VegEpa - Fish Oil Swizz or Worth Trying?

Fish oil is good for you. We all know that. But I still don't know what to take - I can't often stomach oily fish, so please don't lecture me on dietary sources!

The ME Association appears to support the use of VegEpa fish oil - or maybe they're simply grateful for the fundraising efforts of the nice lady who formed the vegepaclub.com and has raised £58,000 to date for ME Biobank through selling it!

At around £40 a month, (might be less, I couldn't get the price list up - this is Dr Myhill's price), I'm very wary. Fish oil IS expensive. My ADHD son's Nordic Naturals, high dose EPA and a lower DHA, is £18 a month. But that has clinical evidence behind it.

I've not heard ANYTHING about this miraculous VegEpa stuff anywhere but on Dr Myhill's website, though.

Here's a summary someone did of the work behind this product's formation. I'm too crashed to get through it critically.

http://www.vegepaclub.com/prof-puri/

Has anyone tried it? If so, for how long?

Thanks

 

Snake oil.

If something were this effective it would go viral, not be promoted in an obscure corner in the middle of nowhere

 

Some years ago I tried VegEpa for a number of months, perhaps six months or more, can't be sure of the details now.

It was at a time when things were going relatively smoothly, but if there was any effect it was not dramatic. I stopped because I was not convinced it was having any effect on my general health.

 

I think I remember that Vegepa was developed by Prof Bassant Puri maybe for people with ME?

 

Was there not a trial in the mid 1990s which suggested that there was no benefit? That may have only related to Efamol Marine, but the main ingredients would appear similar. Is there any reason to suppose that this is efficacious?

 

Fish oil contains DHA and EPA.

https://www.selfhacked.com/blog/fish-oil-top-22-science-based-health-benefits-of-fish-oil/

I picked the above link almost at random - I make no claims it is any good!

Some companies have recently started promoting products containing just one or the other of these things rather than both, from vegan or vegetarian sources.

Whether DHA is helpful on its own or EPA is helpful on its own... I have no idea.

Anecdote : In the 1990s I was persuaded by things I read online that high dose fish oil would help a medical problem I had. I got a short-term response that nowadays I would put down to placebo. The other effect I got was that I started to smell like a rancid fish. So perhaps vegan EPA or DHA has advantages over taking fish oil. Except, of course, there is probably far more to fish oil than just DHA and EPA.

 

cod liver oil for vit D, not fish oil
Fish Oil versus Cod Liver Oil: Is Vitamin D a Reason to Go Back to the Future
"However, although fish oil is an excellent source of omega-3 LCPUFAs, it doesn’t provide the significant levels of vitamin D that cod liver oil does.2 Vitamin D is concentrated in the liver of the fish and thus plentiful in cod liver oil, a time-honored source of vitamin D. Fish oil is made from the whole body of the fish and has an insignificant amount of vitamin D."

http://www.jabfm.org/content/18/5/445.1.full

 

It's snake (well, fish) oil. I know many people who sunk a fortune into it and it did nothing for any of them. The quantities which you're supposed to take are ridiculous too. What's the point? You may as well just cross your fingers and hope you get better, and the chances will be about the same.

 

Thanks everyone for your great replies. I'll stick to my nice, reasonably priced Vitamin D drops then. Bullet. Dodged.

I can't see much reason for me to take fish oil at all - even the regular kind.

 

I think the main benefit is heart health for the omega hence the 2 portions of oily fish a week. That’s too much for me so I take Tesco’s own brand fish oil capsules which give you equivalent amounts and are cheap on a multi buy. For vitamin D there is some research (from memory) that shows that too much (5000?) isn’t a good thing so taking a smaller daily dose is probably best. If interested I can hunt around for the papers on this.

 

I do know of some kids this has helped - they were not severely affected. It is a high dose (8 capsules / day for teenagers) and done at this level for up to 3 months. Like most things this improvement did not last for all.

To process these you need sufficient cofactors ( b12, magnesium etc ) , so it may be that for those who are moderate/ severe who may have more significant issues with low levels of cofactors that it cannot be adequately broken down to be effective?

Delta 6 desaturase may be part of the puzzle for those with fatty acid issues. I think @mariovitali looked at this within the machine learning programme and the link to FADS SNPs.

 

@arewenearlythereyet I'll look at the Tesco's fish oil. Might as well add it to the on line shop. Gosh 5000 a day of vitamin D sound very high. Mine is 2000. Husband just said front page of tomorrow's Guardian says doctors shouldn't recommend people take vitamin D in winter because there's no evidence for it's benefits.

Well then.

Still going to take it. They'll change their mind next month.

