I did not believe in the effectiveness of Vascepa , and after the presentation of the results even more so it became clear that fish oil does not work. And it is not surprising that after the conference AHA18 shares began to fall.
People see Amarin stock going up and hype them like crazy, but in fact it grows only due to promising statements this fraudulent corporation makes. Nothing is real behind all this buzz about Vascepa being the scientific breakthrough, it really is nothing more than a dietary supplement.
Here we go again. George Orwell should have been a medical investigator: Fish oil works, fish oil don't work. Fats are good for us. Fats are bad for us. Spin your head and see what happens next.
4
What is the current impact of fish oil production on the total catch?...a percent, or two,... more?
Could it be that fish oil is produced from scraps of other fish products, such salmon heads, tails, guts, and whatnot?
2
It is entirely possible to produce vast quantities of EPA from algae, which is really the source of the EPA in fish oil
4
@Heckler "Seven of the world’s top ten fisheries (by volume) target forage—also known as low trophic level—fish, 90 percent of which are processed into fishmeal and fish oil."
https://www.worldwildlife.org/industries/fishmeal-and-fish-oil
Fish oil helps me swim faster
9
I can tell with certainty that it did not help me or other folks I met that had a heart attack. We all took (7-8) of us fish oil supplements and we all had heart attacks. I realize this is a very small sample, but we were all fit (not obese), exercised at least 2-3 times a week, and didn't eat horrible (that is we at veggies and fruit - not on an American Standard Diet)
3
The thing about Vacepa is that it's not fish oil. It's a highly purified (>95%) EPA drug. Regular fish oil is garbage and you have to take large doses over a period of time, >4grams per day.
3
Rather obviously this should also apply to the arteries of the brain and other organs.
This is only new in America and several countries. The omega-3/omega-6 ratio should be tracked. Search that ratio for zoo and domesticated animals and wild life compared and for Japanese and Aleuts.
Domesticated on grain run 17
Japanese 1-5 — 2.5
Eskimo .75-1.5
When less than 1 strikes and disease go up.
Americans run 19-23
EPA is critical to brain health.
1
This is horrible for the environment. We need to lower our consumption of omega 6 fatty acids, by decreasing our consumption of processed foods. Omega 3 can be obtained through plant-based sources like flax seeds and black mustard seeds just to name two. Studies have shown that vegans have just as much DHA in their cell membranes as non vegans indicating that the efficiency of the enzyme converting omega 3 into DHA can be altered by the diet, particularly the ratio of omega 6 to omega 3. All this study does is destroy the ocean and make supplement manufacterers rich.
6
this is nonsense. the conversion of ALA (the flaxf
- based n-3 fatty acid) to EPA in the human body is grossly inefficient, and from EPA to DHA is also grossly inefficient. the difference in efficiency for vegans is significant, but not the same order of magnitude.
The quantity of flaxseed oil it would take to get as much EPA and DHA end-product as a mere teaspoon of fish oil is frankly more calories than any reasonable person should be taking in for a supplement.
Human beings are omnivores. Your herbivorous ethical choices are laudable, but the dogmatic insistence that they are optimal for health flies in the face of both empirical research and basic intuition.
1
No, we need to increase not reduce. vegans are certainly not the healthiest people on the planet that is just silly.
Is Vascepa fish oil? What is the difference between a "dietary supplement" and a "prescription drug?"
1
@John Booke Thanks to Orin Hatch (Utah) there is no guarantee whatsoever what one buys as "supplement" is required to contains the exact amount or for that matter whatever is on the label . So 1000 mg of fish oil may have less than 1000 mg of fish oil or even no fish oil altogether
6
@John Booke Hundreds of millions of dollars in research for one. Diet supplement companies can say whatever they want over diet supplements when pushing over the counter fish oils and vitamins. They don't need to adhere to the rigorous testing standards of the FDA like pharmaceutical companies do when designing and marketing drugs. So while diet supplements claim Omega 3s are heart healthy - to date - until this most recent test - none have actually been proven to help hearts. Vascepa is the first time it has actually been proven in the U.S. It is all about the dose (4 grams) and the content in the capsule (pure EPA). Over the counter is throwing money away.
3
Regular fish oil is garbage. Most includes all kinds of toxins including mercury and is a mix of oils. Vacepa is a drug. It is highly purified via Amarin's patented processes drug containing >95% pure EPA component from the fish oil. It's a world of difference over OTC fish oil.
2
It would have been helpful had the article given us the recommended doses of fish oil.
