![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 38. Go back in thread:
Posted by Maisy on June 24, 2001, at 19:46:59
In reply to Omega-3 fish oil in psychiatry., posted by eoflaherty on June 24, 2001, at 17:24:15
Does it have to be fish oil? I believe that omega 3 fatty acids are also found in flax seeds. Comparable??
Posted by yo-wazzzup on June 24, 2001, at 21:28:36
In reply to Re: Omega-3 fish oil in psychiatry., posted by Maisy on June 24, 2001, at 19:46:59
> Does it have to be fish oil? I believe that omega 3 fatty acids are also found in flax seeds. Comparable??
You read my mind... I'm a vegetarian. I won't touch fish. I take UDO'S CHOICE CERTIFIED ORGANIC ULTIMATE OIL BLEND to supplement my eating habits. If I recall, omega 3 & 6 are essential fatty acids that your body doesn't produce on it's own. The blend I take contains flax oil, sunflower oil, sesame oil, MCT (medium chain triglycerides, evening primrose oil, soy lecithin (GMO free), rice bran & germ oils, oat bran &germ oils, rosemary extract,tocotrienol; the oils in this blend supply a range of fatty acids including a 2:1:1 ratio of omega 3, 6, & 9. I know that Flax seed oil is god for omega 3 & 6 as well as hemp seed oil too.
Posted by lissa on June 24, 2001, at 21:44:13
In reply to Omega-3 fish oil in psychiatry., posted by eoflaherty on June 24, 2001, at 17:24:15
I've been keeping up with the research on this too. For me, the fish oil did not work well, but I am glad you and your patients have found such success with it. Congratulations.
My question for you is maybe a little off-topic. Not being a scientist or doctor, I am just wondering how researchers come up with these hypotheses. To say that the reason fish oil works is because our ancestors lived by the sea; to say they have lower incidences of mental disorders and some forms of cancer is because they eat fish; for an African doctor to travel to New York and hypothesize that his subsequent depression was caused by changes in light -- well, it all seems far-fetched to me and I wonder how they get funding. I'm not mocking their efforts, sometimes I guess this is how science works.
As for me, I find my moods correlate highly with changes in barometric pressure. If I were to hypothesize about the Japanese, then, say, I'd say they have lower incidences of mental disorders because most live at low altitude near the coast where the barometric pressure tends to be higher (I correlate low and falling pressure with low moods and rising and high pressure with better moods) ... So, yeah, that's what I might say, but it would still be really, really far-fetched. If I were really a scientist, do you think I could present this as a hypothesis, be taken seriously by my colleagues, and get funding? It seems so bizarre to me.
Well, however it is that the fish oil is helping your patients is not the issue here. I'm glad it is helping and that you have so astutely kept up with the research for their benefit.
Best Wishes,
Lissa
Posted by Sulpicia on June 25, 2001, at 0:25:10
In reply to Omega-3 fish oil in psychiatry., posted by eoflaherty on June 24, 2001, at 17:24:15
> Phew -- sorry but what a mess!
A correct version of the reasoning behind the efficacy of fish oil -- specifically the essential fatty acids DHA [docosapenaetic acid sp?] and EPA [eicosapentaetic acid] in LIMITED psychiatric disorders can be found in Andrew Stoll, The Omega Nutrition Solution -- check Amazon.com for the full ref.
Some corrections: our ancestors didn't come from the sea, they came from semi-tropical rainforests -- and the sea has nothing to do with the argument here at all. In a nutshell, the paleolithic diet, especially the game, allowed our ancestors to have a diet much higher in important essential fatty acids, especially DHA and EPA. The modern diet by contrast is much lower in essential fatty acids and this situation is exacerbated by diets relatively high in saturated fats and trans fatty acids, the latter of which decreases or prevents the absorption of the essential fatty acids that we do eat.
Some research shows that indigenous populations with diets high in DHA and EPA have lower levels of depression, and other studies have correlated depression with low levels of DHA in the blood. there are some problems with these studies, especially the basic caveat about epidemiological studies per se, but there is an emerging body of research that suggests supplementation with EFA and DHA may help in certain psychiatric disorders.The real problem is that essential fatty acid metabolism is extremely complex.
