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ME/CFS: A disease at war with itself
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cellular inflammation, omega 6 and omega 3 ratio??

Discussion in 'General ME/CFS News' started by heapsreal, Oct 25, 2011.

  1. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    australia (brisbane)
    READERS SUMMARY:
    1. Is it correct to believe that omega 6?s are always bad?
    2. What are the pathways these fats travel and what do they really do?
    3. Do we need some type of ratio for optimal health?
    4. What are the normal ratios of O6/O3 in certain organs?
    5. Why is knowing what your current O6/O3 ratio critical to your Optimal Health?

    Today I was getting ready for the Ancestral Health Symposium and I struck up a conversation with two UCLA students on the Santa Monica Pier. After about ten minutes, I realized that before todays meeting I had to discuss omega six fats. These two bright kids had the clear impression that omega 6 fats were always pure evil for optimization. I asked them where they got that idea and they told me they got it from popular paleo blogs and books they had read and it was reenforced by their peers. I told them both that they just motivated me to go back to my hotel early and begin a new blog before todays first ever Ancestral Health Symposium. So here it goes.

    Many times we hear in the paleo world talk about the wonderful things omega three fats do for us. We also hear about the many bad things that omega six oils can do to us. We rarely hear about why O6 fats are good or infect necessary. Well, they are folks. In fact we need them in EXCESS as compared to O3 fats! Most invoke the standard american diet (SAD) argument because a processed food diet has 25 to 40 to one ratio of omega 6 to three ratios compared to an ancestral diet as outlined by Cordain et al. This information is true to some degree but the story has many nuances that one needs to understand for optimal health in my view. Lets take a look at some of the data we should be mindful of.

    What exactly are the paths that EFA travel in humans? Is the pathway of all omega six fats inflammatory? Is the current concept of a dietary balance omega-6/3 ratios based on a true biologic reality? We also hear a lot of background posting about the inflammatory pathway from linoleic acid (LA) to arachadonic acid (AA) as the main argument against dietary sources of O6 fats. This is the AA pathway that leads to the formation of prostaglandins. Interestingly, the real pathway that O6 fats travel is not to just foster inflammation, but to also limit it. Many researchers and bloggers assume that the pathway from AA to PGE2 is a constant finding if we eat dietary excesses of O6 fats. This is not true at all. The interesting finding is that the body only produces PGE2 when it is actually needed by the body. It does not happen with the excess consumption of omega 6 by itself. In fact, most EFA are produced in the human body on an ad needed basis. So, AA is not dangerous in an of itself. The adverse effect idea arose because of the role of AA as a precursor of thromboxane and other eicosanoids participating in activating thrombus formation and the inflammatory process. But this is not the only thing AA does in the human body! If it was I would never be able to operate on anyone!

    AA is a major component of the endothelial [inner arterial lining] phosphoglycerides, particularly on the inner cell membrane layer. AA and adrenic acid are consistent companions in other cell membranes. It is the precursor for prostacyclin: a vasodilator and inhibitor of platelet adhesion; it is the most potent platelet inhibitor we know of in nature. This stops the clotting process when it is no longer needed. It is also vital to smooth vascular and laminar flow and allows us to overcome wounds we sustain in injury or create in surgery by helping seal the wounds. If there is damage to the endothelium, such as in bruising, infection or cutting, then the phospholipases release AA. In the free form, and in conjunction with activated platelets, AA is peroxidized to provide eicosanoids for the response to injury. This is how the body is supposed to work. I rely on O6 fats every day in surgery to get people to clot and off the operating table.

    Moreover, in vivo, we never find prostaglandins from omega 3s or from omega 6s acting alone. They act in concert as a violin and violinist would. One without the other is simply useless. PGE1 is made from omega 6 fats and is a fast acting pain inhibiting cytokine that also modulates the immune response to an injury. PGE3 is made form omega 3 fats and has similar function but the PGE1 response is more brisk and powerful to help in wound healing. They always act in unison and are symbiotic. This is why when someone takes too many omega 3s in supplement form we often can see skin bleeding and discoloration and frank internal bleeding. It is also why when our ratio is 40 to 1 due to processed foods we see the opposite end of the spectrum. But we must realize it is in fact a spectrum of balance that we need to strive for.

