Posted with Permission/ Dr. Stordy and Malcolm Nicholl's December newsletter

[Guest guest]

http://www.drstordy.com/ezinedec01.html

DHA or EPA or both?

What is more important—DHA or EPA? What's the best balance of these

omega-3 fatty acids? What's the best product for my child?

These questions are being asked with increasing frequency as more and

more children with ADHD, dyslexia, dyspraxia and apraxia receive LCP

supplements and parents experiment with different products. The

debate among many parents and scientists rages on—and continues to

gather momentum!

The simple answer, I'm afraid, is that no-one really knows for sure.

ly, not enough clinical research has yet been conducted to

enable anyone to categorically give a scientifically-valid answer to

these questions. We do, though, have some good indicators based on

basic science information, the results of several studies, and a

growing volume of anecdotal reports. So what do we know so far?

1 There is hardly any EPA (eicosapentaenoic acid) in

the brain and in nerve cells.

2 The most important omega-3 fatty acid in the brain is

DHA (docosahexaenoic acid).

3 The most important omega-6 fatty acids in the brain

are AA (arachidonic acid) and ADrA (adrenic acid).

4 Studies on infants show the supply of DHA and AA in

early life is critical for good brain and visual development. No

studies on EPA in infancy have shown similar results yet.

5 In the ADHD studies conducted at Purdue University no

EPA was found in red blood cell membranes in either controls or boys

with ADHD, so EPA is clearly not a constituent of red blood cell

membranes and certainly is not the defining difference between boys

with and without ADHD. In contrast, a deficiency of DHA, AA and AdrA

in red blood cell membranes was found in boys with ADHD.

6 In the Purdue studies, the plasma fatty acids of ADHD

boys with high scores for signs of fatty acid deficiency were

compared with those with low fatty acid deficiency signs. The result

was that there was no significant difference between EPA values in

the two groups, BUT the high fatty acid deficiency group did have

LOWER DHA levels. In general, boys with ADHD did have lower amounts

of both EPA and DHA in their plasma polar lipids.

7 EPA, in normal circumstances, is converted in the

body to DHA. We do not know yet whether this process is impaired in

dyslexia, ADHD or dyspraxia. Until the specific biochemical

differences between people with the specific learning disorders and

those without is clarified it is as well to use supplements that

provide the fatty acids that are deficient in their tissues.

8 Studies in schizophrenia have shown both DHA and EPA

supplements to be effective, but that EPA rich oils were relatively

more effective. This is possibly because EPA blocks the removal of

LCPs from membranes.

9 It has been shown that one of the problems in

schizophrenia may be the accelerated removal of LCPs from membranes.

10 Conversely, in patients with dyslexia, brain MRS

studies have shown there is reduced incorporation of LCPs into

membranes not an accelerated removal of LCPs from the membrane.

11 Studies of more than 100 children with dyslexia, 35

children with features of ADHD, and 15 children with dyspraxia, have

shown that a high-DHA fish oil based supplement (Efalex) improves

reading performance, reduces symptoms of ADHD and improves movement

skills. So far, there are no large trials—either open, or double

blind placebo controlled—that indicate high-EPA fish oil is better

for these conditions. There is a report of a single case of

schizophrenia together with dyslexia that showed good improvements of

both schizophrenia and dyslexia with high-EPA oil.

12 All fish oils provide both DHA and EPA, as well as AA;

it is just the proportions that vary.

So where does this lead us? To date, high-DHA fish oil based

supplements have been shown to be effective for dyslexia, ADHD and

dyspraxia. There is very little evidence of EPA deficiency in these

conditions, whereas there is evidence for DHA deficiency. (On the

other hand, in schizophrenia, high-EPA oils may be more effective

because of the way in which EPA blocks the removal of LCPs from

membranes).

As I stated in our book, The LCP Solution: The Remarkable Nutritional

Treatment for ADHD, dyslexia and dyspraxia, supplementation is

currently a blunt tool. Most of the reported studies on ADHD,

dyslexia and dyspraxia did use fish oils rich in DHA, that also

provided some EPA and AA. It is not possible to clarify from such

studies which fatty acids are most important, and how much of each

fatty acid is required until more detailed comparative studies are

completed. Until then it may well be wise to use the high-DHA

supplements that have been shown to work in large studies,

particularly in the double blind, placebo controlled trials.

What about Apraxia?

