1 of 4
1
Poll
In regards to fish oil consumption. chesk all that apply
I use fish oil capsules 2
I do not use fish oil capsules 8
I take it for my joint pains or arthritis 0
I take it for general health 0
I have had a heart attack or stroke and want to prevent another 0
I have never had a heart attack or stroke but would like to prevent one 0
My doctor recommended that I take fish oil capsules 1
I decided on my own to take fish oil capsules 2
Total Votes: 13
You must be a logged-in member to vote
JUst a quick poll. WHo here uses FIsh Oil Capsules and for what indication are you taking them
Posted: 03 March 2014 01:20 PM   [ Ignore ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2140
Joined  2007-04-26

Fish oil capsules a pretty commonly used supplement and many physicians recommend them to their patients although I find even among doctors there is some confusion about the appropriate indications for their use. I’m curious how many forum readers take Fish Oil supplements, what they are being used for and whether they are being taken under the advice of a physician or self prescribed. Thanks

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 03 March 2014 01:23 PM   [ Ignore ]   [ # 1 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4417
Joined  2008-08-14

I don’t take ‘em.
Oh, I see. I forgot to check-“I have never had a heart attack, but would like to prevent one”.
I didn’t see we could check all that applies.
I would have checked the prevention thing too.  I’m doing that through exercise and better diet.

 Signature 

Row row row your boat gently down the stream.  Merrily Merrily merrily merrily life is but a dream!

Profile
 
 
Posted: 03 March 2014 01:51 PM   [ Ignore ]   [ # 2 ]
Moderator
RankRankRankRankRankRankRankRankRankRank
Total Posts:  5500
Joined  2010-06-16

Sorry, Mac, but apparently our wonderful software program screwed up again.  I checked that I did, that I had a heart attack, and that my doctor recommended them.  None of them came through so apparently the survey results will be incorrect. Either that, or the program doesn’t like me for criticizing it.  smile

Occam

 Signature 

Succinctness, clarity’s core.

Profile
 
 
Posted: 03 March 2014 02:09 PM   [ Ignore ]   [ # 3 ]
Moderator
RankRankRankRankRankRankRankRankRankRank
Total Posts:  5500
Joined  2010-06-16

And the reason I take them is because there is quite a bit of published research which indicates that omega-3-fatty acids seem to benefit heart health.

Occam

 Signature 

Succinctness, clarity’s core.

Profile
 
 
Posted: 03 March 2014 02:54 PM   [ Ignore ]   [ # 4 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27

I was unable to check all that apply. Checking one prevented me from checking any others. 

For the record, I don’t take them, though I did try some for a short time a year or so ago, I have not had a stroke or heart attack but I would like to prevent them.  I have never had them recommended by a doctor.  I also have not seen any evidence that they are effective for anything. Are they?

Lois

[ Edited: 03 March 2014 02:59 PM by Lois ]
Profile
 
 
Posted: 03 March 2014 03:12 PM   [ Ignore ]   [ # 5 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2140
Joined  2007-04-26

Sorry everyone. I was trying to figure out a way to ask several questions at once in the poll and didnt realize the poll only lets you answer one question at a time. FIrst time trying to do that. A clear case of operator error. There doesn’t seem to be any way to have multiple separate questions either so I guess this is a bust.

Maybe I will just describe what motivated the poll. Occam is correct that there is a fair amount of literature on this issue but let me summarize

There have been retrospective population studies showing that societies with fish based diets have less heart disease. From that and other studies which showed that Omega 3’s cold have a positive effect on the lipid profile ( good and bad cholesterol) a theory developed that Omega 3’s might reduce the risk of heart disease. Randomized controlled trials were done and there seems to be good evidence that Omega 3’s may reduce the risk of a heart attack in someone who has already had a first heart attack, however the evidence for primary prevention is not there. In other words if you have never had a heart attack or stroke and you take Omega 3’s there is no good evidence that it won’t help which is interesting because I find among my own patients that this is the primary situation for which people are taking this supplement.

Some people have advocated using Omega 3’s for joint disease as well. There is some limited evidence that Omega 3’s help with Rheumatoid arthritis but not osteoarthritis yet the vast majority of arthritis sufferers ( and the vast majority of people taking Omega 3’s for their joints) have osteoarthritis.

It seems in both cases that the message has been distorted either intentionally or through a simple misunderstanding both on the part of patients as well as physicians. The result is that many people are using this product who may be getting no benefit from it. Yes Omega 3’s can help reduce heart attacks in people who have had one before but that doesn’t mean everyone who takes them can expect the same benefit and in fact the majority of people taking them may get no benefit. The same being true for most arthritis sufferers as well as anyone who is taking them to improve their overall health.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 03 March 2014 03:34 PM   [ Ignore ]   [ # 6 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4065
Joined  2006-11-28

I used to take them for primary prevention of cardiac disease as I have had high LDL levels and there seemed to be some evidence to suggest it was a reasonable step. Eventually, however, I decided the evidence was more supportive of eating fish than of taking supplements, so I chose to do that instead. Recent systematic reviews have questioned even the secondary preventative benefits, so I think the jury is still out.

