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Hooked on The Idea of Taking Fish Oil Supplements? Before You Start, Learn About the Benefits and Potential Side Effects.
Fish oil is on a roll.
Its difficult to open up a health or fitness magazine, browse the Internet or turn on the TV without seeing yet another piece on this wonder supplement. The health claims made in the media and online are often as amazing as the idea that we can distill down the oil of hundreds of fish into a single capsule: Reduce heart disease! Prevent cancer! Stave off depression! Stop arthritis! Improve your mood!
Not since Linus Pauling published his work on the benefits of Vitamin C (which has come under increased scrutiny by scientists in the past few decades), has there been so much buzz around a single supplement.
So before we dig into some of the possible benefits (and the potential side effects) of fish oil, lets take a look at how we got here in the first place.
A Brief History of Fish Oil
The whole fish oil story started with a simple observation: People who had diets high in certain types of fatty, cold-water fish appeared to have lower rates of heart disease than other populations who ate less fish. The traditional Japanese diet, for example, contains large amounts of fish, as do certain Norwegian and arctic populations (like the Inuit.)
Scientists were intrigued enough with this correlation that they started to conduct studies to see if whether including more cold-water fish in the diets of people who dont normally eat fish, could produce a similar benefit. Their results, while not conclusive, did find a strong correlation between the consumption of certain fats contained in fish, and decreased risk for certain form of heart disease.
So whats so great about fish?
Aside from being high in protein and low in cholesterol, most species of fish are high in three kinds of essential, non-saturated fatty acids called Omega-3s: α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).Essential means that youre body can not create these fatty acids on its own you have to include them in your diet.
Its these fatty acids that scientists believe contribute to the health benefits of fish consumption. As research around Omega-3s and their health benefits began to emerge, fish joined the ranks of olive oil as a source of healthy fats that may have protective qualities for the body. In fact, results were encouraging enough that in 2004, the U.S. Food and Drug Administration gave a qualified health claim to EPA and DHA, saying that supportive, but not conclusive research had shown that consumption of EPA DHA may reduce the risk of coronary heart disease.
Fish oil as a medicinal treatment has actually been around for centuries. Cod liver oil has been a folk remedy for all kinds of aches and pains. However, fish liver oils are also relatively low in Omega-3s and high in Vitamin K, which can be toxic in high doses.
In the past 20 years, manufacturers have gotten much better at purifying and distilling down fish oil, to the point where they can actually standardize and control the amount of Omega-3s in the finished product. This has allowed people to get more Omega-3s in their diet, even if their actual fish consumption is relatively low. Its also replaced cod liver oil as a safer, more concentrated form of the healthy fats in fish.
Understanding Omega-3s
Omega-3s are interesting because there are only a few sources of these fatty acids in nature. Fish by far has the highest concentrations, and then flaxseed and then smaller amounts in things like walnuts and almonds.
Omega-3 is an essential unsaturated fatty acid, meaning that along with Omega-6 fatty acids, your body requires a certain amount of it, in the proper ratio to other fatty acids, for proper cellular function. The problem is that because the typical Western diet is so high in grain and corn (which is rich in Omega-6 fatty acids), the ratio of Omega-6 to Omega-3 is often between 10:11 to 30:1, when it ideally should be 5:1. Your body needs Omega-6s, just not in the large quantities that are typically characteristic of modern, Western diets.
There is some research to indicate that this high Omega-6-to-Omega-3 ratio could be contributing to a whole host of health issues, especially inflammatory disease like arthritis and auto-immune disorders like allergies.
Even societies (like the Japanese) that have traditionally included large amounts of fish in their diet seem to be experiencing some of the negative effects of this imbalance of Omega-3s-to-Omega-6s as they have shifted toward a more Western diet, that contains higher amounts of grain and corn-fed beef.
Health Benefits of Fish Oil and Omega-3s
While the initial focus of research around Omega-3s focused on their potential to reduce the risk of heart disease, studies over the past few years have also suggested (though not conclusively proven) a wide-range of possible additional health benefits to fish oil and Omega-3 supplementation, including:
- Improvements in circulatory health
- Decreased risk of stroke
- Decreased blood pressure
- Reduction in blood triglyceride levels
- Improvements in mood and cognitive ability
- Mild anti-depressant effects
- Improved immune function in infants
- Anti-inflammatory properties that may help reduce the symptoms of rheumatoid arthritis or neck, back and joint pain
Fish Oil and Heart Disease
There is a growing body of evidence that suggests that fish oil supplementation may reduce the risk of heart disease.
