【保健知多D】一字之差?魚油 vs 魚肝油?(一)
〈魚油同魚肝油有咩分別?〉
有時候,一字之差往往可以「差之毫釐,謬之千里」,帶出很多好美麗的誤會。
舉例說,「魚油」、「魚肝油」便是一對活生生的例子。
根據經驗,很多人往往經常會將「魚油」看成「魚肝油」或者將「魚肝油」說成「魚油」。所以如果是第一次買魚油或者魚肝油的話,藥罐子大多都會不厭其煩問清楚對方所指的到底是魚油還是魚肝油。
那兩者其實到底又有什麼分別呢?
首先說到魚油,便不得不提魚油的歷史:
其實人們之所以會對魚油感興趣,主要源於一種自相矛盾的怪現象。
這種怪現象徹底打破了一般人一種根深蒂固的觀念,跌破了很多人的眼鏡……
這種怪現象便是……
理論上,根據一般人的認知,脂肪的攝取量愈多,患上心血管病症的風險自然便會愈大。
簡單說,攝取大量脂肪固然可能會增加肥胖的風險,同時還可能會增加患上心血管病症的風險,例如冠心病(Coronary Heart Disease, CHD),對吧?
不過有一種人偏偏就是例外。
這種人便是……
愛斯基摩人(Eskimo)!
首先愛斯基摩人長年住在北極這種天寒地凍、冰天雪地的極北之地,面對這片寸草不生的不毛之地,人們不能耕種,只能狩獵為生,主要是魚、海豹、鯨魚。
當然同是北極,這些獵物當然不懂穿羽絨,不過體內卻會屯積大量脂肪來隔溫保暖,面皮……不、不、不,應該是皮下脂肪一般較厚,所以這些愛斯基摩人的餐單裡自然離不開大量脂肪,不過這類人偏偏就是較少患上心血管病症,例如心臟病發。
好奇怪,對吧?
後來人們發現這些脂肪蘊含豐富的奧米加3脂肪酸(Omega-3 Fatty Acids)這種多元不飽和脂肪酸(Polyunsaturated Fatty Acids, PUFAs),或許能夠解釋這個現象。
實際上,魚油同樣蘊含豐富的奧米加3脂肪酸,其中較重要的主要有二十二碳六烯酸(Docosahexaenoic Acid, DHA)、二十碳五烯酸(Eicosapentaenoic Acid, EPA)兩種。
對,這就是我們經常掛在嘴邊的DHA、EPA。所以與其說二十……這兩個冗長的中文,倒不如直接說英文好了。
實際上,藥罐子相信大家可能聽過DHA、EPA,不過未必真的聽過「二十二碳六烯酸」、「二十碳五烯酸」這兩個化學名吧?
真的要說的話,DHA、EPA各有長短。
其中相較DHA而言,EPA較能降低極低密度脂蛋白膽固醇(Very-low-density Lipoprotein Cholesterol, VLDL-C)、低密度脂蛋白膽固醇(Low-density Lipoprotein Cholesterol, LDL-C)(俗稱「壞膽固醇」)、三酸甘油脂(Triglycerides)的水平,同時還可能會增加高密度脂蛋白膽固醇(High-density Lipoprotein Cholesterol, HDL-C)(俗稱「好膽固醇」)的水平。[1]
這就是說,理論上,魚油可能會改善體內的膽固醇,所以可能會紓緩高脂血症(Hyperlipidemia),從而可能會減少出現心血管病症的風險。
不過暫時還是言之尚早,所以美國食品藥物管理局(U.S. Food and Drug Administration, FDA)暫時只容許魚油產品作出以下類似意思的聲稱,例如:
"Consuming EPA and DHA combined may reduce blood pressure and reduce the risk of hypertension, a risk factor for CHD (coronary heart disease). However, FDA has concluded that the evidence is inconsistent and inconclusive.……"[2]
話雖如此,實際上,只要改良魚油並進化成為Omega-3 Fatty Acid Ethyl Ester,這種升級版的魚油便會從「保健品」升為一種「藥品」,用於治療高三酸甘油脂血症(Hypertriglyceridemia)。[1][3]
至於相較EPA而言,DHA或許較能抗凝血[4]、降血壓[5]。
在副作用上,魚油看來一般安全。
不過說到魚,自然離不開魚腥味;說到油,自然離不開油膩膩的口感,兩者同樣可能會影響依從性。
同時,市面上的魚油大多源自深海魚,所以偶爾會稱為「深海魚油」,海床愈深,光源便會愈少,溫度便會愈低,脂肪便會愈厚,DHA、EPA自然便會愈多,同時因為這些深海魚大多位居食物鏈的高層,所以一些污染物便可能會沿著食物鏈層層遞進進入這些深海魚裡面,例如汞(Mercury)、多氯聯苯(Polychlorinated Biphenyl, PCB)、二噁英(Dioxin)。
當然不用問,這條食物鏈的最高層當然是人類。
所以當人們服用這些魚油的時候,這些污染物便可能會沿著這條食物鏈進入人體,日積月累,便可能會構成毒性,從而可能會增加中毒的風險。
還有,因為魚油可能會抗凝血,所以較可能會加強一些抗凝血藥的功效,例如華法林(Warfarin),從而可能會增加出血的風險。[6]