FWIW, in my field fish oil supplements are ubiquitous for treatment of atopic dermatitis, osteoarthritis, possible prevention of cognitive dysfunction, and a hodgeppdge of other indications. There is weak clinical trial evidence for a steroid-sparing effect in dogs with atopy and for minimal improvement in dogs with arthritis, and most of the other indications have little if any supporting evidence.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 03 March 2014 05:01 PM   [ Ignore ]   [ # 7 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2140
Joined  2007-04-26
mckenzievmd - 03 March 2014 03:34 PM

I used to take them for primary prevention of cardiac disease as I have had high LDL levels and there seemed to be some evidence to suggest it was a reasonable step. Eventually, however, I decided the evidence was more supportive of eating fish than of taking supplements, so I chose to do that instead. Recent systematic reviews have questioned even the secondary preventative benefits, so I think the jury is still out.

You’re correct. The jury is still out on secondary prevention, I may have overstated the benefits. You raise a good point about eating fish though. I have to go back and look at some of the original population studies that triggered this whole line of investigation but I have often wondered if the reason that fish eating populations had lower rates of heart disease was simply because those who eat a lot of fish are most likely eating fewer hamburgers.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 03 March 2014 05:35 PM   [ Ignore ]   [ # 8 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3058
Joined  2011-08-15

I hope that it helps; not only do I take the capsules as recommended by my doctor but I eat fish at least once a week. He suggested. I take two capsules daily. He takes them too and we’re about the same age. So far I’ve had no joint pain, just muscle and that can be chalked up to lack of exercise.

Cap’t Jack

 Signature 

One good schoolmaster is of more use than a hundred priests.

Thomas Paine

Profile
 
 
Posted: 03 March 2014 06:24 PM   [ Ignore ]   [ # 9 ]
Moderator
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  4065
Joined  2006-11-28

Yes, the issue of why some things seem beneficial in epidemiologic studies looking at diet but turn out not to seem so useful when isolated as supplements always raises the question of why. Are whole food sources somehow more effective due to unidentified synergies between compounds, or are specific food consumption patterns so confounded with other risk factors that the associations are not causal at all? It can be really hard to tell, yet the problem crops up pretty frequently.

A separate issue is when do we classify something like this as “alternative medicine?” I generally don’t consider supplement use or nutritional interventions as “alternative” when there is a large amount of controlled scientific research evidence related to it, since such interventions are a routine part of science-based medicine. Fish oils in this case, Zn supplementation in children with diarrheal diseases and at risk of deficiency, Vitamin A in children with measles, Vit B12 in the elderly, reductions in consumption of saturated fats, etc are all rational uses of dietary supplements or dietary interventionsconsistent with normal scientifi medical practice, yet somehow they get labeled “alternative” and folks who push far less evidence-based or rational practices take credit for them. It is implied that conventional medicine doesn’t concern itself with supplement use or dietary therapy, but of course this isn’t true. Science-based medicine simply requires some reasonable evidence for safety and efficacy rather than assuming supplements are a good thing if there is a little preclinical research evidence or even a cultural tradition of using them. I understand why you chose this folder for this thread, but I thought it is an interesting question why this seemed a better place for such a discussion than, say, the “Science and Technology” folder.

 Signature 

The SkeptVet
The SkeptVet Blog
Militant Agnostic: I don’t know, and neither do you!

Profile
 
 
Posted: 03 March 2014 06:31 PM   [ Ignore ]   [ # 10 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2140
Joined  2007-04-26
Thevillageatheist - 03 March 2014 05:35 PM

I hope that it helps; not only do I take the capsules as recommended by my doctor but I eat fish at least once a week. He suggested. I take two capsules daily. He takes them too and we’re about the same age. So far I’ve had no joint pain, just muscle and that can be chalked up to lack of exercise.
Cap’t Jack

I obviously don’t know your situation Jack and your doctor may have good reasons for his recommendations but it wouldn’t surprise me if he was just “following the crowd”. I find that a surprising number of physicians make recommendations based on dubious sources of information (A single study or speaker at a conference, the newspaper, articles in non-medical magazines ( TIME), the nightly news, and even Dr Oz) or because its what their colleagues are doing. Its especially problematic in areas where the evidence is conflicting.

Unfortunately as McKenzie and I have already pointed out, there does not seem to be any real benefit for most people who use these supplements. You may want to read this Cochrane review for more information. Be sure to click on the abstract link to read the details.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 03 March 2014 06:58 PM   [ Ignore ]   [ # 11 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2140
Joined  2007-04-26
mckenzievmd - 03 March 2014 06:24 PM

Yes, the issue of why some things seem beneficial in epidemiologic studies looking at diet but turn out not to seem so useful when isolated as supplements always raises the question of why. Are whole food sources somehow more effective due to unidentified synergies between compounds, or are specific food consumption patterns so confounded with other risk factors that the associations are not causal at all? It can be really hard to tell, yet the problem crops up pretty frequently.