    As explained above, the western diet is estimated to have undergone a huge shift in the omega 6 to 3 content since 1900. Many place the spike in neolithic disease at this concomitant spike over the last 110 years. Our bodies target ratios of EFA should still be capable of oxygen-transference ratio of a maximum of 6 to 1 omega-6 to omega-3 for good functioning. So if you understand biology, humans need more O6 fats than O3 fats normally in their diet to function optimally. So it should now be clear that AA is not the dark side! If we could get it to two to three to one ratio it likely would be ideal, but with today food sources I think this is rather difficult to do without a lot of money and time.

    The other interesting factor I have seen few speak of is the requirement that each organ of the body has for omega 6 and 3 fats. I decided to look into this issue more several years ago when I was researching my own health. I always believed that the brain had a large omega 3 component naturally and it turned our I was dead wrong. The brain makes up 3% of our body weight (BW) but has a 100 to 1 ratio of 06 to 03 within it normally. It appears in certain diseases of the brain the ratio gets dramatically altered and may actually be a good biomarker for us to use diagnosis and prognosis. Skin makes up 4% of our BW and has 1000 to 1 ratio normally. Skeletal muscle makes up 50% of our BW and sets at a 6 to 1 ratio. Our internal organs, make up 9% of our BW have the lowest ratios at 4 to 1. Adipose tissue sits at 22 to 1 ratio and makes up 15-35% of our total BW depending upon how fat we are.

    Summing it all up:

    THE MOST IMPORTANT FACTOR IN THE O6/O3 ratio is CONTEXT!!!!! This blog was really motivated by a conversation I had yesterday on the Santa Monica Pier with two college students who were going to attend the Ancestral Health Symposium at UCLA later today. I felt after speaking with them that this blog needed to be written because I think there is much mischaracterization out there about O6 fatty acids. They should not be vilified indiscriminately. We need an small excess of O6 to O3 normally in a healthy human diet. The current SAD grossly exceeds that normal excess to a great degree. Therefore, we can not and should not vilify all O6 fats. The real problem we face is that certain chronic disease conditions such as obesity, arthritis and ischemic heart disease, is where the damage has already occurred. This situation results from a chronic stimulation of the inflammatory pathways of eicosanoids in response to this neolithic insults. This is evidenced by an elevated HS-CRP, IL-6 or TNF alpha on blood testing. This is not the fault of AA or DGLA in our diets, but it is the original cause of damage of the disease process. The key point is that we should strive for a diet that limits omega six consumption to the appropriate ratios for human optimization based upon an ancestral biochemistry. This ratio is 2 to 1 to 6 to 1 by most good studies I have read. So when you begin your own trek to get healthy and optimized I would strongly suggest you get your own omega 6/3 ratio drawn so you can see how far your past diet led you astray from what should be idealif that number is greater than 6 to 1 and you have active chronic inflammatory markers that are elevated, then your first move should be to bring down the omega 6 content of your diet and increase the dietary consumption of omega 3s before you supplement with fish oil! My concern is that fish oil supplements are becoming the proxy for good dietary choices in our paleo/primal community. Once you get your diet repaired and back to ancestral balances of O6/O3 fats, then you can titrate the effective dose of supplemental O3 oils to your desired O6/O3 ratio based upon your own blood work. This is the context I use for myself and patients. If you overdo your fish oil supplementation and dont test you could actually hurt yourself and your cause long term. You may even cause stalls of changes in your VAP and HS CRP levels. They may also confound you and your doctor because you forgot the context of why this has happened. Remember fish oil in supplement form is a PUFA too and is subject to serious peroxidation and ALE formation when it is taken improperly or when it is adulterated. So it too, can be a double edge sword like the O6 content has been vilified in our community. REMEMBER CONTEXT!
    http://jackkruse.com/category/cellular-inflammation/

    Just thought i would post this after a similar thread was discussing inflammation, omega3 and 6 etc
    Whats your opinions on this guys theories Alex??
    The rest of the link discusses hormones, vit d in relation to inflammation.

    cheers!!
  2. aprilk1869

    aprilk1869 Senior Member

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    Scotland, UK
    17 years ago my mum was diagnosed with MS. She's never developed the symptoms normally associated with MS and as a result I've always felt she was misdiagnosed. However when the neurologist told her "there's nothing we can do, go home and forget about it" she ended up buying Judy Graham's book on MS.

