Prof Puri & vegEPA for ME/CFS

pinkcadillac

You might like to know that i have negotiated a scheme (in conjunction with the manufacturer) for ME people which offers Vegepa and related products at a fraction of the RRP
PLUS
50p per pot goes to ME Research UK for crucial, biomedical research into ME!

To date, over 2,000 Scheme Members find VegEPA highly beneficial and in just our 1st year we’ve raised £9,000 for biomedical research! There are no public funds for ME research only private so this is a relatively huge amount of money.

Check out the site if you have ME.
thevegepaformescheme.com

Prohealth2007

I just visted my Doctor today and he highly recommeded this product! He was wondering if there are any American Distributors that sell vegEPA for the same price or less then they do on the offical vegEPA website in UK?? This would obviously defer the shipping costs and arrival time.

Also, I wonder if it is possible to become a Distributor for USA?
Any suggestions??

moontree

I've been taking VegEPA for over a year now for depression, but have decided to try switching to ZipVit's super strength omega fish oil which is £5.95 for 90 capsules. This will give me the same amount of EPA, but also contains DHA (and I'm going to take a separate evening primrose oil suppplement). Some of the studies I've looked at suggest that DHA makes the EPA less effective, but others suggest it doesn't... we'll see! I'll let you know how I get on.

moontree

I'm reporting back with my experiences and research findings.

First of all, obviously I was taking VegEPA for depression and not CFS/ME, so the results may be different. But Professor Puri recommends the same product at the same dose for depression as he does for CFS, and the scientific theory behind it appears to be the same. (Also, I figure others with depression may be reading this thread.)

The reason I decided to switch to Zipvit (apart from the obvious cost factor!) is that everything else I've read on using omega 3 to treat depression says EPA is the necessary ingredient, but that the presence or absence of DHA is not important. This page summarises some of the research:
http://www.psycheducation.org/depression/meds/Omega-3.htm

I've now been taking Zipvit's products (first the super strength capsules, now the Omega Juice) for just over a month and have not noticed a difference. I guess I'll need to wait for about three months to be certain it's working, since that's how long you're supposed to wait for the supplements to kick in in the first place. I'm getting the same doses of EPA and EPO (via a separate supplement) as I was on VegEPA, but just with additional DHA.

I recently got hold of an older (2004) edition of Puri's book on depression and it doesn't say that DHA is a problem. As an alternative to VegEPA it recommends other supplements which do include DHA, such as Eye Q. My guess is that the evidence suggesting that the EPA-DHA ratio matters must be quite recent... so it probably did work for some people even with DHA, but presumably EPA only is more effective or more likely to be effective.

(In other words, EPA only gives you the highest chance of success, but if money's a problem then EPA plus DHA is worth a try. Just my opinion!)

Here's what the VegEPA website has to say about the need for EPA without DHA:
http://www.vegepa.com/vegepa.php?n=WhynoDHAinVegEPA&indi=3&ti=Science

I'll post again in a couple of months to let you know how I'm getting on with the Omega Juice.

runciblespoon

How did people get on with the VegEPA?

Noticed another product which is essentially the same composition as VegEPA (300mg EPA, 24mg GLA) but may be cheaper depending on what's on offer:
http://www.mind1st.co.uk/omega_3_info.asp

I'm still working through the science (I'm an engineer not a biochemist). Puri's paper:

The clinical advantages of cold-pressed non-raffinated evening primrose oil over refined preparations Medical Hypotheses (2004) 62, 116–118
This paper basically says that cold-pressed evening primrose oil (note: not fish oil - the test subject is actually 'qarma' from Equazen) is of a different composition to 'a randomly chosen commercially available refined evening primrose oil'. He finds NMR peaks which suggests the cold-pressed oil contains a 'closely related triterpene caffeoyl derivative of betulinic acid.'. He then says 'it is hypothesized that a cold-pressed, non-raffinated evening primrose oil preparation is likely to have superior clinical therapeutic benefits.' There's no evidence for this in this paper, nor is there a cite for this statement.