Of great interest is the large number of anecdotal reports of

children with the speech disorder known as apraxia that have enjoyed

remarkable benefits from LCP supplementation. The majority of these

children were given a fish oil/borage oil supplement (ProEFA)

containing 148 mg of EPA, 99 mg of DHA, 41 mg of " other Omega-3 fatty

acids, " 40 mg of GLA (gamma-linolenic acid). Some parents have

reported great success with high-DHA products such as Efalex but many

parents feel that the high EPA combination is more effective. Until

there are well-designed comparative studies between high-DHA and high-

EPA fish oils it is not possible to say which fish oil is most

effective.

As all fish oils provide the three LCPs, DHA, EPA and arachidonic

acid (AA) I speculate that there would be little difference between

various fish oils given long term, although, in the short term, one

may produce a response faster than another. Quantitatively, the

difference between ProEFA and Efalex is very small in body weight

terms and in relation to the amount of body lipids in membranes and

elsewhere.

One of the reasons some parents have found their apraxic children do

better when moved from a high-DHA product to a high-EPA product is

that it takes time for LCP supplements to be effective. The first

period on the high-DHA product has started the process but it is

completed, just by chance, when they have switched onto the second

product (high-EPA). If the sequence of supplementation had been high-

EPA then high-DHA, it might well have been the high-DHA product that

appeared to work. This is all speculation. Speculation is not

science. What we need are good comparative studies.

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DYSLEXIA (Letter from Germany)

Dear Dr. Stordy,

The results of Efalex on several of the dyslexic children I am

teaching is interesting. In the cases of two German boys, aged twelve

and fifteen, they are suddenly able to learn English vocabulary.

Before they started taking Efalex, I was confident that they had

mastered the words " yes " and " no " but nothing beyond that. They are

now getting A's and B's in vocabulary tests. Wonderful! In another

case, the mother is taking the capsules with her dyslexic son and she

has become much more balanced in general, not so frightened of

everything. Thank you.

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AUTISTIC RESULT

Dear Dr. Stordy,

I realize that the EFAs mentioned in your book were not directed at

children with autism. However, so desperate to try to help our ten-

year-old son, who seemed to be getting worse as he got older, I

decided to try the Nordic Naturals ProEFA. I gave him a one capsule

twice a day to try to flood his system, since he was probably really

low in EFAs. To my delight, within one week our severely autistic son

has started using more nice sounds as well as saying " mama "

and " baby " (I call him baby). Until now, he had not spoken a word

since he was three years old; mostly he yelled all the time. I know

that there is more going on that needs to be addressed, but this was

the opening door, back to his soul and regaining his delightful

spirit. "

Sincerely,

SD

Editor's note: There is confusion between the terms EFAs and LCPs.

All indications are that it is the LCPs in products such as ProEFA

that are effective for individuals with dyslexia, ADHD and dyspraxia.

This letter adds yet another condition that may respond to LCP

supplements.

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PREGNANCY Q & A

Question

Hello Dr. Stordy,

I am a dietitian and highly recommend fish oil to my clients for a

variety of reasons. My question is: what about women who are

pregnant? Is it safe? We know that during pregnancy it is important

to avoid certain fish.

Answer

It is very important for pregnant and lactating women to take plenty

of LCPs. I would not recommend that they use fish liver oils such as

cod liver or halibut liver oil. Liver oils provide a lot of vitamin

A, and excess vitamin A in pregnancy is a teratogen—causes

malformations in the fetus. I would recommend a fish oil with LOW

amounts of vitamins A and D, such as that used in the manufacture of

Efanatal, an LCP supplement specifically designed for pregnancy and

lactation.

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TOP PERFORMER

(Excerpted from a long letter!)

Dear Dr. Stordy,

While searching on the Internet I came across your book, The LCP

Solution. I was very interested in the ADHD and dyspraxia component.

Our seven-year-old daughter had never been formally diagnosed with

dyslexia, but definitely had problems with reversals in reading and

writing, time, left and right, etc. I began giving her 1,000 mg of

fish oil tabs a day. Within two weeks she was finishing all her work

at school. In the previous three months she had only finished her

work once. Her reading took off and her handwriting and spelling

improved tremendously. Her " twitchiness, " especially during reading,

was greatly reduced.

