Omega-3

For the same reason I've been reccomending fish oil to several psyche pts.

You got to take into consideration that only about 50% get benefits from antidepressants, and that of this amount only about 30% get to a level of improvement that was comparable to their predepression state. (I'm remembering this off of STAR*D, if I'm wrong correct me).

Pts need any boost they can get, whether it be from excercise, psychotherapy or a holistic boost like this.

On top of that, there are plenty of studies backing this one up.

I have though sat through a few lectures where the speakers stated that the evidence points that of the Omega fatty acids (EPA & DHA) Its only EPA doing it, not DHA. So reccomending something such as flax seed oil (which according to the speakers) has DHA, but not EPA won't help.

Just watch the mercury.

I just gave grand rounds on Psychiatric effects of toxin exposure, with focus on heavy metals and solvents.

Here's a link to the fish/mercury ppm levels. Nobody can afford erethism.

http://www.cfsan.fda.gov/~frf/sea-mehg.html

So on the flax seed issue -- it appears that vegetarian sources of omega-3s are generally ALA, which the body inefficiently converts to DHA and EPA. So maybe fish consumption is a more direct route, but high amounts of vegetable omega-3s might be beneficial.

Have any studies been done specifically on the efficacy of flax seed, etc., or is it just that all the studies have been done using fish?

psisci said:

The point is neither flax or fish are good ways to get Omega-3's. Flax is veg, but you have to take in a ton of it to get anywhere near a dose needed to treat anything, and fish is basically contaminated so to eat enough of it to get a good dose you get heavy metals to boot. Supplements that certify they are free of heavy metals and other contaminants are the best way to go as far as using this as a method to treat anything.

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Well, yeah, duh. You're still missing a big objection to fish oil supplements (which btw is what the link you supplied is for) -- vegetarians don't eat dead fish, so we can't take 'em. A poster above mentioned that concern, too, so it's not like I'm being the lone freaky vegetarian person who doesn't want to take fish oil supplements regardless of their purity.

Also, are heavy metals an issue with salmon? I thought it was mainly a tuna issue. If you're eating fish itself for EFAs, you're probably eating salmon. Of course, farm-raised salmon isn't as great of a source anyway, and that's what most people are stuck buying, so eh, maybe supplements are still better.

i think it comes down to Freud not enough flax= anal retentive

the more the better.

you could always try colon blow...

SNL: "how many bowls of your favorite cereal does it take to match the fiber content of colon blow?

6?... no! 14?.... no!

4000!!

that's right, 4000 bowls of your favorite cereal to equal the fiber content of colon blow..."

Doctor Bagel said:

So on the flax seed issue -- it appears that vegetarian sources of omega-3s are generally ALA, which the body inefficiently converts to DHA and EPA. So maybe fish consumption is a more direct route, but high amounts of vegetable omega-3s might be beneficial.

Have any studies been done specifically on the efficacy of flax seed, etc., or is it just that all the studies have been done using fish?

Click to expand...

As you know, it's tougher if you're vegetarian. A tablespoon of flax seed oil a day is about the best you can do, as that provides about 8.0g of ALA daily, and the ratio of ALA to LA is relatively low, as too high an LA level prevents the conversion to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Next best is flaxseed ground I think.

Anasazi23 said:

As you know, it's tougher if you're vegetarian. A tablespoon of flax seed oil a day is about the best you can do, as that provides about 8.0g of ALA daily, and the ratio of ALA to LA is relatively low, as too high an LA level prevents the conversion to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Next best is flaxseed ground I think.

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Thanks for taking my concern seriously!

psisci said:

If your issues are more important than your health then go for the flax. Salmon and tuna swim in the same water oh enlightened one. I am so glad I am moved out of California......................

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"issues" -- nice. I hope no vegetarian is ever so unfortunate as to seek you out as a health care provider. I also hope that if they do, they have enough sense to know they deserve to be treated by someone who doesn't dismiss their valid concerns as "issues."

