Saturday, December 08, 2007

The omega syndrome

I've been trying to make sense of all the new information that has emerged from the discovery of Samter's Triad. If Wikipedia and one or two other articles are to be believed, this is quite a well researched condition.

The following is an entirely unscientific account of the situation pieced together in my head over the last 24 hours:

The salicylate hypersensitivity seems to be caused by an interaction of salicylate and omega-6 fats, perhaps only some omega-6 fats as it's a substance called arichadonic acid. This interaction leads to excessive production of inflammatory substances called leukotrienes. So it seems the problem we have is not with the body's handling of salicylate but with its handling of omega 6.

Omega 6 and omega 3 are essential fatty acids, found in various mixtures in most oils and fats. Sunflower oil is rich in omega 6 and rapeseed oil in omega 3.

It's the leukotrienes that cause a range of allergy-like symptoms. Unlike pure allergy, however, they may not represent an immune reaction. Singulair works by blocking them - so must be pretty good.

So the worst thing possible would be a diet rich in omega 6 and salicylate. The ideal diet would be low in omega 6 and zero salicylate. And a low salicylate, rich omega 6 diet might also prove not very effective - and that may explain why attempts to reintroduce are not very successful.

Now I've been avoiding sunflower oil and all unspecificied vegetable oils, especially margarine, because I thought they might contain salicylate. And I've been using rapeseed oil because I thought it was zero salicylate. So that's just a lucky coincidence.

Interestingly a couple of weeks ago a bottle of sunflower oil popped up in our shopping and that was about the time I got terrible rheumatism of the neck and shoulders. Last night I went to a function and had lots of cheese, ham and egg sandwich. This morning I've woken up with a sore eye and other minor symptoms. Good chance they were spread with margarine.

Of course omega 6 is found all over the place. The really bad news is that it's rich in cashew nuts, which are the only salicylate free nuts. I've been relying on them for snacking and quick lunches, although I must admit I've had my doubts about whether they are okay.

So what would be the impact of trying to eliminate omega 6 from the diet? Apparently it's an essential fatty acid - that means you have to have it in the diet. If you follow the links through Wikipedia you come to prostaglandins and it becomes very unclear how important they are. I think I read that omega 6 deficiency leads to hair loss, dry skin and possibly increased prostate cancer risk. Dry skin sounds familiar.

But if the body isn't handling omega 6 well in any case and is wrongly converting it to leukotrienes rather than other substances, are we already sufferring from the effects of omega 6 deficiency?

Wiki-browsing leads me to a biologist called Ray Peat who suggests there may be other ways of compensating for essential fatty acid deficiencies. I'm posting the link without even having read his work yet - but will be browsing it.

I promised an unscientific run-around. If you're an expert, I'd welcome your comments but do try not to make them too technical.


Sasha said...

I suffer from Samters/salicylate intolerance and have read that if we bring more omega-3 into the diet it will help with the reactions. My problem is I can't do fish oil because it is high in histamine/amines (also sensitive) and I'm not sure about flax. Have you tried flax oil? I'm trying to figure this all out as well.

RAS said...

Hi NTH. For cooking we use rapeseed oil, which I understand is rich in omega 3. In the UK it's usually sold as cheap vegetable oil and you have to read the small print to check its rapeseed. Hadn't heard about histamines in fish oil. Bananas, especially unripe ones, are similar I believe.

Horizon said...

Hi Nat. From what ive read and about to pursue, molecularly filtered fish oil is free of organic compounds / contaminants and is safe from a histamine-free perspective. I had a horrendous histamine poisoning last week after 3 days of 10g per day unpure fish oil. Not fun. Re Flax: stay away if your very sensitive or trying to rebuild your tolerance. Its apparently not high is sals so in time may be able to use it as an alternative omega 3 source. But pure fish oil will be far more potent in EPA/DHA and safer.

Anonymous said...

HI! I am omega 3 intolerant so I have to have these weird injections, followed by adrenalin to keep myself alright. It's really inconvenient because its in nearly everything!

Anonymous said...

Have you had any experience with an omega 3 allergy? I have started having reactions (swollen stomach, very painful stomach, hives, itching scalp, etc). With avacado, eggs, almonds, and canola oil. The only link between these is omega 3. Not even sure this is the correct allergy link. Just needing direction. Can't seem to find any answers online. Thanks.

