I find it strange that two completely different conditions with different aetiologies have the same name. Very confusing, especially if the word 'stroke' on its own is mentioned and a treatment advice given.
Stroke isn't the real word. Stroke isn't a doctor word really. Cerebrovascular accident is the real word - CVA. The word CVA is used because it describes a presenration and only on CT scan do you know the subtype. Either ischaemic CVA or haemorrhagic CVA. In the days before scans there was not a chance of a subtype grouping except in atrial fibrillation the chance of it being embolic and this thrombotic was higher.
So the one word is a remnant of those days.
The thing is us docs know what we mean by context, but it obviously confuses laypeople a LOT. Sorry.
Another example of a word used incorrectly and misleadingly is "fat".
My concern is recommending over 5 grams of fish oil. Wow. Also if you took 5 grams of fish oil and 12 tablespoons of EVOO, let's just say my mind is blown. Actually speechless. Then adding aspirin. I will check out of this thread because I do not want to have my negative vibes interfering.
I've read the thread and don't see anyone recommending 5 grams of fish oil. Am I missing something? FWIW, I take 1 gram a day of DHA and some misc. EPA (that comes along with that) in addition to many plants and some limited animal sources of Omega-3. Most of us aim for an Omega-3 Index (RBC=DHA+EPA) of 10% or higher.
Julie G wrote:Most of us aim for an Omega-3 Index (RBC=DHA+EPA) of 10% or higher.
And testing this is very useful. I had a score of 11.5 when I wasn't even supplementing fish oil but I was eating high omega 3 fish at least once a day. (Next in this department I learned with a mercury test that I was jacking that up even choosing low mercury fish, so now I'm much better balanced between low mercury fish and supplement and it's time to retest this and see where I'm at.
This is why I sacrifice other things in life I'd like to spend money on in order to pay for labwork for things that can be tested but insurance won't cover. Otherwise we really are flying blind through a misty forest. I realize even blood tests aren't perfect for various reasons in various cases, but I feel they at least provide a guide that can be tested over time. It's sometimes hard for me to resist taking some commonly touted brain/mito supplements that can't be lab tested for, and I've started taking nicotinamide riboside, but I really try to mostly limit supplements to what I can check and recheck.
Another simple example is vitamin D3. I was initially at 40 before I started supplementing. On retest I was at about 110! Cut way back and just came back at 50, so now I'll up a bit and find the sweet spot. It seems the formulas they recommend for D3 dosing may only apply to people who don't get much sun?
So the question I have is ... Are there specific blood tests that measure or suggest how thin one's blood is? Oh, Cleveland Clinic says 'prothrombin time'. I think I've heard of that. Maybe something we should be adding to our list of biomarkers to test.
Stavia I love all your clarifications on medical terminology and mechanisms. Thank you.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
I was going to stay out of this thread , but since you might have missed it, Slacker is taking 5 grams, she is not recommending, just stating. Tin is taking and I stand corrected over 6 grams, "recommended" by his doctor. Now George is meticulous with his doses and documentation, so it does not worry me for him. But for others reading this thread, let me be the first to say that is an insanely high daily dose with aspirin, and other supplements like medicinal herbs.
You are thinning your blood a lot with doses this high. Under strict doctor supervision and routine blood work it can be ok. But for the average person trying to prevent AD or CVD, I think it is excessive. Like 5 to 6 times the standard dose. No one would take 5 times their statin dose. Or 6 times their insulin dose. Or 5 times the amount of digitalis that is required for efficacy. But for supplements the caution and common sense sometimes goes out the window. If it is doctored ordered, than that is a different issue.
With blood overly thinned, if you ever have an emergency or need surgery you now have a new set of problems. But it is only my opinion. Strong opinion, but readers have the right to skip over it, ignore it, or say that guy is crazy. I can live with it. I just get concerned for the less seasoned people on the boards, newbies, or those who are not getting the results they are looking for. Some readers on this forum might read and think 5 to 6 grams of fish oil with aspirin is ok or the norm. It's not, ever, without doctors supervision. I am also talking about the guests that I see on the boards all the time, people whom we don't even know. They can't open everything, but enough to read threads like this.
Finally like I said earlier, the science is not settled on fish oil and it's benefits. In fact most are junk and contaminated. A few companies put out a good product. For every study I find touting its benefits, I find a similar study saying it does not prevent CVD or other conditions that are claimed as treatable with fish oil. Independently for AD I do not see any hard evidence that as a montherapy it is effective for patients. I see a few that have shown benefits for RA. These RA trials have been repeated as well. A few studies have shown fish oil to be beneficial for Raynauds patients at high doses.
They are also used at high doses for toxin protocols. This is too complex for me to explain in detail on the forum; but the short version is they help with herxheimer reactions. You treat the body with high doses of fish oil, then when you start detoxing with certain drugs, it helps reduce the amount of down days you have. If you are lucky you can detox from beginning to end without having to take breaks. Most people have to give their liver and kidneys time to recover as well. Then continue at a later time.