Anyway, about the mercury thing -- apparently tuna and salmon are both considered to be low mercury foods. Albacore tuna is higher mercury, though. Sure, they all swim in the same waters, but apparently they're not all contaminated in the same amount.

http://www.epa.gov/waterscience/fishadvice/advice.html

So does nordicnaturals give you a kickback? Just wondering.

the mercury thing tend to be an ecological pyramid scheme. Fish/crustaceans can't clear the methylmercury from their bodies, and while fish can absorb the mercury from the water, they also get it from ingesting other fish. The more fish you eat-- especially if you eat fish that eat other fish that eat other fish... like sharks and tuna's, the more concentrated the methylmercury is. Salmon, though swimming in the same water, aren't as high on the food chain so they tend to have less mercury. It's just like DDT in the 80's.

So if you want to watch your mercury levels, vegetarians are a much better source of protein than Inuits.

Chewbacca Jung said:

So if you want to watch your mercury levels, vegetarians are a much better source of protein than Inuits.

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Hey, don't tell people that.

Anasazi23 said:

As you know, it's tougher if you're vegetarian. A tablespoon of flax seed oil a day is about the best you can do, as that provides about 8.0g of ALA daily, and the ratio of ALA to LA is relatively low, as too high an LA level prevents the conversion to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Next best is flaxseed ground I think.

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It's best to consume flaxseeds within the first 24 hrs of grinding, otherwise it becomes oxidized and loses potency. This is anecdotal, but I've also heard ground flax seeds help reduce water retention during pregnancy.

grishko2007 said:

It's best to consume flaxseeds within the first 24 hrs of grinding, otherwise it becomes oxidized and loses potency. This is anecdotal, but I've also heard ground flax seeds help reduce water retention during pregnancy.

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Yeah, I've heard that, too. Back when I did the flaxseed thing (too lazy now), I'd grind each time I ate it. I think flax seed oil goes rancid really fast unfortunately.

Sorry I didn't jump into this earlier.

From one groundrounds I sat through the lecturer mentioned that flaxseed may actually disrupt some of the benefit of EPA. I had asked the speaker on how this happens, and he did give me an answer but it was over a year ago and I didn't memorize it. I'd actually spend some time too look more into this but I got step III in about 1.5 weeks so I'll leave this one alone for now.

Yes, buying any fish oil can have heavy metals in it. Certain stores sell fish oil from areas with low levels of contamination or have been molecularly distilled to have the heavy metals removed.

Chewbacca's statements are basically what I've read too on mercury levels in fish.

I've also been reading a lot of articles that fish oil-DHA is highly beneficial for neurological disorders as well. Read some studies showing it raises seizure threshold, may hold some benefits in MS and a bunch of other things too.

I also went to a grand rounds with someone highly eminent in Alzheimer's research and he said that DHA inhibits one of the processes that needs to go on for several years to cause Alzheimer's disease. He said fish oil may be a future therapy to prevent it, especially in those that have a genetic predisposition.

Nuts--sorry. I'd fish for links but I'm in fear factor mode because Step III is close.

Only problem I've been having is I've been giving this to my inpatients in the psyche ward and some of the attendings are like--"you think you're Dr. Wiel?, he's a quack", or "this holistic stuff is BS". I was a bit bugged with this because the studies with DHA have quite numerous and show some excellent benefits, and on top of that, antidepressants really aren't very efficacious. Why not give them something that helps that's not bad for them?

With respect to the original study correlation doesn't imply causation.

> As for my views on vegetarians that is not important, but I think we all know some do it for legit reasons and some as a form of eating disorder.

Lol. As for my views on psychologists that is not important, but I think we all know some do it for legit reasons and some as a form of mental disorder.

I can't believe you just said that.

1) Engage brain
2) Open mouth

Hey there.

> notice how nobody who actually has any training in mental health questioned my comment.

Is the thought that this tells you something about me, or something about people with training in mental health?

I'd like to think that people assess what is said on the basis of its merits rather than on the basis of who the person is. To dismiss something that a person has said on the basis of who the person is rather than on the basis of the merit of what is said is known as an 'ad hominem attack'. I'm tempted to say that that is something that we learn over in first year philosophy but quite a few people have a grip on critical thinking these days. Heres some more on that in case you missed it:

http://www.nizkor.org/features/fallacies/ad-hominem.html

> We congratulate you on being so wonderfully PC, that is so new these days.

For me it isn't a matter of political correctness so much as a matter of my finding it tiresome that people maintain you can't be healthy in eating a vegetarian or vegan diet. To consider it to be a matter of 'political correctness' is to miss the point. I was surprised that you seemed to be all but rolling your eyes because someone would choose to refrain from condoning practices around causing living beings to suffer, or potentially suffer if you aren't so sure whether fish have nervous systems that are developed such that they can feel pain.

