Is Fish Oil Good Or Bad?

Is Fish Oil Good Or Bad?

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1. Is it correct to believe that omega 6’s are always bad?
2. What are the pathways these fats travel and what do they really do?
3. Do we need some type of ratio for optimal health?
4. What are the normal ratio’s of O6/O3 in certain organ’s?
5. Why is knowing what your current O6/O3 ratio critical to your Optimal Health?

Today I was getting ready for the Ancestral Health Symposium and I struck up a conversation with two UCLA students on the Santa Monica Pier. After about ten minutes, I realized that before today’s meeting I had to discuss omega six fats. These two bright kids had the clear impression that omega 6 fats were always pure evil for optimization. I asked them where they got that idea and they told me they got it from popular paleo blogs and books (paleo solution and primal blueprint) they had read and it was reenforced by their peers. I told them both that they just motivated me to go back to my hotel early and begin a new blog before today’s first ever Ancestral Health Symposium. So here it goes.

Fish oil never beats the Epi-paleo Rx. Ever.  A modern microwaved world creates a massive need of DHA and this is why omega 6’s are placed in our cell membranes.  It is not a diet problem, it is an environmental epigenetic effect.

Many times we hear in the paleo world talk about the wonderful things omega three fats do for us. We also hear about the many bad things that omega six oils can do to us. We rarely hear about why O6 fats are good,  or in fact, necessary for proper function. Well, they are folks!!!! In fact, we need them in EXCESS as compared to O3 fats! Most invoke the standard American diet (SAD) argument because a processed food diet has 25-40 to one ratio of omega 6 to three ratios compared to an ancestral diet as outlined by Cordain et al. This information is true, to some degree, but the story has many nuances that one needs to understand for optimal health, in my view. Lets take a look at some of the data we should be mindful of.

What exactly are the paths that EFA travel in humans? Is the pathway of all omega six fats inflammatory? Is the current concept of a dietary balance omega-6/3 ratios based on a true biologic reality? We also hear a lot of background posting about the “inflammatory pathway” from linoleic acid (LA) to arachadonic acid (AA) as the main argument against dietary sources of O6 fats. This is the AA pathway that leads to the formation of prostaglandins. Interestingly, the real pathway that O6 fats travel, is not to just foster inflammation, but to also limit it.   The redox potential of the extracellular environment is what determines this signaling path the chemicals will travel.  Many researchers and bloggers assume that the pathway from AA to PGE2 is a constant finding if we eat dietary excesses of O6 fats. This is not true at all. The interesting finding is that the body only produces PGE2 when it is actually needed by the body. It does not happen with the excess consumption of omega 6 by itself.  In fact, most EFA are produced in the human body on an ad needed basis. So, AA is not dangerous in an of itself. The adverse effect idea arose because of the role of AA as a precursor of thromboxane and other eicosanoids participating in activating thrombus formation and the inflammatory process. But this is not the only thing AA does in the human body!  If it was, I would never be able to operate on anyone!

AA is a major component of the endothelial [inner arterial lining] phosphoglycerides, particularly on the inner cell membrane layer. AA and adrenic acid are consistent companions in other cell membranes. What many in the ancestral health community do not know is that EPA in the marine food chain limits the amount of AA that we can place in our tissues.  It is like an internal control switch if our circadian signaling is working well.  The control switch is optical and uses hydrogen in a unique way.  Since most modern humans have an altered circadian signaling today this switch is no longer operational.  This is why people get excessive omega 6 levels in their tissues.  EPA must come from seafood.  AA is not always a bad actor.  Consider the following:

AA is the precursor for prostacyclin: a vasodilator and inhibitor of platelet adhesion; it is the most potent platelet inhibitor we know of in nature. This stops the clotting process when it is no longer needed. It is also vital to smooth vascular and laminar flow and allows us to overcome wounds we sustain in injury or create in surgery by helping seal the wounds. If there is damage to the endothelium, such as in bruising, infection or cutting, then the phospholipases release AA. In the free form, and in conjunction with activated platelets, AA is peroxidized to provide eicosanoids for the response to injury. This is how the body is supposed to work. I rely on Omega 6 fats every day in my patients in surgery to get people to clot and off the operating table.

Moreover, in vivo, we never find prostaglandins from omega 3’s or from omega 6’s acting alone. They act in concert as a violin and violinist would.  One without the other is simply useless. PGE1 is made from omega 6 fats and is a fast acting pain inhibiting cytokine that also modulates the immune response to an injury. PGE3 is made from omega 3 fats and has similar function but the PGE1 response is more brisk and powerful to help in wound healing. They always act in unison and are symbiotic. This is why when someone takes too many omega 3’s in supplement form we often can see skin bleeding and discoloration and frank internal bleeding. It is also why when our ratio is 40 to 1 due to processed foods we see the opposite end of the spectrum. But we must realize, it is in fact, a spectrum of balance that we need to strive for in concert with the redox potential in the extracellular matrix.  This is not the context the ancestral health community talks about at all.

