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Sticky: The difference between steroid abuse and hormone replacement therapy.

Sticky: The difference between steroid abuse and hormone replacement therapy.

June 20, 2014

Adverse Effects of Anabolic Steroid Abuse vs. Benefits of Physician- Supervised Hormone Replacement Therapy (HRT)

Due to an increase in media coverage of sports and athletes regarding non-medical use of anabolic steroids, the difference between hormone replacement therapy and anabolic steroids has become confusing to the general public. Young athletes illegally take synthetic male anabolic steroids without a physician’s supervision because they wish to increase their physical stamina for enhanced athletic performance. This is done through tissue building effects and an increase in male physical characteristics, desired by both male and female athletes alike.  Synthetic anabolic steroids mimic the effects of the male sex hormone, testosterone, which can increase muscle mass and strength in short periods of time.

Steroids are no stranger to the fitness/bodybuilding world and competitive athletics, but today more and more “regular guys” are taking steroids in an effort to combat the effects of aging and reduce its impact. While legal steroids do have a place and serve useful, medically-valid purposes, they are frequently abused. Part of this stems from their widespread availability in gyms, health clubs, online from Internet pharmacies, friends and more.

Besides being illegal without a prescription, steroids – when taken without proper medical supervision – are known to cause a variety of health problems. The short-term adverse physical effects of anabolic steroid abuse are fairly well known, but the effects of their long-term use are not well-studied. Abuse or overuse of synthetic anabolic steroids may cause the male body to become “feminized,” causing irreversible physical and psychological damage – depending on the dosage, type of synthetic steroid being taken, and usage duration. Some examples are high blood pressure, serious changes in cholesterol levels, heart problems in the left ventricle, and liver damage if oral steroids are taken. In this sense, the difference between hormone replacement therapy and anabolic steroids has a lot to do with non-medical versus medical use, and the illegal use of a synthetic form of testosterone versus legal use of pure testosterone.

The real problems arise when steroid users become steroid abusers. They buy their steroids at the gym or from a friend, self-administering them and regulating their intake themselves, rather than under the guidance of a trained medical professional. This is a recipe for disaster. When someone buys steroids off the black market the potential for dangerous repercussions is astronomical.

First of all, when buying steroids off the black market, you never really know what you are going to get. The majority of steroids sold on the streets in the U.S. come from other countries where quality standards can be very lax at best. It’s also very common to take steroids prepared for animals rather than for humans because they are usually cheaper-but also potentially very dangerous. There is also a prevalence of fake or counterfeit steroids on the U.S. black market. These can not only be dangerous, but they can be deadly as well.  The only benefit of using an anabolic steroid is when it is prescribed medically for medical conditions, the same as hormone replacement therapy. In certain medical cases, it is the only answer for quality life. The main difference between hormone replacement therapy and anabolic steroids comes down to how each is used, specifically if it is used under proper medical supervision.

There’s no getting around the fact that our bodies age. For men, as we get closer to the middle age mark, natural testosterone production in the body begins to slow down by about one to two percent each year – though this can vary widely. Around age 50 or so, about one-half of men will experience what’s known as “andropause,” which is the result of declining levels of androgen in the body. The symptoms of andropause will vary from one man to another but may include a decrease in energy (lethargy), diminished libido or less interest in sex, erectile dysfunction (ED), muscle weakness, difficulty sleeping, hot flashes, night sweats, mood swings or depression and more. Because of the symptoms’ similarity to what women experience in menopause, andropause is sometimes referred to as the “male menopause,” although in men the reproductive system does not shut down entirely as it does in women – it just slows down.  To fight the symptoms of andropause many men turn to either steroids or hormone replacement therapy (HRT).

Hormone replacement therapy (HRT) is practiced under a physician’s care and is medically used for abnormal testosterone levels in menopausal individuals, chronic wasting diseases, and to treat a multitude of symptoms. Hormone replacement therapy also does not use a synthetic steroid, but a pure form of testosterone. It is used under physician care for many medical benefits. The goal of hormone replacement therapy is to keep abnormal hormone levels normal and to treat certain medical conditions, not to build muscles and strength. Hormone replacement therapy has been used for reductions of heart disease, abnormal cholesterol levels, high blood pressure, strokes, type-2 diabetes, and early death. In fact, the use of testosterone in hormone replacement therapy has improved the lives of a many aging men. Previously they were diagnosed with no sex drive, with erectile dysfunction, extreme fatigue, irritability, a serious loss of energy, and felt their life was going nowhere.

In contrast to self-regulated/self-administered steroid abuse, Hormone Replacement Therapy (HRT) is a medically supervised regimen that seeks to duplicate the body’s natural testosterone production cycles. Administered properly, HRT can bring about the benefits of restoring testosterone to its previous level, without the significant side effects or safety hazards associated with self-regulated/self-administered steroid regimens or abuse. HRT starts with a blood test and medical examination to determine testosterone levels and uncover any potential health risks. This is an important-and necessary–step in order to be certain that testosterone deficiency is indeed the root of the andropause symptoms and not diabetes, hypertension or the result of taking certain medications.

Through HRT testosterone is administered orally, by injection or through trans-dermal systems (through the skin). A fourth method-a tablet that adheres to the surface of the gum-was recently approved by the FDA. HRT has proven beneficial to men suffering from symptoms of andropause resulting from a testosterone deficiency in a number of ways including:

Increasing sex drive

Increasing muscle mass

Increasing strength

Improving mood

Increasing bone density

These are just some of the benefits that are associated with a properly-administered, medically-supervised HRT regimen. Once treatment begins, HRT recipients are monitored for possible side effects or adverse reactions to the treatment. Generally though, this is not the case. The overwhelming majority of HRT recipients are very satisfied with the results, generally reporting few, if any, negative side effects or consequences. While many of us like to think that we’re smart guys and know what we’re doing with our own bodies, the risks associated with self-administered/self-regulated steroid regimens far outweigh any potential benefits. And in addition, the potential for abuse is great. If you think you may be suffering from andropause/testosterone deficiency, do yourself a favor and consult a qualified medical professional and investigate hormone replacement therapy as a treatment, not your friends at the gym.



August 26, 2011

Drug Reference Information

Usual Adult Dose:
100 mg to 200 mg orally two times a day.

Severe cases of endometriosis may require an initial dosage of 400 mg orally two times a day.

To assure that the patient is not pregnant, therapy should be initiated during menstruation. If this is not possible, a sensitive pregnancy test that detects early pregnancy should be done to insure the patient is not pregnant. A non-hormonal birth control method is recommended.