> BTW, correlation does not equal causation is very undergrad, by the time you get to medical school or grad school you don't think this is new info you have to tell people.

Right. So there are other studies behind this that lead people to believe that increasing omega will cause them to be healthier then?

For me it isn't a matter of political correctness so much as a matter of my finding it tiresome that people maintain you can't be healthy in eating a vegetarian or vegan diet.

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Now now now, let's all calm down a bit.

I don't believe being vegetarian is a bad thing. Its actually quite healthy in a lot of ways. I don't think anyone here is suggesting that vegetarianism is bad (at least I don't think so).

The bottom line though is from what I do understand the big mental health benefits are from EPA, not DHA. Again, if someone finds contrary data please post it.

And there are non animal sources of EPA available.

http://en.wikipedia.org/wiki/Eicosapentaenoic_acid

It is available from some non-animal sources—spirulina and microalgae. Microalgae are being deveolped as a commercial source.[1] EPA is not usually found in higher plants, but it has been reported in trace amounts in purslane.[2]

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Not trying to advertise and I swear I've got no connection with the below site but here's a site selling vegetarian EPA

http://www.diagnose-me.com/treat/T409718.html

http://www.water4.net/

Note, if putting in this direct advertisment breaks the forums rules, kindly edit the post. I'm just trying to help out.

toby jones said:

Hey there.

>
> We congratulate you on being so wonderfully PC, that is so new these days.

For me it isn't a matter of political correctness so much as a matter of my finding it tiresome that people maintain you can't be healthy in eating a vegetarian or vegan diet. To consider it to be a matter of 'political correctness' is to miss the point. I was surprised that you seemed to be all but rolling your eyes because someone would choose to refrain from condoning practices around causing living beings to suffer, or potentially suffer if you aren't so sure whether fish have nervous systems that are developed such that they can feel pain.

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Whoa! Toby, I didn't see anything saying that vegetarianism can't be healthy -- I did see something saying that sometimes "vegetarianism" is used as a cover for an eating disorder.

Guess what? It is. In fact, it's not that uncommon in eating disorders to see someone claiming vegetarianism as a reason for not eating. That doesn't mean that ALL vegetarians are anorexic, nor that all anorexics are vegetarians. It only means exactly what was originally stated: "some vegetarians are legit, some have an eating disorder."

OK, everyone gonna play nice now? Pretty please?

I apologise for the tone in my post. Mostly the tone was in response to this:

> We congratulate you on being so wonderfully PC, that is so new these days.

Am I the only person who sees the tone in this quote as sarcastic and condescending? If the tone is jokey I guess I fail to get it. Mostly because the majority of people I know who are vegetarian / vegan are for serious moral reasons and to consider vegetarianism / veganism a matter of political correctness is to patronise their views. Come to think of it I don't really see what is so objectionable about 'political correctness'. So it isn't okay to go grabbing the asses of female coworkers. That is simply not PC. Get used to it.

> I did see something saying that sometimes "vegetarianism" is used as a cover for an eating disorder. Guess what? It is.

Right. And this claim is probably about as fair as the claim I made about a career choice in psychology being a cover for a mental disorder. Guess what? It is.

What good is there in saying so? Did the person mean to imply that we don't need to take vegetarianism / veganism seriously because it is often a symptom of mental disorder? If that was the point of what they said their claim would be false. On more charitable readings of what they said (like yours) their claim would be true but uninteresting and not to mention irrelevant to the present conversation.

I don't really see why we can't discuss things without the tone and the derogatory comments. They annoy me at times... But, you know... It simply isn't worth it at the end of the day.

If I read this right you sortof attacked psisi first? Anyhow I agree with whopper, psisi and others because I have seen people using vegetarianism, veganism as a cover for eating pathology alot. As a clinician this is something you have to be aware of. Sure you can be healthy if you eat such a diet, but it is alot harder. Unlike horses we humans cannot make proteins out of grass.

Omega 3's in the Psychiatric News:
http://pn.psychiatryonline.org/cgi/content/full/42/6/16-a

> If I read this right you sortof attacked psisi first?