There's rather more meat in his review paper:
Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis (chronic fatigue syndrome) J Clin Pathol 2007;60:122–124
First he suggests that:
Back in 1935, Stoesser{14} reported that acute viral infections were associated with a reduction in the levels of long-chain polyunsaturated fatty acids. That the cause of this reduction was the ability of many viral species to inhibit the delta-6 desaturation of the precursor short-chain essential fatty acids was discovered four decades later by Dunbar and Bayley{15} !!16}
...
As a result of viral, or other, inhibition of delta-6-desaturase, an inadequate supply of the long-chain polyunsaturated fatty acids is available for incorporation into the membrane phospholipid molecules.
and then goes on to suggest that this might have an unfavourable effect on neurotransmission.

!!14}, !!15}, !!16} are citations I haven't chased up yet:
!!14} Stoesser AV. Effect of acute infection on iodine number of serum fatty acids. Proc Soc Exp Biol Med 1935;32:1326-7
!!15} Dunbar IM, Bayley JM. Enzyme deletions and essential fatty acid metabolism in cultured cells. J Biol Chem 1975;250:1152-4
!!16} Bayley JM. Lipid metabolism in cultured cells. In: F Synder, eds. Metabolism in mammals. Vol II. New York: Plenum Press, 1977:352-64

Then he says:
Therapeutic implications
Inhibition of delta-6-desaturase can be bypassed by treatment with a combination of evening primrose oil, which supply the n-6 long-chain polyunsaturated fatty acid gamma-linolenic acid, from which dihomo-gamma-linolenic acid and arachidonic acid can be biosynthesised, and the n-3 long chain polyunsatured fatty acid eicosapenteanoic acid'
...
'In administering this regimen, it is more advantageous to use virgin, cold-pressed non-raffinated evening primrose oil rather than the more commonly available refined preparation, as the virgin evening primrose oil is rich in lipophilic pentacyclic triterpenes, which have free radical scavenging, cyclo-oxygenase and neutrophil elastase inhibitory properties{22}'.
!!22} is a cite to the Medical Hypotheses paper above. Again this is about evening primrose oil (GLA, Omega 6) and not Omega 3.


So I've yet to find anything in the literature about the absence of DHA.
If I've blinded you with science, have a read of a report of Puri's talk to the Sheffield ME group:
http://www.sheffieldmegroup.co.uk/Prof_Puri_web_version.pdf
In the Q&A session he says, regarding EPA/DHA:
In the EFA supplements which trials found to be beneficial for people with depression and Huntington’s disease, DHA is usually left out. This is for several reasons including: 1) EPA converts easily to DHA and usually there is not a problem with DHA deficiency 2) trials have shown that it makes sense to maximise the ratio of EPA to DHA in supplementation 3) DHA is more susceptible to deterioration 4) DHA actually showed no benefit in trials with attention deficit hyperactivity disorder.

In other words for CFS/ME the answer seems far from clear, even from Puri himself. In addition, what you do in a trial (wishing to exclude all other factors) is different to what you might do in a patient (not worry if there are other things that might muddy the waters if they have a positive therapeutic effect).

Ted_Hutchinson

Bear in mind the cost using 2 to 4 capsules per day for up to three months for the oil to be fully absorbed.

While I fully accept that EPA appears to function better than DHA for treating mood disorders I'm not convinced it has to be removed from fish oil. We find that people who use Cod Liver oil (which has a high DHA content) also consistently have lower depression rates)

It may therefore work out more cost effective and just as effective to use a Molecularly distilled high EPA fish oil with a borage oil

Natural Factors, RxOmega-3 Factors Pharmaceutical Grade, 120 Softgels $13.47
400 EPA 200 DHA (25% more EPA than Mind first 3 of these = 4 of the mind1st for EPA content) = $0.11 each

Nature's Way, Evening Primrose High Potency EFA Gold, 1300 mg, 120 Softgels
130 mg GLA (one of these provides more cold pressed GLA than mind1st) $14.75 $0.12


+$12 p&p
There is a $5 introductory discount code for Iherb in the Referrals board. There are other cheaper USA discount supplement providers but these use more expensive Carriers than Iherb so the overall cost is more)

So the cost daily of 3 x the EPA + 1 GLA= approx $0.45 or 23p daily
4 of the Mind first are going to be in the order of 75p daily.