The actual mechanisms are complex, since fish oil supplementation seems to reduce certain precursors to heart disease like blood triglycerides, while also improving circulation and reducing blood pressure. This may have a preventative effect, although it is not a treatment for existing heart disease. However, a 1999 study of patients with myocardial infarction, found that treatment of 1 gram per day of Omega-3 fatty acids reduced the occurrence of death, cardiovascular death and sudden cardiac death by 20%, 30% and 45% respectively. Furthermore, a study found that supplementation with EPAs from fish oil decreased the thickness of the caratid arteries in Japanese men with unhealthy blood sugar levels and improved blood flow, versus those who received a placebo.
But before you get too excited, you should also know that Omega-3s are not for everyone especially those with certain pre-existing heart conditions. Individuals with congestive heart failure, chronic recurrent angina or evidence that their heart is receiving insufficient blood flow are advised to talk to their doctor before taking fatty acids, since they may actually aggravate, rather than treat, these conditions. In some cases, this can be fatal.
Fish Oil Health Claims That Still Require Additional Research
Although there is strong clinical evidence that suggests consuming omega-3 fatty acids can reduce blood pressure, triglyceride levels, sudden heart attack, inflammation and rheumatoid arthritis, there is also a long list of health claims of fish oil that are less conclusive and require additional clinical research. These include:
- Age-related macular degeneration
- Agina pectoris
- Asthma
- Atherosclerosis
- Attention Deficit Hyperactivity Disorder (ADHD)
- Learning and Behavioral Disorders
- Bipolar Disorder
- Cancer Prevention
- Cardiac Arrhythmias
- Colon Cancer
- Acute Coronary Disease
- Cystic Fibrosis
- Dementia
- Depression
- Eczema
- Increase Energy Efficiency and Metabolism
- Epilepsy
- Increase Infant Body Mass/Growth Rates
- Improved Immune Function
- Inflammatory Bowel Disease (IBD)
- Lupus
- Prostate Health
- Psoriasis
- Schizophrenia
- Stroke Prevention
- Diabetes
- High Blood Cholesterol
Recommended Dosage of Fish Oil
In healthy adults, the American Heart Association recommends individuals eat two servings of fish a week. Fatty fish, such as anchovies, carp, bluefish, catfish, halibut, salmon, herring, lake trout, whitefish, mackerel, pompano, tuna and striped sea bass, are the best. The World Health Organization recommends consuming 0.3-0.5 grams of EPA plus DHA daily and between 0.8 to 1.1 grams of alpha-linolenic acid (ALA) per day. Women who are pregnant or nursing should consult a doctor regarding fish consumption, because of concerns around heavy metal and PCB contamination especially if you are eating Great Lakes fish. Also, if you have fish-related food allergies, youll obviously want to skip the fish oil supplements.
How much fish oil is that? It really depends on the concentrations of EPA and DHA in the fish oil capsules you purchase.
For example, a single serving (one fish oil capsule) Natures Bounty Omega-3/Omega-6 Fish Oil Capsules (1200 mg) contains 216 mg of EPA and 144 mg of DHA. To reach a half gram of EPA and DHA, youd need to consume around two capsules a day. Some capsules have higher and lower amounts of EPA and DHA, so its really necessary to read the label. Remember, there is 1000 mg in a gram. So 0.5 grams is about 500 mg each of DHA and EPA.
Non-Animal or Non-Fish Sources of Omega-3 Fatty Acids
If you are a vegan or vegetarian and do not consume fish, there are some alternative sources of Omega-3 fatty acids, in particular ALA.
Non-animal sources of ALA include rapeseed oil (canola), soybeans, walnuts, perilla, hemp, chia (yes, its more than just a pet) and the big, ALA powerhouse, flaxseed.