As explained above, the western diet is estimated to have undergone a huge shift in the omega 6 to 3 content since 1900. Many place the spike in neolithic disease at this concomitant spike over the last 110 years. I do not.  The biggest problem in my view is the loss of control of the redox potential in the extracellular matrix.  This links it to the number of electrons and protons in the ECF.  Redox is a function of the net negative charge in our cells.  Our bodies target ratio’s of EFA should still be capable of an oxygen-transference ratio of a maximum of 6 to 1 omega-6 to omega-3 for good functioning. So if you understand biology, humans need more O6 fats than O3 fats normally in their diet to function optimally. This idea shocked the young paleo kids I spoke too.  So it should now be clear that AA is not the dark side!  If we could get it to two to three to one ratio it likely would be ideal, but with today food sources I think this is rather difficult to do without a lot of money and time.

A word of caution: I am one of the few in this community who think there is a major benefit to 06’s in mammalian biochemistry. The real problem we have with 0mega 6’s are the sheer number and amount in balancing the 0mega 3’s for ideal proper cell membrane signaling. This ratio is critically tied to the environment we are adapted too because this links it to the redox potential of the extracellular matrix. Most in our community fail to realize this point because they really do not understand how mammalians use 0mega 6’s to their advantage.

The other interesting factor I have seen few speak of,  is the requirement that each organ of the body has for omega 6 and 3 fats. I decided to look into this issue more several years ago when I was researching my own health. I always believed that the brain had a large omega 3 component naturally and it turned out, I was dead wrong.  The brain makes up 3{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of our body weight (BW) but has a 100 to 1 ratio of 06 to 03 within it normally.   By weight the brain isis 80{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} water molecules.  Hydrogen bonding networks work in concert with the cell membranes at the atomic level.  DHA is critical in the proper selection of the correct amount of lipids within our cell membranes.  It appears the 0mega 6 to phosphatidyl choline and phosphatidyl serine ratios are more critical for cell membrane signaling for protein confirmational bending after proteins are made in the brain. This single insight, made me realize that ‘mammals do something special’ (quantum) with their 0mega 6’s for some reason. It turns out this is related to proton function.  As the Quilt unfolds, I will tell you more about this.

It appears in certain diseases of the brain the ratio gets dramatically altered and may actually be a good biomarker for us to use diagnosis and prognosis in neurodegenerative disorders. These changes always funnel back to leptin signaling.  Skin makes up 4{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of our BW and has 1000 to 1 ratio normally. Skeletal muscle makes up 50{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of our BW and sets at a 6 to 1 ratio. Our internal organs, make up 9{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of our BW have the lowest ratios at 4 to 1. Adipose tissue sits at 22 to 1 ratio and makes up 15-35{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of our total BW depending on how fat we are.  It also turns out DHA levels determine the size and shape of our organs and determine our optimal body composition.

Summing it all up:

THE MOST IMPORTANT FACTOR IN THE O6/O3 ratio is CONTEXT!!!!! This blog was really motivated by a conversation I had yesterday on the Santa Monica Pier with two college students who were going to attend the Ancestral Health Symposium at UCLA later today. I felt after speaking with them that this blog needed to be written because I think there is many mischaracterizations out there about Omega 6 fatty acids. They should not be vilified indiscriminately. We need a small excess of O6 to O3 normally in a healthy human diet.

The current SAD “grossly” exceeds that normal excess to a great degree. Therefore, we can not and should not vilify all O6 fats. The real problem we face is that certain chronic disease conditions such as obesity, arthritis and ischemic heart disease, is where the damage has already occurred. This situation results from a chronic stimulation of the inflammatory pathways of eicosanoids in response to this neolithic insults. This is evidenced by an elevated HS-CRP, IL-6 or TNF alpha on blood testing. This is not the fault of AA or DGLA in our diets, but it is the original cause of damage of the disease process.

The key point is that we should strive for a diet that limits omega six consumption to the appropriate ratios for human optimization based upon an ancestral biochemistry. This ratio is 2 to 1 to 6 to 1 by most good studies I have read. So when you begin your own trek to get healthy and optimized I would strongly suggest you get your own omega 6/3 ratio drawn so you can see how far your past diet led you astray from what should be ideal………if that number is greater than 6 to 1 and you have active chronic inflammatory markers that are elevated, then your first move should be to bring down the omega 6 content of your diet and increase the dietary consumption of omega 3’s before you supplement with fish oil!

My concern is that fish oil supplements are becoming the “proxy” for good dietary choices in our paleo/primal community. Once you get your light cycles repaired with the Leptin Rx, then the diet can be repaired (Epi-paleo Rx)  and back to ancestral balances of O6/O3 fats, then you can titrate the effective dose of supplemental O3 oils to your desired O6/O3 ratio based upon your own blood work. This is the context I use for myself and patients.

If you overdo your fish oil supplementation and don’t test you could actually hurt yourself and your cause long term. You may even cause stalls of changes in your VAP and HS CRP levels.  It also stops weight loss and can make autoimmune conditions worse.  They may also confound you and your doctor because you forgot the context of why this has happened. Remember fish oil in supplement form is a “PUFA too”,  and it is subject to serious peroxidation and ALE formation when it is taken improperly or when it is adulterated. Lipid peroxidation liberates free fatty acids that breakdown down to CO2 and water.  That water contains hydrogen isoforms and oxygen that are processed in our mitochondria.  So it too can be a double edge sword like the O6 content has been vilified in our community. REMEMBER CONTEXT is critical for Optimal!