Duncan Green said...

Well your article pretty much mirrors my own investigation into Samters which I've had for years but which only became a problem in the last few years where I adopted a 'healthy' diet. This diet was broadly based around The Whole 30 ( see and Paleo diet. Undoubtedly this would have been very heathy had it not been for our friend the Aspirin Triad.

I completely agree that this condition is about disregulation of arachidonic acid metabolism. In essence Aa causes inflammation. The degree of inflammation that occurs can be reduced by including more omega 3 fats. These compete in the body for enzymes shared with the Aa cascade. The more EPA and DHA you can produce or consume the less enzyme (Google delta 6 desaturated) is available for Aa conversion.

Is I am experimenting with fish oil and flaxseed oil in addition to reducing omega 6 fats. Avoiding vegitable oils like the plague. My breathing seems better but I am not long since a course of steroids so is hard to tell what impact is occurring. One thing I found amazing, from research the change in dietary omega 6:3 ratio is reflected in cell biliplid membrane after 4-6 weeks. This is an incredibly short period with which to experience a palliative effect at such a profound level. I am quietly optimistic.

Your point about Aa deficiency is a good one and could be a problem for sustained use of fish oil as that further depresses Aa absorption. One thing that's not clear to me is that if salicylates depress Cox1 enzyme function (which up regulates the more inflammatory Cox2 enzyme) what happens when Cox2 is stimulated less by reduced Aa? There are so many questions. However medicine is catching up and there are studies going on right now into the viability of both high omega 3 and low omega 6 intake. So we could be on the right track.

Good luck.

el confundido said...

Hi Duncan,

Thanks for the information in your post! I have Samters and have only started researching in detail (just been living with the symptoms for past few years). I was wondering what is your opinion on aspirin desensitisation treatment? I have seen online that this can be of benefit and can decrease the liklihood of polyps re-occurring after surgery to remove them. Is that still the current thinking?

Duncan said...

Hi El Confundido,

I think aspirin desensitisation is one way to go and some people do get relief though mainly their nasal symptoms more than the asthma. It is not recommended here in the UK and I can see why. The problem is the long term use of aspirin can cause other problems. Also you only have to miss one or two days taking your pills and you have to be desensitised again.

Something of greater potential is the Interleukin 5 antagonists due to be available this year. These will inhibit the release of eosinophils which are the 'suitcase' cells that carry all the nasty inflammatory metabolites around the body. These drugs could really improve asthma symptoms. Ask your healthcare worker about these. In the UK you need to have an eosinophil level above 0.5 to be considered (mine is 0.8 :) ).

Good luck


p.s sorry for the delayed response but I didn't get an email that someone had replied to my post.

Duncan said...
This comment has been removed by the author.
Duncan said...

Not sure why it's shwing me as Unknown :(

Duncan said...
This comment has been removed by the author.
Manyhahama said...

I am new to this but feel I am dealing with Samters and have had it a long time now. My allergies lately have really gotten extreme and altho i don't seem to exhibit asthma (did as a child) I do have chronic inflammation and chronic sinusitis. My Chiropractor put me on Standard Process Super EFF in place of the fish oil...more easily digested and absorbed...I couldn't tolerate fish oil...seem to do okay with Evening Primrose Oil and I use flax seed in my morning green drink, which I seem to be okay with. What I get the most inflamed with is fats and red meats and alcohol....but it is hard to tell anymore, seems like everything causes a reaction. Thanks for the info...I have alot more to learn.
All the best,

Shimul Roy said...

There is definitely a lot to learn allergy sufferer for allergy test.

I really like all of the points you've made.

Unknown said...

Excellent post on omega syndrome and really helpful for many sufferers. I would like to thank you for helping the sufferers with the details and updated information of The omega syndrome.

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Anonymous said...

Great post and blog - learned a lot.Your symptoms ar similar to mine -after nearly a decade of searching, finally have a correct diagnosis: Mast Cell Activation Syndrome. If there is a mast cell specialist in your area, might be worth checking it out. Symptoms have eased since going on a low histamine diet, and taking meds to block different histamine types and also taking the one you mention singular which blocks leukotriene.Also take a DAO supplement.

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