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During the 1980s Professor Behan from Glasgow demonstrated that essential fatty acids could be very helpful in treating fatigue syndromes and indeed he conducted a placebo controlled double blind trial using ‘Efamol Marine’ – a mixture of evening primrose oil and fish oil, with beneficial results. See Effect of high doses of essential fatty acids on the postviral fatigue syndrome

See also Clinical Impovements in CFS/ME: The Role of Fatty Acids by Professor Basant K Puri for more information and studies.

Professor Puri, who is a Professor at the MRI Unit, Hammersmith Hospital and also Head of the Lipid Neuroscience Group at Imperial College, London, has picked up on some of this work and had similarly good clinical results. He wrote a book called “Chronic Fatigue Syndrome, a Natural Way to Treat ME” published in 2005. See link for 'Chronic Fatigue Syndrome: A Natural Way to Treat M.E.'

Professor Puri’s main work is to do with neuro-development in children and he demonstrated that getting the right balance of essential fatty acids was essential for normal brain development, behaviour and intelligence.

Correct balance of essential fatty acids in the body is essential for many normal processes

  • They are vital to maintain the correct structure of cell membranes. Without EFAs the cell membrane becomes more rigid and this reduced flexibility may result in abnormal functioning of receptors and enzymes that lie in or are held on membranes. One of the things that I often find in the people on whom I do mitochondrial function tests are problems with oxidative phosphorylation. The bundles of enzymes which are responsible for oxidative phosphorylation lie on mitochondrial membranes and are called crystae. If these enzymes are not held in their correct configuration, then they cannot work properly and so this could be a reason why oxidative phosphorylation goes slow in some patients. There is a particular phospholipid peculiar to mitochondrial membranes, called cardiolipin, and by doing cardiolipin studies, this gives us some insights into what is going wrong with mitochondrial membranes.
  • Essential fatty acids are necessary to make the eicosanoids, which are essential for normal inflammatory responses.
  • Essential fatty acids are necessary to make natural sleep mediators.
  • Essential fatty acids, particularly EPA, are directly and indirectly virucidal – that is to say they kill viruses.

EFAs protect us from viral infection

Chronic fatigue syndrome is often triggered by viral infection. Normally we can get all the essential fatty acids we need from natural oils in the diet such as sunflower oil, safflower oil (Omega 6) and linseed oil (Omega 3). However, the first step for these fats to be converted into essential fatty acids requires an enzyme delta 6 desaturase. This enzyme is inhibited by viruses. So the viruses have worked out a very clever way of ensuring their survival in the body. If they inhibit delta-6-desaturase, then the body cannot make the essential fatty acids it needs in order to kill the virus.

Professor Puri and Professor Behan therefore worked out that we can get around this problem by supplying essential fatty acids, which are already converted, namely evening primrose oil and fish oil. The actual preparation of oil and the dose seems to be quite critical. That is why Professor Puri specifically recommends a product called VegEPA, which contains the right balance of evening primrose and fish oil, which is in the correct form to get the result. He recommends high doses, i.e. eight capsules a day for three months and then reducing to a maintenance dose of four capsules daily. For children under the age of 14 the adult dose should be halved.

Good fats and bad fats

Treating chronic fatigue syndrome is all about balance and in addition to getting the right balance of essential fatty acids in the supplements, it is also important to avoid the bad fats in the diet. The main oils used for cooking should be olive oil, animal fats (such as lard or mutton fat) and butter (so long as one is not allergic to dairy products). The bad fats which should be used with caution are the transfatty acids, hydrogenated fats and margarines. Because of where the block is in the system, one should use sunflower oil and safflower oil in moderation.

Essential fatty acids cannot be made in the body – they have to be consumed! So eat them!

  • OMEGA-6 FATTY ACIDS - linoleic acid, i.e. sunflower, safflower
  • OMEGA-3 FATTY ACIDS - alpha-linolenic acid, i.e. linseed oil (otherwise known as flaxseed oil)

Delta-6-desaturase is the enzyme which converts the above oils into the oils below - see the first step in the diagram below. This enzyme can be blocked by viruses. Further conversion of these oils occur in a 'metabolic line' - again please see the diagram below.

--Gamma linolenic acid (GLA) i.e. Evening Primrose Oil,borage seed oil
--Dihomo-gamma-linolenic acid (DGLA)
--Arachidonic acid (AA)
--Eicosapentanoic acid (EPA) i.e. fish oil
--Docosahexanoic acid (DHA)

Essential Fatty Acids Metabolic Line

AA is essential for killing viruses and making sleep hormones. AA and DHA are essential for membrane fluidity and may have profound effects on communication between cells, including nerve cells – clinically deficiency may cause poor short-term memory and inability to think clearly.

The diagram helps explain one of the reasons why vegetarianism is a risk factor for CFS – if vegetarians don't eat fish, then they may get very little DHA through their diet and if they also have a blockage of delta-6-desaturase then they cannot make DHA in the body. That is the advantage of VegEPA – it bypasses this block by directly providing EPA which helps to metabolise DHA.


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