Amen!  I took Lovaza for a year when my physician gave me a coupon for a monthly supply at $5/month for 12 months.  I obviously stopped when it ran out because of the "real" price.  I've started using CardioTabs (http://www.cardiotabs.com/Omega-3-Fish-Oil/productinfo/OMEGA-EC/) instead on the advice of my physician.  Any feedback on this brand?

What is your opinion about Nordic Naturals DHA?  It contains 450 MG DHA and 90 MG EPA, along with 15 IUs of Vitamin E (alpha tocopherol) in two soft gels.  I've read in many places that fish oil containing more DHA than EPA is superior.

Even though Obama and his socialists would vehemently disagree, you make a logical point.

I use Spring Valley brand and it costs me about $11 for a two for one deal (two bottles). 200 capsules per bottle 1000 mg each. EPA + DHA is only 300 per capsule but for the price taking 6 per day isn't a problem. Under $12 every 2 months isn't bad.

Hello everybody!

Well, I see this article refer to a matter of price and less about quality.

Dr Davis, please, what do you think about NOW Foods suplements?
Sorry for being offtopic!
Thanks for your blog, your work changed my life.
All the best from Romania!

For maximum absorbability, use liquid not capsules or gels, and eat with a high fat meal.

New research also shows the probiotics in yogurt also help to minimize the oxidation:
http://www.nutraingredients.com/Research/Yogurt-proteins-could-stabilize-omega-3-enrichment

as does pollen spore shells (exines)
http://www.nutraingredients.com/Research/Pollen-spores-could-enhance-omega-3-bioavailability

A good value for omega-3s is Twin Labs:
http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=TL-1403

Take a look at Trader Joe's odorless omega 3. 90 capsules for less than $9. 1200 mg fish oil 400 mg EPA and 200 mg DHA in each capsule. The only brand I have been able to find with a 2 to 1 ratio of EPA to DHA. And there is no after taste.

I eat omnly grassfed beef and wildcaught salmon. Chicken is pastured. I don't eat grains or vegitable oils. I use coconut oil and tallow for cooking.
That being said, can one get too much Omega 3?

Great point about the cost effecting others. Studies ghave shown that fish oil that is too pure is not as good as fish oil with a little bit of "mother" in it. Clean not sterile.

Huge props to you, Dr. Davis, for admitting regret and posting future accountability by NOT filling scrips for Lovaza.

Hopefully, the husband of that patient reads your blog.  But I doubt it.

Hi Dr. Davis,
Thank you for living your principles, and, as always, for your candid and unvarnished thoughts.
Sincerely,
Tom C

I take 4 of Sam's Club triple-strength fish oil plus a 1 gram Krill Oil from Puritan's Pride.  The omega 3s, ground flax seed, curcumin, and Jean Carper's Super Osteo Gold have allowed me to jog at age 71 without any joint injury.

Assuming no problems with Lp(a) you can reduce the need for so much fish oil by changing your diet to low omega-6 intact.  There is competition between the two essential fats so try to limit foods high in omega-6 first.  Once you've done that you can cut back on all those fish oil capsules. It's probably helpful to take some vitamin E too to prevent potential fatty acid oxidation.

Thanks for not being part of the problem, Dr. Davis.

The thing is, some prescription plans have a copay. If the plan of the couple is like mine, they'd have had a $30 copay. It's possible they were only saving $20 a month. For our friends outside the U.S., that'll buy a movie ticket and popcorn for one person. Nine hundred dollars is more than my mortgage payment.

The real problem is the pharmaceutical industry and not patients who wish for prescriptions or insurance companies. Here in the UK, the last I heard,  Lovaza (marketed under the name Omacor) costs the National Heath Service £50 ($78) per 100 capsules, that is considerably less than what it costs in the US and roughly the same as comparable fish oil omega-3 supplements from health food shops in the UK. This is the pharmaceutical company charging this and it is they who should be brought to account when it comes to over profiteering from patients and insurance companies, imho.