Following an initial favorable response (amenorrhea develops), the dosage should be titrated to the minimum dose that suppresses disease activity.

Therapy should continue uninterrupted for 3 to 6 months. Administration of danazol up to 9 months may be necessary. Should symptoms recur, danazol treatment may be reinitiated.50 mg to 200 mg orally two times a day.

To assure that the patient is not pregnant, therapy should be initiated during menstruation. If this is not possible, a sensitive pregnancy test that detects early pregnancy should be done to insure the patient is not pregnant. A non-hormonal birth control method is recommended.

Resolution of pain and tenderness usually occurs following 1 to 3 months of therapy. Elimination of nodules often requires 4 to 6 months of uninterrupted therapy. Symptoms recur within one year in 50% of patients and therapy may be reinitiated if necessary.200 mg orally two to three times a day.

To assure a female patient is not pregnant, therapy should be initiated during menstruation. If this is not possible, a sensitive pregnancy test that detects early pregnancy should be done to insure the patient is not pregnant. A non-hormonal birth control method is recommended.

Following an initial favorable response (prevention of edematous episodes), attempts should be made at 1 to 3 month intervals to reduce the dosage to the minimum continuous dose that will prevent angioedema. Dosage reductions up to 50% per interval may be considered. Should angioedema recur, the daily dosage may be increased up to 200 mg.

Danazol is contraindicated in patients with severe renal or hepatic dysfunction, acute intermittent porphyria, or in women who are suspected or known to be pregnant, who are nursing, or have undiagnosed abnormal genital bleeding.

Thromboembolic and thrombophlebotic events (including sagittal sinus thrombosis), some resulting in fatal strokes, have occurred.

Life-threatening peliosis hepatis and benign hepatic adenoma have occurred following prolonged danazol administration.

Benign intracranial hypertension (pseudotumor cerebri) has been reported.

The pituitary-suppressive actions of danazol are reversible. Ovulation and cyclic bleeding usually return in 2 to 3 months following discontinuation of danazol.

Side Effects
Cardiovascular side effects have included edema and congestive heart failure.Endocrine side effects have included the inhibition of estrogen synthesis, resulting in flushing, sweating, vaginal dryness and irritation, and reduction in breast size. During administration of danazol, endogenous testosterone synthesis and release may be inhibited through feedback inhibition of pituitary luteinizing hormone (LH). Large doses of danazol may suppress spermatogenesis through inhibition of pituitary follicle stimulating hormone (FSH). Danazol may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged and there is no clinical evidence of thyroid dysfunction.Gastrointestinal side effects have included nausea and vomiting. Rare cases of pancreatitis have been reported.Genitourinary side effects have included oligospermia and decreased ejaculatory volume. Elderly male patients may experience prostatic enlargement resulting in urinary obstruction. Priapism and excessive stimulation may develop.

In female patients, the use of danazol may result in virilization including deepening voice, hirsutism, acne, clitomegaly (rare), and menstrual abnormalities. Discontinuation of medication at signs of mild virilization may prevent irreversible virilization.

Alterations in libido may occur (increased/decreased).Hematologic side effects have included thromboembolic and thrombophlebotic events (including sagittal sinus thrombosis), some resulting in fatal strokes, and increased red cell production.Metabolic side effects have included significant increases in low density lipoproteins (LDL) and decreases in high density lipoproteins (HDL). Decreased glucose tolerance requiring adjustments in hyperglycemic control has occurred.Other side effects in female patients have included virilization, including deepening voice, hirsutism, acne, clitomegaly (rare), and menstrual abnormalities, due the androgenic activity of danazol. Discontinuation of danazol at signs of mild virilization may prevent irreversible virilization. Reduction in breast size may occur due to decreased estrogen synthesis.Renal side effects have included the retention of nitrogen, sodium, potassium, chloride, water and phosphorus, and decreased urinary excretion of calcium.Oncologic side effects have included rare cases of hepatic neoplasms following prolonged use.Hepatic side effects have included life-threatening peliosis hepatitis and benign hepatic adenoma following prolonged danazol administration. Rare cases of hepatic neoplasms following prolonged use have been reported. Danazol can exacerbate acute intermittent porphyria. Serum transaminase levels may be increased.

Danazol has been assigned to pregnancy category X by the FDA. Animal (rat) studies using danazol at doses 7 to 15 times that of a corresponding human dosage on days 6 to 15 of gestation failed to reveal evidence of teratogenicity or embryotoxicity. Studies in rabbits during days 6 to 18 of gestation at doses 2 to 4 times that of a corresponding human dosage resulted in inhibition of fetal development. There are no controlled data in human pregnancy. Danazol use is considered contraindicated during pregnancy.

Reversible oligospermia may occur in adult males after prolonged administration or excessive dosage. If this effect occurs, danazol can be discontinued and if restarted, a lower dosage should be utilized.If therapy is not initiated during menstruation, a sensitive pregnancy test that detects early pregnancy should be done to determine that the patient is not pregnant. A non-hormonal contraceptive method should be used during danazol therapy. If pregnancy occurs during therapy, danazol should be discontinued. Patients should be advised of the possible risks to the fetus.

There are no data on the excretion of danazol into human milk. Breast-feeding is considered to be contraindicated by the manufacturer.


Danazol, a synthetic androgen, is derived from ethisterone.

Danazol inhibits pituitary release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) resulting in reduced gonadal (sex) steroid synthesis. Danazol may directly inhibit sex steroid synthesis and competitively inhibits sex steroid binding to intracellular target tissue receptors. Suppression of ovarian function induces endometrial inactivity and atrophy. Danazol decreases IgG, IgA, IgM, and autoantibodies levels in patients with endometriosis.

Danazol exerts weak dose-related androgenic activity. Androgenic activity induces normal growth and development of male sex organs, maintains secondary sex characteristics, and modulates the growth spurt of adolescence and eventual termination of linear growth.

Danazol increases serum concentrations of C1 esterase inhibitor (C1 IHN) which results in increased concentrations of the C4 component of the compliment system.

Danazol is FDA approved for treatment of endometriosis and fibrocystic breast disease. It is also indicated for use in prevention of attacks of hereditary angioedema.

Danazol has been used in treatment of gynecomastia, menorrhagia, and precocious puberty. It has also been used in female or male contraception, breast cancer, certain anemias (red cell aplasia and other deficient red cell production anemias) to enhance red cell production, as treatment in select coagulopathies (Antithrombin III deficiency or fibrinogen excess), in inflammatory responses (autoimmune hemolytic anemia, asthma, SLE) and to modulate growth failure (primary or secondary) or short stature associated with Turner’s syndrome.


