title: Gastrointestinal bleeding after high intake of omega-3 fatty acids, cortisone and antibiotic therapy: a case study.
abstract: Omega-3 fatty acids exert a plethora of physiological actions including triglycerides lowering, reduction of inflammatory indices, immunomodulation, anti- thrombotic effects and possibly promotion of exercise performance. Their use is widespread and for commonly ingested doses their side- effects are minimal. We report a case of a 60 y amateur athlete who consumed about 20 g omega-3 fatty acids daily from supplements and natural sources for a year. After the intake of cortisone and antibiotics he presented duodenum ulcer and bleeding although he had no previous history of gastrointestinal problems. Although several animal data support gastro-protective effects of omega-3 fatty acids in the present case they were not able to prevent ulcer generation. The present observation may be explained by (i) the high dose of omega-3 fatty acids and their effect on bleeding, (ii) the fact that cortisone increases their oxidation and may render them proinflammatory, (iii) other antithrombotic microconstituents included in the consumed cod-oil and/or the diet of the subject and (iv) the differences in the coagulation and fibrinolytic systems of well- trained subjects. Further studies are needed to substantiate any possible interaction of cortisone and omega-3 fatty acids in wide ranges of intake.
authors.affiliation: Dept. of Nutrition, General Hospital Korgialenio-Benakio (Red Cross Hospital), Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Detopoulou
authors.forename: Vasilios
authors.initials: V
authors.lastname: Papamikos
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003060:Cod Liver Oil / Q000737:chemistry; D003348:Cortisone / Q000009:adverse effects*; D004032:Diet; D019587:Dietary Supplements; D004347:Drug Interactions; D004381:Duodenal Ulcer / Q000139:chemically induced*; D015444:Exercise; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D015227:Lipid Peroxidation; D008297:Male; D008875:Middle Aged; D013177:Sports / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D015525:Fatty Acids, Omega-3; D003060:Cod Liver Oil; D003348:Cortisone