods and rising and high pressure with better moods) ... So, yeah, that's what I might say, but it would still be really, really far-fetched. If I were really a scientist, do you think I could present this as a hypothesis, be taken seriously by my colleagues, and get funding? It seems so bizarre to me.
>
> Well, however it is that the fish oil is helping your patients is not the issue here. I'm glad it is helping and that you have so astutely kept up with the research for their benefit.
>
> Best Wishes,
>
> Lissa
Posted by lissa on June 26, 2001, at 17:44:41
In reply to Some reading apology:Omega-3 fish oil, posted by Sulpicia on June 25, 2001, at 15:20:03
> No more grumpy posts. I promise.
> S.S., your post was not cranky, I think it was a reasonable reaction to what I wrote. I’m sorry about my obnoxious post. Since I do not have the education to evaluate scientific studies on fish oil and other therapies, I should not have had an opinion on whether the reasoning behind scientists’ claims about omega-3 fish oil is sound. I was cynical because I keep trying out new alternative therapies for my problem and they haven’t helped, but that says nothing about the evidence supporting them. So, sorry for the solipsism and thanks for the citations. I'll keep out of scientific discussions from now on. I wish you the best in your research. And, for the record, I was not trying to say our ancestors were mermaids :o).
Posted by Lorraine on June 26, 2001, at 23:16:06
In reply to Re: Some reading apology:Omega-3 fish oil, posted by lissa on June 26, 2001, at 17:44:41
> > No more grumpy posts. I promise.
> > S.
>
> S., your post was not cranky, I think it was a reasonable reaction to what I wrote. I’m sorry about my obnoxious post. Since I do not have the education to evaluate scientific studies on fish oil and other therapies, I should not have had an opinion on whether the reasoning behind scientists’ claims about omega-3 fish oil is sound. I was cynical because I keep trying out new alternative therapies for my problem and they haven’t helped, but that says nothing about the evidence supporting them. So, sorry for the solipsism and thanks for the citations. I'll keep out of scientific discussions from now on. I wish you the best in your research. And, for the record, I was not trying to say our ancestors were mermaids :o).
Posted by Elizabeth on June 27, 2001, at 11:57:07
In reply to Re:elizabeth, posted by mila on June 26, 2001, at 8:46:05
> how much B6 were you taking with INH?
300 mg INH with 50 mg B6.
> (I have began INH treatment last Friday, also will last six months). It turns my liver into a huge hard stone.
You should be having liver function tests done at least for the first couple months.
> Was your test negative after the treatment?
No, the skin test will always be positive for TB antibodies once you've been exposed. You have to have a chest x-ray. My CXRs were all normal, both before and after the INH: what probably happened was that I was exposed and my hyperactive immune system fought it off. < g >
BTW, my liver tests were all normal, even though I was taking Nardil along with the INH. INH is a hydrazine-derived drug, as is Nardil. The chemically similar iproniazid was the very first MAOI discovered to have antidepressant activity, but it proved to be so hepatotoxic that it wasn't suitable for use in TB or depression. Isoniazid (a non-MAOI), and the hydrazide MAOIs phenelzine and isocarboxazid, are still used today.
> I was shocked when I accidentally discovered that I was infected last week. My arm was hugely swallen. I checked my familty, no one shows even 1 mm of induration.
Yup, all my roommates and family had to get tested too. Nobody was positive but me. I don't think I ever had active TB; it's common for people who work in health-care settings to pick it up.
-elizabeth
Posted by lissa on June 27, 2001, at 21:51:25
In reply to Re: What an evolved post :-) no msg » lissa, posted by Lorraine on June 26, 2001, at 23:16:06
I've looked over the Eaton articles (and they don't agree with what I know about paleontology/paleoclimatology, but what do I know?), a Finnish study published on Medscape, press about the APA's stance on this matter, and an article about the original 1999 Stoll study -- a study which included approximately 30-40 subjects, split into two groups, both of which kept taking their usual medication regimen. One group received the omega-3 fish oil treatment (I believe) and the other took olive oil.
There are a lot of variables there and I'm not sure what to think. Maybe there is a lot of anecdotal evidence about the efficacy of this treatment, but is there strong scientific evidence that it works and is safe?
OK, OK ... I'm not a scientist, so I'll just stay out of this discussion from now on ... I hope this is not taken as incivility and that it is OK within this forum to not agree all the time.
Posted by Lorraine on June 27, 2001, at 22:21:24
In reply to Re: What an evolved post :-) no msg » Lorraine, posted by lissa on June 27, 2001, at 21:51:25
It's perfectly ok to disagree. I've been taking it for 2 1/2 months and have no indication it works. Others have posted with similar reactions. It's hard to say. Maybe it works for some or maybe the study is flawed. Only time will tell.