Danazol is available for oral administration.

Danazol is rapidly and almost completely absorbed. Peak levels occur within 2 hours. Bioavailability is increased when danazol is taken with food (especially fatty foods), however, the time to peak concentration is delayed approximately 30 minutes.

Dosage increases do not produce proportional increases in danazol serum concentrations. Doubling the dose increases serum concentrations only 35% to 40%.

The plasma protein binding of danazol is unknown.

The volume of distribution of danazol is unknown.

The apparent total body clearance is 710 L/hour.

The elimination half-life averages 9.44 hours.

Danazol is metabolized to various metabolites. Six metabolites have been identified. Ethisterone appears to be an active metabolite and possesses progestational and mildly androgenic activity. Danazol undergoes extensive enterohepatic circulation. Danazol is found primarily in the adrenals and kidneys. Danazol is excreted by the kidneys (50%) and to a lesser extent in the feces (36%).

There are no data on the pharmacokinetic disposition of danazol in patient with renal and/or hepatic dysfunction.

There are no data on the hemodialysis or peritoneal dialysis clearance of danazol.

Menopause Hormone Blood Test

Menopause Hormone Blood Test

The Menopause Hormone Blood Test identifies deficiencies (or excesses) of sex hormones estradiol, estrone, estriol, progesterone, and testosterone.

The “female” estrogens: estriol, estradiol, and estrone, all affect health throughout the body.

Progesterone, which balances the action of estrogen, serves as a precursor for other hormones, and plays an important role in mood, blood sugar balance, libido, and thyroid function, as well as adrenal gland health.

The “male” hormone testosterone, which helps to maintain lean body mass, bone density, skin elasticity, blood cell production, and libido .

Health conditions this test is used to assess
This test can determines your baseline hormone levels, so you can make an informed decision about hormone replacement therapy. It can also provide guidance in the treatment of endometriosis , breast cancer, high blood pressure and heart disease, osteoporosis, and low libido.

What this test involves
This test involves collecting three saliva samples collected in test tubes and sent to the lab.

How can I get this test done?
Talk to your health care professional about your symptoms and ask if this test would be useful for you

Required Male Blood Panel for Hormone Replacement Therapy

1. Homocystine,Plasma……
2. TSH Free T4
3. Lipid Panel With LDL/HDL Ratio
4. Comp. Metabolic Panel
5. Testosterone Free and Total
6. IGF-1
7. Triiodothyronine, Free, Serum
8. FSH, LH
9. Estradiol
10. CBC With Differential/Platelet
11. PSA
12. Cortisol
13. DHEA Sulfate
14. Hemoglobin A1C
15. Thyroid Panel with TSH
16. Insulin, Fasting
17. Ferritin, Serum
18. SHBG

Estrogen Test

Estrogen Test

An estrogen test measures the level of the most important estrogen hormones (estradiol, estriol, and estrone) in a blood or urine sample.

  • Estradiol is the most commonly measured type of estrogen for nonpregnant women. The amount of estradiol in a woman’s blood varies throughout her menstrual cycle. After menopause, estradiol production drops to a very low but constant level.
  • Estriol levels usually are only measured during pregnancy. Estriol is produced in large amounts by the placenta, the tissue that links the fetus to the mother. It can be detected as early as the 9th week of pregnancy, and its levels increase until delivery. Estriol can also be measured in urine.
  • Estrone may be measured in women who have gone through menopause to determine their estrogen levels. It also may be measured in men or women who might have cancer of the ovaries, testicles, or adrenal glands.

Both men and women produce estrogen hormones. Estrogens are responsible for female sexual development and function, such as breast development and the menstrual cycle. In women, estrogens are produced mainly in the ovaries and in the placenta during pregnancy. Small amounts are also produced by the adrenal glands. In men, small amounts of estrogens are produced by the adrenal glands and testicles. Small amounts of estrone are made throughout the body in most tissues, especially fat and muscle. This is the major source of estrogen in women who have gone through menopause.

For pregnant women, the level of estriol in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman’s blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman’s age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

10 reasons for Hormone Replacement Therapy (HRT) Clinic

10 reasons for Hormone Replacement Therapy (HRT) Clinic

August 15, 2011
(1). HRT will stop your hot flushes and sweats

Troublesome hot flushes, severe night sweats and headaches causingchronic insomnia are characteristic symptoms of the menopause.These symptoms may last for many years. Apart from being sociallyembarrassing they result in tiredness and depression becauseof lack of sleep. These symptoms can almost invariably be curedwith the correct small dose of estrogen. Although selectiveserotonin reuptake inhibitor antidepressants have been suggestedfor the treatment of vasomotor symptoms, no other treatmentis nearly as effective as estrogens. Women who still have auterus should still have 7–12 days of progestogen in orderto produce a withdrawal bleed and prevent endometrial hyperplasia.

(2). Estrogens will treat vaginal dryness and many causes of painful intercourse and lack of libido

Thinning of the pelvic tissues producing vaginal dryness andoccasionally bleeding is another characteristic result of estrogendeficiency that occurs after the menopause. This also can besuccessfully treated with estrogen either by tablets or throughthe skin by patches or gels or implants. Transdermal estrogentherapy is probably the safest and most effective route as hepaticcoagulation factors are not stimulated. Local estrogens canalso be given for this symptom using local vaginal applicationsof weak estrogens such as oestriol that are hardly absorbed.Other related problems of painful intercourse, loss of libidoand recurrent ‘cystitis’, if due to pelvic atrophyare also effectively treated by systemic or long-term localvaginal estrogens.

(3). HRT increases bone density and prevents osteoporotic fractures

Every study confirms that estrogens are the most effective wayof increasing bone density and preventing osteoporotic fractureseven in low-risk women. This treatment is very safe when startedin women under the age of 60. It is more effective and beneficialthan the bisphosphonates that are frequently used by bone physiciansas first choice and by general practitioners unsure about thesafety of estrogen therapy. These non-hormonal drugs with theirconsiderable long-term complications should have no place inmaintaining bone density in women under the age of 60. For therecently menopausal women receiving estrogen therapy for climactericsymptoms such as flushes, sweats or vaginal dryness, there willbe a considerable increase, up to 15% in 10 years to such anextent that osteoporotic fractures 20 years later in the olderwomen are much less likely to occur. If these women have lowbone density, even without typical menopausal symptoms, estrogensmust be seen as first-choice therapy. For those younger womenwith severe osteopenia or osteoporosis due to premature menopause,early hysterectomy and oophorectomy or anorexia with amenorrhoea,estrogens are an essential long-term treatment.