To start with: people with bipolar disorder should consult Stoll's 1999 paper [sorry no citation, wrong computer tonigh] -- research has clearly demonstrated that bipolars must take EPA in dosages AT LEAST TWICE AS HIGH as the dose of DHA. They learned very early in the study that DHA alone or in ratios of less than 2:1 pitches bipolars into severe depression. And nobody stopped or lowered meds -- the study showed that the bipolars on supplements and meds had fewer incidences of destabilization.
The metabolic complexity comes into play very quicky once you start reading about essential fatty acids. For them to be metabolized at all, you have to exclude all trans fatty acids from your diet. Then you have to cope with the form of the supplement: esters are poorly absorbed unless consumed with a high fat meal so probably a de-esterated supplement is a good bet.
To assist the metabolism you also need gamma linolenic acid but only in small quantities --like a serving of steel cut oats once a day. Lots of alt. med enterprise has gotten into this research and since they want to sell things, they sell GLA supplements, usually evening primrose oil. The problem gets nasty right here: the whole point of taking EFA and DHA is to lower the level of arachidonic acid -- high levels of this depress blood levels of EPA and DHA and trigger off several classes of eicosaniods that increase inflammation, increase bad cholesterol, increase thromboxanes [blood clotting more likely] etc.
Lowering arachidonic acid does roughly [very] the opposite and this is why "eating fish" is supposed to be good for decreasing cholesterol, risk of stroke, and now, we think, helpful for depression.
GLA in small doses, along with DHA and EHA in a readily absorbable form lower arachidonic acid. High levels of GLA increase arachidonic acid and creates precisely the wrong result. Nobody knows the right amount either.
Tho many web sites that sell supplements will harp on the fact that they're totally safe and natural, and not drugs but food, but this is misleading and probably wrong. The essentail fatty acids taken as supplements are powerful bioactive substances and more is not better -- people with asthma should avoid them until research has a better understanding, and also people in treatment for cancer since if you get the beneficial effect of increasing EFA and DHA levels in the body, tumor necrosis factor decreases.I'm sorry I wrote a novel here and there is good research that backs up efficacy in some areas -- I guess I'm irritated because I've run across lots of places selling supplements without a clue of what they do. No, I'm not a med professional -- I've just finished looking at the metabolism and diet research for work I'm doing in another field.
I'll post some of the pertinent citations tomorrow so folks can judge for themselves.
and no doubt I misspelled several things...
S.
Posted by Jackster on June 25, 2001, at 2:15:53
In reply to Omega-3 fish oil in psychiatry., posted by eoflaherty on June 24, 2001, at 17:24:15
In fact I try it now on almost every psychiaric patient as well as prescribing regular medication.
If you are prescribing medication as well, how do you know it is the omega 3 working and not the medication?
Posted by Elizabeth on June 25, 2001, at 6:18:34
In reply to Re: Omega-3 fish oil in psychiatry., posted by Jackster on June 25, 2001, at 2:15:53
> In fact I try it now on almost every psychiaric patient as well as prescribing regular medication.
Indeed. Andy Stoll even uses it *himself*, which I think says a lot. My understanding is that the most reliable and standardised brand is OmegaBrite.
> If you are prescribing medication as well, how do you know it is the omega 3 working and not the medication?
You don't start more than one drug at the same time.
-elizabeth
Posted by Bill L on June 25, 2001, at 9:40:01
In reply to Re: Omega-3 fish oil in psychiatry. » Jackster, posted by Elizabeth on June 25, 2001, at 6:18:34
I just started taking it. According to Stoll, the brand should have vitamin E included to make it stable. I think he advises taking about 1,000 mg of EPA per day. I believe that the OmegaBrite brand that he recommends was developed by him so I guess he profits on sales. I bought a cheaper brand at Walmart.
> > In fact I try it now on almost every psychiaric patient as well as prescribing regular medication.
>
> Indeed. Andy Stoll even uses it *himself*, which I think says a lot. My understanding is that the most reliable and standardised brand is OmegaBrite.
>
> > If you are prescribing medication as well, how do you know it is the omega 3 working and not the medication?
