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Fish Oils
 
large product photo   OVERVIEW & BENEFITS

Fish oils, also known as marine oils, are essential fatty acids (lipids) found in fish, particularly cold water fish, and other marine life such as phytoplankton. These oils are rich sources of long-chain polyunsaturated fatty acids (LCPUFA) of the n-3 (omega-3) type. The two most studied fish oils are the 20 carbon eicosapentaenoic acid (EPA) and the 22-carbon docosahexaenoic acid (DHA).

Most fish oil supplements are 18% EPA and 12% DHA, or a total of 30% omega-3. These omega-3 fatty acids, unlike the omega-3 fatty acid found in flaxseed oil and other vegetable oils, keep blood triglycerides in check and may inhibit the progression of atherosclerosis.

Fish oils may primarily be indicated to lower triglyceride levels in those with hypertriglyceridemia. Another important indication may be to prevent death in those who have suffered myocardial infarctions. Fish oils are used to decrease clotting tendencies of the blood. They may also be indicated for lowering blood pressure, for preventing restenosis following coronary angioplasty, for alleviating some of the symptoms of rheumatoid arthritis and ulcerative colitis and for helping to prevent relapse in Crohn's disease. They may help stabilize mood in bipolar disorder and may have beneficial effects in IgA nephropathy. There is evidence they may help prevent rejection in renal transplant patients, and they are used in enteral feeding of various patient categories.

Primary Medical Indications of Fish Oil

Fish oil is considered useful in treating:

  • Crohn’s disease (enteric-coated, free-fatty-acid form of fish oil)
  • High blood pressure
  • High triglycerides
  • Rheumatoid arthritis
Secondary Medical Indications of Fish Oil

Fish oil may be useful in treating:
  • Asthma
  • Atherosclerosis
  • Bipolar disorder
  • Breast-feeding support
  • Cardiac arrhythmia
  • Cystic fibrosis (EPA)
  • Depression
  • Eczema
  • Heart attack
  • Immune function (omega-3 fatty acids for critically ill and post surgery patients only)
  • Kidney disease
  • Lupus
  • Osteoporosis (in combination with evening primrose oil)
  • Phenylketonuria (if deficient in polyunsaturated fatty acids)
  • Pre- and post-surgery health
  • Pregnancy and postpartum support (to prevent premature delivery)
  • Psoriasis
  • Raynaud’s disease
  • Schizophrenia
  • Sickle cell anemia
  • Ulcerative colitis
Fish Oil Dosage and Administration

Natural fish oil is the most common form of fish oil usually produced from the body of cold-water fish. These fish oils are, typically, 30% EPA and DHA with a ratio of EPA to DHA of 1.5. A typical 1 gram soft gel capsule of fish oil contains 180 milligrams of EPA and 120 milligrams of DHA. Natural EPA and DHA are chemically triacylglycerols. Natural fish oil capsules containing 50% EPA and DHA in a 1.5 ratio are now available. Some natural fish oil supplements contain EPA and DHA in a higher ratio, i.e. higher EPA. There are also fish oil supplements with a lower ratio, i.e. higher DHA.

A more concentrated form of fish oil is the semi-synthetic ethyl ester product containing 85% EPA/DHA. One such product contains 490 milligrams of EPA ethyl ester and 350 milligrams of DHA ethyl ester per 1 gram capsule.

Enteric coated EPA and DHA as the free fatty acids are also available. These capsules are more concentrated in EPA and DHA. Emulsions of fish oils are now available that can be used as constituents for salad dressings and other foods. Functional foods, including bars containing fish oil, are becoming available. Infant formulas containing DHA are available in Europe and Japan. Certain enteral supplements contain EPA and DHA as well as other immune-modulating nutrients such as L-arginine, L-glutamine, and RNA.

Recommended fish oil products must contain antioxidants such as tocopherol to protect against their oxidation. Further, fish oil products that contain high quantities of vitamin A and D, which could be toxic, should not be used.

The usual oral dose of fish oil for use in hypertriglyceridemia is about 5 grams of combined EPA/DHA daily. The values expressed in this section refer to the amounts of EPA plus DHA. The actual weight of the capsule is typically much higher. Labels should be checked in order to determine the actual EPA/DHA content. The daily intake should be taken in divided doses; the supplements are best tolerated with meals. The usual dose for hypertensives that have not previously been medicated is about 3 grams of EPA/DHA daily. About 3 grams daily is also the usual dose for those with rheumatoid arthritis, Crohn's disease, and ulcerative colitis. Those who have had successful angioplasty and are trying to prevent restenosis might use 4 to 5 grams daily. Based on the GISSI-Prevenzione trial, a dose of 1 gram daily of EPA and DHA might have protective value for those who have had an MI.