Q: I have read that essential fatty acids (EFAs) can be helpful in treating depression. Is there evidence that shows whether fish oil or flaxseed oil is better?
A: Essential fatty acids can be helpful in depression. I recommend fish oil instead of flaxseed because fish oil needs no processing by the body. Flaxseed needs to be elongated to be in its active form (DHA), and the enzyme required to elongate it is used competitively by other fats for their processing. So, if there are other fats in the diet – especially trans fats and saturated fats – the flaxseed oil may not get processed adequately. A recent study in Atherosclerosis (July 2005) revealed that the declines in LDL cholesterol with fish oil were not reproduced by flaxseed oil supplementation.
Q: I am a 56-year-old white male. Some 30 years ago, I contracted genital herpes. Shortly after that I started to develop white spots on my skin. Though limited, over the years these de-pigmented spots have spread to various parts of my body. I've been to a handful of physicians. They have diagnosed the skin patches as vitiligo. Due to my personal experience, I'm convinced there is a connection between the herpes and the vitiligo. I have been unable to find any literature or research connecting the two. I am wondering if you know of any information about this, or if you know of any researchers or doctors with a real interest in these diseases.
A: Herpes virus has been associated with a loss of pigment on the lip, a condition termed “herpes induced lip leucoderma.” Vitiligo is thought to represent an autoimmune disease, and some authors suspect that viruses may be involved in this category of diseases. There is one study that revealed that 38 percent of patients with vitiligo had cytomegalovirus (a herpes virus) DNA in their skin biopsies compared to none in controls (Grimes, 1996. Journal of the American Academy of Dermatology). Another case describes extensive vitiligo after a patient had received donor T-cells expressing herpes simplex virus thymidine kinase (Aubin, 2000. Lancet). There is not a lot of information available on this subject. You may want to present yourself to the dermatology department at your local medical school as a potential research case.
Q: Most of the doctors I have had take a very allopathic approach to care; their impulses seem to be to treat symptoms indefinitely with copious pharmaceuticals. I'm interested in a more holistic approach, but I'd like to stay within in the medical establishment of hospital affiliation, licensing, insurance coverage, etc. I've found it difficult to find out which doctors in my area are open to such an approach. Should I be looking for a doctor with a particular type of degree (such as a DO)? Are there any online resources for finding such a physician? Are there any local groups that offer referrals?
A: This is a great question, but unfortunately, without a great answer! The American Holistic Medical Association www.holisticmedicine.org is a good place to start. It has a directory of physicians nationally who subscribe to holistic beliefs. It is by no means encompassing, however, because many “holistic” practitioners have not chosen to join. Osteopathic physicians (DOs) certainly have a long history of holism in their approach, but many DO schools are becoming more “allopathic” in their thinking in order to fit more into mainstream to encourage acceptance. As mentioned, the question is much better than a possible answer!
Disclaimer: The information contained in this column is not meant to diagnose or treat any condition. Seek the advice of a medical professional before making any changes to your diet, supplements or medication.
Tanya Edwards, M.D., M.Ed., is the Medical Director for the Center for Integrative Medicine and is a staff member in the Department of Family Medicine at the Cleveland Clinic. As a Family Practice physician, she sees patients at the Cleveland Clinic Independence Family Health Center, and will begin wellness consultations at the new Cleveland Clinic Wellness Center. For the past seven years, she has been teaching complementary and alternative medicine courses at the Case Western Reserve University School of Medicine.
Some questions in the “Ask Dr. Edwards” column appear courtesy of NetWellness.org.
NetWellness.org - Consumer health information that's unbiased and credible from university health professionals. Ask university faculty questions. It's completely confidential, anonymous, unbiased and free.