10
@Philip W It is not over the counter fish oil that was used. The study used a medication called Vascepa which is an ultra-pure omega 3 fatty acid with no impurities like over the counter pills. The actual term for the medication in Vascepa is Eicosapentaenoic acid (EPA). Vascepa has no DHA which is also a form of omega 3 fatty acid which raises certain cholesterols. The daily dose is 4 grams of EPA. To get 4 grams of EPA in over the counter fish oils you would need to take 30-40 over the counter pills PER DAY. The over the counter medication has all sorts of impurities which you can see if you freeze one. They become cloudy when frozen. Vascepa remains crystal clear when frozen.
3
I’m reading a lot of comments saying this is pseudoscience. Because this is not true I want point you to the REDUCE-IT study protocol
https://clinicaltrials.gov/ct2/show/NCT01492361
3
Believe me this is real. In addition to treating heart disease, there are numerous other possible uses for high doses of EPA including Dry Eye Syndrome. The main effects of EPA are it's ability to lower inflammation which in the end, causes a host of all sorts of human ailments.
3
And so back we go, to the fish oil.
First it was good to take, then it was worthless.
Now golden again.
Medicine certainly is a see-saw.
Qu: are there going to be enough fish to produce all the oil that will be needed?
13
See my earlier comments. Vacepa is NO fish oil
2
It would help for articles of this type to list the number required to be treated to prevent 1 event, in this case a heart attack or death. Since most people reading this article doesn't know the occurrence of the rate of heart attack we don't know if one needs to treat 10 people or 10000 people to prevent one heart attack.
8
If everyone really did take fish oil every day, what would happen to the fish stocks?
So great, we get a few more years. But at what cost to the environment?
7
Hopefully NYT Comments persons will understand this is all on topic. It’s all connected. Yes, there you’ve opened up a real problem. The ocean and has been ignored for over 50 years. Fish are in peril. So with global warming has the climate crisis we are in with overheating oceans and the temperature of the planet overall and drought increasing, overpopulation and disease associated with hot climates spreading. Fish in jeopardy means the oil is, drought means food is. This is all ignored and with this administration ignored and denied for personal money gain. Sir we breathe in peril.
6
Perhaps large doses of fish oil will lower heart attack risks for some. However, based on a large fish oil study completed in 2013, large doses of fish oil appear to pose a significant risk of prostate cancer in men.
Prostate Cancer Risk And Omega-3 Fatty Acid Intake From Fish Oil
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828934/
by W Alexander - 2013 - Cited by 5 - Related articles
After years of hearing that eating fatty fish or taking fish oil supplements was good for the heart, the eyes, and even mood, the public was puzzled this summer by a study that suggested a risk of prostate cancer in men with high levels of omega-3 fatty acids obtained from these sources.
6
This is not fish oil but EPA. There is a big difference between the 2
6
I wish I knew what fish oil the researchers used. Eight years ago I had intense sciatic nerve pain and pinched nerves in my neck. Happened every winter. Doc said I had nascent arthritis. I’ve taken cod liver oil every day since 2009 and have had NO nerve pain and not so much as a cold or flu, no sick days at all, since then. Cod liver oil lubricates cartilage, connective tissues, mucous membranes, sinuses, eyes, hair, skin. It’s been a miracle. It’s my hobby horse, to be honest. Haven’t monitored triglycerides unfortunately.
8
@Cousineddie It says it in the article - it's called Vascepa. And it is not from an actual fish but rather algae. It is an ultra pure Omega 3 fatty acid known as Eicosapentaenoic Acid - or EPA which is 96.5 percent pure grade prescriptive Omega 3. There is no DHA in the pill which can elevate certain cholesterols. You can ask your doctor for it off label for your arthritis. I did and it has helped mine. This stuff also doesn't make you burp like regular over the counter pills do . It also takes 30-40 over the counter omega 3 pills to equal the amount of EPA in one Vascepa. The success of this trial was all about the quantity of the EPA. That is why prior studies of fish oil and cardio vascular issues have failed - not enough EPA in the other omega 3s.
13
Thank you. I’ll be asking about it.
2
@Cousineddie The article says what fish oil was used. Vascepa, which is highly purified and costs roughly $30K a year, from what I read elsewhere.
7
We were told only a few months ago here in the UK that this made no difference at all? Which is it?
Not that it matters, I take one capsule a day anyway, placebo or not. It seems to make a difference, but no idea. A few quid from the pharmacy isn’t much for several months worth of pills.