Fish is best from food, not a pill!

1. S. Bunting, S. Moncada, and J.R. Vane, “Prostacyclin—Thromboxane A2 Balance: Pathophys- iological and Therapeutic Implications,” British Medical Journal, (1983) Vol. 39, No. 3, pages 271-276.
2. Spector, A.A., “Plasma Free Fatty Acids and Lipoproteins as Sources of Polyunsaturated Fatty Acid for the Brain,” Journal of Molecular Neuroscience, Vol. 16, 2001, pages 159-165.
3. R.S. Chapkin, et. at., Journal of Lipid Research, Volume 27, pages 954-959, 1986, Markides, M., et al., “Fatty acid composition of brain, retina, and erythrocytes in breast- and formula-fed infants.
4. The American Journal of Clinical Nutrition, 1994;60:189-94 and Agneta Anderson, et. al., American Journal of Endocrinological Metabolism, 279: E744-E751. and Agneta Anderson, et. al., American Journal of Endocrinological Metabolism, 279: E744-E751.
5. What is the role of alpha-linolenic acid [parent omega-3] for mammals,” Lipids 2002 Dec;37(12):1113-23
6. Essential Fatty Acids as Possible Mediators of the Action of Statins,” Prostaglandins, Leukot- rienes and Essential Fatty Acids, Vol. 65, No. 1, July 2001.

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  1. Shijin13 August 5, 2011 at 8:05 am - Reply

    So Dr. K, how does the ratios of O6:O3 impact leptin sensitivity/resistance? once we get our ratios – that will help determine how much O3 you need to consume to bring your ratios back into balance?

  2. Rob August 5, 2011 at 8:18 am - Reply

    Dr. Kruse,

    What do you think about the idea of keeping total PUFA (Both 6 and 3) low? Such as under 4% of your daily calories. I'm thinking particularly of the Lands studies, which I learned about from Guyenet and Kurt Harris. Perhaps you've talked about this in another blog post that I haven't read. I do find it reassuring that a 1:1 ratio isn't necessary or even ideal. Thanks for the post.

  3. Dan Han August 5, 2011 at 8:29 am - Reply

    great article Dr. Kruse! So if someone was dieting steadily and say, has 30lbs to lose, what would be a general recommendation of fish oil grams they should eat considering if they are already following a Paleo diet? Also, you keep mentioning Rx grade (as opposed to normal health-food grade?) fish oil, what brand do you use?

  4. Kaleein August 5, 2011 at 9:42 am - Reply

    Wow, Dr. K! The more I read the more confused I get… just when I think I'm beginning to understand a fraction of what you write. Didn't you comment on the MDA forum that a ratio of 1:1 of O3/6 was what to shoot for? One lady has a 4:1 and you said it was good but could be better.

    So, is this new research you have done to change your mind about this? Or, is this written from purely a healthy body standpoint … which anyone needing to do a Leptin Reset obviously doesn't have.

    At your recommendation I am taking high RX Omega 3 (since my last CRP was 14). I've also attempted to drop all Omega 6 loaded foods from my diet, like nuts, seeds, and even turkey and chicken now, in any form. You have also said it takes YEARS to reduce an O6 overload. That said, how long might I wait to get tested before I see noticable improvement? I know the recommendation is for quarterly testing, but I can't afford that. If my last test was 3 months ago, might I wait another 8 months to test and not find out then that my 6 got too low and is now the cause of my pain?

  5. Joe L. August 5, 2011 at 9:52 am - Reply

    What is the O3:O6 test called? My doctor never heard of it. Is there a proper name for this test?

  6. Jack August 5, 2011 at 9:55 am - Reply

    1 to 1 is what we should for but with today's food supply and how incongruent whole foods are supplied across our globe the range is six to one or lower or better. The closer you can go the better. The major focus needs to be understanding where you are now by getting tested. That way you can assess your current habits and beliefs about your food supply. This was a major eye opener for me. Then you can adjust on the fly for your needs health wise and your budget. I personally test quarterly and have done so for five years. I make changes based upon what I find and what I find amazes me.

  7. Natty August 5, 2011 at 1:27 pm - Reply

    Jack, great post. Kent Rieske recommends borage oil and Nora Gedgaudas recommends black currant seed oil as good Omega 6 FAs. Are these good supplements, do you think?

  8. Dexter August 5, 2011 at 1:47 pm - Reply

    Joe L

    This company has a home test kit for O6/O3 ratio.

  9. Cindy August 5, 2011 at 8:48 pm - Reply

    I'd like to know what the O3 to O6 ratio test is called, too. My doctor never heard of it either. He didn't know how to order it and said there was nothing on his lab order sheet close to what I was asking for.

  10. Jack August 6, 2011 at 7:20 am - Reply

    @ Cindy Its just called an omega six/three ratio.

