If I understand the article correctly, the headline is misleading. The article raises the possibility of a link between fish oil overdose and pulmonary edema.
The athlete profiled in the article was taking 9 capsules per day.
Most good things end up being bad for you if you take them to excess. Even oxygen is toxic if you breathe it in 100% concentration.
Katie, I absolutely agree with what you have said here. And the teammate I profiled in my article did indeed take whopping doses. However, the study itself did not ask about dose levels. See following.
The individual whose story is in the article was indeed taking enormous doses of fish oil. But the statistical research the article describes has more predictive or explanatory value than the single-person anecdote. That research found a significant association between fish-oil supplementation and SIPE, but the article does not say whether or not the study showed that association to be dose-dependent in any way. The study design may well have asked only "yes" or "no" on fish oil, not how much. I doubt every fish-oil-taker in the sample was taking 9 capsules per day.
You are correct. The number of SIPE victims was relatively low, and the questionnaire did not ask about dosing levels, just whether the athlete took fish oil or not.
Here is part of the interview transcript with the lead author, Dr. Miller:
We cast a wide net on supplement use, as you correctly suspect, to see if we could identify any patterns there. We were indeed surprised to find not only that fish oil use was statistically associated with SIPE, but that the association persisted after multivariable adjustment, which means it wasn’t just following along with something else already measured. We did not ask dose questions, so don’t have that information. I am not a hematologist and do not claim to understand the mechanisms by which an effect of fish oil might occur. I do know that aspirin, which is also an antiplatelet agent, has been associated with blood tinged pulmonary secretions following apnea dives, so there is at least some empirical support for some kind of platelet function effect. It could just be an incidental finding, but would be worth looking into further.
If Jeremy was powering down mass quantities of fish oil anything is possible, though I would expect diarrhea more than pulmonary edema in that situation. But you never know. I suppose you could put a lot of platelets to sleep that way. As I said earlier, it certainly bears watching.
But the story only gives the one example of the 1 individual who took 9 capsules a day--over 4 times the recommended dosage.
While I've been taking fish oil capsules for years, I only ever take 1 per day. Heck even during peak marathon training I never take more vitamins.
It would be interesting to know more about this sample group and how many capsules they actually took.
As I indicated above, I should be at risk to develop this; I fit the bill nearly every step of the way, including past history of hypertension, and a family history of cardiac problems. Yet I've never had anything remotely close.
I read a similar story somewhere else recently that pointed to wetsuits as the culprit.
The wet suit link has certainly been reported, but it remains a bit controversial. I think that SIPE is rare enough that even the majority of those with all the identified risk factors (a hypertensive female who takes fish oil and is swimming a long distance) probably still have a low absolute risk, though their relative risk would be elevated. To illustrate the distinction:
Say Condition X strikes, on average, 1 person in a 1000. The absolute risk of getting it would be .1 percent.
Say you have a risk factor that doubles your risk for Condition X.
Scary, right? Yes, but not that scary.
Your absolute risk only goes from 1 in 1000 to 1 in 500--still a very, very long shot of having the problem.
This is a completely false statement, one that's being perpetuated both by the media and government. There is an entire section of the CRF (Code of Federal Regulation) that was written specifically for dietary supplements.
The problem is, the FDA has too little money, manpower, or authority to do anything about the shady, fly-by-night places that are making some of the supplements out there. There are plenty of companies that are following the rules the government has put in place, and care about customers, following the law, and generally doing things right. You just never hear about them, because they're not getting in trouble. Because they're doing things by the book.
Mollie is correct, to a point. But the FDA's authority was considerably weakened by the Dietary Supplement Health and Education Act of 1994, also known as DSHEA. You have Senator Orrin Hatch and the state of Utah, home to a disproportionate share of supplement makers, to thank for this.
Isn't it great when science is controlled by anti-evolutionists and global warming deniers?
Keep this in mind the next time you chug down your favorite miracle Ergogenic Elixir!
www.quackwatch.org/.../dshea.html
If I understand the article correctly, the headline is misleading. The article raises the possibility of a link between fish oil overdose and pulmonary edema.