4
I am in my late 50’s, have a history of high cholesterol and triglycerides, and a family history of heart disease. I stopped statins after more that 10 years because of the side effects. A decent diet and frequent exercise (I’m 5’9” and 163 lb) did not reduce the numbers enough. After considerable consultation with my cardiologist, I now use a non statin approach, Welchol. That moderated my LDL and total cholesterol, but the triglycerides were still high at approximately 150.
I used to take 2 fish oil tablets a day. After discussing with my doctor, he mentioned Lovaza, but getting approval was going to be an issue. I started taking 6 teaspoons a day of Omega 3 Fish Oil sold by NOW, a molecularly distilled fish oil from Norway. That gives me 4.4g of EPA and 2.7g of DHA. The triglycerides dropped to 105-115, while making no other changes. My absolute level of LDL is still considered high, but the LDL/HDL ratio is well within the good range. Follow up tests show the change has been maintained for almost 2 years. This works for me. The only ‘problem’ is that each teaspoon has 40 calories, so I have to consider that in my overall diet.
11
@AJ in Houston DHA will raise cholesterol. EPA does not. EPA also improves statin performance by 25%. And no burps!
2
At an “Updates on Dementia” conference 4-5 years ago, sponsored by the Alzheimer’s Assn., Stanford University and other organizations, a lead neurologist from Stanford reported findings on trial of fish oil for prevention of Alzheimer’s disease. He reported no beneficial effects, and a significant increase in prostate cancer in the group taking the dose of fish oil. I don’t have easy access to details at time of this writing. On line I found that night a British study stating similar findings re: relationships between extended dosing of fish oil and increased risk for prostate cancer.
1
Hard to know who it helps. Not too much downside though, except for the fish.
1
@Peter Silverman And $3.2K/year
How much will it cost?
1
@Bartolo I read something like $32K/year
2
@Bartolo Before or after insurance? Before insurance it runs around $200/month. Remember - it is a prescription and not over the counter diet supplement with all sorts of impurities. You can see the impurities in the over the counter diet supplements if you freeze one of their pills. Cloudy. Freeze a Vascepa - perfectly clear.
Anyway - back to cost.... Amarin Corporation has a coupon on its website - good for a year - which gives you $70 discount per month. You can add that to any insurance you have. I know some people pay as little as $9 per month when all is said and done. I myself pay around $40 - and expect to pay even less now that Reduce-It is proven successful as I expect to see the drug drop from Tier 3 to Tier 2 on my insurance due to the preventative qualities that are worth so much to my insurance company.
1
These totally unscientific results on outliers make for great "click bait". One day it is coffee will kill you, the next it is good for you. Then the alcohol thing, changes about every time the page is refreshed. Many of these studies are funded by interest groups.
7
First fish oil is a cure all.. then we are told it does nothing (i take it anyway)... now we are told they are making a prescription out of it... We should really give snake oil another chance
15
@Rob
rattlesnake oil is very high in EPA.
2
Does anyone know which types of LDL cholesterol are increased by DHA? Given that DHA lowers triglycerides and increases LDL, one would surmise that it's the more benign light and fluffy LDL rather than the more dangerous small particle LDL, but I would like confirmation on this.
2
@Bruce
This is a highly complex subject with no easy answer. Anyone interested in learning more should start with articles on the epigenetics of lipid metabolism. One highly technical paper;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421987/.
These results are interesting. Given that these results apply to people with high triglycerides, one would think that doctors would recommend diet as an important first step. People are usually able to reduce their triglycerides by avoiding sugars and starches.
4
@Bruce I'm sure that was one of the first suggesions
This is an interesting study and differs from what is gone before in two important ways; selection of patients with high triglycerides and the dose of EPA. We showed in the late 80s that 10gms / day of EPA was needed to have an effect in patients with 'normal' lipids on blood clotting equivalent to aspirin and something only slightly less than that would reduce elevated blood pressure. The trials up to now ( aside from the ones that were only epidemiological) have typically delivered doses way below this ( often considerably less than 1 gm/day) and usually were a mixture with DHA that might elevate LDL, However, the late Roger Illingworth first showed that elevated triglycerides were highly sensitive to even low doses of fish oils. Here, the combination of patient selection and a pretty high dose of EPA (4gms/day) delivered success. Just like the prior trials had no strong rationale and could be predicted to fail, this one really tested a rational hypothesis. Congratulations to the investigators ( of whom I am not one).
