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Heart Disease (Expert Forum)
Fish Oil Revisited-Friend or Foe??
Answered by
Cleveland - OH
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Fish Oil Revisited-Friend or Foe??
by jerry1978, May 02, 2004 12:00AM
Several months ago, I wrote to you about some studies' that show Fish Oil Supplementation has a tendancy to INCREASE LDL.
Well, apparently, that seems to hold true, at least in my case.
Before Fish Oil my lipids were: TC-180 and Direct LDL-87.
Only 6 months later, without a dietary change, my lipids went to TC-235 and direct LDL of 150. Tri's remained boderline high at 170-200.
My cardiologist is having my blood retested this week, as he thinks a lab error occured.
(1) Is it possible in 6 months for a TC and LDL to Increase that much without significant dietary change?
(2) Are Lab Errors Common?
(3) The only other medication I added between tests were Zoloft, hydrochlorothiaizide and Toprol XL-Would any of those have a lipid effect?
(4) What is the current thinking on Fish Oil-Friend or Foe?
Well, apparently, that seems to hold true, at least in my case.
Before Fish Oil my lipids were: TC-180 and Direct LDL-87.
Only 6 months later, without a dietary change, my lipids went to TC-235 and direct LDL of 150. Tri's remained boderline high at 170-200.
My cardiologist is having my blood retested this week, as he thinks a lab error occured.
(1) Is it possible in 6 months for a TC and LDL to Increase that much without significant dietary change?
(2) Are Lab Errors Common?
(3) The only other medication I added between tests were Zoloft, hydrochlorothiaizide and Toprol XL-Would any of those have a lipid effect?
(4) What is the current thinking on Fish Oil-Friend or Foe?
Doctor's Answer
by Cleveland Clinic, May 02, 2004 12:00AM
, May 02, 2004 12:00AM
jerry,
thanks for the post.
1) Yes. There are other factors that can also influence the lab value such as amount of time fasting and recent diet. We see significant changes in lipid profiles based on timing. Medications can change the profile also in as short as a few weeks.
2) I would interpret the values more in the context above. Lab errors can occur, but often timing of the test is a more important source of vaiablity.
3) No, not to a great extent. Hydrochlorothiazide has been associated with abnormalities in lipid levels in higher doses, but not in the doses typically used for hypertension (25 mg).
4) Jerry, most likely friend. Observational and trial data thus far have found an association with the intake of long chain fatty acids found in fish and a decreased risk of dying from coronary heart disease. There are 3 large studies underway that hopefully will confirm this association. I don't necessarily suggest buying and consuming large amounts of OTC supplements, but a diet that includes fish intake several times a week is generally what I recommend.
Netrox -- Statins are one of the most studied medications in the history of heart disease. There is a large amount proof in the form of multiple, large, randominzed controlled studies showing the proof and magnitude of the benefit of statin therapy in the prevention of the complications of coronary heart disease, including mortality. There are a paucity of data on many websites and isolated case reports put out by supplement companies that suggest the benefits of various neutraceuticals including CoQ10 in order to hawk these drugs.
thanks for the post.
1) Yes. There are other factors that can also influence the lab value such as amount of time fasting and recent diet. We see significant changes in lipid profiles based on timing. Medications can change the profile also in as short as a few weeks.
2) I would interpret the values more in the context above. Lab errors can occur, but often timing of the test is a more important source of vaiablity.
3) No, not to a great extent. Hydrochlorothiazide has been associated with abnormalities in lipid levels in higher doses, but not in the doses typically used for hypertension (25 mg).
4) Jerry, most likely friend. Observational and trial data thus far have found an association with the intake of long chain fatty acids found in fish and a decreased risk of dying from coronary heart disease. There are 3 large studies underway that hopefully will confirm this association. I don't necessarily suggest buying and consuming large amounts of OTC supplements, but a diet that includes fish intake several times a week is generally what I recommend.
Netrox -- Statins are one of the most studied medications in the history of heart disease. There is a large amount proof in the form of multiple, large, randominzed controlled studies showing the proof and magnitude of the benefit of statin therapy in the prevention of the complications of coronary heart disease, including mortality. There are a paucity of data on many websites and isolated case reports put out by supplement companies that suggest the benefits of various neutraceuticals including CoQ10 in order to hawk these drugs.
Just a while ago, a doctor said he stopped recommending fish oil because a new study found that it increased the risk of VT in some patients.
However, a newer study came up saying the opposite. The major difference in that study is that they injected omega-3 oil in their blood and they delibratedly induced dangerous arrythmia.
"In the study, researchers injected the patients with an infusion of omega-3 fatty acids and then tried to induce an episode of ventricular tachycardia. At the start of the study, researchers were able to induce this irregular heartbeat in seven out of 10 of the participants.
After the fish oil infusion was delivered, researchers were only able to induce the arrhythmia in two of the patients, and the second was only after a more aggressive attempt. In the remaining five, the fish oil appeared to prevent the irregularity."
http://my.webmd.com/content/article/86/99043.htm
-jeff
I mean let's be honest, fish is good for you so why not carry on taking the supplements.
http://www.n3inc.com/SmartMoney%20Reprint_103003Web.pdf
-jeff
You are focusing on to many details with this. There isn't alot of data regarding the effects of these oils on HDL.
If you are interested in increasing your lipid profile, I would suggest you look more into complete lifestyle modification as opposed to pills and supplements.
I would suggest you look into dietary modifications with combinations of plant sterols, high fiber and elements of the mediterranian diet. Aggressive physical activity, and hopefully tobacco absinence (if you smoke). These will have a greater impact on your HDL then any type of supplement or medication currently available.
good luck
Also, I have been told by two different doctors in past years to always take a good CoQ10 everyday for my heart. Is this not correct? Right now I am taking Quione Gold 100 mg.
Glenn
Erik
I take 500mg Niacin at bedtime. I take an OTC brand by Spring Valley called "No Flush" Niacin (I buy it at Wal-Mart). By taking both it and the Omega 3 at bedtime, I sleep through any uncomfortable side effects... but, with the "No Flush" Niacin, I have very little of the awful "hot flashes" I got when taking Niaspan. I have mitral valve regurgitation and (so far) poorly controlled hypertension. My Cardiologist just adjusted my Avapro to 450mg a day in 150mg doses 3 times a day. (The normal upper limit is 300mg), plus 40mg of Lasix, which appears to be controlling the BP (finally). I was concerned about the effect of the Niaspan on the Avapro (I phoned the pharmaceutical company and they told me to "not" combine the two), but I have had no problems with the OTC Niacin, and juding by the results I have seen, I will stay on it as long as it continues to work so well.