  11. Jack August 6, 2011 at 7:22 am - Reply

    @Shijin LR can be caused by high levels of fructose or other carbs, sustained inflammation from cytokines, and from PUFA's in processed foods. If one loses weight you can still have a higher O6/3 ratio that will slow your loss or cause huge stalls. Moreover, it will slowly degrade your hormone levels and cause many clinical symptoms. You must test to assess.

  12. Jack August 6, 2011 at 7:23 am - Reply

    @Natty I think a good rounded paleo diet, high or low carb should provide enough o6's without the need of supplementing O6's.

  13. Jack August 6, 2011 at 7:26 am - Reply

    @Dan…..30 lbs…..depends upon body comp, hormone status, and HS CRP levels. I would have you try a diet higher in 3's and lower in sixes while your cutting the weight but adding a ton of sashimi to it. This is my favorite way to do it. IF you have stalls get tested and then maybe add some fish oil to the mix.

  14. Jonathan August 6, 2011 at 1:19 pm - Reply

    I'm confused how is 1 to 1 ratio ideal if you should have more O6 than O3. "So if you understand biology, humans need more O6 fats than O3 fats normally in their diet to function optimally"…You can't have a 1 to 1 ratio and have more Omega 6 than Omega 3..more would be higher than a 1 to 1 ratio… So do you mean ideal would be between 1 and 2 so like 1.5 to 1?

  15. Jack August 6, 2011 at 6:41 pm - Reply

    @jonathon. It’s a goal……you likely will never be able to get there……but if you try hard the neighborhood wind up in is pretty awesome.

  16. Ted Hutchinson August 6, 2011 at 3:04 pm - Reply

    Nice paper summarising the relationship of omega 3omega 6 with useful illustrations here.

    <a>Resolution of Adipose Tissue Inflammation

    Stephan (Wholehealthsource) has some useful blogs reminding us The half-life of linoleic acid in fat tissue is about two years, so reducing it is a long-term prospect.

  17. cancerclasses August 6, 2011 at 5:32 pm - Reply

    Thank you for that excellent article, and welcome to the O-6 club. The only thing I'd add is to be sure to clearly distinguish the difference between good, organic cold pressed CIS molecule form of omega-6 (as found in evening primrose, sunflower, safflower & pumpkin seed oils) which BALANCES the body's eicosanoid production and the toxic, pre-oxidized adulterated TRANS molecule form in processed "foods" which are inflammatory & cause all the disruptions of our entire hormone & fat metabolism processes.

    For more than 10 years now Brian Peskin, Ed & Patricia Kane PhD. and a few others have been educating the public about the physiological primacy of the CIS molecule form of Omega-6 linoleic acid as opposed to the toxic TRANS form in processed foods & the pharmacological overdoses of eicosapentanoic (EPA) & docosahexanoic acids (DHA) in from fish oil, which are physiologically unnecessary anyway and are not true EFA's since the body can make them from the parent base substrate Omega-3 such as is found in Flax oil.

    In answer to the questions regarding the optimum O-6 to 3 intake ratio, EFA researcher Mary Enig PhD. & others state that taking more than 3 or 4 grams of polyunsaturated fatty acids per day can induce too much phospholipids uptake into the cell's bi-lipid membrane structure & make it too "leaky".

    • Jack August 6, 2011 at 11:01 pm - Reply

      @cancer… had to be written because if those two UCLA students were believing this others in our community must too.

      • Arborescence July 13, 2015 at 10:39 am - Reply

        Is this possible to make an overdose of DHA if we eat too much fish eggs?

  18. Gene K August 7, 2011 at 7:01 pm - Reply

    Dr K, do the same recommendations hold for APO E4 people? I gathered from your comments to Dr Davis's post about APO E4 that this category of people should avoid PUFAs (

    • Jack August 7, 2011 at 11:04 pm - Reply

      Absolutely Gene…….for APoE4 you must be careful with all PUFA's. But this is athe biggest key. You must keep your HDL high by using coconut oil as your number one diesel fuel and simultaneously keep your HS CRP as close to zero as one can imagine. I also think your insulin levels need to be as low as possible. A low carb high fat paleo diet is the Rx you need to consider in that case with your doc.

  19. cgb August 8, 2011 at 5:24 am - Reply

    Since our bodies are affected by the relative excess in our systems of Omega 6 deriving from long term patterns eating, I had the impression that it was better to supplement Omega 3 until the balance is restored. If I understand this article correctly, we need to take in some Omega 6 at all times, even if our tests show a relative deficit of Omega 3.

  20. cancerclasses August 8, 2011 at 1:18 pm - Reply

    @cgb: If you look at the Eicosanoid pathway chart in Mary Enig PhD's article "Tripping Lightly Down The Prostaglandin Pathway" you'll see at the top of the chart that production of the COMPLETE suite of prostanoids, leukotrenes, lipoxins and thromboxin eicosanoids requires a balance of BOTH parent essential oils, meaning the organic CIS form of Omega-6 along with Omega-3.

    If you overwhelm the pathway with an oversupply of Omega-3's that dominate the delta 6 desaturase enzymes, and omit or don't take more Omega-6 than Omega-3 you're IM-balancing the system by not providing the base substrate oils for synthesis of all the eicosanoids derived from Omega-6 on that side of the chart & pathway, including the body's most powerful anti-inflammatory agent PGE1 prostaglandin and PGI2 prostacyclin which is the body's most powerful anti thrombotic and anti platelet adhesive which works as a blood thinner & helps maintain proper blood viscosity, and therefore pressure, as well as blood circulation velocity (speed).