I've started using CardioTabs instead on the advice of my physician. Any feedback on this brand?

Not a very good deal, Anonymous.

Each bottle includes 180 capsules, but a serving size is 3 capsules (to equal 975mg of DHA and EPA). Multiply that serving size by 6 to attain Dr Davis's objective of 6000mg of DHA and EPA per day. This means:
1) You must ingest 18 (!) capsules/day;
2) Each bottle of 180 capsules is a mere 10 days supply; which means
3) 3 bottles/month at a cost of ~$100/month.

Several commenters have asked about specific brands.

Consumer Lab (www.consumerlab.com) is a great place to start to see what brands have been tested.

While it is clear that no mercury, PCBs, dioxin, or furans have been measured in any brand of OTC fish oil (slight contamination of cod liver oil, not fish body oils, with PCBs), there are differences in oxidative breakdown products.

A quick test of oxidation: Smell your fish oil. It should only be faintly fish, not overwhelmingly fishy.

Can you give us some references on why 6,000 epa/dha for lp(a) carriers?

Finding a suitable plaques for our home is little hard to do. Your special taste of art and rare places provide it in best quality sometimes become the challenges to do it. But, because of the importance of the plaques you have to find it whatever it takes.

What about Weston A. Price suggesting that there is a potential for Omega 3 overdosing as well as the concern from contaminants  in fish oil compared to Cod liver oil due to fish oil being mostly from farmed fish? Also the benefits of Vitamin A and D from taking Cod liver oil rather than fish oil.  Personally I don't use cod liver oil, but should I be concerned about too much fish oil? Have there been long term studies?
Thanks

Tommy

This is one of the many reasons for our skyrocketing insurance costs. People need to take more responsibility for their own health. Unfortunatley, this concept is in direct conflict with the prevailing trend in our society.

With the direction our health care industry is going, future costs will become quite prohibitive. In an effort to fight class warfare this new health care system will create a class of those who will be able to afford effective health care while the rest of us who are dependent on the government's version will be left waiting . . . It really is our fault.

What's pathetic about the situation is, if the insurance company would shoulder some of the cost of basic fish oil instead of the prescription Lovaza, everyone in the system would benefit.  The way it is, everyone in the system loses.

I have always used scott emulsion. A couple tbs per day.
is that one good?

Anonymous about insurance paying for supplement fish oil--

Yes, a brilliant idea!

I've had the same idea and wondered why an insurance company didn't just shell out the money to prove for themselves that OTC is every bit as good as the prescription, then encourage their insured to use this instead. It would provide HUGE savings with no downside.

Dr Davis

with the us treasury printing currency by the boatload if everyone operated with cost savings in mind there would be hyperinflation due to excess money floating in the economy. So government channels try to mop up and circulate as much currency as possible and keep the bottlenecks to a minimum.

No wonder usa is looking at a consistent high inflation future or maybe hyperinflationary future.

I wonder about oxidation and possible immune system suppression at the 6 gram dose level. Although I suppose in patients with high Lp(a), it's the lesser of two evils. Emulsified fish oil may be worth trying, to see if it decreases Lp(a) even further.

Eventually Lovaza will go generic, which will be sort of odd, when prescription fish oil potentially could be in the same ballpark as OTC. Not sure how the FDA will make sense of it, unless the dosages are exactly the same... not sure how prescription fish oil ever really made sense really.

Also, don't eat with fiber as this hurts absorption.  

The following are listed in the ConsumerLab.com report, but I'm not a member so don't know how it rates:

Twin Labs Mega EPA ( 1 capsule = Epa 550 Mg, Dha 215 Mg )
http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=TL-1403

Nordic Natural Ultimate Omega + CoQ10  ( 2 capsules = Epa 650 Mg, Dha 450mg)
http://www.nordicnaturals.com/en/Products/Product_Details/98/?ProdID=1446

Green Pastures Fermented Cod Liver Oil and Butter Oil Blend (~139 mg EPA, ~83mg DHA),
http://www.greenpasture.org/retail/?t=products&a=line&i=fermented-cod-liver-oil

Vital Choice Wild Salmon Oil (240 mg EPA, 220 mg DHA)
http://www.vitalchoice.com/product/omega-3-salmon-oil/1000-mg-sockeye-salmon-oil-softgels-180-count

The nordic product also has 60mg of CoQ10, and 30IU of vitamin E!