The athlete profiled in the article was taking 9 capsules per day.
Most good things end up being bad for you if you take them to excess. Even oxygen is toxic if you breathe it in 100% concentration.
Katie, I absolutely agree with what you have said here. And the teammate I profiled in my article did indeed take whopping doses. However, the study itself did not ask about dose levels. See following.
The individual whose story is in the article was indeed taking enormous doses of fish oil. But the statistical research the article describes has more predictive or explanatory value than the single-person anecdote. That research found a significant association between fish-oil supplementation and SIPE, but the article does not say whether or not the study showed that association to be dose-dependent in any way. The study design may well have asked only "yes" or "no" on fish oil, not how much. I doubt every fish-oil-taker in the sample was taking 9 capsules per day.
You are correct. The number of SIPE victims was relatively low, and the questionnaire did not ask about dosing levels, just whether the athlete took fish oil or not.
Here is part of the interview transcript with the lead author, Dr. Miller:
We cast a wide net on supplement use, as you correctly suspect, to see if we could identify any patterns there. We were indeed surprised to find not only that fish oil use was statistically associated with SIPE, but that the association persisted after multivariable adjustment, which means it wasn’t just following along with something else already measured. We did not ask dose questions, so don’t have that information. I am not a hematologist and do not claim to understand the mechanisms by which an effect of fish oil might occur. I do know that aspirin, which is also an antiplatelet agent, has been associated with blood tinged pulmonary secretions following apnea dives, so there is at least some empirical support for some kind of platelet function effect. It could just be an incidental finding, but would be worth looking into further.
If Jeremy was powering down mass quantities of fish oil anything is possible, though I would expect diarrhea more than pulmonary edema in that situation. But you never know. I suppose you could put a lot of platelets to sleep that way. As I said earlier, it certainly bears watching.
But the story only gives the one example of the 1 individual who took 9 capsules a day--over 4 times the recommended dosage.
While I've been taking fish oil capsules for years, I only ever take 1 per day. Heck even during peak marathon training I never take more vitamins.
It would be interesting to know more about this sample group and how many capsules they actually took.
As I indicated above, I should be at risk to develop this; I fit the bill nearly every step of the way, including past history of hypertension, and a family history of cardiac problems. Yet I've never had anything remotely close.
I read a similar story somewhere else recently that pointed to wetsuits as the culprit.
The wet suit link has certainly been reported, but it remains a bit controversial. I think that SIPE is rare enough that even the majority of those with all the identified risk factors (a hypertensive female who takes fish oil and is swimming a long distance) probably still have a low absolute risk, though their relative risk would be elevated. To illustrate the distinction:
Say Condition X strikes, on average, 1 person in a 1000. The absolute risk of getting it would be .1 percent.
Say you have a risk factor that doubles your risk for Condition X.
Scary, right? Yes, but not that scary.
Your absolute risk only goes from 1 in 1000 to 1 in 500--still a very, very long shot of having the problem.
This is a completely false statement, one that's being perpetuated both by the media and government. There is an entire section of the CRF (Code of Federal Regulation) that was written specifically for dietary supplements.
The problem is, the FDA has too little money, manpower, or authority to do anything about the shady, fly-by-night places that are making some of the supplements out there. There are plenty of companies that are following the rules the government has put in place, and care about customers, following the law, and generally doing things right. You just never hear about them, because they're not getting in trouble. Because they're doing things by the book.
Mollie is correct, to a point. But the FDA's authority was considerably weakened by the Dietary Supplement Health and Education Act of 1994, also known as DSHEA. You have Senator Orrin Hatch and the state of Utah, home to a disproportionate share of supplement makers, to thank for this.
Isn't it great when science is controlled by anti-evolutionists and global warming deniers?
Keep this in mind the next time you chug down your favorite miracle Ergogenic Elixir!
www.quackwatch.org/.../dshea.html