>
> You don't start more than one drug at the same time.
>
> -elizabeth
Posted by Lorraine on June 25, 2001, at 9:47:34
In reply to Re: Omega-3 fish oil in psychiatry., posted by Bill L on June 25, 2001, at 9:40:01
I've been taking the Omega-brite brand for over 2 months with no noticable benefits. I decided to use Stoll's brand because of the risk of mercury toxins in other brands (his uses fish from near Alaska--where the water is purer). Anyway, I suppose this is a trial, I should abandon at this point. Hope it works for others.
Posted by shelliR on June 25, 2001, at 10:00:59
In reply to Re: Omega-3 fish oil in psychiatry., posted by Lorraine on June 25, 2001, at 9:47:34
I have been eating 1/4 cup of flax seed daily for the last several months, but also don't feel a difference. I grind the seeds in a little electric coffee grinder and add them to yogart. With lemon yogart, tastes really good, like lemon with pie crust. Really!
Even if it doesn't help my depression, it's still really good for your brain. According to my pdoc in the hospital, results should show after three months.Shelli
Posted by Cam W. on June 25, 2001, at 10:11:02
In reply to Re: Omega-3 fish oil in psychiatry., posted by Jackster on June 25, 2001, at 2:15:53
I had thought that to be able to reach therapeutic quantities of omega-3 fatty acids from fish oil, that you had to take quantities so large that one would have a fishy smell exuding from the skin.
Also, didn't Dr.J.Calabrese susbequently respond to Stoll's Archive article in issues subsequent to the May, 1999 article. Calabese had some issues with the fish oil used and the types of statistics employed in the conclusion.
- Cam
Posted by Chris A. on June 25, 2001, at 12:15:56
In reply to Re: Omega-3 fish oil in psychiatry., posted by Cam W. on June 25, 2001, at 10:11:02
I took nine grams a day without developing a fishy odor - that I know of. My husband would at least never admit that I smelled like dead fish. I limited myself to Alaskan salmon oil because of the methylmercury concerns. I discontinued it after several months as it didn't seem to be helping and I developed an aversion to swallowing all of those capsules - a bit of overload.
Is that the Archives of Psychiatry you are referring to? Is it online? Stoll stated his orginal research preliminary but promising.Chris A.
Posted by eoflaherty on June 25, 2001, at 12:34:31
In reply to Re: Omega-3 fish oil in psychiatry., posted by Maisy on June 24, 2001, at 19:46:59
>It looks as if it very difficult to get it in adequate quantities except from fish oil.It might be possible in newborns using ALA from vegetable sources such as flax oil but in adults the conversion of this to EPA and DHA seems to be poor.Strict vegetarians usually have lower levels of EPA and DHA than carnivores.Seeing that fish oil starts off as plankton which is later digested by algae it may be possible to get DHA supplements in future dirctly from the algae.I think I saw a reference to this commodity somewhere on the net.
> Does it have to be fish oil? I believe that omega 3 fatty acids are also found in flax seeds. Comparable??
Posted by Cam W. on June 25, 2001, at 12:47:26
In reply to Re: Omega-3 fish oil in psychiatry. » Cam W., posted by Chris A. on June 25, 2001, at 12:15:56
Chris - The Stoll article that everyone refers to is from the May, 1999, Archives of General Psychiatry. I do not believe it is available free online, but any university medical library should have it in the stacks and it can be copied. There is a commentary on this study by Joe Calabrese, in the same issue. Also, I have looked for, but not found the follow-up letters to the article (I have them at work). - Cam
Posted by Sulpicia on June 25, 2001, at 15:20:03
In reply to Re: Omega-3 fish oil in psychiatry., posted by eoflaherty on June 25, 2001, at 12:34:31
> >First, apologies for my earlier cranky response. Current grad school workload is killing me.
