San Antonio Express-News (Sunday)
Fish oil helps dry eyes but may trigger AFib
Q: I have had atrial fibrillation, or AFib, for 15 years. Recently, I read about a study of fish oil at Cedars-Sinai. Apparently, the combination of EPA and DHA can cause AFib if the dose is over 1 gram.
I was taking an over-thecounter product for dry eyes. I stopped the product and have had no AFib in more than two months.
A: Fish oil has a good reputation for treating dry eyes. However, a placebo-controlled trial does not show that it’s better than olive oil (New England Journal of Medicine, May 3, 2018).
Some doctors recommend fish oil or prescribe a purified version of EPA called icosapent ethyl (Vascepa) to reduce the risk of heart attacks (EClinical Medicine, August 2021). A meta-analysis of 38 studies shows that such omega-3 acids can be helpful. On the other hand, EPA (eicosapentaenoic acid) alone increases the chance of AFib by about 35 percent. It may also raise the chance of bleeding, especially if taken with anticoagulants like apixaban (Eliquis) or warfarin (Coumadin).
Q: I was intrigued to read on your website that a lowcarb diet can help heartburn.
Eliminating grains has reduced my gastritis pain a lot, as I’ve just realized. If I indulge in an occasional piece of cornbread or gluten-free bread, I seem to have more pain the next day. I’ll pay closer attention and maybe cut down on carbs even more. Perhaps others will benefit
from this, too.
A:
Most people, including physicians, don’t automatically think of carbohydrates as culprits behind heartburn. Yet research 15 years ago demonstrated that a very low-carb diet can help relieve chronic heartburn (Digestive Diseases and Sciences, August 2006). Simple carbs, such
as bread, pasta, rice and cookies, may be particularly troublesome. Some people find that their heartburn is much better if they avoid grains (Nutrients, March
28, 2021).
Mayo Clinic experts suggest trying lifestyle approaches, such as diet, before taking acid-suppressing pills ( Journal of Primary
Care & Community Health, January-December 2021). You can learn more about these approaches in our eGuide to Overcoming Digestive Disorders. This online resource may be found under the Health eGuides tab at PeoplesPharmacy.com. We also discuss celiac disease, IBS, constipation, diarrhea and flatulence.
Q: Beginning in my 30s, I tried a variety of prescribed antidepressants. The results were uniformly disastrous. When I was 50, I found a psychiatrist who diagnosed me with seasonal affective disorder, or SAD, and prescribed a light box. It’s been life changing.
I would encourage people who have problems with depression, especially if it’s more serious in the winter months, to investigate light boxes. Mine has been a huge help for over 20 years. I also found a counselor who used CBT (cognitive behavioral therapy), but for me it was an adjunct to the light box.
A:
Bright-light therapy has been used to treat SAD for at least three decades. A review of 19 randomized controlled trials found such treatment to be effective (Psychotherapy and Psychosomatics, January 2020). Thank you for reminding us that some people find light therapy to be quite helpful.