Q: I would like to know your opinion about the following: Why don't doctors use thermographs more than mammograms for exams on women? Our doctors have used thermographs for more than 25 years, and my wife also has used this form of breast testing. Our family has given her grief for using it, yet thermography is safer and more thorough than mammography.

A: Thermography has been around for more than 50 years. According to the radiologists at the Cleveland Clinic specializing in breast imaging, the studies on thermography have not been able to support the claims made by those using it. The modalities used for breast imaging, such as MRI, PET scanning, digital mammography and even ultrasound, are providing far superior results than thermography at picking up very early cancers in very dense breasts. A review of the published literature available to date would support that thermography is, in fact, very sensitive (picks up most everything – benign and malignant), but falls very short in being specific (unable to discern benign from malignant). At best, it may be helpful if used along with one of the above-mentioned techniques for imaging the breast, but not alone.

Q: Both my husband and I were impressed after reading your recent article in Cleveland Clinic Magazine, "Fighting Inflammation with Fish Oil." We would like to include a fish-oil supplement in our diets, and since this would be an over-the-counter product, we have a question. We notice in the Puritan Pride catalog that it offers an "enteric-coated" Omega-3 Fish Oil softgel capsule. It claims "no fish burps!" It states that "enteric coated – meaning the active ingredients by-pass the stomach and are digested in the small intestine – can minimize aftertaste." (A 1,200 mg capsule contains 216 mg of EPA and 144 mg of DHA, which is not a 50-50 combination.) Would you recommend going with the enteric coating or choose a regular softgel that does have a 50-percent combination of EPA and DHA?

A: Enteric-coated fish oil is certainly one way to avoid a fishy burp, but not the only way. Puritan's Pride has passed the quality checks done through Consumerlab.com, a very reputable source for researching the quality of herbs and supplements. My recommendation is still to get the largest amount of EPA and DHA possible per capsule. There are several brands that contain 500 mg or more per capsule. To avoid the fishy aftertaste, buy a flavored brand, take the fish oil with a meal and/or store them in the freezer (this keeps them from melting until they have passed through the stomach, simulating the “enteric coated” effect).

Q: I read your article on fish oil in Cleveland Clinic Magazine. Will flaxseed oil do the same thing? If not, what is the difference? For what is each good?

A: Flaxseed oil and fish oil are both excellent sources of omega-3 fatty acids. Flaxseed, however, must be converted to the longer chain fatty acid in order to exert maximal effect on the body. Fish oil is already in the form (long chain) that the body can utilize. The enzyme necessary to convert the short-chain fatty acid to the longer chain is very inefficient. Recent studies suggest that only five to ten percent of it actually gets converted. If I am concerned that a patient is deficient in omega-3 fat, I do not recommend flaxseed oil at all. I usually recommend fish oil in the range of 2,000-4,000 mg/day. Ground flaxseeds, however, are a great source of protein, phytoestrogens and lignans, which have been shown to help prevent breast cancer in animal studies. So, use freshly-ground flaxseeds as a part of a healthy diet, but for omega-3 supplementation, use fish oil.

Do you have a question for Dr. Edwards? Please e-mail it to Doctor@BalancedLivingMag.com.

Tanya Edwards, M.D., M.Ed., is the Medical Director for the Center for Integrative Medicine and is a staff member in the Department of Family Medicine at the Cleveland Clinic. As a Family Practice physician, she sees patients at the Cleveland Clinic Independence Family Health Center, and will begin wellness consultations at the new Cleveland Clinic Wellness Center. For the past seven years, she has been teaching complementary and alternative medicine courses at the Case Western Reserve University School of Medicine.

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