Dr Davis as a practicing neurosurgeon and age management doc I write for Lovaza all the time.  At least 75 Rx a month.  Does it bother me?  Yes it does.  But I feel better knowing those who are taking it are being proactive and healthy instead of a dog chasing its tail with his or her PCP.  Everything is relative my friend.  I suggest you focus in on the good because their is bad in everything but if you focus in on the good it magnifies itself.  Keep fighting the battle.  I do. I get more patients off Statins and on Fish Oil and resveratrol than you can imagine.  Love your work and the book.  I have saved lives because of you.  you passed it forward and now I do too everyday.  Dr. K

Presumably, the guy has been paying his health care insurance premiums.  Based on the facts you describ, his insurance covers prescriptions for Lovaza.  Why should he have to pay additional money out of pocket to receive a benefit to which he is entitled under his insurance program?

@anonymous who wrote:

"Why should he have to pay additional money out of pocket to receive a benefit to which he is entitled under his insurance program?"

If we focus only on an insured and his contractual rights under his insurance policy, he should not "have to pay additional money out of pocket..."

However, that focus is arguably too narrow as it fails to consider the effect on insurance premiums for the rest of an insurance company's policy holders/payers. This is one of the evils of a system that requires citizens to obtain health insurance - it forces other people to subsidize, to use Dr. Davis's example, an expensive prescription when cheaper and equally effective alternatives exist. This is not an isolated example; consider prescription Vitamin D2 vs. D3 supplementation, etc...

I can appreciate your feelings about writing such a costly perscription.  For years... when my GP would write a perscription for a cheap oc medication I just bought it without submitting the script and having my insurance incur the pharmacists dispensing fee as well as the basic cost of the OC medication. It seemed so ridiculous and costly!
Over the years I realized that my extended benefits cost me about $3,000 out of pocket whether I use them or not.
  I figure I did not create this mess and even though it is silly I don't worry much about the costs to my insurer.
I can see both sides of the situation. The situation is a grey area.
I know that my insurer is in buisness to make a profit and doesn't hesitate to refuse and question claims. I figure that I am in the buisness of making the best of my  personal finances.

I can appreciate your feelings about writing such a costly perscription.  For years... when my GP would write a perscription for a cheap oc medication I just bought it without submitting the script and having my insurance incur the pharmacists dispensing fee as well as the basic cost of the OC medication. It seemed so ridiculous and costly!
Over the years I realized that my extended benefits cost me about $3,000 out of pocket whether I use them or not.
  I figure I did not create this mess and even though it is silly I don't worry much about the costs to my insurer.
I can see both sides of the situation. The situation is a grey area.
I know that my insurer is in buisness to make a profit and doesn't hesitate to refuse and question claims. I figure that I am in the buisness of making the best of my  personal finances.

As a liberal, I say thank you. We can only provide health care for all, if it is affordable. Abusing the system only ensures less and less people will have access to quality health care.

I love this article.  It makes me gag when I see commercials on TV for Lovaza or Niaspan.  This is one example of what's broken in our healthcare system.

+! on the Trader Joe's omega-3 capsules. They are cheap and they have 50% concentration of combined EPA/DHA. TJ's sells two models of their omega-3 and the other has a lower concentration.

I'll take Lovaza when it's a free sample. It has a 90% concentration but I think the overall total in Lovaza is not much higher than what is available from the local drug store.

The only advantage Lovaza could have is that is monitored very carefully for purity and the like. I'm not sure that's much of a concern.

