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Omega blood testing dr tom gilhooly

Omega blood testing
Dr Tom Gilhooly MB ChB

Can one test change the face of medicine? Modern medicine has been dominated by
pharmaceutical agents with little attention paid to any underlying nutritional
imbalances which may contribute to or even be the cause of the “dis–ease”. The basis
of nutritional medicine is to discover and correct imbalances which can reduce the
need for drug treatment. Nutritional medicine is therefore highly reliant on reliable
biochemical testing of nutrient levels. Omega 3 is well recognised as one of the most
important essential nutrients but paradoxically it has been one of the most difficult
to accurately measure.
Omega 3 has been shown in epidemiological and intervention studies to improve
outcomes in heart disease, depression, arthritis and a number of autoimmune
disorders 1,2,3,4,5. They have even been shown to be superior to modern wonder drug,
statins, in improving mortality and cardiac events 6. A meta analysis of 97 studies
of cholesterol lowering agents showed omega 3 to have superior outcomes to all the
pharmaceutical agents used. Omega 3 is best known to the general public as a
general supplement and in certain groups has even become more popular than
multivitamins in the United States. 7

While the importance of this natural essential fatty acid has become well known among the public it is
less well known that omega 3 levels can be tested in the lab. A recent market research survey asked
over 500 members of the general public if they were aware of such a test. 87% had not heard of it but
over half immediately expressed an interest in having this test done 8. Why is this test not better
known and carried out more? It does make sense that knowing the actual supplement requirements
would lead to more effective and accurate supplementation recommendations. In The Essential
Health Clinic in Glasgow we routinely carry out this test with over 500 carried out so far. It is a very
predictable test and does allow for more precision in designing omega 3 supplement regimes.
There are two main methods of measuring omega 3 levels in the blood, testing cell membranes and
whole blood phospholipids. Cell membrane testing is a more accurate but more technically
challenging test. This method of analysis measures the fat content in the erythrocyte cell membrane. It
is a four to five day process to extract and analyse the membrane fats. It is not surprising that most
laboratories do not even attempt to carry out this complex test and of those that do, few can produce
consistent and reliable results. The other main method of analysis is to look at whole blood
phospholipids which is an easier process but is influenced by recent dietary intake. The cell
membranes take several days to construct whereas the omega 3 in whole blood can reflect intake from
a few hours earlier.
Research with Cell Membrane Testing
The Institute of Aquaculture in Stirling University has one of the most experienced laboratory teams
and specialises in measuring essential fatty acids in cell membranes. Having had samples tested in
labs from all over the world, we now use the skill and experience of this University department as do
many of the clinics in the UK. The Doctor’s Laboratory in London als0 use this lab for fatty acid
analysis, the results then are interpreted by our team in The Essential Diagnostic Lab in Glasgow and
a recommendation of omega supplementation is given with each report.
One of the benefits of working closely with the University is the opportunity to do joint research. The
cost of the cell membrane analysis both financially and in lab time meant that this would always be a
niche test. We know from the market research that the general public would be interested in omega 3
testing but the capacity and expertise to do this is not and will not be available using current methods.
An alternative method of analysis is to measure plasma phospholipids on a whole blood analysis using
a sample obtained by a finger prick method. This has many advantages as far as sample collection is
concerned, it could be easily collected in a pharmacy, clinic or even at home. The blood sample is
collected on blotting paper and the sample is stable in this form for two weeks rather than the two
days of a normal blood sample. Several researchers are looking at this type of sampling throughout
the world but as yet the validity of the test is unproven compared to the gold standard of cell
membrane testing. We have obtained funding for a joint project with the University to examine this
aspect of the test. Using the considerable expertise in the Institute of Aquaculture, we intend to