As many readers here will know I suffer from PPS the symtoms of which are more or less indistinguishable from CFS/ME.

I have found following the supplement regime provided by Direct ms org that includes Omega 3 Essential Fatty Acids – 3 grams of EPA +DHA and Vitamin D3 - 4000 IU put me on the road to if not recovery as the effects of polio are not curable but at least able to manage the late effects. However it is only recently I put into operation fully their nutritional recommendations.. Losing a load of weight has made a huge difference and it is clear to me my mind works better on a low carb regime.

Maybe low carb (paleo style) diets work better in those who have the vitamin d status that paleo man would have naturally acquired? Given the relatively low amount of omega 3 and vitamin D in Cod Liver Oil it does have a greater effectiveness than might be expected. I wonder (but cannot prove) if Vitamin D works together with EPA/DHA so that together they provide more impact than when trialled separately?

runciblespoon

I hate to be rude, ilovetosavemoney, but I notice you've only posted twice, in both cases plugging that website.

I'm not convinced by the balance of research shown on that site. A good research summary is one that highlights the negative or inconclusive trials as well as the positive ones. There are no direct references to studies, only to press articles about them.

Secondly, the Omega 3 pastilles you mention on the other thread aren't that good value. They're £4 for 30 pastilles each containing 100mg of DHA. That's 13.3p per 100mg of DHA, or 6.7p per 100mg since they're currently on 2-for-1.

Zipvit's Omega 3 Juice has 600mg of DHA per 5ml spoon; 360ml costs £5.99. That's 8.3p per 5ml dose, or 1.4p per 100mg of DHA. omega4.co.uk's Omega 3 pastilles are 5 times as expensive as Zipvit's Omega Juice. And that's just for the DHA: Omega Juice also provides 900mg EPA per 5ml dose too.

If you have a particular need to have a DHA-only intake then there might be of interest, except that I can't see any evidence of them being any purer than other generic Omega 3 supplements.

Edit: I realise that especially children have trouble with some forms, but a 5x premium does seem a bit much. The other omega4.co.uk supplements don't seem to be hugely remarkable - eg 90x 1000mg Omega3 for £4.15 with 140mg EPA and 100mg DHA. For an equivalent to the Zipvit 5ml dose that's 27.7p.

runciblespoon

Since I've been posting to this thread, I might mention my own VegEPA-substitute regime that I've come up with...

Per day:
10ml of Zipvit Omega 3 Juice
1.25ml of Power Health cold-pressed evening primrose oil

The Omega Juice provies 1800mg of EPA and 1200mg of DHA per day. This is a relatively high proportion of EPA; I'm not convinced by the evidence of the effect of eliminating DHA so this is my best attempt. At £5.99 for 360ml it works out at 16.6p/day.

The evening primrose oil (EPO) is intended to duplicate the oil used in Puri's 'cold-pressed non-raffinated EPO' paper. At 1.25ml (I intended 1ml, but only have a 1.25ml measuring spoon) it's 5p/day and provides 1140mg of EPO containing 103mg of GLA. I picked it from Google Products because few people advertise cold-pressed EPO, and it's £7.14 inc P&P for 180ml. Zipvit say in their catalogue their EPO is extracted without chemicals ('non-raffinated') but don't mention whether it's cold pressed.

I forgot how much VegEPA is under the VegEPA-for-ME scheme, but I'll assume it's £8.95 for 60 tablets. Each tablet contains 280mg EPA and 100mg of EPO.

My regime:
1800mg EPA
1200mg DHA
103mg GLA (in 1140mg of EPO)
Cost: 21.6p/day

6 tablets of VegEPA:
1680mg EPA
54mg GLA (in 600mg of EPO)
Cost 89.5p/day

Whether it helps or not will be difficult to say, as I've made quite a few other changes so it'll be hard to work out any causes. Anyway, I hope it's useful.