    Omega 6/3 balancing requires stopping the intake of ALL adulterated, oxidized TRANS molecule forms of Omega-6 (TRANS fats) because TRANS molecule fats disrupt the body's entire hormone production & regulation system by blocking the absorption & utilization of all the essential fatty acids the hormone system requires, and then supplementing with the correct ratio of omega-6 & omega-3 at around a 1 to 1 ratio up to a 2.5 or 3 to 1 ratio.

    For more do a Google search for the article "The Scientific Calculation Of The Optimum PEO Ratio" by Brian Peskin.

  21. Jack Kronk August 9, 2011 at 4:00 pm - Reply

    Dr Kruse – I know that our current food availabilities in 2011 have changed drastically over the centuries and all that, but even still considering this… I have always had a hard time understanding why supping with so much fish oil has been propagated so much in the last few years. We never would have had access to eat that much o3 thousands of years ago. And if even there are cultures or 'tribes' that live off of fish, maybe they were actually getting too much o3, like you mention here.

    But at this point, my only sources of o6 pufa are currently bacon, some occassional chicken, and avocados. That doesn't comprise very much of my diet so I should probably go get tested for o6/o3 levels. (which I still don't know how/where to do that.) Anyway that is why I was so reluctant about giving up raw almonds/pecans. I just don't think that the minimal amount of Pufa I get coudl possibly be a problem when others are getting 20 times what I eat.

    By the way.. I took Borage Oil for a time based on Rieske's recommenation. He specifically makes a case that since Borage oil is rich in GLA, it's a the best source because it's a 'special' type of o6. Natty asked abotu that specifically. Stephen Aegis also asked about this on PaleoHacks a long time ago but nobody really knew the answer. I stopped taking the Borage Oil but most of what I read about it was very positive.

    Thanks Doc,

    Jack Kronk

    • Jack August 9, 2011 at 4:19 pm - Reply

      Im a large fan of obtaining O3 from food first as you know. But those who paleo with regular grain feed meats need to do something. And same thing with farmed fish……but sardines are dirt cheap. The only people I push fish oil with are the real sick ones. Jack realize who I see in my clinic is not representative of most people on MDA or PH etc…….You guys are way better off than most of my patients. I think y'all forget that context sometime. Those people who usually have severe pregnenolone steal or seriously overweight need drastic refurbishing. there is no way to avoid the fish oil there. I am very cautious with fish oil in neurodegenerative diseases for the reason mentioned in the blog. Again this is not who we see on PH or MDA either.

  22. cancerclasses August 10, 2011 at 12:22 pm - Reply

    Oops, correction to my comment at #17: should read "eicosapentanoic (EPA) & docosahexanoic acids (DHA) in from fish oil, which have a naturally low physiological demand and conversion rate anyway…"

    • Jack August 10, 2011 at 2:07 pm - Reply

      I understood where you were going… harm no foul.

  23. Susan November 14, 2011 at 1:00 pm - Reply

    I am wondering is it the The Omega-3 and 6 HUFA Testâ„¢ you are talking about? Kind of expensive to buy the kit but, I will if I need to. A doctor can't order this? I still want to take Vital Choices salmon oil with D3, but you don't seem to think everyone needs this. I need to read more and think it through. YOu feel taking D3 is okay? I am hesitant because of what I read about D3 and the liver. It was so long ago I can't remember what it said. That's the problem here. With me being so tired all the time, I often get confused and tire from all. this reading.

  24. Paul December 1, 2011 at 3:30 pm - Reply

    Can fish oil exacerbate thrombocytopenia?

    • Jack December 1, 2011 at 8:01 pm - Reply

      @Paul not that I am aware of.

  25. Alicia January 8, 2012 at 4:58 pm - Reply

    As someone with high CRP (16) and low HDL (46) and needs to lose over 100lbs I am confused about the Fish Oil supplement. Starting the reset tomorrow and picked up D3-5000, CoQ-10 Ubiquinol, Multi and Fish Oil 1000mg today. The bottle says, Fish Oil 1000mg with 300 mg Omega-3 Fatty Acids…is this the wrong type of supplement? If so, what Omega 3 should I be looking for or should I not take any and use Coconut Oil exclusively during the reset?

    • Jack January 8, 2012 at 5:16 pm - Reply

      @Alicia you need to eat a ketogenic paleo diet with lots of coconut oil and lots of Fish oils and krill oil and you single number one goal right now it flat line your CRP and raise your vitamin D levels…….you need to serial test and readjust. You also need to follow the leaky gut Rx too because with that CRP your gut is a sieve. ITs not hard…….just keep reading and following along.

  26. Alicia January 8, 2012 at 6:08 pm - Reply

    Thank you Doc…will find the ketogenic paleo diet & leaky gut Rx info tonight so I can start first thing in the AM. Should these be in conjuction with the Leptin Reset (as in the BAB in the morning)?

