Can Low Blood Pressure Patients Safely Take Evening Primrose or Fish Oil? - Pharmacology

Dr. Huang Yicheng reply Pharmacology

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1.
Evening primrose oil contains gamma-linolenic acid (GLA) and linoleic acid (LA), which may promote the synthesis of prostaglandin E1 (PGE1), resulting in anti-inflammatory, anticoagulant, vasodilatory, and immune-regulating effects.
GLA may also help maintain normal hormone secretion, which is believed to improve premenstrual syndrome.
Additionally, some studies suggest that it may enhance brain cell activity by increasing the levels of polyunsaturated fatty acids in the body.
However, the clinical efficacy remains unclear, and more evidence is needed; its current classification is that of a nutritional supplement.
Excessive intake may lead to decreased blood coagulation, as well as nausea, vomiting, and diarrhea.
Patients with breast cancer, epilepsy, or those taking anticoagulants, antihypertensives, anticonvulsants, or antipsychotic medications should avoid its use.
Fish oil primarily contains docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are polyunsaturated fatty acids (Omega-3 fatty acids).
These may compete with excessive Omega-6 fatty acids, inhibiting the synthesis of inflammatory substances such as prostaglandins and leukotrienes, thus providing anti-inflammatory, anticoagulant, lipid-lowering, and vascular regulatory functions.
Similarly, its actual effects still require validation.
Currently, manufacturers in Taiwan have applied for health food status, with approved health benefits mainly including lowering total cholesterol, low-density lipoprotein cholesterol, triglycerides, and/or reducing risk factors for cerebrovascular and cardiovascular diseases.
Long-term use (daily doses exceeding 1500 mg) may lead to fatty liver, bleeding, and decreased immune function, and concurrent use with calcium products may cause mild diarrhea.
It is contraindicated in pregnant women, hemophiliacs, and individuals with poor liver function (including chronic alcoholics).
Due to its blood pressure-lowering effects being mostly indirect or not strong, general consumption should be safe; however, if dizziness or significant blood pressure drops occur after consumption, it should be discontinued.
2.
Seborrheic dermatitis is a chronic skin condition that commonly occurs on the scalp, eyebrows, sides of the nose, and lower face.
Symptoms include erythema, scaling, and occasionally yellow, greasy flakes, which may cause mild itching but not severe discomfort.
In severe cases, it may lead to oozing and secondary fungal infections.
This type of dermatitis is difficult to eradicate completely and requires treatment from a professional dermatologist to minimize the frequency and severity of flare-ups, without significantly affecting daily life.
Minoxidil topical solution (available in concentrations of 2% and 5%) is primarily applied to the scalp to stimulate hair growth.
Its active ingredient, minoxidil, has vasodilatory effects that improve blood circulation and nutrient supply to the scalp, promoting hair follicle growth, particularly effective for frontal and vertex baldness.
It is often combined with oral finasteride (Propecia; 1 mg) to enhance efficacy and speed of hair regrowth.
After discontinuation, hair loss may gradually return to baseline levels over several months, but it does not accelerate hair loss.
Being a topical treatment, it theoretically has fewer side effects; however, a small percentage of users may experience tachycardia (sometimes attributed to psychological factors).
If confirmed, they can discuss with their physician about reducing the concentration, frequency of use, or discontinuation.
Additionally, it is important to note that there is a minoxidil shampoo available in Taiwan, which contains no active medication and is intended for hair care, addressing common symptoms of oily scalp and hair, without treating baldness.
Finasteride was originally developed for treating benign prostatic hyperplasia, and some patients have unexpectedly found increased hair growth while on the medication.
It must be taken daily, with initial effects on reduced hair loss and increased hair volume appearing after about three months, and normal new hair growth occurring after 6-12 months.
If effective, lifelong use is necessary; discontinuation will lead to a gradual return to baseline hair loss levels, but will not accelerate hair loss.
Common side effects include decreased libido (1.8%), erectile dysfunction (1.3%), and ejaculation disorders (1.2%), which generally resolve after stopping the medication.
Since the drug is metabolized by the liver, individuals with liver dysfunction must have their liver capacity confirmed by a physician before use.
Currently, the only FDA-approved non-surgical treatments in the U.S.
are minoxidil (Rogaine) and finasteride (Propecia).
As for the hair growth spray you mentioned, I cannot ascertain its ingredients.
3.
The normal growth curve for children is constructed by measuring various growth parameters of many boys or girls of the same age.
Theoretically, children of the same age are sorted from smallest to largest, and based on their growth parameters, percentiles are defined.
For example, the 75th percentile means that a child ranks 75th among 100 children of the same age.
Growth parameters such as weight, height, head circumference, and chest circumference are considered normal if they fall between the 3rd and 97th percentiles.
Values below the 3rd percentile indicate significant growth delay, while values above the 97th percentile indicate abnormally high measurements compared to peers.
A typical growth chart (included in children's health insurance cards) displays seven growth curves representing the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles, with the horizontal axis representing the child's age.
This allows for comparison of the child's height or weight against the growth curves.
Values below the 3rd percentile are considered abnormally low, while those above the 97th percentile are considered abnormally high.
Based on the information you provided, the first child (female, born 2720g, 48cm) at 2 years and 10 months weighs approximately 12 to 13 kg (around the 25th to 50th percentile) and is 90 cm tall (slightly below the 25th percentile); the second child (male, born 3150g, 52cm) at 1 year and 4 months weighs approximately 9 to 10 kg (around the 3rd to 25th percentile) and is likely around 77 to 80 cm tall (around the 10th to 50th percentile).
Both fall within the normal range.
These growth parameters are related to genetics, and the average weight and height of the parents can serve as a rough predictor for the child's normal growth.
Larger head size and prominent foreheads may also be genetically influenced.
However, sudden extreme increases or decreases in percentiles indicate abnormal conditions.
For instance, if a child's weight drops from the 75th percentile to the 10th percentile within a few months, it warrants investigation for potential underlying health issues, and consultation with a pediatric specialist is advised.
Birth weight is influenced by the uterine environment, and after birth, it gradually reflects the genetic predisposition.
Therefore, growth percentiles may show more noticeable changes before the age of two without necessarily indicating specific health issues.
Factors such as malnutrition most significantly impact weight, followed by height, and then head circumference.
Congenital factors like chromosomal abnormalities or congenital infections proportionately reduce growth parameters.
Sincerely, Huang Yi-Cheng, Pharmacist, Hualien Hospital, Department of Health.

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Reply Date: 2004/12/08