當然,除此之外,其他西藥例如亞士匹靈(Aspirin)或者中藥例如當歸、丹參同樣可能會跟魚油產生這種相互作用,從而可能會增加出血的風險。
所以如果正在服用這些中、西藥的話,一般建議服用魚油前首先應該諮詢醫生的專業意見。
最後,魚油是魚油,不是魚肝油,這點,千萬不要弄錯。
(如欲了解更多用藥資訊,歡迎看看「小小藥罐子」網誌。)
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Reference:
1. McKenney JM, Sica D. Role of prescription omega-3 fatty acids in the treatment of hypertriglyceridemia. Pharmacotherapy. 2007;27:715-728.
2. U.S. Food and Drug Administration, Food, News & Events from CFSAN, CFSAN Constituent Updates, FDA Announces New Qualified Health Claims for EPA and DHA Omega-3 Consumption and the Risk of Hypertension and Coronary Heart Disease, available at https://www.fda.gov/food/cfsan-constituent-updates/fda-announces-new-qualified-health-claims-epa-and-dha-omega-3-consumption-and-risk-hypertension-and (Accessed 9 Sep 2020)
3. McKenney JM, Sica D. Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia. Am J Health Syst Pharm. 2007;64:595-605.
4. Woodman RJ, Mori TA, Burke V, et al. Effects of purified eicosapentaenoic acid and docosahexaenoic acid on platelet, fibrinolytic and vascular function in hypertensive type 2 diabetic patients. Atherosclerosis. 2003;166:85-93.
5. Mori TA, Bao DQ, Burke V, et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension. 1999;34:253-260.
6. Buckley MS, Goff AD, Knapp WE, et al. Fish oil interaction with warfarin. Ann Pharmacother. 2004;38:50-52.
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从老公的角度看试管婴儿疗程
当一对夫妻要做 #IVF试管疗程时,做丈夫的应该用什么态度来面对?常常有网友告诉我说,我的老公精子不好,可是他还是不能戒烟戒酒,好不配合。要知道,不孕症不只是女人的责任,男人也是有责任。这篇文章,是以男人的角度出发,里面分享身为丈夫应该如何帮助太太一起度过疗程,文章是英文内容,是奥莉爸爸写的,奥莉爸不会中文。分享给大家😊
IVF Journey, A Husband’s Perspective
Hi all, before reading further I would like to say this is NOT an instruction or tips for IVF and hopefully readers will understand my poorly written English. This is my journey as a father of the IVF baby girl. Why am I sharing all this? It is because my wife had a Facebook page of her IVF journey at https://facebook.com/ivfjourney2015/ and she told me that majorities (not all but most) feedback indicate husband not supportive enough to commit into a journey of IVF. I’m not a true supportive husband either, least I made up my mind to make it happen.
