The lead researcher of the paper on swimming-induced pulmonary edema has had a lot more luck finding cases among triathletes than dedicated OW swimmers.
Maybe triathletes have a tendency to use more supplements, in general, and fish oil, in particular, than open water swimmers? Or maybe the population is a whole lot larger.
Skip
I am not sure how many blue marlins Jeremy would need to eat a day to get the equivalent of 9 x 1200 mg capsules, but I daresay he'd weigh a bit more if he consumed his fish oil by eating actual fish as opposed to swallowing lozenges!
Wiki has some useful information.
en.wikipedia.org/.../Fish_oil
"The FDA says it is safe to take up to 3000 mg of omega-3 per day. (This is not the same as 3000 mg of fish oil. A 1000 mg pill typically has only 300 mg of omega-3; 10 such pills would equal 3000 mg of omega-3.) Dyerberg studied healthy Greenland Eskimos and found an average intake of 5700 mg of omega-3 EPA per day."
I'm guessing it wouldn't be too hard to get that level of omega 3's if you like salmon.
There might be some issue where levels that are OK for most people to take are not OK for ironmen triathletes. Intuitively, I would think the opposite - exercise burns toxins away- but this stuff is very complicated.
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.
Maybe triathletes have a tendency to use more supplements, in general, and fish oil, in particular, than open water swimmers?Many of us open water swimmers prefer natural fish oil instead of taking supplements.
3667
Suppliments are unregulated...
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.
I do stand corrected, thanks for the info.
Used to work for small pharmaceutical gig that manufactured new drugs for trials and testing. I witnessed the required standards that at times seemed extreme but gave me trust in quality. I have also seen some stuff that would make you avoid generic unless it was absolutely necessary:afraid:
I just assumed that supplements were less regulated, maybe a better thing in some cases
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
I do stand corrected, thanks for the info.
Used to work for small pharmaceutical gig that manufactured new drugs for trials and testing. I witnessed the required standards that at times seemed extreme but gave me trust in quality. I have also seen some stuff that would make you avoid generic unless it was absolutely necessary:afraid:
I just assumed that supplements were less regulated, maybe a better thing in some cases
l
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
I am not really an expert on supplements,but it was my understanding that since DSHEA supplements could not make false claims of efficasy,but they did not have to prove efficasy and only had to prove safety if the safety was called into question,not before marketing.
I know more about generics.Your Pharmacy will say that they can substitute a generic equivalent to your medication.What they don't say is that goverment declared that equivalent is"not less than 80% nor more than 125% as bioavailable as the brand name.That is a very low bar to clear.
