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Thursday, January 09, 2003
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By Alan R. Gaby, MD
Healthnotes Newswire (January 9, 2003)—A fatty acid found in fish oil can relieve the symptoms of depression in people who have failed to respond to antidepressant medication, according to a report in Archives of General Psychiatry (2002;59:913–9). The results of this study represent an important advance in the treatment of this common and often debilitating condition.
Seventy people with depression that had persisted despite treatment with standard antidepressants were randomly assigned to receive ethyl-eicosapentaenoate (E-EPA), in the amount of 1, 2, or 4 grams per day or a placebo for 12 weeks, in addition to their antidepressant medication. Compared with the placebo group, the group receiving 1 gram of E-EPA per day had a significantly better outcome on each of three different rating scales for depression. The difference between E-EPA and placebo was statistically significant on two of the three rating scales within 4 weeks of the start of treatment, and the advantage of E-EPA over placebo became even more pronounced after 8 and 12 weeks. Sixty-nine percent of the participants treated with 1 gram of E-EPA per day experienced a clinically significant improvement (at least a 50% reduction on the Hamilton Depression Rating Scale) whereas only 25% of those receiving the placebo had clinically significant improvement.
Surprisingly, no statistically significant improvements were seen in the groups treated with the larger amounts of E-EPA (2 and 4 grams per day). No serious side effects were seen, although some people taking 4 grams of E-EPA per day experienced gastrointestinal symptoms.
E-EPA is a chemically modified form of EPA, which occurs naturally in fish oils and which can be manufactured in the body from a precursor molecule found in certain oils such as flaxseed and soybean oil. For reasons that are not clear, depressed people often have subnormal levels of EPA. A deficiency of this fatty acid can impair the functioning of cell membranes, including the membranes of brain cells. EPA also appears to play a role in signal transmission in the brain, an effect that may influence mood. The presumed mechanism of action of E-EPA is fundamentally different than that of conventional antidepressants, which usually work by raising the levels of serotonin or other “chemical messengers.” Consequently, E-EPA therapy offers a new approach to the treatment of depression; one that has the potential to enhance the benefits of prescription drugs, or to be helpful when prescription medications are not.
In the new study, the best results were achieved with the smallest amount of E-EPA tested, whereas the larger amounts tested produced little or no benefit. The authors of the study speculated that taking too much E-EPA might cause an imbalance between the two major classes of essential fatty acids: the omega-3 class (which includes EPA) and the omega-6 class (which includes linoleic and arachidonic acids). Omega-3 and omega-6 fatty acids are both essential for normal brain function, and taking too much of either might lead to a relative deficiency of the other.
It is not known whether taking fish oil would produce the same benefits as those seen with E-EPA. Fish oil contains a mixture of fatty acids, some of which might conceivably interfere with the effect of the EPA. In addition, it is possible that the ethyl molecule, which is added to EPA to make E-EPA, somehow improves the transport or utilization of EPA. Unfortunately, E-EPA is not widely available at the present time. One gram of EPA is contained in approximately 5.5 grams of fish-oil concentrate or 10 grams (approximately 2 teaspoons) of cod liver oil.
Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.
Copyright © 2003 Healthnotes, Inc. All rights reserved. Republication or redistribution of the Healthnotes® content is expressly prohibited without the prior written consent of Healthnotes, Inc. Healthnotes Newswire is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. Healthnotes, Inc. shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Healthnotes and the Healthnotes logo are registered trademarks of Healthnotes, Inc.
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5:17:29 PM 
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By Alan R. Gaby, MD
Healthnotes Newswire (January 9, 2003)—Supplementation with vitamins C and E can reduce the incidence of life-threatening complications in critically ill surgical patients, according to a report in the Annals of Surgery (2002;236:814–22). The results of this study suggest that this simple, safe, and inexpensive treatment might help save the lives of people who have sustained serious injuries, while at the same time reducing the cost of medical treatment.
Five-hundred and ninety-five people admitted to a surgical intensive care unit (ICU), 91% of whom were victims of trauma, were randomly assigned to receive standard care (control group) or standard care plus vitamins C and E. Vitamin E was given orally in the amount of 1,000 IU three times per day, and vitamin C was given intravenously in the amount of 1,000 mg three times per day.
Treatment was continued until the person was discharged from the ICU, or after 28 days, whichever was shorter. The incidence of multiple organ failure was significantly lower (by 57%) in the group receiving antioxidants than in the control group (2.7% vs. 6.1%). In addition, the average length of stay in the ICU was significantly lower (by 17%) in the antioxidant group. After 28 days, the mortality rate was 44% lower in the antioxidant group than in the control group (1.3% vs. 2.4%), but this difference was not statistically significant.
Critically ill surgical patients frequently develop severe and potentially fatal complications, such as pneumonia or multiple organ failure, days or weeks after major surgery. There is evidence that these complications are mediated, at least in part, by highly reactive oxygen-derived compounds known as free radicals, which are capable of causing damage to various tissues and organs of the body. Antioxidants such as vitamins C and E, selenium, N-acetylcysteine (NAC), and glutathione can prevent some of the damage induced by free radicals.