References for essential fatty acids:
Drevon, C.A., Baksaas, I. & Krokan [edd.] Omega-3 Fatty Acids: Metabolism and Biological Effects Basel (1993)
Nettleton, J.A. Omega-3 Fatty Acids and Health New York (1995)Essential fatty acids and mental health:
Smith, R.S. "The macrophage theory of depression" Medical Hypotheses 35 (1991) 298-306
Weissman, M.M. et al. "Cross-national epidemiology of major depression and bipolar disorder" J Am Med Assoc 276 (1996) 293-299
Maes, M., Smith, R.S. "Fatty acids, cytokines, and major depression" Biol Psychiatry 43 (1998) 313-314
Hibbeln, J.R. and Edwards, R.W. have some interesting papers from the NIH Workshop on Omega-3: Essential Fatty Acids and Psychiatric Diseases - I'm not sure if they've been published yet but are available from the authors if you check the workshop web site.
Between the bibliographies in the books and articles, most of the important papers should be covered.The Paleolithic diet and problems with the modern western diet:
Eaton, S.B., Konner, M. "Paleolithic nutrition: a consideration of its nature and current implications" N Engl J Med 312 (1985) 283-289
Eaton, S.B. "Humans, lipids, and evolution" Lipids 10 (1992) 814-820
Eaton, S.B., Eaton, S.B. III, Konner, M. "Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications" European J Clinical Nutrition 51 (1997) 207-216Hominid ancestry and enviroment is in the Cambridge Ancient History, Vol. 1, pt. 1 Prolegomena and Prehistory Cambridge (1981), tho probably any standard textbook on physical anthropology/archaeology would do just as well.
No more grumpy posts. I promise.
S.
Posted by shelliR on June 25, 2001, at 16:35:16
In reply to Re: Omega-3 fish oil in psychiatry., posted by eoflaherty on June 25, 2001, at 12:34:31
> >It looks as if it very difficult to get it in adequate quantities except from fish oil.It might be possible in newborns using ALA from vegetable sources such as flax oil but in adults the conversion of this to EPA and DHA seems to be poor.
>
>
Do you have any references to support the above statement? I'm not saying you are incorrect, just would like to know where you have read or learned that the conversion of flax oil to EPA and DHA are poor? Especially since I eat 1/4 cup a day!shelli
Posted by Neal on June 25, 2001, at 16:43:43
In reply to Re: Omega-3 fish oil in psychiatry., posted by Cam W. on June 25, 2001, at 10:11:02
A little off topic but, I've read some articles recently citing some studies about Omega-3 and the risk of stroke. Omega-3 seemed to have a favorable effect for stroke.
Posted by gilbert on June 25, 2001, at 20:10:20
In reply to Re: Omega-3 fish oil in general health, posted by Neal on June 25, 2001, at 16:43:43
Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals. Until the FDA starts to regulate the health food stores and supplements the quality assurance is scant. It also appears to prey on peoples wishes to control their own destiny by doctoring themselves instead of having trained professionsals tell them things they simply do not want to hear. I think we have gone back to the days of selling elixer from the back of the carny wagons it just is mass marketed and packaged and sold at GNC now.
Gil
Posted by Elizabeth on June 26, 2001, at 1:53:30
In reply to Re: Omega-3 fish oil in general health, posted by gilbert on June 25, 2001, at 20:10:20
> Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals.
Nutritional supplementation is very different from "homeopathy." Although "homeopathic medicine" is almost certainly quackery, it is true that some people can benefit from taking supplements such as folate and omega-3's. It is possible to get standardised supplements (although the "food supplement" industry is not regulated nearly as strictly as the "pharmaceutical" industry is). This is why, if you're going to try "food supplements," it's important to investigate the reliability of different brands.
There are some drugs that can cause vitamin or mineral depletion; for example, the anti-TB drug isoniazid (INH) carries a high risk of pyridoxal phosphate (vitamin B6) deficiency. When I found out I'd been exposed to TB (positive skin test, but normal chest x-ray), I took isoniazid for 6 months. My doctor said I should take the B6 supplements that the pharmacy carried rather than random over-the-counter B6 supplements. I don't know whether OTC vitamin and mineral supplements are really all that unreliable, but plant extracts (like St. John's wort) and other supplements (amino acids, inositol, SAMe, etc.) definitely can vary depending on the brand.