-- Boris

Are such high doses necessary? 7-8 grams per day of EPA/DHA seems like it would get you well past the desirable 8-10% on the HS-Omega-3 Index (usually only requiting 1-3 grams daily). Is there any need to go beyond 10%?

I take 5-6 TJ omega-3 capsules during the day. Maybe that's a bit much but maybe there is a saturation point? I don't know. I know that omega-3 has cleared my mind, reduced my eye pain, and lowered my blood pressure.

-- Boris

So glad to hear it. When the ads came on TV, it was just another Big Pharma scam. Take a natural product and package it for mega profits.

I finally knuckled under and let my doctor write a prescrption for Niaspan for me - as we were fighting terribly as she was *ADAMANT* that I HAD to take STATINS as my cholesterol was too high (though my HDL was 62 and my triglycerides were 65) and I was flat out refusing. So she then suggested I had to take Niacin.

I was willing to give Niacin a try as I have seen Dr. Davis talk about it here - and she just sent in the prescription via her computer to the mail-order pharmacy I'm required to use to get my prescription insurance coverage.

So imagine my SHOCK when I got the online notice that the prescrption had been filled, and I was able to look it up. A 90-day prescription of Niaspan was about $400! I almost fainted, though my patient share was $75 - or $25/month.

But I still thought it was highway robbery and will never fill the prescription again. If I continue t take Niacin I think it will be Slo-Niacin for me. I'd heard Niaspan was expensive, but had no clue it was that much!

Dear friends,

On Omega-3 highdoses EPA/DHA ; Minami Nutrition is providing Supecrital extraction (low temperature, and not molecular distillation!!) Omega-3 as well guaranties on purity below the detection limit next provinding a 93% Omega-3 per one softgel or 820 mg EPA/DHA per one softgel. look into www.minami-nutrition.co.uk availabel in the US at Wholefoods.

Some people are worry on too much intake of fish oils. Indeed if you swallow standard fishoils with low levels of EPA/DHA as most US products you may swallow also a lot of saturated fats. Go for 1 softgel a day a softgel tahts provide you almost 1 g Omega-3 or a minimum as 820 mg EPA+DHA per softgel. a lot of brands having high levels of pcb's.(see http://www.cbsnews.com/stories/2010/03/02/health/main6259938.shtml ) be also a ware when mention "per serving" could be 2 to 4 or more softels a day.  Avoid liquid oils as they oxidize fast, as well I'm not in favor of codliver oils as too low on EPA and DHA and to high on vitamin A when taking 500 mg EPA/DHA.

THANK YOU!! For taking a stand where many in your profession will not. We need more of this!

Even the traditional medical community is finally realizing that the omega 3s in fish oil provide some of the best natural health benefits on the planet. Worldwide, the omega 3 supplement market is in the billions of dollars. The drug companies want a piece of the action.

Great insights about how we can have a healthy lifestyle.Omega 3 is good for the heart that's why many people are eating foods rich in Lycopene.

Vitacost.com has their own brand of fish oil, NSI Mega EFA® Omega-3 EPA & DHA.  At 6000mg EPA/DHA a day (10 capsules) in a 240 cap container for $22, that comes out to be $27.50 per month.  And they often have 10% off sales, like right now till 10/31/10.  My personal experience with them has been good, their NSI brand has been high quality, and I rarely find a better price elsewhere.  I'm currently taking 6000mg EPA/DHA daily.

Very interesting post. My mother has been taking a Thyroid supplement for years, and I'm always interested to find out more facts about the medicine she takes. I'll make sure to tell her to shop around before committing to one pharmacy. Wal-Mart is the price leader? How unusual! Thanks for sharing.

You guys in the US are lucky.  In Sweden, you have to beg to even get T3 (synthetic form, of course), and the main treatment is levothyroxine.

To get Armour Thyroid, you have to apply for a *license* with the Swedish equivalent to the FDA, and even then, you have to have been on medication for a year w/ stable values, but residual symptoms for a sub-functioning thyroid.

