Q: I’ve been suffering from an undiagnosed rheumatic disorder for five years. Since my eyes were affected, I started taking fish oil.

A few months later, I developed an irregular heart rhythm and read your article about the link with fish oil. I stopped the fish oil and several days later, the situation improved. Can you tell me more about fish oil and heart rhythm disturbances?

A: Scientists have conducted a number of randomized placebo-controlled trials to determine whether the omega-3 fats in fish oil have cardiovascular benefits. One study with more than 8,000 people at high risk for heart attacks tested icosapent ethyl (Vascepa), a prescription drug that acts like eicosapentaenoic acid, one component of fish oil (New England Journal of Medicine, Nov. 10, 2018). This medicine significantly reduced the chance of a heart attack or stroke. However, it also slightly increased the likelihood of atrial fibrillation.

Investigators recently analyzed data from a trial that included more than 1,000 older Norwegian heart attack survivors (Journal of Internal Medicine, Jan. 4, 2022). People whose blood levels of eicosapentaenoic acid increased the most were least likely to develop serious heart problems, but they did have a higher risk of AFib.

Q: I was diagnosed with ulcerative colitis at age 70. Mesalamine controls most of the symptoms except gassiness and bloat. Simethicone doesn’t help.

I tried Lactaid, and the impact was immediate and amazing. I have never had a sensitivity to dairy, so this puzzles me. I don’t know why it works, but I’m glad it does!


A: The sugar in dairy products (lactose) can cause symptoms such as gassiness, bloating, cramps and diarrhea for people who lack the enzyme lactase. Lactaid supplies that enzyme if taken at the same time as the lactose-containing food.

Many people may not realize that they are lactose intolerant. According to the National Library of Medicine, about 30 million Americans develop this condition. You may not have realized you were susceptible until you started adding lactase to your regimen.

Q: Is there still a problem with generic Wellbutrin? I take bupropion for depression and am getting no relief from my most recent prescription. I wonder if the manufacturer is not doing a good job. Do you have any advice?

A: We first started hearing about problems with generic Wellbutrin early in 2007. People who had been switched from Wellbutrin XL 300 to the first generic version of this drug reported problems. Many experienced side effects such as anxiety, dizziness, nausea, tremor, headache, irritability and insomnia. They often reported a return of depression, and some became suicidal.

We brought this to the Food and Drug Administration’s attention, and five years later the agency determined that a number of generic bupropion products were not bioequivalent to the brand name.

You can learn more about this scandal in our eGuide to Saving Money on Medicines. This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

We have again begun to hear complaints from other readers about generic bupropion problems. Although brand name Wellbutrin is outrageously expensive in the U.S., you can purchase this brand-name drug for far less from a legitimate Canadian pharmacy.