Fish Oil

Uses and Choosing the Best Product

There is much to know about fish oil. Why should I take it and what is the correct dose? What should I look for when purchasing a product? How do I know it is safe? Let's start from the beginning.

Why take fish oil?
Long-chain polyunsaturated fatty acids are an essential part of our diet. Marine vertebrates are the main source of omega-3 fatty acids which contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). EPA and DHA are eicosanoids (signaling molecules) that are known to decrease inflammation throughout the body and have overall health benefits due to their involvement in many bodily processes. Inflammation is a well-researched cause of many types of illness, thus reducing it can be one of the best methods of preventing disease (1).

Heart disease has been the most well researched area for use of fish oil. Studies have shown that fish oil can reduce risk of arrhythmias, decrease triglycerides, lower blood pressure and slow growth rate of atherosclerotic plaques (2).

Joint health is affected by inflammation thus fish oil has been found to be beneficial in reducing pro-inflammatory elements in white blood cells and improving pain from rheumatoid arthritis (3) and osteoarthritis (4).

Skin conditions including psoriasis, acne, eczema, dermatitis all are improved with use of essential fatty acids. Often the body is deficient in these important skin nutrients and once increased in the diet along with other dietary adjustments can resolve or greatly improve the condition. Hallmark signs of deficiency include dry, scaly, itchy skin (5).

Mental health is one of the newer promising areas of study with the utilization of fish oil. Bipolar disorder and depression have both been studied and mood and mood swings have both shown improvement with use of fish oil (6,7).

Other areas that essential fatty acids support the body are immunity including allergies, eye health and fetal development.

Dosing
Dosing varies based on condition and body weight. Generally I recommend a total of EPA/DHA 1000mg-4000mg daily. This is not the Total omega-3 or total fish oil dose you see on the label. Always look to see how much EPA and DHA are in the fish oil and take enough of the liquid or capsules to ensure you get the recommended dose. (See Nordic Naturals liquid fish oil label below. The total EPA/DHA is 1375mg per 1 Teaspoon.)

Capsules or Liquid
Either are fine. The capsules will dissolve and are as available to your digestive tract as the liquid. The capsules are easier to take for some people who don't like the fishy taste or texture of the liquid. I often recommend taking your oil at night before bed if burping of fish flavor is an issue for you. You won't notice this in your sleep!

Storage
Always keep your fish oil in the refrigerator once it is opened to prevent your oil from going rancid. If the oil smells rancid do not use it as it has oxidized and you don't want to add oxidative stress to your body.

Safety
It has become clear that sourcing quality fish to make fish oil is of paramount priority. As our oceans have become more polluted with chemicals and metals, which fish then contain in their body and organs, having a high standard of choosing fish and processing the oil is necessary. Knowing the practices of the company you choose your fish oil from is the first place to start. High quality fish oil generally comes from cod liver and fish that are small such as sardines and anchovies as they are abundant in EPA and DHA and low in heavy metals. Companies that test every batch of their product assures to a greater extent that the fish oil is free of harmful chemicals and metals. Also, companies that have third-party testing outside of their own facility assures proper data for the product.

Sustainable fishing practices are also an important area with regards to production. The supply of fish in our seas is threatened due to overfishing, thus purchasing a high quality fish oil from a company that also focuses on sustainable fish harvesting supports the ongoing availability of this source of essential fatty acids.

Companies I recommend are Nordic Naturals, Vital Nutrients and Carlson's.

For more information on sustainable fishing practices and safety check the International Fish Oil Standards Program (IFOS) http://www.iffo.net/.

Side Effects
Fish oil is safe for most people including pregnant and breast-feeding women. At low doses (1-3mg) side effects are generally not noted aside from the possibility of digestive upset. At higher doses >3g blood clotting may be affected and there may be an increased risk of bleeding. Discuss taking fish oil with your doctor if you are on a blood thinning medication such as coumadin, have a clotting disorder or are having surgery.

References

1. Am J Clinical Nutr. 2008 Jun;87(6):1978S-80S.

2. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Fish-and-Omega-3-Fatty-Acids_UCM_303248_Article.jsp

3. Arthritis Rheum. 1995 Aug;38(8):1107-14.
4. Osteoarthritis and Cartilage. 2011 Sept;19(9):1150-1157.
5. Dermatoendocrinol. 2009 Sep-Oct; 1(5): 262-267.
6. Curr Opin Psychiatry. 2013 Jan;26(1):33-40.
7. Translational Psychiatry (2001)1.

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