However, unlike the Omega-3 fatty acids in fish, ALA is a precursor to DHA and EPA. This means the body has to convert the ALA into DHA and EPA. Unfortunately, the body isnt particularly effective at doing this, so the amounts of DHA and EPA that become available to the body from the ALA in flaxseed is substantially less than with fish oil. Therefore, you may need to consume higher amounts of ALA from flaxseed or other vegetarian sources than with fish to achieve the recommended EPA and DHA intake levels.
There is some preliminary research that has associated ALA intake with increasedrisk of macular degeneration and prostate cancer. However, in the case of the prostate cancer research, this was a meta-study, which examined other studies to arrive at its conclusions. Meta-studies continue to be somewhat controversial from a methodology standpoint, so you should be careful about drawing too many conclusions from them.
Potential Side-Effects of Fish Oil Supplementation
The US Food and Drug Administration (FDA) considers intake of up to 3 grams of omega-3 fatty acids from fish as generally safe. There are a few warning however. There is a slight risk of increases in blood sugar levels among diabetics. Omega-3 fatty acids may also increase the risk of bleeding (since they thin the blood), although there is little evidence of significant risk at lower doses (under 3 grams.) Extremely high levels may increase the risk of hemorrhagic stroke, and high level fish oil intake has also been associated with nosebleeds and blood in the urine.
Also, make sure your doctor knows you are supplementing with fish oil, especially if you are undergoing a surgical procedure, since fish oil can reduce blood clotting.
There may be some stomach or intestinal upset with fish oil, including diarrhea, increased burping, acid reflux and indigestion, and abdominal bloating. Taking fish oil supplements with food, versus on an empty stomach, can help prevent some of these minor but annoying side effects.
As always, its a good idea to consult with your physician before starting any supplementation program.
My Own Experience With Fish Oil
I personal supplement with 3-4 grams of fish oil a day, taken in two doses two grams in the morning with breakfast and another two with dinner or before bed.
I started taking it primarily for the cardio-vascular benefits, but discovered that it appears to have a positive (though completely anecdotal) additional benefit. Ive had a moderate-to-severe problem with neck pain for about eight years and tried everything from muscle relaxants to a chiropractor with mixed results. After about two months of fish oil supplementation, I found that my neck pain had nearly disappeared.
As an experiment (completely non-scientific), I stopped fish oil supplementation for about six weeks, and began experiencing a return of neck pain symptoms. When I resumed supplementation, the symptoms subsided. This could, of course, have been the result of a placebo effect, so its not conclusive.
However, in my case, I would prefer to take the fish oil capsules (even if they are acting as a placebo) than over-the-counter anti-inflammatories, which have never been particularly effective at reducing the neck pain in the past.
There also appears to be some clinical research to support my own experiences with reduced neck pain as a result of fish oil supplementation. A study published in the journal Surgical Neurology by researchers from the University of Pittsburgh Medical Center found that fish oil supplementation was as effective in reducing acute and chronic non-specific neck and back pain as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuproben, with less serious potential for side effects.
I am personal trainer in Arizona and would like to use your fish oil information on an exercise and health DVD for clients. In appreciation for use of your information I will list any organization information and web site you may have. Please contact me if you are interested. Thanks, Lou Ettore
I am personal trainer in Arizona and would like to use your fish oil information on an exercise and health DVD for clients. In appreciation for use of your information I will list your organization information and web site. Please contact me if you are interested. Thanks, Lou Ettore
Hi Lou, thanks for stopping by. Id be glad to let you share my fish oil information as part of your DVD project. Ill reach out to you directly via e-mail to discuss.
Hello Matt, Great article. My doctor has recommended I take 4 grams of fish oil per day. He claims Norwegian fish oil is the best. Can you recommend a brand and where to buy it? Thanks. Dave Reynolds
Dave, what you really want to look for is a fish oil with a high percentage of DHA/EPA the two forms of fatty acids that give fish oil its health benefits.
From a cost perspective, the more concentrated the DHA/EPA levels, the better the bargain (you wont have to take as many capsules to get the same health benefits.) In terms of brands there are a number of brands you can choose from, and they will vary in price although quality differences are generally overstated.
In general, the differences between fish oils are more marketing hype than reality. While there is a lot of talk about fish oil purity (especially from the fish oil manufacturers themselves) studies have found that most major brands contain very few contaminants (PCBs, mercury, etc.) This is the primary concern for most people.
