Fish oil may lower bad cholesterol. Top expert in Integrative Medicine from California talks about natural methods to decrease coronary artery disease risks.

How to use fish oil for coronary artery disease treatment? Dr. Anton Titov, MD. How fish oil lowers cholesterol? How to prevent second heart attack by integrative medical treatment. Fish oil use in secondary prevention of heart disease. How safe is fish oil use for coronary artery disease. Omega-3 fatty acids change lipid profile. How fish oil improves cholesterol profile? Are there problems in using fish oil for heart disease prevention? Fish oil use to lower high triglycerides. Video interview with top expert in integrative medicine. Medical second opinion ensures that diagnosis is correct and complete. Dr. Anton Titov, MD. Medical second opinion also helps to choose the best holistic natural treatment strategy for coronary artery disease. Seek medical second opinion on coronary artery disease and be confident that your treatment is the best. Fish oil for coronary artery disease. Integrative medicine treatment. Dr. Anton Titov, MD. Fish oil and heart disease. Fish oil is well known. It is widely used in treatment of heart disease. There is scientific evidence that fish oil decreases high cholesterol. Fish oil is used to treat hyperlipidemia. Dr. Anton Titov, MD. Can you please discuss use of fish oil in prevention of heart disease? Dr. Kevin Barrows, MD. Integrative Medicine specialist, Director of Mindfulness Program, UCSF. Yes. It is absolutely unequivocal that fish oil lowers triglycerides. The research is very strong that fish oil can help to treat hypertriglyceridemia. Fish oil is equal to pharmaceuticals in lowering triglycerides. There is even an FDA-approved version of fish oil for treatment of hypertriglyceridemia. It is more more controversial whether fish oil can be used in secondary prevention of coronary artery heart disease. We have good medications today for secondary prevention of heart disease. Secondary prevention is prevention of second heart attack after first heart attack already happened. We have aspirin, statins, ace inhibitors, beta blockers. Now these effective medications became standard of care to prevent second heart attacks. But before that era fish oil showed a very large benefit for reducing mortality after heart attack. Fish oil reduces sudden cardiac death. Fish oil reduces myocardial infarction. Today all these powerful medications, aspirin, beta blockers, ace inhibitors, statins, to prevent second heart attacks are used in many patients. Does fish oil have additional benefit in patients who already take these powerful medications? We do not yet have an answer to that question. The good news is that fish oil has almost no side effects to its use. We have to continually study fish oil to make sure there are no adverse effects. But we use fish oil readily in patients with heart disease. Sometimes the medicine is very toxic or risky. You need good evidence before you give this medicine to a patient. You have to be sure that benefits of using this medicine are stronger than the risks of toxicity. We would love to have impeccable evidence of safety for all natural medicines. But sometimes the medicine is very safe. Then you could argue that you probably don't need to be hesitant to use natural medicine. Because there is often no harm of using many natural medicines, like fish oil. Dr. Anton Titov, MD. There is a clinical trial from Finland that looked at benefits of adding more fish, white fish, to the regular diet. The additional amount of fish that patients ate was not significant. Nevertheless scientists showed that those patients who ate more fish had beneficial effects on their cholesterol composition. Importantly, benefits of eating more fish were not so much in levels of total cholesterol, LDL and HDL fractions of cholesterol. These are cholesterol fractions that are typically measured in the laboratory. Benefits from eating more fish were more subtle and went beyond standard lipid fractions. Health benefits were seen in the relative ratio of cholesterol and lipid fractions. These fractions could only be measured by research-grade methods. There are multiple classes of lipid particles in the body. Cholesterol metabolism is very complex. So this clinical trial probably speaks to the benefits of using more fish and more fish for heart disease prevention. Dr. Kevin Barrows, MD. I think you are correct. This is one of the mechanisms by which fish oil is beneficial for cardiovascular system. Fish oil changes a composition of LDL. Sometimes you use fish oil. Sometimes your LDL goes up a little bit because you are ingesting fish oil, which is a fat. Sometimes you eat enough fish oil. Then you can actually increase your LDL levels. But you fractionate the LDL particles. Then you will see that the character of LDL particles changed. LDL particles became larger and more buoyant. We know that larger LDL particles are less atherogenic than the small dense LDL particles. Dr. Anton Titov, MD. So the details matter. Dr. Kevin Barrows, MD. That is correct! Fish oil for coronary artery disease and high cholesterol. What are nuances of fish oil use in heart disease secondary prevention?