Let’s start with “Why IVF?”
We went for a fertilization test and results with;
Husband: Teratospermia (Human language, sperm is weak for fertilization process)
Wife: Unexplained infertility (I think this is easy to understand, there is for the confirming reason for this result and we don’t go for further test after it because it will consumes too much time and money)
We married and planned to have children late 2011, both our ages were 37 in 2015 because of late marriage. My wife introduced IVF because she does not want to give up and feels regretful in future and so do I. Maybe because I did too many regretful things in the past, now I do not want this happened to my wife. At least I do it better then ignoring it.
Preparation for IVF
Financially, I know it will involve amount of 20k – 30k “Ringgit Malaysia” in the whole process depending on the situation and this is only one chance for me. I don’t have the money for a second attempt because I need to allocate funds for delivery if success.
Mentally, I do some studies/research on IVF. The whole journey took 50 days and in one of the process my wife needs to do a self-injection daily. I quickly asked my wife “Daily injection?! Do I need to fetch you to clinic daily to do this?” She answered “No, we need to do this ourselves”. A final question from me going to be “How?!” After we sat down and discuss, we comes into conclusion and I will do the injection for her. This was the most painful and nervous moment I ever experience by poking a needle to my wife’s belly EVERYDAY!
Lifestyle, 6 months earlier. My wife told me the NO’s, NO alcohol NO smoking NO midnight wandering NO stress. I said, I will fly up to the skies like butterfly if I able to do all the NO’s. It’s like a mission impossible. How can a man like me not go out to social with friends without alcohol and smoke? The joke was sleeping early! You want me to social with my friends in breakfast or lunch time? At this time, she softly said “I really wants to have a cute baby in future, it looks more like a family. Furthermore, I don’t want to have regretful moments in future”. All these words came out of my love (wife), her words melted in my heart deeply. I told her “Ok, we will go for it BUT you will need to promise me ONE IMPORTANT thing. No matter the process success or not we only have one attempt we need to accept the truth and live happily without regret in future.” she agreed.
Commitment, this is not some empty promise. I made a huge commitment to change my lifestyle into zero alcohol, tobacco and lesser stress. If comparing the pain and suffers my wife will take in this journey e.g., injection, medication effects, hormone changes and all the effects from pregnancies to delivery, mine looks more alike small potatoes (looks much more simple). Trust me guys, don't compare it, if you do and more likely you're going loose badly. For the sake of making a better future, I had fulfilled this commitment.
IVF Journey Phase 1 “Unskilled Husband Injection”
Day 1, doctor consults us for Buserelin injection. I need to inject this medication into my wife's belly each day sharp at 8AM. The nurse had guided me side by side to do the first injection.
Day 2, I started my first injection to my wife's belly without anyone guiding beside. Feels a bit nervous because this time I'm doing it all by myself. I try to hum some music to distract my wife's from looking at the needle while injecting but still she is looking at it.
Day 3 - Day 15, sometime the injection hurting and causes bleeding/bruise to her. I need to find a new spot to inject every time and sees her bruise makes my pain in the heart too. My injection skills improved dramatically. She even told me that she doesn't feel pain like the beginning stages.
Day 16, follow up 2nd checkup. Doctor said, everything goes smoothly and added another medication to inject called Gonal-F to take home and start injecting on day 23. This message never surprises me because I've been told earlier, but just that the price to pay for this medication is quite costly.
Day 17 - Day 22, nothing much on these days and we just stick on the plan as usual.
IVF Journey Phase 2 “Stressful Night”
Day 23, Gonal F injections start today. This needle doesn't look same as those earlier, it comes with medication in it and look like a pen.
Day 24 - Day 26, side effects of the Gonal F medications started. My wife is feeling irritation at the injection site, fullness, bloating and tenderness in the lower abdomen due to the increasing size of the ovaries. Her mood changes dramatically as I can tell, but she endures it and tell me she can handle it.