    Judy heavily promotes the benefits of Evening Primrose Oil (EPO) and as a result my mum took pretty large quantities of EPO supplements. What makes EPO so great is that is contains large amounts of Gamma Linolenic Acid (GLA) which is easily converted into PGE1. Whereas AA found in most omega 6 foods isn't easily converted into GLA for a number of reasons. For instance you need zinc, magnesium, b6 and biotin. Also, alcohol, viruses, saturated fat etc can block the conversion.

    She says that GLA converts into PGE1 easily whereas AA tends to convert into PGF2. PGE1 is far better than PGF2 for many reasons. PGE1 is needed to increase levels of T suppressor lymphocytes and a deficiency of these causes other parts of the immune system to attack the body. It can also dampen down B lymphocytes which have been shown to attack the CNS. This of course should be of interest to those who have been reading the latest research from Norway!

    There are many other benefits but these are just a couple.

    I did a quick search for more info and came across this, I haven't read it yet but it looks interesting:-

    Systemic Omega-6 Essential Fatty Acid Treatment and PGE1 Tear Content in Sjgrens Syndrome Patients
    http://www.iovs.org/content/46/12/4474.full

    The version of the book I have is from 1992 but there's a more recent edition which I might see about getting. I would recommend it to anyone as it contains lots of interesting info.

    When I first cam to this site to read up on Freddd's comments, I was surprised that nobody was taking EPO as I really think it should be taken by everyone.
  3. alex3619

    alex3619 Senior Member

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    Logan, Queensland, Australia
    Omega 6 fatty acids are ESSENTIAL fats, without them you die. So they are not bad in themselves. The article makes some important points - omega 6 fats include anti-inflammatory fats (especially in series one eicosanoids as opposed to series two arachidonic acid derivatives). The issue with us is we have increased utilization of arachidonic acid. For many of us a good dose of arachidonic acid from animal fat can do some very bad things. We are also deficient in arachidonic acid, I suspect from two issues operating together. First, we typically don't synthesize enough from short chain omega-6s (vegetable sources). This is complicated by using too much of the arachidonic acid too fast. So we can yo-yo between overt deficiency and overt excess depending on the balance - and our systems change with it. I have experienced this on a titrated arachidonic diet, as have many other patients involved in this type of research. Nobody has ever figured out how to balance this in CFS reliably. Nobody. Omega-3s can't be used to balance it reliably, and neither can the Zone diet, or anything else I have seen. The closest to the balancing act every achieved was the research by Martinovic in the early to late 90s (See Gray and Martinovic on PubMed). The issue here is we do not fully understand what is driving the imbalance. To solve it we have to understand and control:

    1. Cortisol levels and regulation
    2. Nutritional factors including vitamins, antioxidants and minerals
    3. Gut dysbiosis and liver detox
    4. Glutathione synthesis and regulation

    To do that we have to understand ME and CFS pathology. We are not there yet. So the advice we typically see on omega 3 and 6 fats can work, and can help, but it can also be a disaster for some people.

    In my own case if I accidentally (always from eating out) eat too much arachidonic acid (usually as animal fat used to fry commercial food) then I collapse in pain for many hours. This starts within an hour of eating it. Vegetable oils don't do this to me.

    If simple omega-6 or omega-3 supplementation works for you in the long run thats great, but just be aware that the difference between in balance and totally out of whack for arachidonic acid in CFS is very small.

    Bye
    Alex

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