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HeadWay, Issue #043 -- Fish oil: Just how good is it?
February 21, 2007

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In this month's issue:

Fish oil: Just how good is it?

Investigating Trileptal for migraine and tension

Say what?! Interictal

Fish oil: Just how good is it?

When Judy from the United States asked if I could write about fish oil, I wondered why I hadn't done it sooner. Then again, to be honest, I'm a little suspicious of something that is just so trendy. Fish oil is the latest "miracle food", and omega-3 is the word you put on your box if you want to sell it. Studies are being done all over the place - a lot of them little tiny studies that don't tell us a lot, but at least they're fast, so they can get the word out to the media. But is fish oil really that great? Or is it dangerous? And is it of any interest to a headache sufferer? Let's try to cut through the hype and find out. (Have a suggestion for a topic? Send it through the HeadWay MailRoom, password nomoache).

What's this all about?

By now you've probably heard something about fish oil, but here it is in a nutshell.  Omega-3 fatty acids are plentiful in fish oils and other foods.  Certain types of omega-3s, particularly EPA, and DHA, are the ones that nutritionists focus on.  The evidence is mounting that omega-3s in these "good oils" are excellent for your health.  Ironically, as people have been turning away from red meat and eggs they've been lowering their omega-3 intake, which may be why we're suddenly realizing we need more.

Can omega-3s benefit a headache sufferer?

So far, omega-3s really do seem to be important to headache sufferers, and migraineurs. The good oils we'll talk about in a moment can reduce inflammation, which make them like a natural painkiller. It also may be that omega-3s can help your cell absorb serotonin. Migraine attacks have been linked to low levels of this important neurotransmitter.

Fish oils have been suggested for other diseases that relate to migraine, such as depression and heart disease. (Though a new omega-3 depression study brings into question the whole depression theory.) As I mentioned, so many studies are coming out at once they're liable to go up and down for a while. As a general rule, however, fish oil seems to be very promising. The well known study (published on the National Headache Foundation site) was done in 1986, using Max EPA Fish Oil capsules. Most subjects showed a major reduction in migraines. A 2002 study showed that fish oil held promise for adolescents with migraine. A 2001 study failed to show significant help for migraineurs from fish oil. So although it looks promising on paper, more studies need to be done.

Should I take it?

I'm not a doctor, which is why I look at the research and just point you to it. As I said above, increasing your omega-3 intake looks beneficial for migraine sufferers and headache sufferers alike. It's generally safe, if you follow certain guidelines.

  • 1. Consider eating more fish. The most well researched advice seems to be that we should simply eat more fish. A couple of good meals of fish a week is great. Eat fish that are low in mercury content - that means avoid shark, swordfish, king mackerel, or tilefish, and eat lots of canned light tuna, salmon, and herring. (Fish capsules actually tend to contain less pollutants per gram of DHA+EPA.)
  • 2. Buy a brand you trust. There have been claims that some unscrupulous vendors have filled their capsules with a lot of junk. Make sure you use a brand you trust. Take a look at Source Naturals and Nordic Naturals, which are good brands.
  • 3. Don't take more than 3g a day. There are still concerns with fish oils. There are concerns about the "other" ingredients in some capsules that may cause problems (especially during pregnancy), for example, and concerns about the blood-thinning effects of fish oil. Until more testing has been done, the general suggestion is to take a maximum of 3g of DHA + EPA. Check the EPA and DHA amounts, every brand is different. 1.4-4.5oz or 40-127g of salmon = 1g of DHA+EPA. For more details check the Mayo Clinic on Omega-3 fatty acids, fish oil, alpha-linolenic acid.
  • 4. Check with your doctor. This applies especially if you want to take large doses and/or are pregnant or breast feeding, or if you have concerns about bleeding or blood thinning (watch out if you're taking ginkgo biloba or garlic too. They are blood thinners).
  • 5. The alternatives. If you want to avoid fish altogether, there are other options, such as flaxseed, canola, walnut and soya oils. These don't seem to be as good as fish oil, though there is still debate over just how much good they do in comparison. Flaxseed oil (or linseed oil) seems to be a winner, but don't just eat the seeds themselves, which will go right through you. Try ground whole flax flour (as in my granola - use your password nomoache) or actual raw oil. Make sure it's fresh, and check the date. Don't cook flaxseed oil - pour it on your salad, or mix it with yogourt. High omega-3 eggs are also a good source.

  • Investigating Trileptal
    for migraine and tension

    Here's something else that is the subject of current research. We've been using anti-seizure drugs for a long time to combat migraine. Topamax is a well known drug in this category. But another drug that has been used with some success is Trileptal, or oxcarbazepine. Trileptal is also used for bipolar disorder.

    Not only has there been some success in treating migraine with Trileptal, but also chronic migraine and tension headache. Check this article from John Hopkins University. Even the world reknown Diamond Headache Clinic has started using oxcarbazepine with some patients.

    It may take several months for Trileptal to stabilize in your system. It's a long term stabilize, so give it time. Watch out if you're pregnant or breast feeding, or if you're allergic to carbamazepine. Trileptal may also reduce the effectiveness of oral contraceptives.

    There are many options today for headache patients and migraine patients alike. If you're still looking for an effective preventative, talk to your doctor and pharmacist about Trileptal.

    Thanks to The Pill Book for the information.

    Say what?! Interictal

    I used the term interictal in a recent news post on a new migraine study tool. It's very important to migraineurs, but also anyone with attacks of pain such as cluster or headaches. You see, our lives are not just effected during the attack, but also in between. That's what interictal means - the time in between. It more commonly relates to seizures, but in this case is being used to describe the time between migraine attacks. The actual event, therefor, is described as ictal. There - two words for the price of one! Now you can ask your friend if they're having an ictal moment. :)
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