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Essential Fatty Acids: Treatment for a Heart Condition

by Dr Jav Nazemi(more info)

listed in heart, originally published in issue 123 - May 2006

It's a cliché, but out of adversity there is often triumph. In the case of this story, however, my family's adversity led to more than triumph; it led to the introduction of a new series of innovative fatty acid formulations that have changed the landscape of the omega market.

Every Parent's Nightmare

"I'll never forget – it was a Friday afternoon when my wife Anne took our daughter Roxy to the paediatrician at Stevenage Hospital. Roxy had been suffering from headaches and complaining of black spots in her vision, and the GP, perplexed by the spots, referred her to a specialist. Anne and I were expecting that this would be a routine appointment and that the paediatrician was going to say that Roxy had been suffering from migraines."

It was the beginning of a series of events that I believed was 'routine' and 'ordinary', yet by the end of the day, my family and I were facing a situation that was far from common. "When I returned home from work, they were still not back from the hospital, which concerned me, particularly since I had no way of contacting them as neither of us carried a mobile phone at the time. Finally, I received a call from Anne who had found a pay-phone. She explained that during a routine health-check, the doctor on the paediatrics ward had detected a murmur in Roxy's heart. The doctor had called in the Paediatric Consultant who examined her and surmised that the spots in the vision and the heart murmur were linked. He also said that there was a heart specialist from Harefield Hospital on-site who visited one day a month and this happened to be that day. Roxy was referred to the heart specialist who examined her, ran a number of tests and discovered that there was a problem with the valve in her heart, which had caused a blood clot. The clot had broken up and a tiny part of it had settled on Roxy's optic nerve. As the part on the optic nerve then broke up further, it had caused black spots to appear intermittently in Roxy's vision. The consultants wanted to give her a brain scan to check that there was no clot in her brain and if they did find one then they would have to operate immediately."

It was the type of phone call that a father never wants to receive. The details of the conversation hit me in waves and when I put down the receiver the words that were most prevalent in my mind were 'brain surgery', 'blood clot', 'MRI scan'. It was so far from what I had been expecting. All my elder daughter Mina (then 15) and I could do was wait for further news. It was an extremely difficult time.

Eventually Anne and Roxy, who was only 12 at the time, returned home. We were all shell-shocked and began to consider what to do next, while waiting until after the weekend to be called back to the hospital for an MRI on Roxy's brain. This, thankfully, showed that there was no clot in the brain. The medical term for Roxy's condition was incompetence and stenosis of the mitral valve. In layman's language, one of the valves in her heart is narrowed and does not close properly. This can lead to blood leakage, which in turn can cause clots to occur. So the questions that we wanted answered were: what are the implications of this condition and how do you manage and/or treat it?

I phoned around some of our family friends to see if anyone might know someone in the medical field who could offer advice. Then I remembered that one friend had spoken about a helpful doctor that he knew. The friend gave me the doctor's phone number. I remember that the doctor (now a Professor at Hammersmith Hospital), namely Dr Puri, could not have been more approachable. "I remember phoning him and he was so willing to talk and help. I told him about what had happened to Roxy – the diagnosis of her heart valve condition, the black spots in her vision and the theory of the blood clot causing this." Unsure what to expect, I was a little surprised when Dr Puri advised that Roxy take cod liver oil capsules. "Dr Puri said to make sure that she has cod liver oil – he said the omega-3 would help the blood cells to be more flexible and less likely to clot."

As well as being hugely grateful for the advice, I was encouraged that Dr Puri had suggested a natural solution – where possible my family and I have always opted for nature's remedies – if one of us gets a cold then we take hot lemon, Manuka honey and echinacea. "What Dr Puri had advised further fuelled my interest, and I wanted to learn as much as I could about the properties of fish oil, particularly if it could help Roxy."

Roxy's Consultants suggested that the best way forward was for her to be put on a life-long course of penicillin and aspirin. The antibiotic was in place to stave off potential infection, as they believed that Roxy's heart defect had initially been caused by a bout of rheumatic fever, which she had contracted when she was little. We were unaware of this because in Roxy's case the rheumatic fever presented no symptoms. The aspirin's purpose was to prevent the blood clotting by ensuring that it was kept thin. In addition, a Harley Street Naturopath had suggested that Roxy would benefit from taking regular doses of a variety of herbal preparations and vitamins. My wife and I followed all the advice we received and Roxy ingested daily doses of the prescribed cocktail. Thankfully, her health remained stable, although she continues to be monitored annually at Harefield.

