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Theratears Nutrition
see also:-
TheraTears Nutrition for Dry Eyes (Omega-3 supplement with EPA and
DHA-enriched flaxseed oil) provides the foundation for every dry-eye
treatment program. The oil glands in the eyelid are critical to
tear film structure and eye comfort. TheraTears Nutrition for Dry
Eyes provides a special blend of pharmaceutical grade Omega-3 essential
fatty acids that your eyes, lids and tear film need to function
their best, but your body cannot produce. And most of us don't get
enough Omega-3s from our diet. TheraTears Nutrition provides these
Omega-3s for eye comfort upon awakening and continued eye comfort
throughout the day.*
Whatever the cause for your dry eye (for example, wind, sun, age,
surgery, contact lens wear, computer use, medication side effects),
and no matter how mild or severe, your dry eye just doesn't stand
a chance when you use the TheraTears treatment program.
TheraTears in preservative-free single-use containers is designed
to saturate dry eyes, providing the dosing that is ideal for very
dry eyes. For maximum hydration and relief of dryness, doctors may
recommend saturation dosing--splitting the entire contents of one
container, in both eyes within a 5-minute period after opening at
least 4 times a day.
*These statements have not been evaluated by the FDA. This product
is not intended to diagnose, treat, cure or prevent any disease.
Each 2 softgels contain 100 IU of Vitamin E, 500 mg of Flaxseed
Oil, 225 mg of EPA (Eicosapentaenoic Acid from Fish Oil) and 50
mg of DHA (Docosahexaenoic acid from Fish Oil). Two softgels provide
10.2 calories.
Treating Dry Eye Will Never be the Same
How an EPA-enriched Flaxseed Oil Supplement Treats Dry Eye
(by Jeffrey P. Gilbard, MD )
By decreasing inflammation, and augmenting the oil and water layers
of the tear film, omega-3 supplementation with EPA-enriched flaxseed
oil promises to provide the foundation for a broad spectrum of dry
eye treatment regimens.
Omega-3s are essential fatty acids that your body can't produce.
Your body must obtain them from your diet. Unfortunately, the Western
diet is deficient in Omega 3s. we just don't eat enough salmon and
other cold-water fish. It has been estimated that 83% of Americans
are deficient in Omega-3s. The two best sources of Omega-3s are
fish oil and flaxseed oil, and Omega 3s have a multitude of health
benefits.
Omega-6s are another group of essential fatty acids. Americans obtain
an excess of these through their consumption of beef, dairy, vegetable
cooking oils, and vegetable shortenings (i.e. cookies, potato chips,
snacks etc.). While the ideal dietary ratio of Omega-3s to Omega-6s
is about 1:1, the existing ratio in the American diet is about 1:20.
Let's have a closer look at how Omega-3s address the root causes
of meibomitis and dry eye.
Omega-3s and Dry Eye
First Mechanism-Decrease Inflammation
Once eaten, Omega-3s are acted upon by enzymes in the body to produce
prostaglandin E3 (PGE3) and leukotriene B5 (LTB5) (Figure 1). These
are two eicosanoids * that decrease inflammation. In addition, and
perhaps more importantly, Omega-3s have been shown, in cartilage,
to produce a dose dependent decrease in the gene expression and
activity of proteoglycan degrading enzymes (aggrecanases), the gene
expression of pro-inflammatory interleukin-1alpha (IL-1alpha), interleukin-1beta
(IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and cyclooxygenase
(COX-2) (Figure 2). There is an abundance of clinical evidence that
ingestion of Omega-3s decreases the inflammation seen in the joints
in rheumatoid arthritis3-6 and in the skin in dermatitis as well.7
Not surprisingly given the cartilaginous tarsal plate, reports are
emerging to indicate that consumption of Omega-3s decrease the inflammation
of meibomitis.8 As a result, meibomitis patients taking Omega-3
supplements have experienced relief from eye irritation upon awakening
in the morning.
*Eicosanoids are oxygenated fatty acids that act as local hormones
that act near their site of synthesis. Eicosanoids are derived from
arachidonic acid (AA), dihomo-gamma-linoleic acid (DGLA) and eicosapentaenoic
acid (EPA).
Second Mechanism-Augment Oil Layer
Second, essential fatty acids are used by the meibomian glands in
the eyelid to manufacture the oil layer of the tear film. HPLC/mass
spectrometry studies have shown that the polar lipid profiles of
meibomian gland secretions in female Sjögren's patients are
controlled by the dietary intake of omega-3 essential fatty acids.
Patients with high intakes of omega-3s show a single-prominent-peak
polar lipid pattern whereas patients with low dietary intake show
multiple smaller peaks. 9 It seems reasonable to surmise that dietary
omega-3s are being utilized in the production of meibomian secretions
and are contributing to and augmenting the tear film oil layer.
Clinical reports have observed clearer and thinner oils with omega-3
treatment.8 With an improved supply of Omega-3s, the oils produced
by the meibomian glands flow better and therefore create a better
oil layer covering for the tear film. The improvement of the oil
layer provides dry-eye relief for patients with meibomian gland
dysfunction.
