Friday, January 26, 2018

Fish Oil Associated with Hemorrhage and Reduced Stroke-Related Sickness

Ischemic stroke is associated with motor impairment and increased incidence of affective disorders such as anxiety/clinical depression. In non-stroke populations, successful management of such disorders and symptoms has been reported following diet supplementation with long chain omega-3-polyunstaurated-fatty-acids (PUFAs). However, the potential protective effects of PUFA supplementation on affective behaviors after experimentally induced stroke and sham surgery have not been examined previously. The study investigated the behavioral effects of PUFA supplementation over a 6-week period following either middle cerebral artery occlusion or sham surgery in the hooded-Wistar rat. The PUFA diet supplied during the acclimation period prior to surgery was found to be associated with an increased risk of acute hemorrhage following the reperfusion component of the surgery. In surviving animals, PUFA supplementation did not influence infarct size as determined 6 weeks after surgery, but did decrease omega-6-fatty-acid levels, moderate sickness behaviors, acute motor impairment, and longer-term locomotor hyperactivity and depression/anxiety-like behavior.

My Take:
Obviously, this study is a couple of years old. I ran across it because I have a patient, taking fish oil that had a fall on the ice and suffered a hemorrhage. The hospital physician stopped all her supplements and told her not to take them for three months. I was looking for data to support or refute that position.

Of the four supplements she was taking, only the fish oil might be contraindicated. This study with rats indicates the omega 3-fatty acids may have contributed to some additional risk of bleeding during reperfusion, if performed. Reperfusion is the medical treatment that restores blood to tissue after a blockage of blood supply. This is why physicians advise you to stop taking omega 3-fatty acids prior to surgery.

However, the study supports the reintroduction of the fish oil to speed recovery of the nervous system. This, despite the fact that no apparent reduction in the size of the clots was found. It appears that omega-3 fatty acids speed the healing process apart from any direct effect on clotting or clot resolution.

Another curious finding was the reduction of omega-6 fatty acids with the use of omega-3 fatty acids. Both omega-3 and omega-6 fatty acids are inherently anti-inflammatory. However, the omega-6 fatty acids can be converted into pro-inflammatory arachidonic acid, if aspects of metabolic syndrome are present. I suspect the anti-inflammatory drive from the omega-3 fatty acids depleted the omega-6 fatty acids. It would be interesting to see a similar study performed that also monitored omega-6 fatty acids in recovery from induced stroke.

There is some evidenced-based data for the hospital physician to have stopped the omega-3 fatty acids in my patient after her injury. However, there is no evidenced-based data to stop the other supplements and some evidenced-based date to support reintroducing the omega-3 fatty acids as soon as possible.

The Bottom Line:
Omega-3 fatty acids are essential to the body, cannot be manufactured by the body and must be in the diet. Unless you are eating organic grass feed beef and a lot of wild deep sea fish, your diet is deficient in this vital nutrient. Please supplement it daily but do stop it a week or so prior to any surgical procedure.

Source: Frontiers in Neurology February 6, 2014

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