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3 gm daily, was begun. Within 2 months book there was complete disappearance of premenstrual mastodynia and dysmenorrhea. The perimenstrual melasma. had also cleared. The patient began to complain of dry skin. The dose of Max-EPA was reduced to 2 gm daily, and EPO was reintroduced into the therapeutic regimen at book a dose of 2 gm per day. Skin dryness cleared and there was no return of dysmenorrhea, mastodynia, or melasma. After several months of this therapy, the patient developed dryness and a loss of luster and body to her hair. which improved when Max-EPA was book discontinued. After 29 months. she continues to find that supplementation with LSO, 15 gm every other day, is required to prevent dysmenorrhea. Comment This patient's EFA problems are much more complex than those of Case 2. Her plasma phospholipid fatty acid levels, drawn after 1 month of EPO, suggest a partially compensated block of D6DH (AA is normal-, all other LA metabolites are low).
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