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Fish Oil
(Omega 3 Fatty Acids)


open quote logo quotation Our prescription for your heart health? Eat fish twice weekly or take the supplement containing omega 3 and 6 fatty acids. As heart disease is a leading cause of death around the world, it would be wise to add this supplement to your collection of daily herbs for a healthy heart. close quote quotation logo





Three words summarize it all. Just take it.

In our reviews, we found over 2000 published research studies on the omega 3 fatty acids.  Don't forget to add garlic to your list of daily supplements for heart health as well.

If you are looking for the best form, omega-3 fatty acids from fish oil are the absolute best choice. Only purchase from company that tells you the amount of EPA and DHA (types of omega-3 fatty acids) in their fish oil or omega-3 capsules.

Warning: This is a huge report with complete facts and details.
 


Table of Contents


Evidence of Benefits (Leaf rating system)

Leaf Natural Remedies Herbal Review Benefits Side Effects High Cholesterol (High triglycerides / Hypertriglyceridemia)

The effectiveness of fish oil in lowering high triglyceride levels is fully established in many research studies. Triglyceride levels can be lowered by as much as 50% when taking omega-3 fatty acids from supplements or dietary sources.

It is also proven to lower low density lipoprotein (LDL or "bad") cholesterol and increase high density lipoprotein (HDL or "good”) cholesterol. If you have high cholesterol, it would be best for you to consider taking omega 3 fatty acids either as a pill form or from dietary sources.

For enhanced cholesterol lowering benefits, omega-3 fatty acids may be combined with niacin.

A recent study showed that lifestyle changes and taking omega-3 fatty acids are as effective in lowering LDL as the prescription cholesterol-lowering drug simvastatin (Zocor).
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Heart Disease / Coronary Arteries Disease (CAD) / Heart Attack (Myocardial Infarction or MI)

Not only does, omega 3 fatty acids work to lower cholesterol, research studies show that it also prevent blood clots from forming leading to atherosclerosis (hardening of the arteries) and stroke.

For those people who have suffered from a previous heart attack or stroke, research shows that taking omega-3 fatty acids reduces the risk of having another one. One study published in July 2008 showed that higher blood levels of EPA and DHA leads to a lower risk of heart attack in women.

A research study published by D. Mozaffarian on using omega-3 fatty acids for preventing heart disease said "The strength and consistency of the evidence, and the magnitude of this effect are ...notable."

Leaf Natural Remedies Herbal Review Benefits Side Effects Heart Failure / Sudden Death from Heart Failure

If you are suffering from heart failure, you must take omega-3 fatty acids. The American Heart Association makes the following statement:

 "We recommend eating fish (particularly fatty fish) at least two times a week. Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)."

Scientists believe the benefit of taking omega-3 fatty acid is in preventing sudden death from heart failure because it can prevent arrhythmias (irregular heart beats).

Omega 3 fatty acids are also suspected to reduce inflammation and other conditions that can cause sudden death. Prescription cholesterol lowering medications don't work as well as omega 3 fatty acids in prevent heart failure (but they should be used for those with high cholesterol).

This latest evidence comes from a very high quality randomized, double-blind, placebo-controlled trial (the gold standard for research study design) published August 2008 in the (very highly respected) research journal Lancet. The study was conducted in 326 cardiology and 31 internal medicine centers in Italy involving 6975 patients for 3.9 years. The study used 1 gram daily of the omega 3 fatty acids.

Leaf Natural Remedies Herbal Review Benefits Side Effects Stroke

Taking omega-3 fatty acids seems to reduce the risk of stroke by just under 30%. As well, research shows that people with a high blood levels of omega-3 fatty acids has a reduced risk of stroke.

Avoid very high doses of dietary fish (greater than 46 grams/day) as some studies show that it actually increases the risk of stroke. One or two servings of fish weekly would be best.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Atrial Fibrillation / Arrhythmias

There is now considerable evidences from laboratory and clinical trials that omega-3 fatty acids of fish oil could prevent fatal arrhythmias (irregular heart beats) in animals and humans.