I didn't mean to be attacking and if I came across that way then I apologise. The comment that got to me was the implication that vegetarianism is typically(?) a sign of pathology.

> I have seen people using vegetarianism, veganism as a cover for eating pathology alot. As a clinician this is something you have to be aware of.

I figure it would need to be assessed and not assumed though.

> Sure you can be healthy if you eat such a diet, but it is alot harder.

It is harder (and more expensive) to eat healthy foods more generally. It is a little bit harder again (and more expensive most probably) to eat a healthy vegetarian diet and a great deal harder (and more expensive most probably) to eat a healthy vegan diet. With a vegan diet you need to get synthetic B12 and thus if people are eating only fresh food (without a B12 source) that will lead to problems long term. While I agree that there are of course a number of people who plead vegetarianism / veganism to account for very bizzarre eating habits I do think it is important to show some sensitivity around the moral issues.

I would have thought that whether people are eating a healthy / unhealthy diet would be something that would need to be assessed rather than assessing for vegetarianism / veganism and making the assumption that that is indeed unhealthy. Oftentimes when it is people need education rather than treatment for pathology at any rate. E.g.,:

http://www.veganoutreach.org/health/stayinghealthy.html

Todays reading:

...and lo, psisci did offend the moderator, and the moderator reached out and smote psisci turning him into guest. The moderator spake unto guest and said "don't f#$% with psychiatry," and there was much wailing and gnashing of teeth.

No actually he resigned, because he is much better as a person who can express himself than an enforcer of rules. BTW the APA letter, which was not done by me was meant as an April fools joke...no humor here I guess.

For those of us who are interested in fish oil and don't want to contribute to the killing of baby seals, you might want to make sure your fish oil supplements don't come from Canada.

Oh but wait -- caring about animals is a sign of pathology.

Anyway, some absolutely horrifying information about the baby seal slaughter that's happening right now. Read the bottom of the page to see the connection between Canadian seafood and the seal hunt.

http://www.hsus.org/protect_seals.html

hmm. was it caring about baby seals or caring about fish that was meant to be a sign of pathology??? i'm a little lost ;-)

<joke>

are you an acutarian?

http://www.unc.edu/~megw/Acutetarian.html

allosteric1 said:

No actually he resigned, because he is much better as a person who can express himself than an enforcer of rules. BTW the APA letter, which was not done by me was meant as an April fools joke...no humor here I guess.

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Hey psisci, nice new name. Good thing you're putting it out there in writing that the APA letter wasn't created by you, because I believe the APA lawyers might be looking for the person who did. Might want to purge your hard-drive all the same.

Doc Samson said:

Hey psisci, nice new name. Good thing you're putting it out there in writing that the APA letter wasn't created by you, because I believe the APA lawyers might be looking for the person who did. Might want to purge your hard-drive all the same.

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Isn't this a little much Doc? I would hope you and your APA would have a better sense of humour than that.

As for Omega-3s, the new issue of *American Journal of Psychiatry* (Volume 163, Issue 6,
June) includes a review article: "Omega-3 Fatty Acids and Mood Disorders." PM me if you want the email address to request a reprint. Here's an excerpt:

In terms of intervention, there are now several studies supporting
omega-3 supplementation as having a distinct antidepressant role.
Predictably, because of the complexities intrinsic to the domain, much
work will be required to determine which omega-3 fatty acid (and in what
ratio to omega-6 fatty acids) is likely to have the greatest benefit and
at what dose. Currently, there appears to be somewhat stronger support
for EPA than for DHA in terms of antidepressant strength. However, this
is of theoretical interest principally, as the two omega-3 fatty acids
are not normally separated but given together as fish oil. It presently
remains unclear whether omega-3 supplementation alone has antidepressant
properties or whether omega-3 fatty acids may have greater potential as
augmenters of standard antidepressants. Finally, while there are two
studies indicating efficacy of omega-3 supplementation for patients with
bipolar disorder, it remains to be further investigated whether its
identified benefits derive from a mood-stabilizing propensity or an
antidepressant effect.

I put the above link to the vegetarian source of EPA. Unfortunately its in the UK. YEah you could of course order it and have it shipped to the US. I haven't found any sold in the US. I'd rather take that that actual fish oil.

But I have quite easily found molecularly distilled fish oil here in the states.