10
@Confucius
I don't think we have enough information to congratulate
anyone yet. You seem to have some scientific knowledge but no scientific skepticism.
1
My husband who has elevated triglycerides...in the order of thousands if left alone has been on only Lovaza. His triglyceride count depends on how much he indulges himself before his blood work. He has been on it for a couple of years so far and it's been good for him. He does exercise daily and we eat healthy to accomodate his profile. Sometimes I wonder if his genetic make up is such that the high triglycerides are just a normal for his body compensated by some other genetic mechanism. The fish oil so far has not interfered in his daily routine.
2
@Meena Have him ask his doctor about Vascepa. You can also read about it on Amarin Corporation website. Vascepa's development was overseen by the same guy who ran the company that developed Lovaza before it sold out to big pharma. Lovaza and Vascepa are different medications entirely - in case anyone tells you they are the same. Lovaza has DHA - Vascepa does not. And the website has a $70 coupon that you can use monthly.
1
I have recommended fish oil for patients for many years. It works for certain problems in supporting patients.
Vascepa costs $311 for 120 capusles of 1 gram each. It contains 1 g. ( 1,000 mg) of EPA.
There is a site, Labdoor, that independently tests supplements.
In an ongoing study of fish oil supplements they point out that several contain high rates of mercury and that their amounts of EPA vary widely, in some cases not as advertised.
Here are the reports:
https://labdoor.com/rankings/fish-oil
I use one of their recommended supplements, Ocean Blue Professional Omega-3, with patients and for myself,.It contains almost twice the amount of EPA as Vascepa. Currently, it is selling for $28.55 for 120 capsules on Amazon. I have no connection with the company or Labdoor and only want to point out that there are alternatives that are of high quality, cost much less, and are available without a prescription.
Caveat emptor.
35
@simon sez There is a coupon at the manufacturer's website which takes $70 off the cost of the script each month. With insurance and the coupon, someone can pay as little as $9 a month - depending on their policy.
I average $50/month with BCBS-FEP. It is currently a Tier 3 drug with BCBS. I expect it to move to Tier 2 as a result of the study findings - which will reduce my cost further.
1
@simon sez $3000 a year, according to Consumer Digest.
Brain Chemistry,Soldiers Suicides and Fish Oil: The U.S. Army conducted a long term research project that analyzed DHA levels. The suicide group was matched for age rank and sex with a control group.
All 800 suicides had low DHA levels. Those in the control
group with the lowest DHA levels were at highest
risk for suicide.
DHA levels returned to normal after 5 grams of fish oil
per day.
There can be big differences in the quality of fish oil.
Norwegian fish oil may be better than others.
Also, flax oil, or ground flax seed may be as good as fish oil, and less expensive. The flax oil must be refrigerated.
Grind the flax seed in a coffee grinder. Keep it in the freezer.
Ref
us army dha suicide
"Fat's That Heal" by Udo Erasmus
6
@David Andrew Henry
The Army study was a retrospective review. It looked at serum levels of fatty acids collected from servicemen on a routine basis. The ONLY variable this study looked at was suicide vs fatty acid levels. It did not look at medications, diet, activity levels. One could say this study found an "association" between fatty acid levels and suicide, but not a "causal relationship". You may want to look at http://www.tylervigen.com/spurious-correlations for more information.
1
Thank you to Dr Ethan Weiss, who said he was happy to be wrong about this. How refreshing to see these words! It does my heart good.
11
This is an industry sponsored trial. We do not have the materials and methods of this study. In view of its extreme departure from other studies of fish oil, we should be skeptical of the results. It should be noted that this article relies on a press release from a company and not peer- reviewed sources.
45
@Mark Frydenborg
Certainly agree with that. No mention of side effects. Fish oils can be associated with increased bleeding risks, constant bruising, among other things. Give us the bad with the good. How many people experienced life altering side effects? Take a look at the incidence of Inuits, whose diet is composed of large fish oil consumption, and their rate of brain hemorrhage. I took fish oils for my heart, then bilateral brain bleeds came along. Thankfully I can still type. Personally, I'm staying clear: sounds "fishy" to me. ?Perhaps a methodology flaw, or industry sponsored bias. We need all the data.
12
@Mark Frydenborg
Here is a site which does independent analysis of these products.
https://labdoor.com/rankings/fish-oil
4
@simon sez
labdoor only tests for quality. It does not do independent testing of efficacy. Prior to this newly released industry study there was no RCT evidence for the efficacy of fish oil in heart disease. The quality of a product may be fine even though it is totally ineffective.