-Who should not take Fish Oil?
-Can I get enough Fish Oil by eating a lot of fish?
-How many CST2050 Fish Oil capsules do you recommend each day?
-What side effects should I anticipate?
-Why not just lower your cholesterol by taking cholesterol-lowering drugs?
-Is it possible to tell how well Fish Oil is working?
-Should I take prescription statins or fibrates along with my Fish Oil?
-What about diet and exercise?
-I started taking Fish Oil and my LDL-cholesterol number did not drop. Why not?
-Will my health insurance cover the cost of fish oil?
-What if my question isn't answered here?
Frequently Asked Questions
Who should take Fish Oil?
Anyone with a family history of vascular disease, heart disease, or stroke should consider taking Fish Oil. Family genetics can contain a tendency towards the dangerous small, densely packed LDL, and other risk factors. But with good diet, exercise, Fish Oil, and a doctor’s care, you can rewrite history for yourself.
Anyone with the following risk factors for vascular disease should consider taking Fish Oil: smoking, high blood pressure, diabetes, waistline obesity, or elevated triglycerides.
Doctors have recently defined a common, particularly threatening Metabolic Syndrome that associates high triglycerides, small dense LDL particles, and low HDL-cholesterol with elevated blood pressure, waist-line obesity, and diabetes. This condition is a perfect situation for the inclusion of Fish Oil in treatment.
Who should not take Fish Oil?
Up to 3,000 mg of Fish Oil per day has been generally recognized as a safe supplement for just about anyone. While Omega 3 fats are increasingly included in nutritional advice, and while the Omega 3 Fat DHA is being added to infant formula, medical advice should be obtained for pregnant women or nursing mothers, and for children.
Research is currently supporting the value of DHA in infant and childhood retinal and brain development, as well as learning and behavioral benefits.
Fish oil has a mild blood thinning effect, and is generally discontinued before surgery, and used cautiously with other blood thinners. Consult your health care provider.
Can I get enough Fish Oil by eating a lot of fish?
The cardiac benefits of fish oil were first investigated in the Inuit natives of northern Grennland, and even small amounts are beneficial, but you would need to eat twenty 6 ounce portions of very oily fish per week to get the amount of Omega 3’s in the Inuit diet. And unfortunately, most of the fish available today contains some level of mercury and other pollutants. Mercury-free and pollutant-free fish oil combined with a varied diet is a healthy alternative to the Inuit meal plan.
Is Fish Oil fattening?
Each capsule of Doc Jim’s Fish Oil contains only 10 calories. The Omega 3’s are very concentrated, so you get more DHA and EPA with less oil.
How many CST2050 Fish Oil capsules do you recommend each day?
A great starting level is two capsules daily, taken either together or at different times during the day. In our work we’ve recommended more according to the patient’s need and response. We monitor our patient’s response with advanced lab tests that measure LDL particle size, in addition to triglycerides and LDL and HDL-cholesterol. Ultrasound measurements of the artery walls also tell us how well the patient is responding to treatment. We’ve encountered increasing benefits and no difficulties with doses up to 8-10 capsules per day.
What side effects should I anticipate?
Occasionally patients notice a fishy burp, which can be minimized by refrigerating the fish oil. Absolutely no liver side effects or muscle aches have been seen.
How do I store my fish oil?
Storage at rooom temperature, with protection from extremes of direct light and humidity is fine.
Why not just lower your cholesterol by taking cholesterol-lowering drugs?
There are many prescription medications--statins--that reduce total levels of cholesterol in the blood. But we worry that this treatment could starve the rest of the body of cholesterol, perhaps slowing vital functions. For example, we worry that excessive LDL-cholesterol reduction might eventually disturb the natural cholesterol composition of cell walls, or of membranes around the cell nucleus or mitochondria.
We respect cholesterol’s functions in the body and recognize that cholesterol is only pathologic when embedded in the artery wall. We prefer to treat patients with Fish Oil to increase particle size and reduce particle number, working to prevent penetration and accumulation of cholesterol into the artery wall while keeping cholesterol in the blood flow for the rest of the body. But we also include statins in their treatment when we do not see a sufficient increase in their LDL particle size and reduction in number with Fish Oil alone.
Is it possible to tell how well Fish Oil is working?
At Cholesterol Studies and Treatment we use advanced lab tests to check a patient’s LDL particle size, as well as other documented risk factors. The tests we use include the NMR LipoProfile available from LipoScience in Raleigh, North Carolina (www.liposcience.com). We also use the VAP profile available from Atherotech in Birmingham, Alabama (www.atherotech.com) and Berkeley Heart Lab Inc. in Burlingame, California (www.bhlinc.com). Information about these tests is available for patients and health care providers on the websites of these companies.
We also use ultrasound technology to measure the cholesterol-related thickening of the artery walls. In a simple office procedure, ultrasound gives us a detailed picture of the carotid arteries, which are close to the surface of the skin in the neck. The carotid artery wall thickness is believed to mirror the thickness of the arteries throughout the body, including those in the heart and the brain. With the help of ultrasound images, we can tailor the intensity of our treatment to the actual state of the patient’s arteries, not just to numbers on lab tests. We measure the thickness of the artery walls, and over time strive to make them grow thinner with treatment.
Should I take prescription statins or fibrates along with my Fish Oil?
Fish Oil is a wonderful complement to these pharmaceuticals. There are no harmful interactions between pharmaceuticals and Fish Oil, and frequently Fish Oil can lead to a dose reduction of your prescription medication.
What about diet and exercise?
We encourage all exercise, and recommend a diet low in trans-fats, sugar, and other quick uptake carbohydrates.
I started taking Fish Oil and my LDL-cholesterol number did not drop. Why not?
Omega 3 fatty acids generally lower the triglycerides but have variable effects on LDL cholesterol. Lowering triglycerides seems to result in larger LDL particles, so that fewer large particles carry about the same total cholesterol load in the blood. In fact, sometimes LDL-Cholesterol even increases a bit as the larger particles “load up.” But because there are fewer LDL particles, the increased LDL-cholesterol may be less threatening.
Will my health insurance cover the cost of fish oil?
Unfortunately health insurance does not cover the costs of nutritional supplements. However, patients with healthcare reimbursement accounts offered by their employee benefit programs can often submit the cost of supplements for reimbursement. Check with your benefits office.
What if my question isn't answered here?
Do you have any more questions? Please send your questions to Dr. James Mickle at DoctorJ49@aol.com. He will respond personally to you questions, and post questions of general interest here.