DHA: On Further Thought…

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I recently posted the video above wherein I stated I have grown uneasy about recommending routine DHA supplementation for vegans. In the video, I said that I had become unsure what possible adverse effects the supplement might be facilitating, and, until I learned more about this subject, I would use this calendar year to optimize my ALA intake with daily ground flaxseeds and an otherwise ALA-rich diet. I plan, in December, to reassess the state of testing methods and see which test, if any, could give me meaningful information about my DHA status. I am not saying that DHA supplements are evil nor that people who take them or advocate their use are wrong or that I have closed the door on their use, especially for people with diabetes, hypertension and advanced age. I’m just saying that, at this time, the science is not mature enough to permit me to feel comfortably giving advice on DHA supplementation.

It was not unexpected that such a video would cause distress in my friend and colleague, Dr. Joel Fuhrman, a passionate advocate of DHA for vegans as a preventative against dementia, which he reports having seen frequently in his practice. Dr. Fuhrman decried my lack of scientific evidence to support my concerns. To that end, I call your attention to the following article that kindled my concerns (1) that demonstrated that the elevation in EPA levels commonly seen with DHA supplementation is not, as widely believed, from “backfilling,” wherein 22-carbon atom DHA somehow turns back into 20-carbon-atom EPA. On the contrary, this study shows that the elevation of EPA is demonstrated here is the result of DHA inhibiting EPA clearance from the blood, thus, producing EPA accumulation in the tissues. This concerns me greatly, as it is a red flag saying to me, “If swallowing pre-formed DHA is backing up EPA metabolism, what else is it doing?”

Compound-specific isotope analysis reveals no retroconversion of DHA to EPA but substantial conversion of EPA to DHA following supplementation: a randomized control trial. https://www.ncbi.nlm.nih.gov/pubmed/3...

I also found evidence confirmed that taking DHA supplements increases cell permeability and I it makes me wonder if that increases permeability to carcinogens.

These concerns were enough for me to question if I really know what I am doing as I tell people to take DHA on a daily basis - and, until I can be confident that my advice is doing no harm, including making the cells more permeable to carcinogens, I have, for now, decided to hold off on my recommendation to take supplemental DHA. If people want to continue taking it, I can understand why that would seem reasonable, as there is evidence supporting that stance, as well.

I know Dr. Fuhrman’s condemnation of me as a physician has been very vehement. It will not dim my friendship with or appreciation of Dr. Fuhrman as a man of character and a fine doctor who has the best interest of his patients at heart. (Likewise with with my friends and colleagues Dr. Joel Kahn and Dr. Michael Greger who probably also will disagree with my clinical decision at this time. They are all respected and cherished lights in the field of plant-based nutrition and my appreciation for them remains undimmed.)

I appreciate all, including Dr. Fuhrman, who are helping me find my way to the truth about this important, complex and subtle subject.

Michael Klaper, M.D.
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ABOUT DR. KLAPER

Dr. Michael Klaper is an experienced physician, an internationally-recognized teacher and sought-after speaker on diet and health. He resolutely believes that proper nutrition — through a whole-food, plant-based diet — and a balanced lifestyle are essential for health.

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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Klaper nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, exercise or other lifestyle program.