If you have or are at risk of developing heart disease, it is essential that you include omega-3 fatty acids as part of your preventative therapy.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects High Blood Pressure (Hypertension)

Studies show that taking 3 or more grams of omega 3 fatty acids reduces blood pressure significantly.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Attention Deficit/Hyperactivity Disorder (ADHD) / (ADD)

Studies have shown in humans and animals that lower levels of omega 3 fatty acids is related to learning and behavioral problems.

In animals, lower levels of omega 3 fatty acids resulted in lower levels of certain neurotransmitters (chemicals needed to allow brain cells to talk to each other).

Clinical studies done in children showed that taking omega 3 fatty acids resulted in significant improvements in their spelling, reading and behaviour.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Dysmenorrhea / Menstrual Pain & Cramps

There is research studies to show that omega-3 fatty acids help to decrease the pain and the need to take anti-inflammatory drugs for women and young teenagers suffering from menstrual pain and cramps.

In one research study involving 200 women, those take more omega-3 fatty acids from diet report milder symptoms of hot flashes and sweating during menstruation.
Leaf Natural Remedies Herbal Review Benefits Side Effects Age-Related Macular Degeneration (AMD)

Taking omega-3 fatty acids from supplements or dietary sources reduces the risk of getting macular degeneration leading to vision loss.

A recent study done showed that omega-3 fatty acids found in fish lowered the risk of getting complicated AMD by 30% over a 12 year period.

Several past studies showed that eating oily fish at least once per week compared with less than once per week reduces the risk of AMD.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Osteoporosis

Taking omega-3 fatty acids increases bone density, thus leading to a reduced risk of bone and hip fractures from osteoporosis. Studies in humans show that taking omega 3 fatty acids reduces bone loss over a 3 year period.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Depression

Omega-3 fatty acids are an important part of the nerve cells. Population studies suggest that eating fish lowers the risk of depression and suicide. Also depression is less in countries with a higher dietary intake of fish.

One study clearly showed that omega-3 fatty acids helped with depression in women during pregnancy. As well, omega-3 fatty acids seem to improve the benefits of prescription antidepressants.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Rheumatoid Arthritis (RA / Rheumatism)

Research studies on using omega-3 fatty acids are done show that it helps significantly to reduce joint pain, inflammation, morning stiffness and range of movement. This means that you could reduce your dosage of your prescription drugs.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Asthma

Research studies in children show that omega-3 fatty acid supplements has their asthma symptom improve compared to the group that took a placebo (sugar pill). Evidence seems to suggest that omega-3 fatty acids reduce inflammation, one of the cause of asthma.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Anorexia Nervosa / Eating Disorder

Individuals with an eating disorder might have lower levels of essential fatty acids such as omega-3's. Experts suggest eating fish or taking omega 3 fatty acids supplements to prevent deficiencies in essential fatty acids.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Autism (Severe)

In a research study, omega-3 fatty acids did not show any benefit in children with severe autism. We will need more study to see if it benefits children with mild to moderate autism.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Low Birth Weight Infants

In one research study, pregnant women with low omega-3 fatty acids tends to give birth to babies of a lower birth weight.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Weight Loss / Obesity

People who are overweight are at risk of developing type 2 diabetes (non insulin dependent diabetes) and high cholesterol. Studies show that these people get a better control of their diabetes and cholesterol when they combine exercise with a diet rich in omega 3 fatty acids.

Another study shows that exercise combined with exercise reduces body fat better than just exercise alone.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Arthritis / Osteoarthritis / Joint Pain
 
Although there is more research done for using omega-3 fatty acids in treating rheumatoid arthritis, it seems that it also benefits in people with osteoarthritis as well. There is evidence to believe that omega-3 fatty acids might prevent cartilage damage in the joints.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Bipolar Disorder

Omega-3 fatty acids when taking with prescription medications seems to benefit the depression part of bipolar disorder. However, it does not seem to benefit the manic part of the bipolar disorder.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Colon Cancer

In human studies, evidence shows that omega-3 fatty acids seem to reduce the risk of colon cancer. In another study in people, omega-3 fatty acids seem to slow down the growth of colon cancer in its early stages.