(4). HRT protects the intervertebral discs

Important recent studies from several centres have shown conclusivelythat estrogens prevent collagen being lost from the intervertebraldiscs, thus maintaining their strength and function. These discsmake up one-quarter of the length of the spinal column and actas cushions preventing crush fractures of the vertebral bodies.It is these crush fractures that lead to loss of height andthe lordosis of the upper spine known as the Dowager’s hump.This important protective effect of estrogens seems to be uniqueas bisphosphonates and the other non-hormonal treatments oflow bone density do not have any beneficial effect upon thediscs. {As pointed out elsewhere bisphosphonates increase bone density by going to the bond long-term, but done make the bones more resistant to fractures–jk}.

(5). HRT does reduce the number of heart attacks

There are about 30 years of evidence from many observationaltrials that estrogens reduce the incidence of coronary heartdisease. This has subsequently been questioned by the 2002 WHIStudy, which showed an increase in heart attacks. However, thisstudy looked at patients of the wrong age and who were usingthe wrong dose of estrogen and progestogen. Subsequent reportsfrom the same investigators have shown a very much reduced incidenceof heart attacks in women who start HRT below the age of 60.This is particularly apparent in women who have had a hysterectomyand can have estrogens without progestogen. The view now isthat HRT, particularly estrogen alone, is very safe and is associatedwith a reduced number of heart attacks if started below theage of 60. Thus there is primary prevention of coronary heartdisease, but there is no evidence of protection in women withestablished coronary damage.

It would appear that the factor that is associated with theapparent increase in severe side-effects such as breast cancerand heart attacks and possibly stroke is the progestogen componentof HRT. As progestogen also produces unwanted PMS-type side-effectsof depression, anxiety, bloating and loss of libido in patientswho are progestogen intolerant, it is sensible to keep the doseof oral gestogen to a minimum. The alternative is to inserta Mirena intrauterine system, which produces amenorrhoea andavoids the use of oral progestogen with its side-effects forfive years or more.

(6). Estrogens help depression in many women

Estrogens are more effective in the treatment of depressionin premenopausal or perimenopausal women than post- menopausalwomen. However there is no doubt that depression is helped inpostmenopausal women who have been suffering from night sweats,insomnia or vaginal dryness, painful intercourse and maritalproblems in that most of these problems can be effectively treatedand removed. However, it is true that the most impressive effecton mood is seen in younger perimenopausal women in the 2–3years before the period cease in the menopausal transition.This cannot be diagnosed by blood tests but by a careful history.This depression often occurs in women who are sensitive to abruptchanges in their hormones, either endogenous oestradiol or progesterone.These women had previously had postnatal depression and premenstrualdepression in what should be known as reproductive depression.They often also have cyclical headaches/migraines that occurwith the cyclical hormonal fluctuations at menstruation. Aspremenstrual depression becomes worse with age, it blends intothe more severe depression of the transition phase and is veryeffectively treated by moderately high-dose transdermal estrogensused by patches, gels or implants.

(7). HRT improves libido

HRT certainly improves libido if estrogens are used to curevaginal dryness and painful intercourse. Even without thesecharacteristic symptoms, estrogens can improve sexual desire.However, if necessary, the addition of testosterone has a moredramatic effect upon libido, frequency of intercourse and intensityof orgasm. Testosterone patches licensed in women after hysterectomyand testosterone gels in the appropriate dose are often andshould be used ‘off license’ with full consent andexplanation.

Women must be aware that testosterone is not only a male hormonebut it is an essential female hormone present in women in about10 times the blood levels as estrogen. It is an essential hormone,important for energy, mood and sexuality.

(8). HRT improves the texture of the skin

After the menopause, women lose about 25% of their body collagen,which is manifested by thin inelastic skin, brittle nails, lossof hair and loss of the collagenous bone matrix. This latterloss is an essential cause of osteoporosis and osteoporoticfractures. Estrogen therapy replaces the lost collagen in theskin and the bone. Its affect on the facial skin is a very obvioususeful cosmetic effect.

(9). ‘I am a nicer person to live with’

This is a quote from a patient. Many women say that when estrogentherapy stops their depression, their loss of libido and theirirritability, they become more agreeable people for their partnersto live with. The depression, irritability, grumpiness and lossof energy and disinterest in sex can usually be improved considerablyby the appropriate doses of the appropriate hormones that mayinclude testosterone as well as estrogen.

(10). HRT is safe

In spite of the press reports stressing bad news, virtuallyall claims of major adverse effects from the WHI study havebeen reconsidered even by the investigators. It seems quiteclear that the reported major side-effects of breast cancer,stroke and heart attacks occurred in women who started the wrongdose of HRT over the age of 60. In women who started below theage of 60 there were fewer heart attacks, fewer deaths, fewerosteoporotic fractures and even less breast cancer in this study.It is probable that the one residual side-effect is a small1% extra lifetime risk of developing breast cancer, but thisis no more than the breast cancer risk of being overweight,drinking wine, having no children or even taking statins. {DISAGREE: As above stated the author

High levels of Estrogen Can cause depression

High levels of Estrogen Can cause depression

Estrogen and Depression

The sex difference in rates of psychiatric illness beginning at puberty and continuing throughout the reproductive years suggest that the brain’s hormonal environment is the thing which modulate the risk and severity of psychiatric morbidity. Hormones play an integral role in the development and prognosis of psychiatric disorders has been increasing attention, especially along with depression treatment. The male-female contrasts in estrogen production throughout the reproductive years are responsible for the modulating the expression of depression between the sexes. Change in mood reported during the late luteal phase of the menstrual cycle and following childbirth mainly.

There are so many causes of increase in the rate of depression at the time of menopause and the recent research for it does not found any evidence that explain that the major depression increases after menopause, at a time when estrogen levels decline. But the thing is observed that post-menopausal women are increasingly vulnerable to depression as the estrogen production reduces in them. Actually the action of estrogen on neurotransmitter and receptor functioning are having the antidepressant symptoms. The main aim of estrogen is to enhance serotonergic functions like increases synthesis and uptake, post-synaptic receptor responsivity, and leads to up-regulation of 5-HT1 and down-regulation of 5-HT2 serotonin receptors.

Estrogen also increases norepinephrine activity in the brain which are responsible for improving the mood and cognition reported in women on estrogen replacement therapy (ERT) and it also involves changes in monoamine oxidase activity. In non-depressed peri- and post-menopausal women though estrogen has been known to improve mood and sense of well being, estrogen alone but it does not improve mood in women with clinical depression. Estrogen as an adjunct to antidepressant therapy is also helpful.