The common argument against is that the T4-to-T3 ratio is too high (which is why you take one in the morning, and one in the afternoon, duh...), as well as non-standardised doses.  The latter claim was recently changed to "potency issues in different batches". Well, it is my understanding that levothyroxin also suffers from this, at laest judging from the past problems with Synthroid in the US.

But perhaps the main problem is that Nycomed, the company producing the most common medication (Levaxin), seem to be unhealthily tight with the endocrinologists. Plus, of course,  hypothyroidism being listed in the MDs guidebooks as being something easy to treat with synthetic T4 replacement...

I showed this to my brother, who is a pathologist specializing in blood transfusions, and he pointed out that since Armour is distilled from thousands of cows, it is possible to get Mad Cow disease from Armour thyroid medication.

What is your take on this?  I myself would rather not take Synthroid.

Jenny

"since Armour is distilled from thousands of cows, it is possible to get Mad Cow disease from Armour thyroid medication"

Armour is made from the thyroid glands of *pigs*, not cows (porcine, not bovine).  Furthermore, the current  leading theory is that MCD is transferred from consuming brain & spine tissue, not muscle meat or glandular tissue.

Now if pigs are fed rendered cow parts that include MCD prions, that might be a cause for concern.  But one would need to know that is the case, and that pigs could get MCD, which as far as I know, isn't the case.

I only found out about the whole T3 thing this week. I've been wondering for the past three years why I still feel like crap.

Unfortunately from what I have read it appears T3 therapy is almost frowned upon in Australia (even the National Thyroid Foundation warns against it's use).

I just don't know what to do, I'm so sick of feeling the way I do.

I have been unable to obtain my Armour thyroid for three days and no "end in sight" I am already feeling horrible. This is so disturbing to me it calls for a class action suit.  I cant help but wonder what is REALLY behind all this.  Not even the docs and pharmacists are being told, let along the sufferers.  I feel angry and helpless-I have had to resort back to my Levoxyl and I dread this.

Dr. Davis, the national shortage of desiccated thyroid meds would be a valuable and timely subject for a post.

There are a number of reasons for the current and projected continued shortage of natural thyroid preparations and patients are pretty much in the dark about what/why happened, and how to manage in the interim.

Both Mary Shomon at thyroid.about.com and Janie Bowthorpe at www.stopthethyroid madness.com (thyroid patient advocates) have posted updates about their communications with suppliers/FDA insiders etc., in an effort to learn more and spread useful information about what is happening with the natural desiccated thyroid shortage and ways to cope if it's impossible to get via your normal avenues.   Some people are finding they can get natural thyroid preparations from Canada, where there is no shortage.  

Chain drugstores are purported to be sold out of nearly all natural thyroid meds.  

Compounding pharmacies are generally the best US option currently, though who knows how long that will last.  I know the one I use is already limiting Nature-throid refills to 30 days and substituting various tablet sizes for splitting and doubling in order to provide people with their Rx.  I had only switched from synthetic Levoxyl and Cytomel less than two months before all this came to a head.

And I'm finding the Nature-throid (natural desiccated sooooo much better than the synthetic T4/T3 duo that I'll try my mightiest to stay with it or another natural thyroid preparation before considering going back to synthetic thyroid hormone.

Belinda,

I understand the same situation with T3 exists in the UK, and that is often the case in the US.  I've been lucky enough to have eventually had doctors who at the very minimum agreed to prescribe T3, too and I found it to be a big improvement over T4 along.  But now that I have been on natural desiccated thyroid (Nature-throid, similar to Armour) I would never willingly go back to the synthetics.  I'd change doctors if necessary.

Even though T3 is frowned upon doesn't mean it is totally off limits, right?  Many, many people feel better with some T3 along with their T4, though the ratio of the two is subject to debate.  But it is quite reasonable to assert yourself and insist on at least a trial of T3 added to your T4.  I know this isn't always easy, but unfortunately it seems we need to be our own advocates with thyroid conditions.  The squeaky wheel gets the grease.  The quiet wheels just roll along...