Studies seem to show that the amount of omega 3 fatty acids in your body is related to tell you the risk of getting colon cancer; those with higher amounts of it seem to have a lower risk of colon cancer.

However, we would caution you. In a research study in rats, high amounts of omega 3 fatty acids made the liver cancer (spread from colon cancer) worst.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Breast Cancer

Studies seem to indicate that women who get omega 3 fatty acids from dietary sources are less likely to get and die from breast cancer. Unfortunately, the evidence is not strong. More research will be needed to verify this.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Prostate Cancer

In animal studies, omega 3 fatty acids seems to slow down the growth of prostate cancer cells. There is no studies done on humans to verify this. The evidence is not very strong.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Endometrial Cancer

There are scientific evidences to suggest that women who eat fish twice weekly have a reduced risk of developing endometrial cancer.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Inflammatory Bowel Disease (IBD) / Crohn's Disease / Ulcerative Colitis

Omega-3 fatty acids, when combined with prescription medications seem to decrease the symptoms of IBD. However, there are other studies that show that it is no more effective than taking the prescription medications alone. Another study shows that by taking omega-3 fatty acids, the dosage of steroid medication can be reduced.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Psoriasis

One study in humans seems to show that those taking omega-3 fatty acids along with their prescription did better than those that took the medication alone.
 
Leaf Natural Remedies Herbal Review Benefits Side Effects Acne / Other Skin Conditions

One study in humans showed that omega 3 fatty acids reduced a person's skin sensitivity to sunlight exposure. Many physicians believe that taking omega 3 fatty acids supplement would help with treating acne.
 
Migraine Headaches - Probably Not Effective

Research studies show that taking Omega-3 supplement does not reduce the number or severity of migraine headaches.
 
Diabetes / Insulin Sensitivity  - Enhances Insulin Sensitivity

Omega-3 supplements does not change blood sugar levels in research studies done. However, people with diabetes are at risk of developing heart disease so omega-3 supplements are highly recommended for the other benefits.

A recent study in July 2008 showed that omega-3 fatty acids improves the insulin response to sugar in the blood (and lowers blood pressure significantly).

When insulin starts to become less effective at lowering blood sugar (called insulin resistance), this is the start towards the path of developing diabetes.
 

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Facts and Frequently Asked Questions

What is fish oil?

It contains a large amount of polyunsaturated fats (PUFAs) called omega-3 fatty acids. These are considered essential fatty acids because our body is unable to make it. The three main types of omega 3 fatty acids are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish oil contains mostly EPA and DHA. Flaxseed oil contains mostly ALA. Your body converts only a very small amount of ALA into EPA and DHA. It is EPA and DHA that your body can easily use.

Research studies clearly show that it is EPA and DHA that have the beneficial properties. As researchers have said "The type of omega-3 found in oily fish is the best kind. There's no question that EPA and DHA are vital for our hearts, brains and immune system." Avoid taking plant sources of omega-3 fatty acids such as from flaxseed oil.

Although omega-3 fatty acids are important, omega-6 fatty acids are also required in proper proportion to avoid other health problems. Experts suggest keeping the balance of about 2 to 4 times of omega-6 fatty acids to omega-3 fatty acids. Unfortunately, our current diet consists of more than 10 to 20 times of omega-6 fatty acids to omega-3 fatty acids. Experts believe that this imbalance contributes to the significant increase in inflammation-related diseases in North America.

Studies looking the dietary habits of people around the world showed that the Mediterranean diet has an excellent balance of omega-3 fatty acids to omega-6 fatty acids and some omega-9 fatty acids. This diet has been proven to reduce heart disease and cancer.

What types of foods contain omega-3 Fatty Acids?

Fishes - Salmon, halibut, tuna, mackerel, lake trout, herring and sardines.

These fishes contain large amounts of omega-3 fatty acids such as EPA and DHA. Typically 3.5 ounce of fish provides about 1 gram of omega-3 fatty acids.

Any comments from researchers and research studies?