Essential Fatty Acids

My interest in fish oil grew. Anne was pretty clued up about the benefits of everything that the Naturopath had suggested – those supplements were good for Roxy's heart and immune system – but like any caring parents, we both wanted to know as much as we could about fish oils.

I found out, from the mutual friend, that Dr Puri was doing much research with fish oils and getting fabulous results. I also discovered that the American Heart Association was extolling the virtues of omega-3 fatty acids found in oily varieties of fish. This fitted in perfectly with Puri's advice for Roxy.

Then I discovered that Puri and other researchers were beginning to say that it was not simply omega-3 that was important but a specific fatty acid called EPA (eicosapentaenoic acid). One of the properties of EPA is that it thins blood – this was ideal for Roxy. Although another omega-3 fatty acid that is present in fish oil, namely DHA (docosahexaenoic acid), was known to be essential for health, as it plays a structural role in the body and brain, there was growing evidence that when taking a combination of EPA and DHA in supplement form, the DHA was inhibiting the beneficial effects of the EPA. Following several studies, Dr Puri, now Professor and Head of the Lipid Neuroscience Department at Hammersmith Hospital, concluded: "In general it has been found that as the ratio of EPA to DHA rises in the supplement used in clinical trials of certain conditions, such as depression and attention-deficit hyperactivity disorder (ADHD), the ability of the supplement to improve the condition also rises." In a study[1] of fatty acids in dyslexia, dyspraxia, ADHD and the autistic spectrum, Dr Alexandra Richardson of Mansfield College, Oxford, states: "All the evidence now points to EPA, not DHA, as the omega-3 fatty acid most effective in improving attention, perception, memory or mood in dyslexia, dyspraxia, ADHD or ASD (Autistic Spectrum Disorder)."

Following discussions with Dr Puri, I also learned that if the body is supplied with enough EPA, it can then convert it into DHA as and when it's needed. This appealed to my preference for the natural option – let the body manufacture and manage the DHA by itself. While I recognized that the body needs DHA, I liked the idea that the body should dictate the amounts required rather than being inflicted with a given amount in the form of a supplement. It also turned out that whereas the EPA could be converted into DHA, (and/or sleep mediators) the same was not true in reverse, therefore, excess EPA could be utilized but excess DHA could not.

Anne is a long-term supporter of Evening Primrose Oil (EPO), which is known to have many health-enhancing benefits and contains the omega-6 long-chain fatty acid GLA (gamma-linolenic acid). Therefore, as a matter of course, we as a family took an Evening Primrose Oil preparation – nevertheless, Anne was particular about the type of EPO we took – it had to be organic, virgin Evening Primrose Oil obtained from the first pressing of the seeds. Furthermore, the pressing technique used had to involve no heat or chemicals. According to Dr Puri, the body required a specific ratio of long-chain omega-3 and omega-6 fatty acids for optimum health of the body and brain. Moreover, Anne's preference for virgin Evening Primrose Oil was well-founded. In its virgin state, EPO is rich in substances called triterpines – these play an important role in immune function and help fight viral infections. Perfect for Roxy, given her life-long prescription of penicillin. In addition, the less refined it is, the richer it is in GLA – the long-chain omega-6 fatty acid.

Research Development

As I researched the market, I saw that there were preparations available that contained the omega-3 from fish oil combined with Evening Primrose Oil. Nevertheless, having discovered all of this information, Anne and I had specific parameters about the omega-3 and 6 supplement we wanted Roxy to take. We wanted it to be a DHA-free omega formulation containing only the long-chain omega-3 fatty acid EPA combined with organic, virgin, cold-pressed Evening Primrose Oil, rich in the omega-6 GLA and triterpines. I began to scour the market for such a supplement. To my amazement it did not exist – all cod liver and fish oil preparations contained both EPA and DHA, and few EPO preparations were virgin, cold-pressed and organic. This was very interesting – it appeared that I had exposed a hole in the omega supplement market.