Although the amounts of vitamin C and vitamin E used in the new study would be considered fairly large for a healthy person, it is possible that even larger amounts would be needed to exert an optimal effect in critically ill individuals. In addition, as antioxidants work in the body as a team, it is likely that using a broad spectrum of antioxidants would be more effective than using only two, as in the new study. Now that researchers have demonstrated a beneficial effect of antioxidants in critically ill surgical patients, the stage is set for additional research to determine the optimal amounts and combinations of antioxidants to administer.
Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.
Copyright © 2003 Healthnotes, Inc. All rights reserved. Republication or redistribution of the Healthnotes® content is expressly prohibited without the prior written consent of Healthnotes, Inc. Healthnotes Newswire is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. Healthnotes, Inc. shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Healthnotes and the Healthnotes logo are registered trademarks of Healthnotes, Inc.
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5:16:56 PM
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By Matt Brignall, ND
Healthnotes Newswire (January 9, 2003)—Coenzyme Q10 (CoQ10) is an effective treatment for people with a common type of high blood pressure, according to a clinical trial published in the Southern Medical Journal (2001;94:112–7).
For this clinical trial, the authors recruited 83 people with a condition called isolated systolic hypertension (ISH), in which the higher blood pressure number (systolic) is elevated, but the lower number (diastolic) is normal. These people were assigned to take either 60 mg of CoQ10 twice daily or a placebo for 12 weeks. Each participant had their blood pressure checked twice weekly for the entire study.
The people taking CoQ10 had an 18-point (18 mm Hg) reduction in systolic blood pressure (from 165 to 147 mm Hg), compared with only a 2-point decline in the placebo group, a statistically significant difference. The diastolic blood pressure, which was initially normal, did not change in either group. A systolic blood pressure reduction of four points or more was seen in 55% of people taking CoQ10 (those people were considered responders), whereas 45% of the participants showed no clinically meaningful reduction in blood pressure. Among the responders, the average reduction in blood pressure showed a dramatic decline (25.9 mm Hg). No significant adverse effects were attributed to CoQ10 treatment.
What is Isolated Systolic Hypertension?
ISH is the most common type of high blood pressure in the United States. This type of high blood pressure is particularly common in people over age 65. People with ISH have a systolic blood pressure of greater than 140 mm Hg, and a diastolic blood pressure of less than 90 mm Hg. In a recent clinical trial, reducing systolic blood pressure in people with ISH by 20 points (a reduction that was easily achieved by the CoQ10 responders) was associated with a decreased risk of dying from stroke, heart attack, or heart failure. The survival benefits were greatest in diabetics with ISH. The new study indicates that CoQ10 may be a viable alternative to prescription medicines for reducing blood pressure in some people with ISH. Individuals with high blood pressure should consult their doctor before taking CoQ10 or changing their medication regimen.
What is CoQ10?
CoQ10 is a vitamin-like substance that is necessary for an important step in the production of energy in the body. CoQ10 is also a potent antioxidant. The mechanism by which CoQ10 exerts such a dramatic blood pressure-lowering effect is not currently known.
At least five other clinical trials have shown a blood pressure-lowering effect of CoQ10. While most studies have shown a more modest blood pressure reduction, one other clinical trial found an effect similar to that seen in the new study. This is the first study to focus specifically on ISH.
Humans can synthesize CoQ10, but there may be situations where supplementing with extra CoQ10 may be beneficial. In particular, people with diabetes and people on certain cholesterol-lowering medications have been shown to have low blood levels of CoQ10 compared with the rest of the population.
Some, but not all, preliminary clinical trials have shown a significant difference in absorption between different preparations of CoQ10. This study used the hydrosoluble form of CoQ10, a form found in one previous clinical trial to be the most efficiently absorbed in humans.
Matt Brignall, ND is a graduate of the University of Michigan and Bastyr University. He works at the Seattle Cancer Treatment and Wellness Center, where he specializes in complementary medicine approaches to cancer. He has been published in several journals, including Alternative Medicine Review, Coping With Cancer, and the Journal of the National Cancer Institute. Dr. Brignall also teaches clinical nutrition at Bastyr University in Kenmore, WA. He is a regular contributor to Healthnotes, Healthnotes Newswire, and the Healthnotes Quick!Reference series.
Copyright © 2003 Healthnotes, Inc. All rights reserved. Republication or redistribution of the Healthnotes® content is expressly prohibited without the prior written consent of Healthnotes, Inc. Healthnotes Newswire is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. Healthnotes, Inc. shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Healthnotes and the Healthnotes logo are registered trademarks of Healthnotes, Inc.
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5:16:15 PM
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© Copyright
2003
Rick@Leaders.net.
Last update:
2/5/2003; 2:57:18 PM.
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