At the end of the year, she exceeded all of the 1st grade reading,

math, vocabulary, etc. performance standards. Physically, she gained

back her lost weight and new hair grew in. She has more self-

confidence and less anxiety. Her drawing skills are almost as good as

before. Developmentally, her physical strength and agility has

greatly improved. She now goes across the monkey bars over and over

again. She can do flips on the monkey bars. At the beginning of the

year she could not cross to one rung and she would freak out when we

tried to help her do the bars. She goes off the 12ft high dive, swims

for hours, rides her bike without training wheels. She was removed

from the O.T. list at school. She was supposed to have Physical

Therapy over the summer to improve her strength and coordination, but

the pediatrician agreed that she no longer needed this therapy.

After she was on the fish oil for about two months we ran out and did

not immediately buy some. Within a week and a half she was not

completing her work at school and was coming home all " weepy. " About

a month later she went to grandmother's who forgot to give her the

fish oil and she became weepy, whiny and argumentative. Within two

days (of being back on the fish oil) she was back to her old self.

Thanks for the book.

LM

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APRAXIA BREAKTHROUGH

Dear Dr. Stordy,

I wanted to share my story with you, to say thanks, and in hopes that

it might help others in some small way. My son was diagnosed with

apraxia of speech at age 4. He had no clear words and could only

communicate by using me as an interpreter. His sounds were limited to

mostly d's and ah's. Prior to age 3, even achieving lip closure had

been a struggle, and he could only make a humming sound with his

bottom lip tucked behind his teeth. Oddly, he fluctuated the humming

sound in a way that imitated the cadence of speech. Combining this

melodic cadence with gesturing enable, me to understand him a

little.

At age 3 we enrolled him in special needs preschool. Upon the urging

of his teachers, we took him to a private therapist as well. He was 4

by the time we were able to get private therapy. He was miserable in

special needs preschool. He was so filled with frustration that he

screamed and fussed a lot. After 3 months of private therapy and no

progress (no clear words at all), we read The LCP Solution and began

supplementing him with Omega 3's.

Within 3 days I saw subtle improvements in his speech attempts and

general behavior. He even began to play with his toys in a more age-

appropriate way. By 2 weeks everyone noticed. His teachers and

therapists were amazed. He started talking in complete sentences and

playing interactively like a normal kid. After a month or so, he

became more cooperative with the private speech therapist. With a

little coercion he would even go into her office without me, and she

was able to accomplish more without mom as a distraction. One day he

announced to her that, " Dr. Pepper makes the world taste better. " She

almost cried.

Preschool became a fun place for him. He gradually changed from a kid

who dangled from my arms crying when I dropped him off, into a happy

kid who ran laughing into the classroom ahead of me saying, " You tan

doh home, mama. " At the end of the school year his special needs

teacher tested him to determine where to best place him next year.

Her results indicated that his expressive speech was nearly age-

appropriate and in every other category he scored at the 6.5 year

level. He is still only 4. He will be going to regular kindergarten

next year.

Sincerely,

L.S.

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MERCURY IN FISH OILS

Question

Dear Dr. Stordy,

I am the mother of a nine-year-old boy who has had severe focusing

problems. I was so excited last May to come across your book! We had

tried flax oil supplementation with some, but little, results. When

we switched to the Efalex the results were dramatic! His reading

ability took a tremendous leap. Also, for the first time in his life,

he was able to settle into the enjoyment of legos, family board

games, and puzzles! But the best part was seeing his self-esteem

blossom! I cannot begin to express the joy and new hope it brought to

my heart!

However...midsummer I read that mercury poisoning from fish is a

significant health threat. This was so unsettling that I pulled him

off of the Efalex. Of course, all of the benefits of the Efalex

evaporated quickly. School starts tomorrow and a sense of dread has

come over both of us. School is so unbearably hard for him. I now

know with unquestionable certainty what the root of the problem is.

And yet, without some real assurance that the fish oils are safe, I

cannot in good conscience give him what I know he so desperately

needs. Might you have any information that would help me? Thank you

for all you are doing to help so many!

Sincerely,

BP

Answer

I am so glad your son made rapid progress while taking Efalex. Please

do not be concerned about mercury in Efalex . The manufacturer is

well aware of potential problems and has very strict specifications

for the fish oil they use. The last time I checked with them mercury

was undetectable in Efalex. My own son has taken Efalex since 1995

and there is no way I would let him do so if I thought it was

dangerous in any way.

B Stordy, Ph.D and Malcolm J. Nicholl

Co-authors, " The LCP Solution: The Remarkable Nutritional Treatment

for ADHD, Dyslexia and Dyspraxia. "

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Copyright © 2001 drstordy.com