While theoretical mechanisms of action and epidemiological data point to a potential platelet inhibitory effect of ALA, 40 human studies have not shown a consistent antiplatelet effect. 8 When 15 hypercholesterolemic subjects consumed 3 slices of bread containing flaxseed plus 15 g of ground flaxseed daily for 3 months, thrombin-stimulated platelet aggregation decreased with the flax supplement. 22 Another study reported that 40 g of flaxseed oil over 23 days produced an increase in the platelet EPA to arachidonic acid ratio, which suggests that flaxseed oil may decrease the tendency of platelets to aggregate. 41
The disorder has been found in blacks, whites, American Indians, and Latin Americans, as well as in families from Malta, Jordan, and Pakistan. Imperato-McGinley et al. (1991) described a cluster of male pseudohermaphrodites in the Simbari Anga linguistic group in the Eastern Highlands of Papua New Guinea. Their studies revealed a phenotypic and biochemical profile similar to that in patients studied in the Dominican Republic, except for a greater abundance of facial and body hair. DHT is responsible for masculinization of the external genitalia of the fetus and for masculinization at puberty. The virilization at puberty in PPSH may be related to the facts that the reductase is not completely absent and that low levels of DHT are found in plasma.