zGlaxo Smith Klein, the largest pharmaceutical company in the world, sells Lovaza which is an omega 3 fatty acid derivative medication approved by the FDA in 2004 for treatment of high serum triglycerides. Elevated triglycerides form one the most common problems in lipid metabolism and an independent risk factor for cardiovascular disease. Hypertriglyceridemia also causes abnormal liver function and dysfunctional lipid function; specifically, fatty liver disease and reduced effectiveness of high density lipoproteins (HDL), the “heart-protective” lipoproteins. GSK synthesized Lovaza in order to tap into the rapidly growing market related to increased consumption of fish oil supplements.

Each Lovaza capsule contains 900 mg of omega 3 fatty acid derivatives, primarily as synthetic ester forms of EPA and DHA, the natural, free fatty acids which constitute the active ingredients in over-the-counter (OTC) fish oil supplements.

Lovaza is not chemically identical to fish oil, and esterification involves further steps during manufacturing; this extra processing and the fact that Lovaza requires a prescription account for its high cost ($300 per month), which in turn discourages coverage by insurance companies.

Both esterified and free omega 3 fatty acids absorb freely from the gut and pass through the liver, where Lovaza is de-esterified to EPA and DHA; thus, it logically appears that no physical or absorption benefit would correlate with adding the esterification step. Pharmaceutical corporations often “medicalize” beneficial natural substances by chemical modification in order to obtain exclusive selling rights and maximize profits.

Does Lovaza have proven, superior medical results with respect to OTC fish oil supplements? In my opinion the answer to this question remains unclear (see links below), but significant differences seem unlikely.

A substantial body of evidence supports the use of fish oils to reduce systemic inflammation, total cholesterol and triglycerides; improve lipid metabolism; prevent fatty liver disease; and maintain healthy hair, skin and nails. For these reasons Glaxo Smith Klein synthesized Lovaza, and financed studies that compared tolerance and side effects of ethyl ester fatty acids to placebo. The pharmaceutical giant relied on the established research associated with EPA and DHA to impute clinical benefits in order to obtain FDA approval. No studies evidenced any differences in the clinical effects of synthetic omega 3 esters and fish oil supplements.

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