Signs & significance of an essential fatty acid deficiency?

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Q: I’ve been on a very low fat diet. I’ve lost weight but my skin and hair have really deteriorated – dry & flaky. My nails are terrible. I read online that this can mean I need more “essential fatty acids,” but it’s confusing – omega-3, omega-6, omega-9? Are there tests or guidelines for this?

A: Essential fatty acids (for example, the kind of fats found in fish) are surprisingly commonly deficient. Among other things, omega-3 and omega-6 fatty acids are responsible for the health of our skin, hair and nails. When deficient in these fats the health of our skin/hair/nails suffers, acting as a general indicator for our levels of these critical fatty acids.

Listed below are typical signs & symptoms seen in essential fatty acid deficiency. The significance of these deficiencies goes far beyond the presence of these obvious deficiency symptoms and relates to a large variety of medical conditions, including cardiovascular disease, inflammatory/auto-immune conditions, mental health conditions, etc. Whether you are trying to overcome a particular health issue or are simply trying to preserve your health, then your balance of fatty acids deserves some attention.

Signs/Symptoms of Essential Fatty Acid Deficiency

•  Dry skin (e.g., feet/face/general)
•  Scaly or flaky skin (e.g., legs)
•  Cracking/peeling fingertips & skin (e.g., heels)
•  Lackluster skin
•  Small bumps on back of upper arms
•  Patchy dullness &/or color variation of skin
•  Mixed oily and dry skin (‘combination’ skin)
•  Irregular quilted appearance of skin (e.g., legs)
•  Thick or cracked calluses
•  Dandruff or cradle cap
•  Dry, lackluster, brittle or unruly hair
•  Soft, fraying, splitting or brittle fingernails
•  Dull nails – lack of surface shine
•  Slow growing fingernails
•  Dry eyes
•  Dry mouth/throat
•  Inadequate vaginal lubrication
•  Menstrual cramps
•  Premenstrual breast pain/tenderness
•  Excessive ear wax
•  Excessive thirst
•  Allergic (e.g., eczema/asthma/hay fever/hives)
•  Crave fats/fatty foods
•  Stiff or painful joints

See also a list of references linking omega-3 fatty acids and mental health  [in general, and relating to depression, dementia, ADD/ADHD, autism, bipolar disorder, and more]. As you will see there is an overwhelming amount of scientific support for this connection.

Treating vs. Testing?

When a person is suspected of having a fatty acid deficiency, a person has two options.

1. They can either treat the suspected imbalance and observe the response,

2. Or they can do a laboratory test to determine both the existence and nature of the imbalance.

Supplement & Observe

Omega-3 fats
When treating, a person may try either 6 grams of fish or krill oil or 1 tbsp of flax oil for six weeks and observe what in the above table changes. If fatty acid deficiency markers show a great reduction during this time, then obviously you were on the right track. If not, then you may need to delve a bit deeper. Fish, krill and flax oils are excellent sources of the omega-3 class of the polyunsaturated fats.

These are much more commonly deficient than the other class, the omega-6 fats.

Omega-6 fats
A subgroup of the population (possibly 10%) – particularly those with allergies – has a unique tendency towards omega-6 fatty acid deficiency. I suspect this issue when an individual shows no change in the above symptoms after omega-3 supplementation, or reports feeling worse after supplementing omega-3 fats, or has certain allergic conditions (such as eczema).

For these people, evening primrose oil tends to be much more effective.

Fatty Acid Balance in Diet

Omega-3 and omega-6 fatty acids compete for sites in cell membranes where they play an important role in regulating cellular function.

An optimum diet probably contains an omega-6 to omega-3 ratio of 1:1 to 5:1, while people typically consume 15:1 to 20:1. See also “CFS – General Diet.”

Laboratory Tests

Laboratory tests are available and do take the guess work out of this process. The most accurate test is called the ‘Red Blood Cell Fatty Acid Analysis’. It is offered via integrative medicine laboratories and not by standard conventional laboratories.

You can see a sample report of a fatty acid profile via one integrative medicine laboratory HERE  (click on Sample Report). [This detailed blood analysis summary reports total saturated and monounstaurated fats, total omega-3 (n-3) and total omega-6 (n-6) plus a breakdown of fats in each category; the ratio of omega-3 to omega-6; and whether these are within or outside established “reference range.”]

Article on Fatty Acid Deficiency and Allergic Symptoms

An article of particular interest to those with allergic/hypersensitivity (atopic) problems is “Increased Requirements for Essential Fatty Acids in Atopic Individuals: A Review with Clinical Descriptions,” by Dr. Leo Galland, MD, FACN, director of the U.S.-based Foundation for Integrated Medicine.

[Though it is technical in parts, this article also clearly explains the roles of essential fatty acids (EFAs) at the cellular level and the role that EFA deficiencies/imbalances may play a role in atopic conditions – including six case histories involving individuals with different atopic symptoms who received dietary supplementation with EFAs.]

Sources of Testing for People in U.S. and Other Areas

Two labs offering fatty acid testing services in the U.S. and many other countries are:

Metametrix Clinical Laboratory – Metametrix is headquartered in Duluth, Georgia, and makes testing available in many parts of the world through international distributors. Their website explains some of the reasons for testing fatty acids.

Genova Diagnostics® – formerly Great Smokies Diagnostic Laborary. Genova is headquartered in Asheville, North Carolina, and makes testing available worldwide through international distributors in 19 other countries.

Testing Offer for People in Australia

I use PathLab in Melbourne for fatty acid testing. It costs $80 AUS. If anyone in Australia would like to have this test done, please send us an e-mail and we can post you a test form. Nutritional Healing will charge you no administration fees for doing this. However, we would request that you fill in a symptom questionnaire (similar to the list shown above) so that we can analyze the correlation between fatty acid levels and signs/symptoms.

Blake Graham, BSc (Honours), AACNEM
Clinical Nutritionist, Perth, Western Australia

* Blake Graham is director of the Nutritional Health Integrative Health Clinic in Perth. He specializes in nutritional & environmental treatments for individuals with chronic medical conditions. This information is reproduced with kind permission from his Nutritional Healing Newsletter at

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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