Recently it is researched that the older depressed women in the age 60 years or more older on ERT who received sertraline had substantially improved well than women receiving sertraline alone. Estrogen augmentation for perimenopausal depression be reserved for a subgroup of women, those suffering from depression like postpartum depression or mood changes related to the menstrual cycle associated with changes in estrogen levels. There is a link between Estrogens and the onset, course and severity of depression suggesting estrogen supplementation may be a useful adjuvant therapy in selected depressed women.

Estrogen Source of Stress

As the survey on depression itself suggest that the stress-related depressions are seen twice in women as compared to men. Estrogens level is the main reason for this happening. Even mild levels of stress which don’t affect men, can affect female very easily as their estrogen levels were elevated as estrogen makes the brain more vulnerable to stress. High levels of estrogen increases brain’s response to stress which is responsible that women are more vulnerable to mental illnesses such as depression and post-traumatic stress disorder (PTSD) than men.

It is known that estrogen can interact with molecular processes involved in the stress response and that certain genetic variations have been demonstrated in clinically depressed women. But how these factors combine to produce the disparity in the prevalence of this disorder is unknown

Red yeast rice

Red yeast rice

Red yeast rice (RYR), a product made from cultivating rice with the mold Monascus purpureus, has been used in China for centuries to treat circulatory and digestive disorders – and apparently without a bit of controversy. RYR has been in use in the U.S. for a much shorter period of time (as a non-prescription cholesterol-lowering supplement), and has generated lots of controversy.

The Controversy and Confusion Over RYR

The controversy began in 1999, shortly after clinical trials first showed that RYR could indeed significantly lower cholesterol levels. At that time it came to the attention of the FDA that RYR’s effectiveness is related to the fact that it contains a naturally-occurring form of the statin drug lovastatin (marketed as Mevacor). So the FDA ruled that RYR was a regulable drug, and thus ordered it removed it from the shelves.

This FDA decision was initially overruled by the District Court of Utah in 1999, but in 2000 the 10th U.S. Circuit Court of Appeals agreed with the FDA that RYR could be regulated. So RYR could still be sold legally in the U.S., but only if steps were taken in its manufacturing process to remove the lovastatin (presumably eliminating its effectiveness).

Then, in 2007, the FDA found that at least some RYR in the U.S. still contained lovastatin, and (after issuing a formal FDA Consumer Safety Alert) took further steps to purge the “tainted” products from the shelves.

Currently, as far as the FDA is concerned, the RYR that you can buy in the U.S. contains no lovastatin. But otherwise, RYR is still considered a dietary supplement, so its formulation and content is still not regulated — and it is very difficult if not impossible to find out what it does contain. (This is the case with any unregulated dietary supplement.)

But Does It Work?

In the face of all this confusion, two clinical trials have appeared in the last few years that show that at least some RYR legally available in the U.S. is still effective in reducing cholesterol levels.

In 2009, a study from Pennsylvania showed that in 60 patients who had to stop taking statin drugs because of muscle pain, taking RYR and initiating lifestyle changes for 24 weeks significantly reduced total and LDL cholesterol levels, compared to taking a placebo and making the same lifestyle changes.

And in 2010, investigators from the University of Pennsylvania reported that in patients who had to stop taking statins due to muscle pain, RYR was just as effective as 20 mg per day of the statin drug pravastatin (Pravachol) in reducing cholesterol levels. (Both RYR and pravachol produced only a very low incidence of recurrent muscle pain.)

In the 2009 study, the investigators performed a formal chemical analysis on the RYR product they used in their study (from Sylvan Bioproducts in Kittanning, Pennsylvania). They found that the RYR contained monacolin K (the naturally-occurring form of lovastatin), as well as eight other monacolins (statins or statin-like substances).

The result of this chemical analysis suggests two things. First, that RYR available in the U.S. apparently still contains at least some lovastatin, and second, even if all the lovastatin were completely removed (which appears to be much harder to do than the FDA thinks) other, similar chemicals in RYR may be effective in reducing cholesterol.

CoQ10 Benefits

CoQ10 Benefits

There are numerous CoQ10 Benefits. CoQ10 has long been accepted as necessary for all cellular energy production and must also be present in every cell in our body. All cells require it to produce energy and provide powerful antioxidant protection. Overall, ninety-five percent of the human body’s energy requirements are met with the energy converted in processes involving it. CoQ10 is sometimes also referred to as ubiquinol, a name formed with the word ubiquitous (which means “being or seeming to be everywhere at the same time; omnipresent”), because coenzyme Q10 is found in virtually every cell in the body.

CoQ10 is found in the highest concentrations in the hardest working organs in the body, such as the heart, brain, liver and kidneys. The ability of these organs to produce energy and protect themselves from free radicals defines what good health and anti aging supplements is all about. Researchers have demonstrated that CoEnzyme Q10 deficiencies are more prevalent with age. As we grow older, we are no longer able to produce CoQ10 from the food in our diet.

As we age, the body loses its efficiency in manufacturing important nutrients. Therefore, even though the young may be able to get enough CoQ10 by making it and ingesting it through diet, a gradual deficiency may develop as we reach middle age and beyond. In addition, people with serious diseases (such as heart disease and cancer) tend to have low CoQ10 levels. Consumed regularly, Coenzyme Q10 fights off the aging process as it contributes to greater health and longevity.



August 8, 2011

Pantothenic acid is a vitamin, also known as vitamin B5. It is widely found in both plants and animals including meat, vegetables, cereal grains, legumes, eggs, and milk.

Vitamin B5 is commercially available as D-pantothenic acid, as well as dexpanthenol and calcium pantothenate, which are chemicals made in the lab from D-pantothenic acid.

Pantothenic acid is frequently used in combination with other B vitamins in vitamin B complex formulations. Vitamin B complex generally includes vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin/niacinamide), vitamin B5 (pantothenic acid), vitamin B6 (pyridoxine), vitamin B12 (cyanocobalamin), and folic acid. However, some products do not contain all of these ingredients and some may include others, such as biotin, para-aminobenzoic acid (PABA), choline bitartrate, and inositol.

Pantothenic acid has a long list of uses, although there isn’t enough scientific evidence to determine whether it is effective for most of these uses. People take pantothenic acid for treating dietary deficiencies, acne, alcoholism, allergies, baldness, asthma, attention deficit-hyperactivity disorder (ADHD), autism, burning feet syndrome, yeast infections, heart failure, carpal tunnel syndrome, respiratory disorders, celiac disease, colitis, conjunctivitis, convulsions, and cystitis. It is also taken by mouth for dandruff, depression, diabetic nerve pain, enhancing immune function, improving athletic performance, tongue infections, gray hair, headache, hyperactivity, low blood sugar, trouble sleeping (insomnia), irritability, low blood pressure, multiple sclerosis, muscular dystrophy, muscular cramps in the legs associated with pregnancy or alcoholism, neuralgia, and obesity.