  27. Alicia January 8, 2012 at 6:12 pm - Reply

    Forgot to mention that I have a shellfish allergy. What can I do about Krill oil in that case? Should I be looking for an Omega 3 that is only DHA/EPA? Thank you

    • Jack January 8, 2012 at 7:45 pm - Reply

      @Alicia get a test to see if Krill also causes allergy. It may not.

  28. Alicia January 8, 2012 at 9:26 pm - Reply

    I will definitely do that. My doc is out of the country until mid February and by then I will be 4+ weeks on my way to Optimal health! I have looked at the leaky gut info and plan on incorporating the probiotics, eliminating dairy, fermented foods and load up on coconut oil for sure. As far as the ketogenic paleo diet (I don't have Robb's book only Sisson's but will get it soon), I am guessing that it is VLC,whole foods, pastured meats, organic veggies (no nightshades), coconut oil, etc. and that is what I was planning with the Leptin reset.

    Am I okay to go ahead with the Leptin Reset Rx @ 25 daily carbs max and incorporating the Leaky Gut Rx along with it and in a way attacking the Leptin, weight, inflammation & leaky gut issues at the same time?

    Thanks for taking the time to do what you are doing:)

  29. Suzanne January 13, 2012 at 9:34 am - Reply

    Do recommend the combination of fish and krill oil for everyone?

    • Jack January 13, 2012 at 9:41 am - Reply

      @Suzanne no I dont. For neurodegenerative diseases I like Krill oil a lot more and I dont like fish oil much at all.

  30. […] mammals. This is why I cautioned people early on, that 0mega 6 fats are not always bad for humans here. Mammalian neural circuitry is the key to understanding where optimal really lies. If you do […]

  31. JanSz March 7, 2012 at 4:01 pm - Reply

    dr Kruse,
    you wrote:
    omega 6/3 ratio
    This ratio is 2 to 1 to 6 to 1 by most good studies I have read.

    You also warn:
    My concern is that fish oil supplements are becoming the “proxy” for good dietary choices..

    There is variety of tests available to check our oils content.
    I did two of those tests.
    One, from Spectracell
    The HS-Omega-3 Index® measures the percentage of EPA and DHA levels in red blood cell membranes (RBC’s) which are highly correlated to myocardial membrane omega-3 levels.

    my omega6/3=2.7
    the index=8.8% (desirable starts at 8% and goes up)

    In reporting they emphasize the index, while omega6/3, AA/EPA ratios and content of individual analytes seem to be of secondary value, they have not provided desirable ranges for them.

    there is no specific instructions there on how to improve.
    The other test I did (few times), is from Genova Diagnostics
    Essential and Metabolic Fatty Acid Analysis.

    They do not highlight any overal index but provide
    desirable reference ranges for individual analytes
    desirable reference ranges for some ratios (including omega6/3)
    evaluate metabolism and give its status relative to desirable range, point to relevant micronutrients that would help to improve status

    Dr Kruse

    Thank you very much for a ground breaking research and having good heart to share it with everybody (for FREE).

    This test from Genova seems to be a poverfull tool.
    It would be nice if you could find a place in your Quilt that would discuss Essential and Metabolic fatty acids in much more detail.

    Finding omega6/3 ratio hardly even scratches a surface of this problem.

    (On post #6 above, you recomend 1:1 for omega6/3 ratio)
    on my test, Genova recomends omega6/3(3.4-9.4) as desirable range.
    That desirable range includes green and yellow bands, red being totally undesirable.
    Optically estimating, the green range is about (5-8)

    In light of your exchange with cancerclasses
    “omega-6 & omega-3 at around a 1 to 1 ratio up to a 2.5 or 3 to 1 ratio”
    Genova’s recommendation may be interesting.

    But in the mean time, I am low on Omega6, and per their recomendation can change that by eating:
    (vegetable oils, grains, most meats, dairy)

    I do not eat vegatable oils or grains, what is going to happen??

    My test can be seen here

    That test reflect my diet and EPA/DHA/GLA/AA supplementation.

    You have mentioned numerous time about Factor X.
    Is it coincidence that to supplement AA,
    Molecular Nutrition X-Factor Advanced w/Arachidonic Acid 100 Softgel
    is used?

    When people eat fish oil, krill oil or pills with EPA/DHA
    those sources usually have large amounts of EPA and much less DHA.

    Reading Genova’s comments I have come to conclussion that it is worthwhile to emphasize on DHA supplementation. Possibly hold off on EPA??
    That should improve estrogen/progesterone binding, insulin work.
    Low DHA levels are associated with breast cancer, PMS, hypertension, diabetis, and depression.

    It is not what we eat, it is what we do with it.

    Free range, grass fed meats are what we should eat. They contain less omega6 in relation to omega3.
    Meat from supermarkets contains higher amounts of omega6.

    I would like to reconcile that wisdom with another (fact??).

    Aging population, and or nutrient defficient, develops problem with enzyme Delta-6 desaturase (converts LA into GLA) (they are omega-6)

    down the same omega-6 line defficiencies in AA develops.

    When I listen to a health program over the radio, supplementing with omega6 (GLA & AA) is often big part of the program.