My philosophy is to always be over cautious on forums that discuss medical issues. Not saying it happens much on this site, but others I am involved with or was involved with, have a lot of protocol jumpers. These are people that every time someone posts research about a product, or a Med, or a supplement, they start taking them. Sounds illogical and irresponsible, but (and I mean a big but), when you are sick, or dying, in a lot of pain, or diagnosed with a progressive illness; patients will do anything for relief/ help. Sometimes to their own peril unfortunately. Because some of these are supplements patients forget they can be very harmful. Especially some medicinal herbs. Stay safe, stay within standard doses unless your doctor recommends super high doses.Even then I would question.
Thanks for sharing your perspective and warnings, Frank. I know your heart is in the right place. Apologies for splitting hairs, but your claim that members were recommending high levels of Omega-3s violates our Community Guidelines; hence my concern.
Refrain from offering direct medical advice to our members. You are welcome to share any strategies you practice or that you recommend for your patients with accompanying evidence. We welcome members of our community to correct factual inaccuracies. Be aware that much of what we discuss is equivocal. Simply acknowledging that often goes a long way towards balancing a very biased perspective.
I’m also surprised/concerned about the high levels that some members are using. I look forward to learning more about their motivations for doing so- great discussion and learning opportunity. Above all, we want to keep everyone safe. The supplementation of fish oil may be one of those “Goldilocks” cases where we need to get levels just right to derive optimal benefit without doing harm.
When I first began my E4 journey, over 5 years ago, evidence suggested that E4 carriers did NOT benefit from Omega-3 supplementation unlike other APOE genotypes. With further examination, that’s been reconsidered and, dare I say, overturned? E4 carriers appear to preferentially metabolize Omega-3s and seem to need more than other APOE genotypes to derive similar benefit. When studying an all E4 dataset, those with a higher Omega-3 index perform better on cognitive testing and even show structural benefit with imaging. Check out our wiki article. We’ve previously discussed resources for determining the safest sources of fish oil supplementation on the forum. Perhaps we should add those caveats to the “strategies” section of the wiki? Check out this recent paper on the subject:
Carriers of an apolipoprotein E epsilon 4 allele are more vulnerable to a dietary deficiency in omega-3 fatty acids and cognitive decline. https://www.ncbi.nlm.nih.gov/pubmed/28733268
Abstract
Carriers of an epsilon 4 allele (E4) of apolipoprotein E (APOE) develop Alzheimer's disease (AD) earlier than carriers of other APOE alleles. The metabolism of plasma docosahexaenoic acid (DHA, 22:6n-3), an omega-3 fatty acid (n-3 FA), taken up by the brain and concentrated in neurons, is disrupted in E4 carriers, resulting in lower levels of brain DHA. Behavioural and cognitive impairments have been observed in animals with lower brain DHA levels, with emphasis on loss of spatial memory and increased anxiety. E4 mice provided a diet deficient in n-3 FA had a greater depletion of n-3 FA levels in organs and tissues than mice carrying other APOE alleles. However, providing n-3 FA can restore levels of brain DHA in E4 animals and in other models of n-3 FA deficiency. In E4 carriers, supplementation with DHA as early as possible might help to prevent the onset of AD and could halt the progression of, and reverse some of the neurological and behavioural consequences of their higher vulnerability to n-3 FA deficiency.
Thank you for allowing me to contribute to stirring up this discussion on blood thinning supplements. All points well taken and perspectives appreciated.
So here is my list of "mea culpas":
First, a misunderstanding of my FMD's recommendation of omega 3 for me. I thought she recommended 3000 mg of DHA daily, but upon review of my notes from Nov 2016, the recommendation I wrote down was 3000 mg total omega 3 supplementation daily. The recommendation was not for monotherapy, but as part of a total treatment plan for cognitive health. This is still a higher amount than some of our members' comfort level. (Note that Dr Bredesen is recommending 1000mg DHA daily in his book, pg 200)
Next, when reporting total omega 3 supplement intake on my last post with charming photo, I did not take into account that the amount listed on the bottle was for 2 pills. Therefore I was taking 2500 mg total omega 3 daily with supplementation, and 1440 mg of DHA, which is half of what was recommended by FMD. I have cut back to 2 pills a day after most recent bruising episode, for a total of 1660 mg omega 3 from supplements daily. I eat salmon sporadically, small palm sized piece 2 to 3 times a week (maybe), when I remember to defrost. (I'm going to the freezer as soon as I finish this post...) I have not tested omega 3 levels.
I'm excited about the possibility that omega 3 index/ratio and prothrombin tests may help us each find our own sweet spot, although I'm aware these may be very hard to get in most countries. I hope DTC blood tests will open up elsewhere. I do wonder why, if one is taking high doses of omega 3 and/or EVOO, they would want to also take asprin. I'm thinking omega 3 provides a potentially safer way to prevent blood clots? Is it possible some are taking the asprin as a conventional recommendation that's not helpful, and might be hurtful, in the context of a heart healthy diet? Of course I realize we're all in our own places on the spectrum from conventional to lifestyle (also recognizing conventional often does include to make the lifestyle changes). Maybe baby asprin recommendation came about because patients wouldn't change their diet/lifestyle (and/or post clot-related stroke or heart attack).
ApoE 3/4 > Thanks in advance for any responses made to my posts.
(I'm going to the freezer as soon as I finish this post...) I have not tested omega 3 levels.
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