In fact, a study published in the January 2005 Archives of Pathology and Laboratory Medicine found that fish oil supplements were safer than eating fish from the perspective of toxic substances.
The study looked at five major fish oil brands (Omega Brite, Kirkland, Natrol Sundown, and CVS) and found that all of them had levels of mercury, polychlorinated biphenyls, and organochlorine [OC] pesticides below the detectable limits. Furthermore, a study of 50 brands of fish oil supplements conducted by ConsumerLab.com found all of them to be free of PCBs, mercury and lead.
Bottom line is that brand and marketing claims are just that. Choose the fish oil supplement with the highest DHA and EPA and go with that. Your local pharmacy, health food store or GNC will have plenty of varieties. There is nothing particularly magical about Norwegian Fish Oil (Indeed, most fish oil will come from cold water regions like Norway, Iceland, and Denmark the rest comes from Peru and Chile), so go with the brand that is the most cost-effective from a DHA/EPA concentration perspective.
Best of luck and stop by again!
Matt
Matt,
Thank you very much for your detailed answer. Hopefully others will benefit from your expertise.
Dave
I discovered (before getting info from this site) the many benefits of fish oil so Ive started to ingest it. well I tried. My neurologist didnt think ill of doing so, so I started though it plugged up my system/stool Ive tried again last night but since I got some blood in the toilet I knew it had caused bleeding. I know fish oil will do a lot of benefits toward my control of Partial Complex Secondary Generalized Epilepsy so I wanted to discover how to avoid that result. I found out taking it with food is a good chance.
I am concerned a one little incident. i recently cleaned myself out to take a colon test.
during the process. with disposal bowels. i notice about 20 or more capsules that i had taken that had not digested. apparently these things dont really digest. Is this what is suppose to happen or should a person take laxatives often to get rid of the empty capsules.
I highly recommend Carlson fish / cod liver oil (very high quality). Fish oil in the summer. Cod liver oil in the winter.
Make sure you take extra A,C, E, Selenium and D3 as well. Hydrate, hydrate, hydrate.. best of health to you all.
Yes Fish oil capsules are very convenient. I do take some at time during the year. I also try to eat a lot of fish and take a break from the pills
Ive been using fish oil for some time due to high triglycerides, and they are working wonderful for me. I go off of them, and the triglycerides go back up again. I think it would be best for me to just suck it up and take them everyday.
Hi Matt,
I just found your site, very interesting. new to fish oil supplements. I recently went to the Dr for menopausal symptoms and besides hormone treatment the Dr told me to take Salmon oil. I bought some Trader Joes Molecularly distilled Salmon oil, 1000mg EPA 120 mg and DHA 80mg, suggested use: 1 soft gel tab daily. But if I understand you correctly, i would really take 4 of these tablets per day to get approx. .5g of EPA and DHA per day.
Also my Dr recomended Alaskan Fish oil Orthomega 3 or Super EPA/DHA, 3 tabs per day, or use Carlsons fish oil, 1 TBL/per day. What is your opinion on these brand recomendations?
Thanks
Cindy
I am 36 years of age and I started taking fish oil about 2 months ago. This my seem strange, but it has been said that fish oil has many benifits, I am starting to be a believer. I have notice in the last 2 to 3 years that my hair has been thinning in the top of my head, but every since Ive been taking the fish oil my hair has thicken, its almost just as thick as the side of my head. I was just wondering has any one else have the same results.
Do you think fish oil will help with shoulder subluxation? Im thinking the anti inflammatory will help reduce the pain
The advantages of Omega 3 are innumerable. Sadly the vegetarians have very few options for the supplements to get their quota of omega 3 fatty acids.
fish oil is amazing from my own experience. you feel the difference right away the first day taking it. i highly recommend the brand Barleans for high quality organic oil. price is reasonable and excellent quality. you can find it at theWholeFoods stores or order online withVitacost. order shipping is free for puchases over 50 dollars. fish oil price at the stores is $25/250 softgels + tax. vitacost price is only 20 dollars and no tax
Interesting post, particularly about the alevement of back pain with fish oil. The benefits of this food supplement just keep on coming.