A separate issue is when do we classify something like this as “alternative medicine?” I generally don’t consider supplement use or nutritional interventions as “alternative” when there is a large amount of controlled scientific research evidence related to it, since such interventions are a routine part of science-based medicine. Fish oils in this case, Zn supplementation in children with diarrheal diseases and at risk of deficiency, Vitamin A in children with measles, Vit B12 in the elderly, reductions in consumption of saturated fats, etc are all rational uses of dietary supplements or dietary interventionsconsistent with normal scientifi medical practice, yet somehow they get labeled “alternative” and folks who push far less evidence-based or rational practices take credit for them. It is implied that conventional medicine doesn’t concern itself with supplement use or dietary therapy, but of course this isn’t true. Science-based medicine simply requires some reasonable evidence for safety and efficacy rather than assuming supplements are a good thing if there is a little preclinical research evidence or even a cultural tradition of using them. I understand why you chose this folder for this thread, but I thought it is an interesting question why this seemed a better place for such a discussion than, say, the “Science and Technology” folder.

I chose to put it here because the way in which many people are using it truly is alt med. While there may be legitimate uses, and certainly if it is being used or recommended based on the data then its not alt med, but I think a lot of people take it for the same reason they take ginko biloba or other alt med supplements. Most people take it because they read an article written by some ill informed writer or frequently because a friend told them it was a good idea. I often ask my patients what motivated them to take the supplements they are on and while the reasons run the gamut, among the Fish Oil users the most common answers I get are.
1) I heard it was good for you
2) My wife put me on it ( No doubt after watching the wizard of oz)
3) A friend of mine who is really in to health told me I should take it

I agree 100% with your definition though. The only difference between alt med and conventional med is the evidence, so a particular substance could be conventional med if used for one reason and alt med if used for another. Vit B12 injections are often prescribed by physicians. If they are given to someone with pernicious anemia they are conventional medicine treatments. If they are given to someone because they are fatigued with no known cause then they are practicing alt med. If fish oil is being used for secondary prevention it is currently conventional med but if its being used to treat osteoarthritis its alt med.

 Signature 

For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Profile
 
 
Posted: 03 March 2014 07:12 PM   [ Ignore ]   [ # 12 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27

It looks as if eating a Mediterranean diet and drinking black or green tea is likely to work better than omega-3 supplements.

Lois

[ Edited: 17 March 2014 06:32 PM by Lois ]
Profile
 
 
Posted: 03 March 2014 09:10 PM   [ Ignore ]   [ # 13 ]
Sr. Member
Avatar
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3058
Joined  2011-08-15

Unfortunately as McKenzie and I have already pointed out, there does not seem to be any real benefit for most people who use these supplements. You may want to read this Cochrane review for more information. Be sure to click on the abstract link to read the details.

Thanks Mac, he’s pretty good at keeping up with the latest reports though. He works for a university medical center and also teaches there as well. No matter what the outcome, I’ll still eat fish once a week, especially sardines. Love em.

 

Cap’t Jack

 Signature 

One good schoolmaster is of more use than a hundred priests.

Thomas Paine

Profile
 
 
Posted: 03 March 2014 10:06 PM   [ Ignore ]   [ # 14 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  3052
Joined  2011-11-04

When my cholesterol levels were first getting high, and my PCP spoke about medicine for it, I lobbied to try fish oil first.  I regularly took 2000 mg. daily.  My cholesterol levels improved, so my PCP suggested I continue with it.  I did for years, but in the past year I have rarely and sporadically taken it, and if I do, it’s only 1000 mg. I have just recently seen a new PCP for the 1st time, and am awaiting review of my lab work with him on the 2nd visit.  My guess is that my cholesterol will be high.  If so, my preference will be to try the regular high dose of fish oil again before trying a prescription that can damage my liver.

 Signature 

As a fabrication of our own consciousness, our assignations of meaning are no less “real”, but since humans and the fabrications of our consciousness are routinely fraught with error, it makes sense, to me, to, sometimes, question such fabrications.

Profile
 
 
Posted: 03 March 2014 11:30 PM   [ Ignore ]   [ # 15 ]
Sr. Member
RankRankRankRankRankRankRankRankRankRank
Total Posts:  2602
Joined  2012-10-27
TimB - 03 March 2014 10:06 PM

When my cholesterol levels were first getting high, and my PCP spoke about medicine for it, I lobbied to try fish oil first.  I regularly took 2000 mg. daily.  My cholesterol levels improved, so my PCP suggested I continue with it.  I did for years, but in the past year I have rarely and sporadically taken it, and if I do, it’s only 1000 mg. I have just recently seen a new PCP for the 1st time, and am awaiting review of my lab work with him on the 2nd visit.  My guess is that my cholesterol will be high.  If so, my preference will be to try the regular high dose of fish oil again before trying a prescription that can damage my liver.

What is a PCP?

Profile
 
 
   
1 of 4
1