Pantothenic acid is also used orally for osteoarthritis, rheumatoid arthritis, Parkinson’s disease, nerve pain, premenstrual syndrome (PMS), enlarged prostate, protection against mental and physical stress and anxiety, reducing adverse effects of thyroid therapy in congenital hypothyroidism, reducing signs of aging, reducing susceptibility to colds and other infections, retarded growth, shingles, skin disorders, stimulating adrenal glands, chronic fatigue syndrome, salicylate toxicity, streptomycin neurotoxicity, dizziness, and wound healing.

People apply dexpanthenol, which is made from pantothenic acid, to the skin for itching, promoting healing of mild eczemas and other skin conditions, insect stings, bites, poison ivy, diaper rash, and acne. It is also applied topically for preventing and treating skin reactions to radiation therapy.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for PANTOTHENIC ACID (VITAMIN B5) are as follows:

Effective for…

  • Treating or preventing pantothenic acid deficiency.

Possibly ineffective for…

  • Treating or preventing skin reactions from radiation therapy.

Insufficient evidence to rate effectiveness for…

  • Attention deficit-hyperactivity disorder (ADHD). There is conflicting evidence regarding the usefulness of pantothenic acid in combination with large doses of other vitamins for the treatment of ADHD.
  • Arthritis. Developing research suggests pantothenic acid (given as calcium pantothenate) does not significantly reduce the symptoms of arthritis in people with rheumatoid arthritis, osteoarthritis, or other forms of arthritis.
  • Improving athletic performance. Some research suggests that pantothenic acid in combination with pantethine and thiamine does not improve muscular strength or endurance in well-trained athletes.
  • Skin problems.
  • Alcoholism.
  • Allergies.
  • Hair loss.
  • Asthma.
  • Heart problems.
  • Carpal tunnel syndrome.
  • Lung disorders.
  • Colitis.
  • Eye infections (conjunctivitis).
  • Convulsions.
  • Kidney disorders.
  • Dandruff.
  • Depression.
  • Diabetic problems.
  • Enhancing immune function.
  • Headache.
  • Hyperactivity.
  • Low blood pressure.
  • Inability to sleep (insomnia).
  • Irritability.
  • Multiple sclerosis.
  • Muscular dystrophy.
  • Muscle cramps.
  • Other conditions.

More evidence is needed to rate the effectiveness of pantothenic acid for these uses.

How does it work?

Pantothenic acid is important for our bodies to properly use carbohydrates, proteins, and lipids and for healthy skin.

Are there safety concerns?

Pantothenic acid is LIKELY SAFE for most people when used in appropriate amounts. The recommended amount for adults is 5 mg per day. Even larger amounts seem to be safe for some people, but taking larger amounts increases the chance of having side effects such as diarrhea.

Pantothenic acid seems to be safe for children when used appropriately.

Special precautions & warnings:

Pregnancy and breast-feeding: Pantothenic acid is LIKELY SAFE when taken in recommended amounts of 6 mg per day during pregnancy and 7 mg per day during breast-feeding. But it is not known if taking more than this amount is safe.

Hemophila: Don’t take pantothenic acid if you have hemophila. It might extend the time it takes for bleeding to stop.

Are there interactions with medications?

It is not known if this product interacts with any medicines.

Before taking this product, talk with your health professional if you take any medications.

Are there interactions with herbs and supplements?

Royal jelly

Royal jelly contains significant amounts of pantothenic acid. The effects of taking royal jelly and pantothenic acid supplements together aren’t known.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The following doses have been studied in scientific research:


  • As a dietary supplement: 5-10 mg of pantothenic acid (vitamin B5).

Recommended daily intakes for pantothenic acid (vitamin B5) are as follows: Infants 0-6 months, 1.7 mg; infants 7-12 months, 1.8 mg; children 1-3 years, 2 mg; children 4-8 years, 3 mg; children 9-13 years, 4 mg; men and women

14 years and older, 5 mg; pregnant women, 6 mg; and breastfeeding women, 7 mg.

Other names

Acide Pantothénique, Ácido Pantoténico, B Complex Vitamin, Calcii Pantothenas, Calcium D-Pantothenate, Calcium Pantothenate, D-Calcium Pantothenate, D-pantothenic Acid, D-Panthenol, D-Pantothenyl Alcohol, Dexpanthenol, Dexpanthenolum, Panthenol, Pantothenate, Pantothenic Acid, Pantothenol, Pantothenylol, Vitamin B5, Vitamin B-5, Vitamina B5, Vitamine B5.

Information on omega 3 and how it helps your entire body!!!!

Information on omega 3 and how it helps your entire body!!!!

Omega-3 fatty acids are considered essential fatty acids: They are necessary for human health but the body can’ t make them — you have to get them through food. Omega-3 fatty acids can be found in fish, such as salmon, tuna, and halibut, other seafood including algae and krill, some plants, and nut oils. Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function as well as normal growth and development. They have also become popular because they may reduce the risk of heart disease. The American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2 times a week.

Research shows that omega-3 fatty acids reduce inflammation and may help lower risk of chronic diseases such as heart disease, cancer, and arthritis. Omega-3 fatty acids are highly concentrated in the brain and appear to be important for cognitive (brain memory and performance) and behavioral function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems. Symptoms of omega-3 fatty acid deficiency include fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.

It is important to have a balance of omega-3 and omega-6 (another essential fatty acid) in the diet. Omega-3 fatty acids help reduce inflammation, and most omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 14 – 25 times more omega-6 fatty acids than omega-3 fatty acids.

The Mediterranean diet, on the other hand, has a healthier balance between omega-3 and omega-6 fatty acids. Many studies have shown that people who follow this diet are less likely to develop heart disease. The Mediterranean diet does not include much meat (which is high in omega-6 fatty acids) and emphasizes foods rich in omega-3 fatty acids, including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.


Clinical evidence is strongest for heart disease and problems that contribute to heart disease, but omega-3 fatty acids may also be used for:

High cholesterol

People who follow a Mediterranean-style diet tend to have higher HDL or “good” cholesterol levels, which help promote heart health. Inuit Eskimos, who get high amounts of omega-3 fatty acids from eating fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fats in the blood). Several studies have shown that fish oil supplements reduce triglyceride levels. Finally, walnuts (which are rich in alpha linolenic acid or LNA, a type of omega-3 fatty acid) have been reported to lower total cholesterol and triglycerides in people with high cholesterol levels.