Day 27, follow up 3rd checkup. Doctor said wife has eggs total of 12 and is ready for Transvaginal oocyte retrieval "Human language, Egg retrieval" at day 31.
Day 28 - Day 29, final injection of Gonal F. At day 29 night, I inject Ovidrel to wife belly to that causes the growth and release of a mature egg (ovulation) for day 31.
Day 30, resting whole day. Finally, we had a day without injection and worrying about holding any needles. Today we wondering about the egg growth, not knowing will the eggs grow more or still the same amount of 12.
Day 31, egg retrieval. 8 egg success retrieves and I give out my sperm for oocytes selection on the same day. Wife given cyclogest for oval protection after the egg retrieval.
IVF Journey Phase 3 “Hopeful Embryo Culture & Embryo Transfer”
Day 32 - Day 35, rest at home. We had pillow talk every night concerning about the growth of an embryo. We also look at sample growth stages of an embryo from the web to see what the current growth stage is.
Day 36, another hopeful and nervous morning. Doctor tells us the result of embryo culture as below;
Total Embryo Retrieve: 8
Embryo Qualified for ICSI: 6
Embryo Success until Cleavage Stage (Day 2 – Day 4): 3
Embryo Success until Blastocyst Stage (Day 5): 2
Embryo Qualified / Recommended for Transfer: 1
Both our eyes looked at each other, knowing only 1 Blastocyst Embryo available to transfer and doctor tell the same after it. I really do not know how to express both our feelings into words here, as we expected to have at least 2 Blastocyst out of 8 embryos and only left 1. We both agreed to proceed this only 1 Blastocyst transfer as this is the only choice we had. It's more likely walking on a 100ft tall string with no supports mission, a single error will fail the mission.
After the transfer process, wife given a room to rest for few hours. A nurse came and give us adjunctive medications, injections and advice while resting at room.
IVF Journey Phase 4 “The Final Moment of IVF”
Day 37 - Day 49, after the transfer. This period is known as 2WW (2 Weeks Wait) with adjunctive medications, injections and be very careful. I just let her sleep/rest more on the bed, I served her every meal in the room. We're also nervous and curious about pregnancy results on day 44, we tested with cheap pregnancy tester and get got a double line on it and we do have a little hope and joy with this result. On day 47, again we test, but this time with expensive pregnancy tester and the results double line again! We're so hopeful and happy at this moment. We really hope this result is true until the next checkup.
Day 50, final checkup. My wife goes for the hCG test by giving a sample of blood, we waited 2 hours for the results. While waiting, nurse guide us to a room to rest. Wife slept and I sat beside concerned on the hCG test results. 2 hours later, the doctor invited us to look for him. Before doctor speaks, while we are sitting down, my wife's eyes were starring in the hCG results number and she spotted the hCG number is 452. She smiles happily while doctor tells her "You are pregnant and congratulations! Come back after 2 weeks to scan for baby heartbeats. And please go out to the counter and ring the bell!”
Just Sharing My Thoughts
By all means, I’m not bragging about my success. I would like to say if anyone is planning on IVF, teamwork is very important and husband play a very important role to increase the success rate. Sometimes, I do feel like a spectator than a participant myself because I never experience any of the medical exams but this is not true. Every injection I put on her belly, I feel the pain in my heart as bad as she has on the belly. Ok, nothing much to share in this IVF journey and next time I might be sharing another journey as a Father! Here is my little baby girl Facebook page奥莉 Olivia Baby - 梁童心心 https://fb.me/oliviababylove if you wish to see her growth updates.
End.
#ivf #ivfmalaysia #ivfjourney #baby #alphafertility
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heart rate中文 在 家醫/職醫_陳崇賢醫師- 【家庭醫學】~ 儲備心率(Heart Rate ... 的推薦與評價
【家庭醫學】~ 儲備心率(Heart Rate Reserve, HRR) 前幾天寫到有氧運動的強度,有提到心率區間的計算,文章最後有講到儲備心率,本來想說應該不用講的, ... ... <看更多>