I mentioned OmegaBrite because the typical health-food store fish oil supplements that I've come across did not seem to have anything close to the amount of EFAs that the preliminary studies on mood disorders have found effective. Stoll is very well respected in academic medical circles as a clinician, a teacher, and a researcher, and I know that he and a number of other doctors (in the Boston area at least) have been impressed with the effects of omega-3's. The theoretical basis for this treatment is sound as well, as far as anyone can tell.
-elizabeth
Posted by mila on June 26, 2001, at 8:46:05
In reply to Re: Omega-3 fatty acids and other supplements » gilbert, posted by Elizabeth on June 26, 2001, at 1:53:30
Hi Elizabeth,
how much B6 were you taking with INH? (I have began INH treatment last Friday, also will last six months). It turns my liver into a huge hard stone. Was your test negative after the treatment? I was shocked when I accidentally discovered that I was infected last week. My arm was hugely swallen. I checked my familty, no one shows even 1 mm of induration.
mila
Posted by Jane D on June 26, 2001, at 12:23:49
In reply to Re:elizabeth, posted by mila on June 26, 2001, at 8:46:05
> how much B6 were you taking with INH? (I have began INH treatment last Friday, also will last six months). It turns my liver into a huge hard stone. Was your test negative after the treatment? I was shocked when I accidentally discovered that I was infected last week. My arm was hugely swallen. I checked my familty, no one shows even 1 mm of induration.
>
> milaMila - Is it possible that there was a false positive. There is a form of vaccination which will later produce a positive skin test. I don't know if this could apply to you. In the US it occurs in people who have immigrated from other countries where they use that form of vaccine. Unfortunately that's about all I know about it.
Jane
Posted by Ron Hill on June 26, 2001, at 12:50:38
In reply to Some reading apology:Omega-3 fish oil, posted by Sulpicia on June 25, 2001, at 15:20:03
S(L):
Thank you much for both of your posts in this thread. Very informative and I did not sense a grumpyness in your first post. In fact, I'm happy you were slightly "torqued" since the emotions gave you the energy to write a lengthy informative post.
- Ron
-------------------------------------------------> > >First, apologies for my earlier cranky response. Current grad school workload is killing me.
> References for essential fatty acids:
> Drevon, C.A., Baksaas, I. & Krokan [edd.] Omega-3 Fatty Acids: Metabolism and Biological Effects Basel (1993)
> Nettleton, J.A. Omega-3 Fatty Acids and Health New York (1995)
>
> Essential fatty acids and mental health:
> Smith, R.S. "The macrophage theory of depression" Medical Hypotheses 35 (1991) 298-306
> Weissman, M.M. et al. "Cross-national epidemiology of major depression and bipolar disorder" J Am Med Assoc 276 (1996) 293-299
> Maes, M., Smith, R.S. "Fatty acids, cytokines, and major depression" Biol Psychiatry 43 (1998) 313-314
>
> Hibbeln, J.R. and Edwards, R.W. have some interesting papers from the NIH Workshop on Omega-3: Essential Fatty Acids and Psychiatric Diseases - I'm not sure if they've been published yet but are available from the authors if you check the workshop web site.
> Between the bibliographies in the books and articles, most of the important papers should be covered.
>
> The Paleolithic diet and problems with the modern western diet:
> Eaton, S.B., Konner, M. "Paleolithic nutrition: a consideration of its nature and current implications" N Engl J Med 312 (1985) 283-289
> Eaton, S.B. "Humans, lipids, and evolution" Lipids 10 (1992) 814-820
> Eaton, S.B., Eaton, S.B. III, Konner, M. "Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications" European J Clinical Nutrition 51 (1997) 207-216
>
> Hominid ancestry and enviroment is in the Cambridge Ancient History, Vol. 1, pt. 1 Prolegomena and Prehistory Cambridge (1981), tho probably any standard textbook on physical anthropology/archaeology would do just as well.
>
> No more grumpy posts. I promise.
> S.
Posted by Ron Hill on June 26, 2001, at 13:19:16
In reply to Re: Omega-3 fish oil in general health, posted by gilbert on June 25, 2001, at 20:10:20
Gil,
I hear ya and your points have some validity. At the same time, I am not ready to throw the baby out with the wash when it comes to supplements. Via trial and error (pronounced "modern psychiatry"), I have found a few supplements that are very helpful augments to my BP II meds. Just my opinion.