 

I took cod liver oil years ago but it did not increase my vitamin D levels much so I stopped. You would have to take a large amount but it might also increase your vitamin A too much. I take vitamin D capsules.

I take fish oils because it is the only supplement that increases my omega 3. I also eat 2 cans of sardines a week.

Back in 1992 the ME doc I saw recommended Efamol for all his patients, I took it for a few years. I also took VegEpa years ago as recommended by Dr. Puri. It was expensive and I can't say it made any difference on how I felt.

 

The evidence about high vitamin D is a bit loose and iffy, as these things always are. The problem may have been patients taking poorly labelled supplements, so that one woman was taking 186,900iu per day! (See here: http://www.nejm.org/doi/full/10.1056/NEJMc063341)

Up to 4,000iu per day is thought to be a safe long-term dose by most UK doctors. It gets contentious beyond that, but it's still mostly quite safe.

10,000iu is supposedly about 15 minutes' exposure in the sunlight for Caucasians. So some doctors advise you can take that dose for up to 3 months, followed by a lower maintenance dose after this.

Is this right? I'm not sure. But I'd been taking the recommended daily daily dose (800iu per day) for about 10 years and was deficient, so that's probably too low. 1,000-2,000iu per day seems a sensible dose if you're taking it every day, although I can see the argument for taking more if you don't get out the house often.

UK reference ranges are 40-100nmol, although some areas (such as Mediterranean countries) have people with 100-200nmol, which is still safe. You're told to cut out supplementation when you reach 250nmol (I got to 199nmol after 6 months on 10,000iu and another six months on 6,000iu; I now take 1,000iu per day and try to bask when it's sunny). 375nmol is the level at which toxicity theoretically becomes a problem, although over 250nmol is undesirable (see here: https://www.vitamindcouncil.org/for...upplementation-blood-levels-and-sun-exposure/ but this is probably a biased source).

The main problem with vitamin D seems to be too much calcium getting into your brain and blood. A lack of vitamin K2 may be partly to blame, though, as it seems to be necessary for the proper metabolising of vitamin D (see here: https://www.ncbi.nlm.nih.gov/pubmed/17145139 and here: https://www.ncbi.nlm.nih.gov/pubmed/11706280). Annoyingly, though, the symptoms of hypercalcaemia are similar to those of ME (fatigue, stomach pain or nausea, and low mood).

This study of 20,000 patients over 10 years noted increased usage of vitamin D supplementation overall: https://www.ncbi.nlm.nih.gov/pubmed/25939935. Only 37 (0.2%) had levels over 250nmol, and only 4 of those (0.02%) had hypercalcaemia despite that and it was only temporary. Only one had true clinical toxicity that required treatment and that person's levels were 910nmol! That's almost four times the upper limit. (For reference, 1ng = 2.5nmol. US uses ng; UK uses nmol.)

Long-term usage of 40,000iu daily may be required for toxicity according to this study: https://www.nejm.org/doi/full/10.1056/NEJMc063341.

I think, therefore, the risk is pretty low.

 

As for cod liver oil versus fish oil: the first is mainly taken for vitamin D and vitamin A, and the second for DHA and EPA (which is what Puri advocates for).

Too much vitamin A is definitely toxic, and much more of a risk than vitamin D toxicity, so if you're megadosing as the vegEPA protocol suggests, it would have to be fish oil only.

That said, I still don't think you need to take megadoses! The amount you need to take a day is ridiculous, and you'll have fish burps all day.

 

Very much agree on this one @adambeyoncelowe . Incidentally, Post-Accutane Syndrome has many overlapping symptoms with ME/CFS. Accutane is a form of Vitamin A and there are well known problems of hepatotoxicity from using it.


@Amw66

Apart from FADS1/2, it is hypothesised that Omega 3 operate on multiple levels : Anti-inflammatory action and also induction of Peroxisome Proliferators (PPARs)

 

Wow @adambeyoncelowe you're an expert.

I was never advised to mega load like this. Maybe that's why my D level is still too low. Thank you so much for all this excellent information!

It's interplay with calcium is interesting. I'm thinking of the opposite problem. Not enough calcium getting into my brain because of very LOW D . Vitamin D helps regulate the amount of calcium we have, and:

"Calcium is a universal messenger of extracellular signals in a great variety of cells; it regulates several neuronal functions, such as neurotransmitter synthesis and release, neuronal excitability, phosphorylation and so on.Calcium is also involved in long-term processes, like memory."

https://www.ncbi.nlm.nih.gov/m/pubmed/8745152/

I'll talk to my GP about taking 10,000.

 

@Squeezy many years ago I was unable to increase my vitamin D levels because I was depleted in magnesium. After I took mg/taurine injections on and off for a few years, my vitamin D levels went up.

They are both essential.