Fish Oil

1. One of the researchers says that fish oil is really only good for lowering triglycerides. Do you agree? why or why not?

2. If fish oil can lower triglycerides and that can prevent a cardiac event, isn't there some value in taking it?

3. Do you think a large number of cardiologists have been pushing drugs like Epanova needlessly, or do they generally know it's not that helpful to prevent cardiac events?

4. Should people take fish oil, OTC or a prescription fish oil med, for any other reason? Why or why not?

5. What do you say to millions of people who take fish oil thinking it can prevent cardiac events?

Fish oil, over the counter, is considered a supplement. It is not GFA regulated andbthusbthebconent of each pill and its overall potency per bottle is unknown. This is important because the protective effects of fish oil are now being defined futher to the compound EPA and not DHA.

An incredibly powerful study reported and now part of guideline based practice from the American Heart Association was the REDUCE-IT trial out of Harvard. 

The results for lowering triglycerides was profound.  The FDA cleared Icosapent ethyl, a highly purified eicosapentaenoic acid ethyl ester.  This was groundbreaking inpatients who have very high TGs despite maximal medical therapy and lifestyle intervention. Elevated TGs are correlated with acute pancreatitis and may play a role in preventing cardiac events.

A further analysis of the REDUCE-IT trial should a powerful reduction in cardiac events.  Cardiologists and the medical community are now understanding the positive data from this trial and, as such, prescribing the trade version of purified EPA, Vacepa.

The STRENGTH trial evaluated the drug Epanova, a mixture of EPA and DHA with an added sugar, or carbohydrate, molecule. That added sugar molecule is thought to help bioavailability and absorption.  It was a negative trial.  This can be taken as one of two ways: First, it reinforces the power of EPA in cardiac protection; and second, it lowers the efficacy and need of DHA.

Fish oil, as an over the counter supplement, is a relatively harmless pill. Minimal side effects and possible benefits from added EPA, in whatever quantity, will be helpful. 

We need to follow the science, and it pointing us to the powerful EPA component of fish oil.  Whether prescription, over the counter, or from nature foods high in EPA content, there is now harm and only benefit in reducing cardiac events.