-- Ron
----------------------------------------------> Maybe I am just not into the whole homeopathic approach to medicating....call me a druggie I don't care give me some good old fashioned conrolled and tested pharmeceuticals. Until the FDA starts to regulate the health food stores and supplements the quality assurance is scant. It also appears to prey on peoples wishes to control their own destiny by doctoring themselves instead of having trained professionsals tell them things they simply do not want to hear. I think we have gone back to the days of selling elixer from the back of the carny wagons it just is mass marketed and packaged and sold at GNC now.
>
> Gil
Posted by eoflaherty on June 26, 2001, at 16:49:16
In reply to Re: Omega-3 fish oil in psychiatry. » eoflaherty, posted by lissa on June 24, 2001, at 21:44:13
>Stoll in his book "The Omega-3 Connection" (available from amazon.com)points out that he started researching in 93 for a better treatment for bipolar disorder and did an extensive search of the literature to find something suitable.He does not mention Donald Rudin at that point in his book but Rudin`s research suggested years earlier that psychiatric illness had a large omega-3 deficiency as a likely cause.
> I've been keeping up with the research on this too. For me, the fish oil did not work well, but I am glad you and your patients have found such success with it. Congratulations.
>
> My question for you is maybe a little off-topic. Not being a scientist or doctor, I am just wondering how researchers come up with these hypotheses. To say that the reason fish oil works is because our ancestors lived by the sea; to say they have lower incidences of mental disorders and some forms of cancer is because they eat fish; for an African doctor to travel to New York and hypothesize that his subsequent depression was caused by changes in light -- well, it all seems far-fetched to me and I wonder how they get funding. I'm not mocking their efforts, sometimes I guess this is how science works.
>
> As for me, I find my moods correlate highly with changes in barometric pressure. If I were to hypothesize about the Japanese, then, say, I'd say they have lower incidences of mental disorders because most live at low altitude near the coast where the barometric pressure tends to be higher (I correlate low and falling pressure with low moods and rising and high pressure with better moods) ... So, yeah, that's what I might say, but it would still be really, really far-fetched. If I were really a scientist, do you think I could present this as a hypothesis, be taken seriously by my colleagues, and get funding? It seems so bizarre to me.
>
> Well, however it is that the fish oil is helping your patients is not the issue here. I'm glad it is helping and that you have so astutely kept up with the research for their benefit.
>
> Best Wishes,
>
> Lissa
Posted by lissa on June 26, 2001, at 17:44:41
In reply to Some reading apology:Omega-3 fish oil, posted by Sulpicia on June 25, 2001, at 15:20:03
> No more grumpy posts. I promise.
> S.S., your post was not cranky, I think it was a reasonable reaction to what I wrote. I’m sorry about my obnoxious post. Since I do not have the education to evaluate scientific studies on fish oil and other therapies, I should not have had an opinion on whether the reasoning behind scientists’ claims about omega-3 fish oil is sound. I was cynical because I keep trying out new alternative therapies for my problem and they haven’t helped, but that says nothing about the evidence supporting them. So, sorry for the solipsism and thanks for the citations. I'll keep out of scientific discussions from now on. I wish you the best in your research. And, for the record, I was not trying to say our ancestors were mermaids :o).
Posted by Lorraine on June 26, 2001, at 23:16:06
In reply to Re: Some reading apology:Omega-3 fish oil, posted by lissa on June 26, 2001, at 17:44:41
> > No more grumpy posts. I promise.
> > S.
>
> S., your post was not cranky, I think it was a reasonable reaction to what I wrote. I’m sorry about my obnoxious post. Since I do not have the education to evaluate scientific studies on fish oil and other therapies, I should not have had an opinion on whether the reasoning behind scientists’ claims about omega-3 fish oil is sound. I was cynical because I keep trying out new alternative therapies for my problem and they haven’t helped, but that says nothing about the evidence supporting them. So, sorry for the solipsism and thanks for the citations. I'll keep out of scientific discussions from now on. I wish you the best in your research. And, for the record, I was not trying to say our ancestors were mermaids :o).
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.