Here what researcher R. Farah & Y. Glick had to say in his paper published in May 2008:

"...common Mediterranean dietary pattern has these characteristics: high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds, olive oil is an important monounsaturated fat source, dairy products, fish and poultry are consumed in low to moderate amounts, and relatively small amounts of red meat is eaten, eggs are consumed zero to four times a week and wine is consumed in low to moderate amounts."

A recent study has once again confirmed that people who closely follow 'the Mediterranean Diet' live longer than other Europeans and Americans and the incidence of heart disease in Mediterranean countries is lower than in the United States."

The latest studies (August 2008) published in the (very respected) journal Lancet showed that omega-3 fatty acids was better at reducing death from heart failure than prescription cholesterol lowering medication. Imagine that! This study, involving 6975 patients and followed for 3.9 years, was randomized, double-blind and placebo-controlled, the ultimate gold standard. (Side comment: We wish all evidence of benefits on using natural remedies will be done to this standards but that's just a pipedream. Can you imagine how much this type of study would cost?)

In a research paper published in 2006 by Y. Yamori, he said "that dietary factors were more important determinants of cardiovascular diseases than genetic factors." So, if heart disease "runs in your family", there is something you can do to reverse this. Take omega-3's supplements.


What are some of the symptoms you might expect to see if you are low in omega-3 fatty acids?

  • fatigue and tiredness
  • immune system problems
  • poor memory and concentration
  • skin problems like dry skin, psoriasis and hair loss
  • depression, mood swings, poor memory
  • blood circulation problems and poor circulation

Omega-3 fatty acids have be extensively studied and have the following important beneficial effects in our body:

  1. anti-inflammatory effect benefits inflammatory conditions such as psoriasis, inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus (SLE) and many others,
  2. blood-thinning effect (antithrombotic) like Aspirin, thus reducing the risk of heart attack,

  3. stabilizes the cell membrane thus may help with irregular heart beat (arrhythmias),

  4. reduce the heart rate; to prevent heart related problems,

  5. reduce hardening of the arteries (atherosclerosis),

  6. dilates blood vessels (vasodilation) to lower blood pressure and to maintain kidney functions,

  7. reduces the production of chemicals (leukotrienes) that causes asthma attack,

  8. significantly lowers triglycerides (a type of fat) in individuals with high triglyceride levels,

  9. lowers the "bad" cholesterol (LDL or low-density lipoprotein) and increases the "good" cholesterol (HDL or high-density lipoprotein),

  10. stabilizes nerve cells membrane and thus help with conditions like depression and attention deficit-hyperactivity disorder (ADHD), and

  11. reduce the formation of prostaglandins (PGs, a chemical made when cells are broken down) that can speed up tumor growth such as prostate, breast, lung and colon cancers.
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Suggested Benefits and Traditional Uses

Orally
  • acne
  • age-related macular degeneration (AMD)
  • allergic rhinitis
  • Alzheimer’s disease
  • anorexia nervosa
  • anxiety
  • asthma
  • atherosclerosis
  • atopic dermatitis
  • attention deficit/hyperactivity disorder (ADHD)
  • autism
  • bipolar disorder
  • breast cancer
  • burns
  • cancer
  • chronic fatigue syndrome (CFS)
  • chronic obstructive pulmonary disease (COPD)
  • colon cancer
  • hair loss
  • heart attack / myocardial infarction
  • heart disease
  • heart failure / sudden death from heart failure
  • insomnia
  • Crohn's disease
  • depression
  • diabetes
  • eczema
  • dry eyes
  • dyslexia
  • glaucoma
  • hay fever
  • high cholesterol
  • high triglycerides
  • hypertension
  • insomnia
  • inflammation (generalized)
  • low birth weight infants
  • lung disease
  • Lyme disease
  • macular degeneration
  • menopause symptoms
  • dysmenorrhea
  • migraine headaches
  • osteoarthritis
  • schizophrenia
  • stomach ulcer
  • pre-eclampsia
  • prostate cancer
  • Raynaud's syndrome
  • rheumatoid arthritis
  • stroke
  • systemic lupus erythematosus (SLE)
  • weight loss and ulcerative colitis
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Side Effects, Toxicity and Warnings

Side effects that have been reported include heartburn, indigestion, dyspepsia, bloating, belching, flatulence, halitosis (bad breath), nausea, diarrhea and rash. None of these side effects are harmful but they can be annoying. Taking an enteric coated or timed-release supplement helps to reduce these side effects. 