Third Mechanism-Stimulate Tear Secretion
The essential fatty acid metabolic pathways are dynamic, complex
and interrelated. Levels of certain omega-3s for example, can influence
activity in the metabolism of omega-6s. The most important example
of this is the activity of eicosapentaenoic acid (EPA) (Figures
1 and 2). It is EPA that has been shown, in cartilage, to produce
a dose dependent decrease in the gene expression and activity of
proteoglycan degrading enzymes (aggrecanases), the gene expression
of pro-inflammatory interleukin-1alpha (IL-1alpha), interleukin-1beta
(IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and cyclooxygenase
(COX-2) (Figure 2). In addition, EPA also inhibits the arachidonic
acid inflammatory cascade (Figure 2). But EPA plays another role
as well. Specifically, EPA competitively inhibits the conversion
of DGLA to arachidonic acid (AA), and in doing so, promotes the
conversion of DGLA to PGE1. Why is this desirable? First, PGE1 has
anti-inflammatory properties,10,11 further helping to reduce meibomitis
and associated ocular surface inflammation. More importantly, PGE1
acts on G protein-coupled receptors designated E-prostanoid or "EP"
receptors. Specifically, PGE1 binds to EP2 and EP4 receptors to
activate adenylate cyclase to increase cyclic AMP (cAMP).12 PGE1
has been shown to stimulate aqueous tear production in rabbits,13
and cAMP has been shown to stimulate aqueous tear secretion in dry
eye patients.14,15
There have been some attempts to treat dry eye with the omega-6
essential fatty acid gamma linolenic acid (GLA) found in black currant
seed oil, evening primrose oil and borage oil. There are two published
studies that concluded GLA was not effective in treating dry eye.16,17
Moreover, there are risks in long-term GLA and omega-6 supplementation
related to the accumulation of arachidonic acid (inflammation, thrombosis
and immunosuppression).18-20
By decreasing inflammation, and augmenting the oil and water layers
of the tear film, omega-3 supplementation with EPA-enriched flaxseed
oil promises to provide the foundation for a broad spectrum of dry-eye
treatment regimens. Studies are now underway with TheraTears Nutrition,
a highly refined patent pending EPA-enriched flaxseed oil, to fully
evaluate the magnitude of its efficacy in treating dry eye patients.
Footnotes
1Simopoulos AP. Omega-3 fatty acids in health and disease and in
growth and development. Am J Clin Nutr 1991;54:438-463.
2James MJ. Dietary polyunsaturated fatty acids and inflammatory
mediator production. Am J Clin Nutr 2000;71(suppl):343S-8S.
3James MJ, Cleland LG. Dietary n-3 fatty acids and therapy for rheumatoid
arthirits. Semin Arthritis Rheum Oct 1997, 27(2):85-87.
4Volker D, et al. Efficacy of fish oil concentrate in the treatment
of rheumatoid arthritis. J of Rhem Oct 2000, 27:2343-2346.
5Fortin PR et al. Validation of a meta-analysis: the effects of
fish oil in rheumatoid arthritis. J of Clin Epidemiology 1995, 48:1379-1390.
6Kremer JM et al. Effects of high-dose fish oil on rheumatoid arthritis
after stopping non-steroidal anti-inflammatory drugs. Arthritis
& Rheumatism 1995,38:1107-1114.
7Goodman J. The Omega Solution. Prima Publishing, Roseville, California.
2001:p4-5.
8Boerner CF. Dry eye successfully treated with oral flaxseed oil.
Ocular Surgery News, October 15, 2000, p147-148.
9Sullivan RM et al. Correlations between nutrient intake and the
polar lipid profiles of meibomian gland secretions in women with
Sjogren's Syndrome. Third International Conference on the Lacirmal
Gland, Tear Film and Dry Eye Syndromes: Basic Science and Clinical
Relevance. Maui, Hawaii, November 15-18, 2000.
10De Perrot M et al. Prostaglandin E1 protects lung transplants
from ishemia-reperfusion injury: a shift from pro- to anti-inflammatory
cyctokines. Transplantation 2001 72(9):1505-1512.
11Kotani N et al. Intraoperative prostaglandin E1 improves antimicrobial
inflammatory responses in alveolar immune cells. Crit Care Med 2001
29(10):1943-1949.
12Narumiya S et al. Prostanoid receptors: Structures, properties,
and functions. Physiol Rev 1999;7:1193-1226.
13Pholpramol C. Secretory effect of prostaglandins on the rabbit
lacrimal gland in vivo. Prostaglandins Med 1979;3:185-192.
14Gilbard JP et al. Stimulation of tear secretion by topical agents
that increase cyclic nucleotide levels. Invest Ophthalmol Vis Sci.
1990; 31:1381-1388.
15Gilbard JP, Rossi SR, Gray Heyda K, Dartt DA. Stimulation of tear
secretion and treatment of dry eye disease with 3-Isobutyl-1-methylxanthine.
Arch Ophthalmol. 1991; 109:672-676.
16Oxholm P et al. Patients with primary Sjogren's syndrome treated
for two months with evening primrose oil. Scand J Rheumatol 1986;15(2):103-8.
17Theander E et al. Gammalinolenic acid treatment of fatigue associated
with primary Sjogren's syndrome. Scand J Rheumatol 2002;31(2):72-9.
18Johnson MM et al. Dietary supplementation with g-linolenic acid
alters fatty acid content and eicosanoid production in healthy humans.
J Nutri 1997;127:1435-1444.
19Phinney S. Potential risk of prolonged gamma-linolenic acid use.
Ann Intern Med 1994;120:692-
20Yam et al. Diet and disease-the Israeli paradox: Possible dangers
of a high omega-6 polyunsaturated fatty acid diet. Is J Med Sci
1996;32:1134-1143.
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