Flax and Fatty Acid Update
January 02, 2008
This oil is commonly recommended in the health literature and I have regularly recommended it to many patients. Based on my experience of probably several thousand patient's use with flax seed oil, I have recently modified my recommendations regarding this supplement.
It has been my experience that at least one-third of patients find this supplement unpalatable. We use the best brands that I know of (Omega Flow and Barleans) so I am certain that the quality of the oil is not the issue.
I believe that if a supplement does not smell or taste good there is a very high likelihood that the supplement will do more harm than good. Our bodies will never lie (our minds do all the time). If our body is giving us a signal to stop these foods we should listen and cooperate. It took me many years to fully appreciate this and bypass the standard nutritional recommendations that flax is such a wonderful supplement and everyone should be on it.
I do believe it is effective for many people; but, as of last month, I have stopped recommending flax oil. I believe that the oil is so perishable that even if it is kept cold it is likely that some of the fat is oxidized and becomes somewhat rancid which accounts for the bad taste that many people experience. I believe that if one uses a coffee grinder or food processor to grind the seeds and sprinkle them on food the flax would be much less likely to have oxidation of its fatty acids.
The other consideration, though, is the metabolism of the fat in flax. The main fatty acid in flax is alpha linolenic acid (ALA). I have been doing large numbers of fatty acid analysis through John Hopkins Hospital and it seems most individuals I have tested have elevated levels of ALA. Many people do not have the necessary pathways optimized to process this fat down the chain so it can be fully utilized. It then backs up and can cause complications.
I believe most people tolerate fish oil (EPA/DHA) much better. The problem with most fish oil (see article this newsletter) is that it is contaminated with mercury and polychlorinated biphenyls (PCBs). If you use this source, it is important to use a supply that has been molecularly distilled. This process will remove these toxic contaminants. I use a product called Nordic Natural (800-662-2544) in my office that is relatively inexpensive yet does not have any mercury present.
Fish oil is an omega three oil which is very similar to flaxseed oil, but it is generally much better tolerated than flax.
However, if one belches, bloats or becomes worse with the fish oil, it should be stopped immediately. It is important to balance omega three oils with omega six oils. A good ratio is about 1:3. The best omega six oil for most people would be evening primrose oil (EPO). We have the 1300 mg EPO capsules in our office but they are also available in 500 mg capsules.
However, only 10% of the oil is GLA or the active fatty acid. In practical terms, this would mean that the capsule has 130 mg of the omega six. One would then require about 390 mg of the EPA/DHA combination to balance it out. Fortunately, the Nordic oils capsules have just that amount (300 mg of EPA/DHA combined). So one of the EPO capsules would be balanced with about one of the fish oil capsules. The precise ratio actually would be three EPO and four fish oil capsules.