Higher doses (above 3 or 4 grams daily) might have additional concerns. It is suspected to decrease the immune functions in our body. As fish oil is a type of oil, it might increase the LDL (bad) cholesterol in some people. It also can act like an Aspirin and thin the blood, leading to an increased risk of bleeding. There is a risk of developing hemorrhagic stroke (bleeding in the brain).

Safety - Fish oil is safe to use by almost adults. In the United States, it has the status of Generally Recognized As Safe (GRAS). It is not harmful to use at dosage up to 4 grams daily.

Also higher dosages have been used safely in research studies with some increased reports of unwanted side effects.

There has been concern of contamination of dietary fish oil with toxins such as mercury, polychlorinated biphenyls (PBCs) and dioxin. This is true if you consume a high dose. Almost all large reputable manufacturers perform routine tests of their fish oil supplements to ensure they meet or exceed the safety requires of FDA (Food and Drugs Administration) in the United States and Health Canada.

If you are taking large doses of fish oil for treating your ailments, buy fish oil supplement from reputable manufacturers in pills or liquid format.

Pregnancy - Safe when taken during pregnancy in appropriate doses. Insufficient omega-3 in the diet (especially DHA) has been linked to shortened gestational periods and possible premature delivery. See above regarding potential contamination of dietary fish oil.

Lactation - Safe when taken in appropriate doses. As omega-3 fatty acid cannot be manufactured by our body, the only source of omega-3 for the baby would be from the mother's breast milk.

Children and Infants - Safe when taken in appropriate doses. See above regarding potential contamination of dietary fish oil. Children taking fish oil supplement should be supervised by your healthcare provider.

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Common Drug Interactions

Warfarin / Blood-thinners - Fish oil may increase the risk of bleeding. Monitor the levels when you are starting or stopping fish oil supplement.

Orlistat (Alli, Xenical) - Orlistat will reduce the absorption of fish oil. That’s how orlistat works as a weight loss supplement. Avoid taking orlistat within 2 hours of taking fish oil.

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Dosage & How to Take It

Dosage for fish oil varies depending on the condition you wish to treat. The dosage should be based on the amount of EPA and DHA found in fish oil. This is because the amount and ratio of EPA and DHA varies significantly among manufacturers.

The typical dose used to treat high cholesterol / triglycerides and most other conditions is between 1 - 4 grams daily.

Heart failure

The dosage used to reduce the risk of heart failure is 1 gram daily.

Depression

Dosages up to 10 grams daily (divided into three doses) have been used for treating depression.

Acne

Some experts suggest using 3 to 5 grams of fish oil daily.


How much is too much?

Do not take more than 4 grams daily unless you are under the direct supervision of your healthcare provider.

Typically, 1 gram of fish oil contains about 0.034 - 0.112 grams (34 - 112 mg) of EPA and 0.015 - 0.062 grams (15 - 62 mg) of DHA. The ratio is usually 2:1. Commonly, 1 gram of fish oil will have omega-3 fatty acids containing 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA. The super concentrated omega-3 caplets may have up to 0.4 grams (400 mg) of EPA and 0.2 grams (200 mg) of EPA.

The best fish oil supplements will clearly indicate the amount of EPA and DHA. Base your purchase decision on the amount of EPA and DHA contents. The pills usually include some vitamin E to prevent oxidation leading to spoilage of the product.

Many manufacturers also use ultra purification methods to ensure that their product is pure and free from heavy metal contaminations.

There has been discussion about buying only "pharmacy grade" or pharmaceutical grade omega-3's. All fish oil sold for human consumption is pharmaceutical grade.

Fish oil is proven safe to use in hundreds of clinical studies and there are no reported harm to people taking this.


When is the best time to take omega-3 capsules?

It is best taken with food or water. Pick a time of day that is easy for you to remember so you won't forget.

Selected References for Fish Oil
Revised: January 10, 2010

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