High blood pressure

Several clinical studies suggest that diets or fish oil supplements rich in omega-3 fatty acids lower blood pressure in people with hypertension. An analysis of 17 clinical studies using fish oil supplements found that taking 3 or more grams of fish oil daily may reduce blood pressure in people with untreated hypertension.

Heart disease

One of the best ways to help prevent heart disease is to eat a diet low in saturated fat and to eat foods that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids). Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the two omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure. Fish oil has been shown to lower levels of triglycerides (fats in the blood), and to lower risk of death, heart attack, stroke, and abnormal heart rhythms in people who have already had a heart attack. Fish oil also appears to help prevent and treat atherosclerosis (hardening of the arteries) by slowing the development of plaque and blood clots, which can clog arteries.

Large population studies suggest that getting omega-3 fatty acids in the diet, primarily from fish, helps protect against stroke caused by plaque buildup and blood clots in the arteries that lead to the brain. Eating at least 2 servings of fish per week can reduce the risk of stroke by as much as 50%. However, high doses of fish oil and omega-3 fatty acids may increase the risk of bleeding. People who eat more than 3 grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may have higher risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.


People with diabetes often have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and apoproteins (markers of diabetes), and raise HDL, so eating foods or taking fish oil supplements may help people with diabetes. Another type of omega-3 fatty acid, ALA (from flaxseed, for example) may not have the same benefit as fish oil. Some people with diabetes can’ t efficiently convert LNA to a form of omega-3 fatty acids that the body can use. Also, some people with type 2 diabetes may have slight increases in fasting blood sugar when taking fish oil, so talk to your doctor to see if fish oil is right for you.

Rheumatoid arthritis

Most clinical studies examining omega-3 fatty acid supplements for arthritis have focused on rheumatoid arthritis (RA), an autoimmune disease that causes inflammation in the joints. A number of small studies have found that fish oil helps reduce symptoms of RA, including joint pain and morning stiffness. One study suggests that people with RA who take fish oil may be able to lower their dose of non-steroidal anti-inflammatory drugs (NSAIDs). However, unlike prescription medications, fish oil does not appear to slow progression of RA, only to treat the symptoms. Joint damage still occurs.

Laboratory studies suggest that diets rich in omega-3 fatty acids (and low in the inflammatory omega-6 fatty acids) may help people with osteoarthritis, although more study is needed. New Zealand green lipped mussel (Perna canaliculus), another potential source of omega-3 fatty acids, has been reported to reduce joint stiffness and pain, increase grip strength, and improve walking pace in a small group of people with osteoarthritis. For some people, symptoms got worse before they improved.

An analysis of 17 randomized, controlled clinical trials looked at the pain relieving effects of omega-3 fatty acid supplements in people with RA or joint pain caused by inflammatory bowel disease (IBS) and painful menstruation (dysmenorrhea). The results suggest that omega-3 fatty acids, along with conventional therapies such as NSAIDs, may help relieve joint pain associated with these conditions.

Systemic lupus erythematosus (SLE)

Several small studies suggest that EPA and fish oil may help reduce symptoms of lupus, an autoimmune condition characterized by fatigue and joint pain. However, two small studies found fish oil had no effect on lupus nephritis (kidney disease caused by lupus, a frequent complication of the disease).


Some studies suggest that omega-3 fatty acids may help increase levels of calcium in the body and improve bone strength, although not all results were positive. Some studies also suggest that people who don’ t get enough of some essential fatty acids (particularly EPA and gamma-linolenic acid [GLA], an omega-6 fatty acid) are more likely to have bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those who took EPA and GLA supplements had less bone loss over 3 years than those who took placebo. Many of these women also experienced an increase in bone density.


Studies have found mixed results as to whether taking omega-3 fatty acids can help depression symptoms. Several studies have found that people who took omega-3 fatty acids in addition to prescription antidepressants had a greater improvement in symptoms than those who took antidepressants alone. However, other studies have found no benefit.

Studies are also mixed on whether omega-3 fatty acids alone have any effect on depression. Depression is a serious illness and you should not try to treat it on your own. See a doctor for help.

Bipolar disorder

In a clinical study of 30 people with bipolar disorder, those who took fish oil in addition to standard prescription treatments for bipolar disorder for 4 months experienced fewer mood swings and relapse than those who received placebo. But another 4-month long clinical study treating people with bipolar depression and rapid cycling bipolar disorder did not find that EPA helped reduce symptoms.


Preliminary clinical evidence suggests that people with schizophrenia may have an improvement in symptoms when given omega-3 fatty acids. However, a recent well-designed study concluded that EPA supplements are no better than placebo in improving symptoms of this condition.

Attention deficit/hyperactivity disorder (ADHD)

Children with attention deficit/hyperactivity disorder (ADHD) may have low levels of certain essential fatty acids (including EPA and DHA). In a clinical study of nearly 100 boys, those with lower levels of omega-3 fatty acids had more learning and behavioral problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels.

However, studies examining whether omega-3 fatty acids help improve symptoms of ADHD have found mixed results. A few studies have found that omega-3 fatty acids helped improve behavioral symptoms, but most were not well designed. One study that looked at DHA in addition to stimulant therapy (standard therapy for ADHD) found no effect. More research is needed, but eating foods that are high in omega-3 fatty acids is a reasonable approach for someone with ADHD.

Skin disorders

In one clinical study, 13 people with sun sensitivity known as photo dermatitis showed less sensitivity to UV rays after taking fish oil supplements. However, topical sunscreens are much better at protecting the skin from damaging effects of the sun than omega-3 fatty acids. In another study of 40 people with psoriasis, those who took EPA with their prescription medications did better than those treated with the medications alone. However, a larger study of people with psoriasis found no benefit from fish oil.

Inflammatory bowel disease (IBD)

Results are mixed as to whether omega-3 fatty acids can help reduce symptoms of Crohn’ s disease and ulcerative colitis, the two types of IBD. Some studies suggest that omega-3 fatty acids may help when added to medication, such as sulfasalazine (a standard medication for IBD). Others find no effect. More studies are needed. Fish oil supplements can cause side effects that are similar to symptoms of IBD (such as flatulence, belching, bloating, and diarrhea).


Studies examining omega-3 fatty acids for asthma are mixed. In one small, well-designed clinical study of 29 children with asthma, those who took fish oil supplements rich in EPA and DHA for 10 months reduced their symptoms compared to children who took placebo. However, most studies have shown no effect.