Although I could not find the exact combination I was after, what I did learn during my exploration of the omega supplement market was that there was a vast array to choose from. Some preparations contained higher concentrations of EPA than others; some were sourced from fish livers, others from the flesh of the fish; some only contained short-chain omega-3 fatty acids from flax or linseed and not the all-important long-chain varieties; some fish-based preparations contained high amounts of vitamin A and so on. Coincidentally, at the time, there were rumblings in the media about the dangers of vitamin A toxicity, which may arise when people regularly exceed the RDA (Recommended Daily Allowance). What some people did not realize is that fish oil is a rich source of vitamin A. There were also concerns about the consumption of fish in relation to exposure to pollutants and PCBs. Some preparations are extracted from the fish liver – an excretory organ which therefore contains concentrated amounts of pollutants. It became clear that the type of fish from which the EPA derives, the waters the fish inhabit, the position of the fish in the food chain and the part of the fish the EPA is extracted from, as well as the purification processes involved, all contribute to the quality of the supplement.

All of this information convinced me that there was room in the market for another omega supplement – one that I would be 100% happy for my daughter to take, a premium quality omega formulation.

The Birth of VegEPA

Time to phone another friend! This time I called a contact whose area of expertise was manufacturing and quality control in the food supplement industry. This friend was extremely interested in what I had to say. He agreed to help come up with the formulation but any further involvement would be limited due to his own commitments. Therefore, I decided to handle the running of the business alone, and in 20032 Igennus Ltd was conceived. Its first supplement, namely VegEPA, was an omega formulation comprising an exact ratio of ultra-pure EPA, zero DHA and organic, Virgin Evening Primrose oil. The EPA was sourced from the flesh of anchovies – small, short-lived fish, low down in the food chain, that inhabit the South Pacific, the cleanest waters in the world. The organic, Virgin Evening Primrose Oil was non-raffinated and obtained by the cold-pressing of the seeds. Realizing that his new product was unique, I immediately applied for a patent, which was approved and granted at the end of 2005. VegEPA is now taken by thousands of people who report improvements not only in general health but also in a variety of conditions including: depression, chronic fatigue syndrome, ADHD, as well as joint and heart problems. Not surprisingly, my favourite testimonial case is my own daughter Roxy, who, at the age of 16, decided that she no longer wanted to take the penicillin or aspirin. She explains: "Mum was nervous about taking me off the medicines prescribed to me but about three years ago I decided myself to come off the aspirin and penicillin. Since then, I have had no further clots, so I presume that the VegEPA is keeping my blood thin and my immune system in good shape!" Roxy, who is now 19 and studying at University, is in good health. The only thing her doctor has advised her to avoid is cross-country running – no real loss so far as she's concerned!

Postscript

The VegEPA story is far from over – it is now used by Professor Puri for his research work. "VegEPA is prescribed by some doctors but I do hope that one day it will be prescribed as a matter of course. I hope that it will become the first defence against certain conditions, so the challenge for me is to conduct more trials."

Other products to join the Igennus range are OmegaForce – an Omega-3, 6 and 9 formulation that is a general health supplement, and a new brand of cofactor supplements. They are specifically formulated to contain the particular combination of vitamins and minerals needed to ensure that enzymes and enzyme-mediated conversions function properly in the body, so that it can make the best use of the omega fatty acids.

References

1. Richardson A. Fatty Acids in Dyslexia, Dyspraxia, ADHD and the Autistic Spectrum, Nutrition Practitioner. Volume 3. Issue 3. 18-24. November 2001.

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About Dr Jav Nazemi

Dr Jav Nazemi BSc MSc PhD was educated at the Universities of Kent and Essex where he gained his doctorate. He lectured at the University of Essex and for the Open University before establishing successful businesses in the communications sector. He is now focusing his entrepreneurial skills on the nutraceutical market. In 2003 he established Igennus Ltd, which produces premium quality fatty acid and cofactor supplements. He is the Chief Executive Officer of this Cambridge-based nutraceutical company. He may be contacted via www.igennus.com

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