    What source of GLA is your favorite (and why):

    borage oil (cheap)
    evening primrose oil (more $$)
    black currant oil


    • Jack March 7, 2012 at 4:09 pm - Reply

      @Jansz to get up your 06 I would rather you eat nuts…..not PUFA oils. GLA is good. But I am no fan of any 06 supplement i’d much rather you eat food with it. I also would tell you as humans age they collect many glycation products in their membranes and this destroys signaling. That is a different levee I have yet to tackle but it is vitally important to older paleo like you and Art DeVany. YOur goal is to run cool and keep your ratio of 06/3 around 4 to 1…….with food. There are doctors who offer IV infusions for cell membrane rejuvenation. Look into Johns hopkins researcher Patricia Kane. In april they are having a symposium in NJ on this topic. Youre in NJ and you should go. I would love to go but I am being pulled in many different directions now.

  32. JanSz March 7, 2012 at 5:44 pm - Reply

    What kind of nuts?


    • Jack March 7, 2012 at 6:33 pm - Reply

      @Jansz for you, almonds, pistachio, macadamia, brazil, walnuts are some I think are OK.

  33. Jamie March 12, 2012 at 7:39 am - Reply

    Jack, you mentioned a symposium in NJ by Patricia Kane. Do you have any more info on this? I tried googling it, but didn’t find anything. I’d like more details on when/where, etc. Thanks!

    • Jack March 12, 2012 at 9:47 am - Reply

      Patricia Kane, Ph.D.
      Neurolipid Research Foundation 501c (3)
      45 Reese Road
      Millville, NJ 08332
      856 825 2143 Fax

  34. Jaime March 12, 2012 at 10:04 am - Reply

    Thanks Dr. Kruse.

  35. Shijin13 March 25, 2012 at 10:36 am - Reply

    Dr K after re-reading just now – with the context of the CT series – it makes WAY MORE SENSE NOW!

    Ok… so If I’m eating in season, my O6 should be coming from the meat, veggies & Dairy(If tolerant) that I eat, same w/the O3. And supplementation should not be required, especially if your O6:O3 ratios are <6:1 (mine are 2:1)

    My question is if you know you have inflammation (arterial in my case) – is O3 supplementation necessary? my PCP still wants me to take a balanced EPA-DHA fish oil, as well as Krill oil to help w/the inflammation.

    I'm thinking that w/my ratios w/the combination of seasonal eating, and CT – I no longer need supplements of O3s? is this correct?

    • Jack March 25, 2012 at 10:45 am - Reply

      If youre at 2:1 and Cting I think your fine…..but you only need to be 4:1 2:1 is where marine mammals who live deep in the cold approach the 1:1 ratio…….when you live in deep cold your ratios then begin to become 03/6 extreme the other way……and this changes adipocyte biology as we understand it……..this is why water based mammals have blubber and land based ones only get it when it is warm………and shred it in cold land based situations……..its all evolution’s work fitting us into the environment and the cell membrane epigenetics is what controls the show.

  36. Shijin13 March 25, 2012 at 11:11 am - Reply

    Ok…thanks.. Then I’m going to stop the O3 and the Krill oil for now… and just let my diet be my supplementation…

    so the CT itself + Paleo diet will reverse all inflammation, no supplementation required…

    • Jack March 25, 2012 at 11:14 am - Reply

      @Shijin when you are below 4:1 there is no reason to go lower……unless you are a walrus or a whale literally not figuratively

  37. Lauren March 30, 2012 at 3:39 pm - Reply

    Dr Kruse, I am apparently either the only one confused on the forum or the only one who cares (along with JanSz) but here is my question… I realise the suggested optimal ratio is roughly 4:1 and that food sources/optimal diet is ideal. However, if you compare the way Dr Kane is calculating the 4:1 ratio it is NOT the same as others are calculating it. For example, someone posted test results with a ratio of 2.55:1 (total O6 to total O3). But when JanSz replied he said, according to the way Dr Kane calculates (which is LA to ALA) and using the exact same labs you get a 1:63 ratio. This is extremely confusing to me and I have not seen resolution of this discrepancy anywhere. It is further confusing because Dr Kane recommends a supplement of decidedly non-paleo oils (flax and sunflower) with diet and possibly fish oil supplementation.

    I really get that the key is optimal balance and context. What I remain unclear about is if the emphasis is meant to be on ALA to LA or total O6 to O3. And if this distinction is important in your view. It appears to be in Dr Kane’s and you referred us to her work, but perhaps it was just for the understanding of context re: importance of O6’s and health, not for her specific formulations and calculations?

    • Jack March 30, 2012 at 4:25 pm - Reply

      Dr. Kane use’s a standard LA/AA ratio and that is part of her PKT protocol. you have to use correct conversion to get your 06/3 ratio from different labs just like many other labs…….If youre below the 4:1 ratio correct it with food… nuts, pork, olive oils……..etc.

  38. Krusing_to_Optimal_in_CA April 19, 2012 at 5:36 pm - Reply

    Interesting newspaper article on whether Fish Oil is good or bad for you…,0,2337564.story

    The most amazing quote in this article, to me, is “maybe these days, drugs such as statins make it hard to detect a benefit from fish oils because the statins and other meds are already helping people so much. This could explain why more recent trials show no omega-3 benefit while older ones did.”