Macular Degeneration

A questionnaire given to more than 3,000 people over the age of 49 found that those who ate more fish were less likely to have macular degeneration (a serious age-related eye condition that can progress to blindness) than those who ate less fish. Similarly, a clinical study comparing 350 people with macular degeneration to 500 without the eye disease found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and more fish in their diets were less likely to have macular degeneration.

Menstrual pain

In one study of 42 women, they had less menstrual pain when they took fish oil supplements than when they took placebo.


Eating foods rich in omega-3 fatty acids seems to reduce the risk of colorectal cancer. For example, Eskimos, who tend to have a high-fat diet but eat significant amounts of fish rich in omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and laboratory studies have found that omega-3 fatty acids prevent worsening of colon cancer. Preliminary studies suggest that taking fish oil daily may help slow the progression of colon cancer in people with early stages of the disease. If you have colorectal cancer, ask your doctor before taking any supplements.

Breast cancer

Although not all experts agree, women who eat foods rich in omega-3 fatty acids over many years may be less likely to develop breast cancer. More research is needed to understand the effect that omega-3 fatty acids may have on the prevention of breast cancer.

Prostate cancer

Population based studies of groups of men suggest that a low-fat diet including omega-3 fatty acids from fish or fish oil help prevent the development of prostate cancer.

Dietary Sources:

Fish, plant, and nut oils are the primary dietary source of omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold-water fish such as salmon, mackerel, halibut, sardines, tuna, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil. Other sources of omega-3 fatty acids include sea life such as krill and algae.

Available Forms:

Both EPA and DHA can be taken in the form of fish oil capsules. Flaxseed, flaxseed oil, fish and krill oils should be kept refrigerated. Whole flaxseeds must be ground within 24 hours of use, so the ingredients stay active. Flaxseeds are also available in ground form in a special mylar package so that the components in the flaxseeds stay active.

Be sure to buy omega-3 fatty acid supplements made by established companies who certify that their products are free of heavy metals such as mercury, lead, and cadmium.

How to Take It:

Dosing for fish oil supplements should be based on the amount of EPA and DHA, not on the total amount of fish oil. Supplements vary in the amounts and ratios of EPA and DHA. A common amount of omega-3 fatty acids in fish oil capsules is 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA. Five grams of fish oil contains approximately 0.17 – 0.56 grams (170 -560 mg) of EPA and 0.072 – 0.31 grams (72 – 310 mg) of DHA. Different types of fish contain variable amounts of omega-3 fatty acids, and different types of nuts or oil contain variable amounts of LNA. Fish oils contain approximately 9 calories per gram of oil.

Children (18 years and younger)

There is no established dose for children. Omega-3 fatty acids are used in some infant formulas. Fish oil capsules should not be used in children except under the direction of a health care provider. Children should avoid eating fish that may be high in mercury, such as shark, swordfish, king mackerel, and tilefish. (See Precautions section.)


Do not take more than 3 grams daily of omega-3 fatty acids from capsules without the supervision of a health care provider, due to an increased risk of bleeding.

  • For healthy adults with no history of heart disease: The American Heart Association recommends eating fish at least 2 times per week.
  • For adults with coronary heart disease: The American Heart Association recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen.
  • For adults with high cholesterol levels: The American Heart Association recommends an omega-3 fatty acid supplement (as fish oils), 2 – 4 grams daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen.


Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications including warfarin (Coumadin) or clopidogrel (Plavix). High doses of omega-3 fatty acids may increase the risk of bleeding.

Fish oil can cause gas, bloating, belching, and diarrhea. Time-release preparations may reduce these side effects, however.

People with either diabetes or schizophrenia may lack the ability to convert alpha-linolenic acid (LNA) to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the forms more readily used in the body. People with these conditions should be sure to get enough EPA and DHA from their diets. Also, people with type 2 diabetes may experience increases in fasting blood sugar levels while taking fish oil supplements. If you have type 2 diabetes, use fish oil supplements only under the supervision of a health care provider.

Although studies suggest that eating fish (which includes the omega-3 fatty acids EPA and DHA) may reduce the risk of macular degeneration, a recent study including 2 large groups of men and women found that diets rich in LNA may increase the risk of this disease. Until more information becomes available, people with macular degeneration should get omega-3 fatty acids from sources of EPA and DHA, rather than LNA.

Fish and fish oil may protect against prostate cancer, but LNA may be associated with increased risk of prostate cancer in men. More research in this area is needed.

Some fish may contain potentially harmful contaminants, such as heavy metals (including mercury), dioxins, and polychlorinated biphenyls (PCBs). For sport-caught fish, the U.S. Environmental Protection Agency (EPA) recommends that pregnant or nursing women eat no more than a single 6-ounce meal per week, and young children less than 2 ounces per week. For farm-raised, imported, or marine fish, the U.S. Food and Drug Administration recommends that pregnant or nursing women and young children avoid eating types with higher levels of mercury (such as mackerel, shark, swordfish, or tilefish), and eat up to 12 ounces per week of other fish types.

Buy fish oil from a reputable source that tests to make sure there is no mercury or pesticide residues in its products.

Possible Interactions:

If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (LNA), without first talking to your health care provider.

Blood-thinning medications — Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). Taking aspirin and omega-3 fatty acids may be helpful in some circumstances (such as in heart disease), but they should only be taken together under the supervision of a health care provider.

Diabetes medications — Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking medications to lower blood sugar, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin. Your doctor may need to increase your medication dose. These drugs include:

  • Glipizide (Glucotrol and Glucotrol XL)
  • Glyburide (Micronase or Diabeta)
  • Metformin (Glucophage)
  • Insulin

Cyclosporine — Cyclosporine is a medication given to people with organ transplants. Taking omega-3 fatty acids during cyclosporine (Sandimmune) therapy may reduce toxic side effects, such as high blood pressure and kidney damage, associated with this medication.

Etretinate and topical steroids — Adding omega-3 fatty acids (specifically EPA) to the drug therapy etretinate (Tegison) and topical corticosteroids may improve symptoms of psoriasis.

Cholesterol-lowering medications — Following dietary guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may help a group of cholesterol lowering medications known as statins to work more effectively. These medications include:

  • Atorvastatin (Liptor)
  • Lovastatin (Mevacor)
  • Simvastatin (Zocor)

Nonsteroidal anti-inflammatory drugs (NSAIDs) — In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen (Motrin or Advil) and naproxen (Aleve or Naprosyn). More research is needed to see whether omega-3 fatty acids would have the same effects in people.

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