measure fifty samples using both methods to assess the comparability of the different methods. The
early results are promising and this test which measures phospholipids is a much simpler one step
process which does not rely so heavily on experience and skill. It is possible that this method could
open up this test to the mass market with more accurate omega supplementation resulting in better
health outcomes.
Omega 3 to Omega 6 ratios
The main marker of interest is the ratio of the most physiologically active omega 6 (arachadonic acid)
to the most active omega 3 (eicospentanoic acid), the AA/EPA ratio. This has been studied in a variety
of conditions, the ideal ratio thought to be between 1.5 and 3.0. This is indicative of the level in Japan
and is very different from the 15 to 20 ratios we see in the UK. High levels of omega 6 from our diet of
grains, dairy products, eggs, meat and vegetable oils leads to higher levels of inflammatory hormones
in the body. Lowering the ratio by altering diet or taking omega 3 supplements, leads to reduced
inflammation and improved outcomes. Simopoulos has shown that a ratio of 10 is associated with
worsening arthritis symptoms, a ratio of 5 with no change and a ratio of 2 with an improvement in
One of my MS patients had been strictly following the Swank diet which recommends an increased
intake of essential fatty acids rather than saturated fats. As omega 6 is much more plentiful in our diet
it was easier for her to take these than the oily fish containing omega 3. She was only diagnosed for
one year when I saw her but she was struggling with energy and walking over moderate distances. As
part of her work up we checked her omega levels and found she had an AA/EPA ratio of 40. She was
shocked as she had been following what she thought was a healthy diet. I advised a large dose of
omega 3, 4 g EPA , to rectify this and at her next appointment she reported a remarkable
improvement in both fatigue and walking ability. Her ratio had improved to an optimal level of 1.8.
We reduced her supplementation to 3 g EPA and one year on she still reports improved symptoms and
her ratio is now 1.75. This is in keeping with the Norvik study9 which showed a 25% improvement in
symptoms in MS when the AA/EPA ratio was improved from an average of 6 to an average of 1.5.
It is clear that this simple change in diet and supplementation had produced a massive improvement
in function and quality of life. More important the patient felt that she had a measure of control over
her condition, she was empowered by this simple nutritional manipulation.
In this case omega testing gave a clear indication of the dose of omega supplement required to correct
the huge imbalance that had been allowed to develop, ironically from following a so called “healthy
The omega test has an influence on every cell membrane in the body so the impact of the test is
extremely widespread. It can provide invaluable information to help assist in developing an optimal
internal environment as we strive for both disease prevention and optimal treatment. The rapid
omega test could open this form of testing to the mass market and allow many more individuals to
benefit from this extremely useful form of analysis.
About the Author
Dr Tom Gilhooly is a General Practitioner who has been practicing in Glasgow’s east
end for the past 20 years. He practices nutritional medicine at Essential Health Clinic
in Glasgow where he has a particular interest in omega 3, multiple sclerosis and
chronic fatigue syndrome. His book “The End Of The Cholesterol Era” is due out
this autumn and will highlight the mounting evidence that cholesterol is not a key
factor in heart disease but the balance of omega 3 to omega 6 levels is.


2) Gago-Dominguez M, Yuan JM, Sun CL, Opposing effects of dietary n-3 and n-6 fatty acids on mammary carcinogenesis: The Singapore Chinese Health Study. Br J Cancer. 2003;89(9):1686-92 3) S. Jazayeri, M. Tehrani-Doost; S.A. Keshavarz, M. Hosseini, A. Djazayery, H. Amini, M. Jalali, M. Peet "Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder" Australian and New Zealand Journal of Psychiatry Volume 42, Issue 3, Pages 192-198 4) Edwards R, Peet M, Shay J, et al. polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998;48(2-3):149-55 5) Simopoulos he importance of the omega-6/ fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood). 2008;233(6):674-88. 6) Studer M, Briel M, Leimensoll B, et al. Effects of different anti -lipidemic agents and diets on mortality. Arch Intern 7) Consumer labs – Consumer trends Feb 2009 8) EDGE Market Research Report Glasgow July 2009 9) , , . Effect of dietary advice and n-3 supplementation in newly diagnosed MS


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