    Really? Ya think THAT is why they couldn’t detect any benefits? Not because maybe the STATINS THEMSELVES were causing issues fish oil simply could not overcome (without dropping meds and changing the diet?).

    Glad I learned critical thinking in school…. and that I read Jack’s blog.

    • Jack April 19, 2012 at 6:45 pm - Reply

      @Krusing you are becoming a super duper starfish…..share this knowledge with people!

  39. Janice Childress April 26, 2012 at 9:08 am - Reply

    Dr. Jack,
    First of all thank you for what you do! My son has P.A.N.D.A.S., strep titer levels are 980, he has mycoplasma pneumoniae, and Lymes. He is now 14, was diagnosed at 10, but he had issues years before that and we could not get a proper diagnosis. I had given krill oil for his brain inflammation, and his Tourette’s increased dramatically. Once taken off they slowed down. I recently purchased Nordic omega 3,6,9. Should this be ok for him to take? He can not tolerate medications so we chose to go the natural route as possible.

    His thyroid is low, triglycerides are on the high side (which I was told was carb intake). His testosterone, and pituitary levels are low but with in normal range. He is not developing as he should, hardly any armpit hair, no leg hair, no facial hair, some pubic hair but size in penis has not increased since he was a small child. A bone study indicated he is in normal limits.. He has size 12 shoes, he is 5’9 .

    We have removed milk, sodas have been gone, and we limit sugar intake as much as possible. I would love to buy all grass fed meats, but I’ve got 3 men in the house and my budget just doesn’t allow it all the time. I plan on getting one of the paleo diet books and making some changes.

    Just curious on your thoughts! Thanks!

  40. E June 5, 2012 at 10:37 am - Reply

    I have recently undergone a D&C for post menopausal bleeding. The Dr said I had inflammation of the womb lining and recommended taking O3 oils. I’m still awaiting biopsy results but Dr thinks nothing ‘suspect’ will turn up. I haven’t been able to test my O3:O6 ratio yet, but should I be taking more o3 based on my situation? I currently take 1g of krill oil on days I don’t eat fish. Thanks for your help Dr. Jack.

    • Jack June 5, 2012 at 11:41 am - Reply

      @ E I would lean on your doctor for this advice since they have seen your endometrial linings and they have a unique insight.

  41. dan han June 9, 2012 at 12:33 am - Reply

    Totally forgot about this article. The comments especially are gold! As I’m not completely lean yet, I’m sure my O6/O3 ratio is hardly skewed in the opposite direction but maybe one day I’ll have the luxury to make sure my O3 isn’t too high lol. Great work, doc

    • Jack June 9, 2012 at 7:20 am - Reply

      @Dan Han……this article is a foundational article in the Quilt for cell membrane signaling……it builds the foundation for the coming CT series when someone begins to read the blog.

  42. dan han June 9, 2012 at 12:39 am - Reply

    I’ve also been doing my own research on excessive O6. I learned that excess O6 (esp under influence of high insulin levels aka SAD) gets converted into not only pro-inflammatory eicosanoids but also into endocanniboids that may act centrally to increase appetite (similar to THC?). My large appetite has always been a problem with weight loss and even on a ketogenic Atkins diet in the past it was still very very high

    • Jack June 9, 2012 at 7:26 am - Reply

      @Dan Han This is why long term atkins had a major problem…..when people ask me if the Epi-Paleo diet is like Atkins I tell them it is worlds apart……..this is one of those reasons.

  43. My Program | Against The Grain June 16, 2012 at 8:21 am - Reply

    […] Krill Oil: 500mg 1x per day.  I know I should probably increase this to 3x per day, but I usually forget to take it except in the morning. I think I probably make up for this by eating wild-caught seafood at least 5 times/week. Reason for taking: Improved O6/O3 ratio. […]

  44. Shane March 13, 2016 at 6:05 pm - Reply

    Dr. Kruse

    I have Pyroluria and am told not to take omega 3 supplements and to supplement with GLA.

    Do you agree with this?


    • Jack Kruse March 13, 2016 at 9:43 pm - Reply

      i dont recommend supplements generally.

      • Shane March 13, 2016 at 10:05 pm - Reply

        Thanks for the quick reply!

        What to you recommend as the best source of GLA?

        What is your opinion on pyroluria? Is there a better way to deal with it than the standard high dose zinc, B6, and GLA supplements that’d you recommend? Do you think the Leptin Reset Rx would help?

        Thank you for your time!

        • Shane March 13, 2016 at 10:14 pm - Reply

          Also, they say that omega 3’s are bad for someone with pyroluria, do they mean from food or supplements, both?


          • Jack Kruse March 14, 2016 at 6:49 am

            Shane DHA is not a problem in this condition at all. That is a meme that makes it circles every so often from bad info from paleo circles. Pyrroles bind with B6 and then with zinc, thus depleting these nutrients. When you eat an Epi paleo diet and get int he sun these patients usually need nothing else. The disease itself has very few manifestations and tends to be a bigger deal in kids who are undiagnosed because their brain ar not mature and it can affect their behavior.

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