Posted by Lorraine on June 27, 2001, at 22:42:01
In reply to Re: What an evolved post :-) no msg » lissa, posted by Lorraine on June 27, 2001, at 22:21:24
I have a book that talks about phosphatidylserine as part of omega 3--which I hadn't realized. Anyway, off to google to search and stumbled on this link which has a lot of info:
Posted by Elizabeth on June 27, 2001, at 23:58:16
In reply to Re: Important link on studies, posted by Lorraine on June 27, 2001, at 22:42:01
> I have a book that talks about phosphatidylserine as part of omega 3--which I hadn't realized. Anyway, off to google to search and stumbled on this link which has a lot of info:
Huh. A friend of mine who's into smart drugs and supplements once recommended phosphatidylserine to me. I should read your link. In the morning!
-elizabeth
Posted by eoflaherty on June 29, 2001, at 7:59:57
In reply to Re: Omega-3 fish oil in psychiatry. » eoflaherty, posted by shelliR on June 25, 2001, at 16:35:16
> > >It looks as if it very difficult to get it in adequate quantities except from fish oil.It might be possible in newborns using ALA from vegetable sources such as flax oil but in adults the conversion of this to EPA and DHA seems to be poor.
> >Stoll whose book is "The Omega-3 Connection" mentions it on page 215.
> >
> Do you have any references to support the above statement? I'm not saying you are incorrect, just would like to know where you have read or learned that the conversion of flax oil to EPA and DHA are poor? Especially since I eat 1/4 cup a day!
>
> shelli
Posted by Ron Hill on June 29, 2001, at 11:09:29
In reply to Re: Important link on studies, posted by Lorraine on June 27, 2001, at 22:42:01
Lorraine,
Good link. Thanks.
What is the connection between Omega-3 and PS according to your book? PS helps me (BP II) although it is an expensive supplement. What is the title and author of the book?
-- Ron
----------------------------------------------> I have a book that talks about phosphatidylserine as part of omega 3--which I hadn't realized. Anyway, off to google to search and stumbled on this link which has a lot of info:
>
> http://ods.od.nih.gov/news/conferences/w6w3_abstracts.html
Posted by shelliR on June 29, 2001, at 14:50:03
In reply to Re: Omega-3 fish oil in psychiatry., posted by eoflaherty on June 29, 2001, at 7:59:57
> >
Posted by Lorraine on June 30, 2001, at 11:44:51
In reply to Re: Important link on studies » Lorraine, posted by Ron Hill on June 29, 2001, at 11:09:29
> Lorraine,
>
> Good link. Thanks.
>
> What is the connection between Omega-3 and PS according to your book? PS helps me (BP II) although it is an expensive supplement. What is the title and author of the book?
>
> -- Ron
> ----------------------------------------------Ron: Great questions. My book says:
"Recently, as reported in the American Journal of Clinical Nutrition, scientists have shown that the omerga-3 fatty acid phosphatidylserine (PS) increased dopamine, norepinephine and epinephrine concentrations in animals.".....
"From all this we can conclude the omega-3 fatty acids are essential for all aspects of healthy brain cell metabolism."....
"As we have seen...our brain health depends on PS more than on any other single fatty acid...."Anyway, he goes on to recommend that you supplement with 300 mg PS and 5 grams of fish oil.
The name of the book is "The Brain Wellness Plan" and the author is Dr. Jay Lombard--his credentials are Board Certified Neurologist, Chief of Neurology at Westchester Square Medical Center, clinical professor of neurology at Cornell University Medical College.
I like the book quite a bit. He discusses Depression, Autism, Alzheimer's, CFS, ADD, MS, Parkinson's and Lou Gehrig's. His central premise is that with each of these conditions what you want to do is a) reduce excessive inflammation, raise mitochongrial activiy and c) rebalance neurotransmitter levels.
Posted by Randal on August 16, 2002, at 17:27:08
In reply to Misinformation, corrections:Omega-3 fish oil, posted by Sulpicia on June 25, 2001, at 0:25:10
Hi,
We are currently having a discussion on a different thread about EPA:DHA ratios. Just wanted to post here to see if anyone who was involved in this discussion (Sulpicia?) can tell me the evidence behind statements such as "They learned very early in the study that DHA alone or in ratios of less than 2:1 pitches bipolars into severe depression.." Is this merely from Stoll's book? He does say that higher ratios of EPA:DHA are best and that anectodally some people become more depressed. However, his statements are nowhere as strong as this. Is there additional evidence that I'm not aware of to back up such strong claims?
Thanks!
It would be nice, but not necessary if you could respond to this on the thread containing our recent discussions.
Randal
Sulpicia said (a year ago):
> 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.
Posted by joebob on July 15, 2003, at 14:39:47
In reply to Re: Misinformation, corrections:Omega-3 fish oil » Sulpicia, posted by Randal on August 16, 2002, at 17:27:08
Posted by Ed O`Flaherty on July 16, 2003, at 7:17:17
In reply to correct ration of epa to dha is 3 to 1 (nm), posted by joebob on July 15, 2003, at 14:39:47
Since I started this topic in 2001 omega-3 fatty acids have rarely left this board for long.I have updated my views on the subject in some detail in www.omega3.20megsfree.com.A good source of regular updates is at www.mcmanweb.com/article-15.htm
This is the end of the thread.
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