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Fish Oil

Docosahexaenoic Acid (DHA); Eicosapentaenoic Acid (EPA); Omega-3 Fatty Acids; Omega-3 Oil(s)

Proposed Uses: General health; Heart Disease Prevention; Rheumatoid Arthritis; and many others

Fish oil contains omega-3 fatty acids, one of the two main classes of essential fatty acids. Essential fatty acids are special fats that the body needs for optimum health.

Interest in the potential therapeutic benefits of omega-3 fatty acids began when studies of the Inuit (Eskimo) people found that although their diets contain an enormous amount of fat from fish, seals, and whales, they seldom suffer heart attacks. This is presumably because those sources of fat are very high in omega-3 fatty acids.

Subsequent investigation found that the omega-3 fatty acids found in fish oil have various effects that tend to reduce risk of heart disease and strokes. However, research into whether use of fish oil actually prevents these diseases, while somewhat positive, remains incomplete and somewhat inconsistent

Fish oil has also shown promise as an anti-inflammatory treatment for conditions such as rheumatoid arthritis, menstrual pain, and lupus. In addition, it may be helpful for various psychiatric conditions.

Requirements/Sources
There is no daily requirement for fish oil. However, a healthy diet should provide at least 5 g of essential fatty acids daily.

Many grains, fruits, vegetables, sea vegetables, and vegetable oils contain significant amounts of essential omega-6 and/or omega-3 fatty acids, but cold-water fish is the richest natural source of omega-3 fats.

Therapeutic Dosages
Typical dosages of fish oil are 3 to 9 g daily, but this is not the upper limit. In one study, participants ingested 60 g daily.

The most important omega-3 fatty acids found in fish oil are called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). In order to match the dosage used in several major studies, you should take enough fish oil to supply about 2-3 g of EPA (2000-3500 mg) and about 1-2.5 g of DHA daily (1000 to 2500 mg). Far higher doses have been used in some studies, however.

Some manufacturers add vitamin E to fish oil capsules to keep the oil from becoming rancid. Another method is to remove all the oxygen from the capsule. If possible, purchase fish oil products certified as free of significant levels of mercury, toxic organochlorines, and PCBs.
Flaxseed oil also contains omega-3 fatty acids, although of a different kind. It has been suggested as a less smelly substitute for fish oil. However, it is far from clear whether flaxseed oil is therapeutically equivalent to fish oil.

Heart Disease Prevention
Studies on fish or fish oil for preventing cardiovascular disease, slowing the progression of cardiovascular disease, and preventing heart-related death have returned somewhat contradictory results that suggest that fish oil's benefit to heart disease, if any, is slight.

Fish oil has been specifically studied for reducing triglyceride levels in people with diabetes, and it appears to do so safely and effectively.

Some but not all studies suggest that fish, fish oil, or EPA or DHA separately may additionally raise the level of HDL ("good") cholesterol and possibly improve other aspects of cholesterol profile as well.

Additionally, fish oil may help the heart by "thinning" the blood and by reducing blood levels of homocysteine, although not all studies have found a positive effect.

Rheumatoid Arthritis
The results of numerous small double-blind trials indicate that omega-3 fatty acids in fish oil can help reduce the symptoms of rheumatoid arthritis. The benefits of the fish oil effect may be enhanced by a vegetarian diet. Simultaneous supplementation with olive oil (about two teaspoons daily) may further increase the benefits. However, unlike some conventional treatments, fish oil probably does not slow the progression of rheumatoid arthritis.

Menstrual Pain
Regular use of fish oil may reduce the pain of menstrual cramps.

Bipolar Disorder
A 4-month, double-blind, placebo-controlled study of 30 individuals suggests that fish oil can enhance the effects of standard treatments for bipolar disorder.

Schizophrenia
Five double-blind, placebo-controlled studies have been performed on EPA for the treatment of schizophrenia, with benefits seen in four out of the five.

Raynaud's Phenomenon
In small, double-blind studies, fish oil has been found to reduce the severe finger and toe responses to cold temperatures that occur in Raynaud's phenomenon. However, these studies suggest that a higher than usual dosage must be used to get results, perhaps 12 g daily.

Osteoporosis
There is some evidence that essential fatty acids may enhance the effectiveness of calcium in osteoporosis.

Safety Issues
Fish oil appears to be generally safe. The most common problem is fishy burps. However, there are some safety concerns to consider.
For example, it has been suggested that some fish oil products contain excessive levels of toxic substances such as organochlorines and PCBs. If possible, try to purchase fish oil products certified not to contain significant levels of these contaminants. Note: Various types of fish contain mercury, but this has not been a problem with fish oil supplements, according to reports on consumerlab.com.

If you decide to use cod liver oil as your fish oil supplement, make sure you do not exceed the safe maximum intake of vitamin A and vitamin D. These vitamins are fat soluble, which means that excess amounts tend to build up in your body, possibly reaching toxic levels. The official maximum daily intake of vitamin A is 3,000 mcg for pregnant women as well as other adults.

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