A Medical Student Blog

Unofficial thoughts on medicine and medical school

More fish, fish oil, omega 3

Dear All,

Many of you have heard that Tim Russert, a beloved journalist and moderator of Meet the Press, died of sudden cardiac death a few days ago.  When I listened to the interview with Tim Russert’s doctor, I was concerned and worried that he didn’t get a chance to hear about fish oil.  The reason why was because I know from personal experience at clinics and at the hospital, that patients are not often told that fish oil is an absolutely critlcal part of treatment strategy.   And when I heard Mr. Russert passed away, I felt very guilty for not stepping it up and letting more people — you — know of the life-saving effects of taking fish oil everyday.  I know these statements may sound over-the-top, but as you will see in the articles I point out, the data is strong, and the scientific evidence is there to support what I just said.  This is a topic I should have talked about long ago — as soon as I had learned about it, I should have started blogging and started youtubing about it.

You may wonder, Jeff is fish oil really that important?  After all, now that I am a third-year medical student, I’ve gotten a chance to experience the oncology floors at the hospital, urgent care, and family clinics.  I realize how little I do know — it’s a humbling experience — and the interns and residents are truly my role models.  My classmates and I greatly admire many of the doctors in the hospital, and there’s even a bit of hero-worship involved, especially when you see an intern tackling so many cases, from doing lumbar punctures to rescuing patients who can’t breathe — all on 0 hours of sleep, having stayed up for more than 28 hours — while smiling and being patient and compassionate 24/7.

So given how much I do not know, and of all the things I’ve seen and learned, many of which are more dramatic than fish, you may ask, incredulously, “do you really have to tell us about fish oil?”

I respect your skepticism, but I hope you hear me out.  Everything I’ve read seems to point that fish oil, is at least as critical as statins and other drugs in preventing sudden cardiac death and death.  In 2005, JAMA’s Archives of Internal Medicine published a systematic review comparing statins head to head with fish oil.  The review found that statins reduced risk of overall mortality by 13%, whereas fish oil reduced risk of death by 23%.   (You can read the article here: http://archinte.ama-assn.org/cgi/content/full/165/7/725)  There are many other studies showing that fish oil saves lives.  Here’s a link to another study published in Lancet, 1999, showing that fish oil reduces risk of death by 15% and risk of sudden cardiac death (which is what Tim Russert passed away from), by 45%.  (You can read about it here: http://www.ncbi.nlm.nih.gov/pubmed/10465168).  Even the American Heart Association recommends that for patients who have coronary heart disease, they should take 1g of EPA and DHA if you have heart disease: http://www.americanheart.org/presenter.jhtml?identifier=4632

After reading these studes, your next question may be, “well Jeff, if so many people are saying you should take fish oil, why are you rehashing the party line?” 

Again, that is a legitimate question, and to that, I can only sadly say, that in my experience, too many patients do not get prescribed fish oil as part of their treatment plan.  For some reason, it’s considered an optional thing to do.  “Nice, but not necessary.”  It’s also not covered by insurance, and so for patients who cannot afford additional financial burden, they do not get access to this life-saving intervention.

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I wish I could be sharing with you some high-tech discovery that would demonstrate a thorough understanding of complex medical problems.  That would impress not just you, but also the interns and the attendings.  In the hospital, the doctors have their codes of respect: if you know how to read supraventricular tachyarrhythmias in EKGs, you’re cool.  If you know how to treat flash pulmonary edema, you’re cool.  If you know how to handle worrisome V-tach’s — you’re cool.

What’s not cool, is fish or fish oil.   It’s not chique — not exactly the kind of topic that wows my interns and my attendings.    But when I heard about Tim Russert’s sudden cardiac death, I felt compelled to stay on this topic and share with you more information about fish oil.  I hope you can share with many of your family members this information, especially the review that I mentioned above showing that fish oil beats out statins: http://archinte.ama-assn.org/cgi/content/full/165/7/725

(Lastly, I just want you to know that all the sources I cite in this article are from trustworthy, prestigious institutions or journals.  JAMA Archives of Internal Medicine, Lancet, American Heart Association)

 

 

 

 

June 16, 2008 Posted by | Health news | , | 6 Comments