I am thoroughly convinced that, for at least 70% of people requiring thyroid replacement, the added T3 component makes a world of difference compared to isolated T4: More energy, greater alertness, better mental clarity, better weight loss, larger effects on lipoprotein(a).

When taking armour thyroid supplements, we must also consider a few factors.  One is if you have a history of diabetes, an overactive thyroid, a long-term underactive thyroid, infertility, swelling of the skin (particularly around the eyes and cheeks), or pituitary gland problems. And if you are going to have surgery, consult the doctor first.

Gee thanks for ruining my dinner! Lol.

Anyway, I came across this article from Fox News website -

"Low-Carb Diet Could Raise Bad Cholesterol Levels"

http://www.foxnews.com/story/0,2933,587393,00.html

I don't know where to begin to point out why it's misleading...

Frustrating when media does that and only to cause more confusion over low carb diet, high carb diet and such.

Lou.

That Fox News article has already been covered HERE.

Nige.

It says:
"Both groups lost around 6 kilograms (13 pounds). But the individuals on the low-carb diet actually had an average increase of 12 milligrams per deciliter increase in their LDL levels, up from 109 milligrams per deciliter (less than 100 is considered optimal); the high-carb diet group showed a 7 milligram per deciliter decrease, down from 102."

"The low-carb group also showed greater increases in their levels of free fatty acids, which are released into the blood when the body breaks down stored fat. High levels of free fatty acids make it more difficult for the liver to store glucose, which in turn ups sugar levels in the blood. Consistently high sugar levels define diabetes."

So I guess the low carbers started burning fat from their guts as if that is bad and also would not be able to store glucose if they were eating any.

Well duh...

Dr. Davis...that picture should be placed on every bag of bread...

Agreed Lou.

Hey, what's the problem? The rat is by far the most nutritious part of that loaf!

Good one.

Uh, wouldn't that raise the protein level and make it less bad?

At our farm, we have a rule: eat our food, and we can eat you. We draw the line at rats and mice though.

The bread was definitely bad for the dead mouse!

I need to get my glasses checked.  I thought I was looking at a chunk of black mold til reading these comments.  When I took a closer look...yuck.  

It almost looks like a contrived photo.

kevin

So I guess the low carbers started burning fat from their guts as if that is bad and also would not be able to store glucose if they were eating any.

I've already been an angioplasty victim ... excuse me, I mean angioplasty patient ... and doctors want me to go through a second angiomutilation ... I mean angioplasty.

Ain't no way they're gonna do that to me again. Even though they would get big bucks from my insurance.

Angioplasty is being promoted as a cure for Multiple Sclerosis Based on Paolo Zamboni's work.
Free download here
Venous Collateral Circulation of the Extracranial Cerebrospinal Outflow Routes
Candian TV program on the subject.
The Liberation Treatment: A whole new approach to MS

I'd be very interested to know if any Track Your Plaque users have MS and whether they have seen improvements in venous blood flow and reduction of MS progression as a result of the program.

Higher levels of vitamin D may well have an impact on the damaging consequences of iron.
By raising adiponectin levels would vitamin D improve bloods anti coagulating properties?
High omega 3 intake should improve blood flow.
Would Niacin also act as a vasodilator and improve blood flow?

"get that feeling of doing something"

says it all...

Angioplasty is not completely useless. As the poster points out "proven useless unless you are in the middle of a heart attack...". It can save lives in such cases.

Say someone switches to a high-potency preparation of 360 mg EPA and 240 mg DHA, providing a total of 600 mg omega-3 fatty acids per capsule, or twice the dose of the low-potency preparation. Would you expect double the effect?

There are  thousands of websites which provides information  about  
how is angioplasty done.
But dilseindia is one  of the websites where one can get good info about the  angioplasty.