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Vitamins: What you really need to take….

By Dr, John G. Alevizos

There are only two valid reasons to take supplements. One is to make sure your diet is sufficient in essential nutrients. The other is to boost your natural immune system so as to provide greater protection against disease—in other words, to slow the aging process and ensure a longer, healthier life.

In this article, I promised to tell you what supplements you really need to take. There aren’t really very many, and fish oil is one of the most important. What can fish oil do for you? The NIH states conservatively that EPA and DHA may be “possibly effective” for attention deficit-hyperactivity disorder in children, dysmenorrhea, rheumatoid arthritis, high blood pressure, stroke, osteoporosis, atherosclerosis, Reynaud’s Syndrome, kidney problems, certain psychological disorders such as bipolar disorder and psychosis, weight loss, endometrial cancer, macular degeneration, psoriasis, hyperlipidemia, cancer-related weight loss and even asthma.
Read the NIH information at: http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html

The most beneficial type of fish oil is the omega-3 variety, which are long-chain polyunsaturated fats, and the most beneficial omega-3’s are DHA (docosahexaenoic) and EPA (eicosapentaenoic), which are both found in fatty fish such as salmon, mackerel, herring, sturgeon, mullet, bluefish, anchovy, sardines, lake trout and albacore tuna. Consider  that  eating  fish  to obtain your fish oil depends on the method of its cooking. While the fish above contain about 1 gram (1000mg) of fish oil in a 3.5 oz. portion, only broiled or baked fish maintain fish oil’s benefits, while frying cancels the benefits. For those who are vegetarian, EPA can also be obtained from flax seed and algae sources.

Please note that there is a huge difference between saturated fats, polyunsaturated fats and trans fats. Without going through a chemistry lesson, it would be sufficient to describe saturated fats as fats that stack (like a stack of paper). Because they are thick and difficult to burn, it’s hard for the body to utilize these fats, and therefore, they tend to deposit on arteries. If you have ever been camping and tried to burn a large stack of paper, you found that it doesn’t burn all the way to the center. The outside of the stack will burn, but the center is airtight and this is similar to the way saturated fats work in our bodies.

Polyunsaturated fats are analogous to the same pieces of paper being crumpled. They take are light, fluffy and take up a lot of space so they can be easily burned; and believe it or not, the body works the same way. Trans fats are not natural; they are the enemy and are much more harmful to the body than even the natural saturated fats. In trans fats, those crumpled pieces undergo a chemical process which flattens out the kinks, and they stack just like a ream of paper (just like saturated fats), but because the trans fats come from a vegetable source, they have zero cholesterol. However, they are actually worse for the body than eating cholesterol from natural sources.

For the rest of this article, let’s talk about health and the medical conditions for which omega-3’s are the most beneficial. Omega-3’s are needed to control the production of multiple chemical messengers called eicosanoids. One of the major eicosanoids are prostaglandins. Prostaglandin I and prostaglandin III function as natural anti-inflammatories, whereas prostaglandin II promotes inflammatory processes in the body. For instance, whenever I strain a muscle, have a back or neck spasm, or have a bruise, I take four grams (4000mg) of fish oil instead of 800mg of ibuprofen. Although ibuprofen inhibits the pro-inflammatory prostaglandins, it also decreases the prostaglandin-protective barrier of the stomach and could cause me significant abdominal pain.

One study I read several years ago compared prescription-strength Tylenol #4 with codeine after back surgery to high-dose fish oil, and the majority of patients preferred the fish oil to the Tylenol with codeine. While I do not advocate going to such extremes, this study serves as an example of the anti-inflammatory benefits of fish oil.
It is well-known that fish oil helps the heart. A study done in Finland of 1,871 men between the ages of 42 and 60 showed that men with serum levels of DHA in the highest 20% demonstrated a 44% risk reduction for acute coronary events (heart attacks) compared with men in the lowest 20%. However, there was no association between EPA levels and the risk of acute coronary benefits. Circulation 2000 Nov. 28; 102 (22):2677-9.

The fish oil supplements that are readily available contain both DHA and EPA. Studies have shown that people with high triglycerides who take three to four grams of EPA and/or DHA per day experience a significant reduction of their triglycerides. Fish oil also acts as a mood stabilizer and provides relief from depression, anx iety, stress, sadness and other nervous disorders. It has also been found to have positive benefits in postpartum depression. Research also indicates that it is beneficial in childhood depression.

Most of my articles mention anti-aging. The Journal of the American Medical Association (JAMA 2010 Jan. 20 303 (3):250) shows that people with EPA-DHA levels in the lowest quartile experienced two and a half times the rate of telomere shortening compared to people in the highest quartile, indicating an inverse relationship between fish oil consumption and telomere shortening. As I have stated multiple times before, telomeres are the blueprints for our cells. As short telomeres make imperfect copies, their length is related to our longevity.

Once again, each year we age, our telomeres get shorter and shorter. A recent  study showed that  whole blood levels of EPA-DHA were inversely proportional with all causes of mortality. More specifically, individuals at or above median levels of EPA and DHA were seen to have a 27% decreased risk of all causes of death. Circ. Cardiovasc. Qual. Outcomes, 2010 July; 3 (4):406-412.
Now, let’s talk about side effects. The NIH feels that fish oil is likely to be safe up to three grams  (3000mg)  per day. However, some studies have shown that too much fish oil can cause hemorrhagic stroke, increased cholesterol and increased chances of bleeding. Therefore, people on blood thinners should consult their doctors before using fish oil.

The main problems I see with people who take too much fish oil are loose stools, heartburn and diarrhea, which immediately resolve with a decreased dose.
For general health, I recommend one to two grams of fish oil per day. On special occasions, such as with a lot of inflammation or a strain/sprain, I will use as much as four grams per day. However, if you want to take more than three grams per day, please consult your physician.

Dr.  John  Alevizos, D.O. is Board Certified in Family Practice and is an Anti-Aging Specialist. He owns Alevizos Medical in Irvine, CA, has been in private practice for 23 years. He did his internship and residency at USC in Los Angeles.

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