Sunday, August 06, 2006

Fish Oil Capsules

Fish is probably not found on too many people's lists of their all time favorite foods. For this reason and also due to the concern of possible mercury contamination in fish, often fish oil capsules are substituted as a source of the omega-3 fatty acids in the diet. Here's what you should know about these supplements.

How much is recommended? The main nutrients in the supplements are EPA (eicosapentaeonic acid) and DHA (docosahexaenoic acid). To keep it simple we'll focus on the EPA. Look at your bottle's ingredients and see how much EPA (eicosapentaeonic acid) is contained in each pill. The recommendations are to take 1200 mg EPA per day.

Is any specific brand recommended more highly? Omacor is the only fish oil supplement approved by the FDA. It contains 465 mg EPA per pill. The USP (U.S. Pharmacopeia) -verified fish oil supplements such as Kirkland or Nature Made contain about 180 mg EPA per pill. Omacor is more expensive than the other supplements. There has not been any evidence of contamination with mercury in these products.

What is the benefit of omega-3 supplements? Recent studies have shown that these supplements can decrease the triglyceride level, and decrease the risk of major coronary events especially in those who are recovering from a recent heart attack. There have also been some reports which indicate the supplements may have a benefit in autoimmune diseases such as rheumatoid arthirits and psoriasis, and possibly even in depression. Although the data for the latter conditions is limited.

Are there any side effects? There has been some concern that they may trigger abnormal heart rhythyms in patients with chronic coronary disease. Other side effects include burping and indigestion, and a bad after taste. In large doses, bleeding time may be prolonged, but this has not shown to be of any clinical significance.

Does taking fish oil capsules reduce the chances of developing heart disease in an otherwise healthy person? Although eating fatty fish may be beneficial, there has been no evidence to show that a healthy person with out any of the above mentioned conditions may benefit from taking the supplements.

Reference: The Medical Letter, Volume 48, July 17, 2006. Please see links for specific references.

Photo: courtesy of dyslexia-parent.

Go here to read this in Farsi.


هاله said...

I am one of those people who won't eat fish unless it’s battered and deep fried - which means I end up not having any whatsoever. I do take fish oil and this is what it says on the container:

"Providing beneficial Omega-3 Marine Triglycerides 300 mg as;

Eicosapenaenoics acid 180 mg
Docosahexaenoic acid 120 mg "

The recommended dose is 3 capsules a day but I take one purely for convenience. So even if I take 3 a day it won't be enough, right? How annoying is that?

Thanks for the information Taraneh, I find the 'Fish Oil 1000mg' written on the container rather misleading. It sounds like you are getting tons of the stuff.

Dr. Taraneh Razavi said...

Hi Haleh

Yes, the information is misleading. In fact that's why I had to go back and research this as I was mystified that the fish oils weren't making a dent in the triglyceride levels of some of the patients even though they swore that they were taking the correct amount prescribed on the bottles.

But remember that if you are a completely healthy person, then the evidence is inconclusive as to whether there is any beneficial effect in taking the capsules.

btw batter and fried is most people's favorite way of eating fish :)

Spyware Remover said...

I have been taking Salmon Omega 3 capsules for over 12 years in hopes that it will pay off later in life. Here's to the future!


محمد said...

Can you please tell me, are Fish Oil Capsules have expiration time? I bought them 6 years ago! and still I have them... Is it ok to use them now?

Dr. Taraneh Razavi said...

Expiration dates should be on the bottle. If not, then it's impossible to tell how effective the medication may be.

Anonymous said...

i have seen some fish capsules in the local costco store. can we buy those?

We are vegiterians, and eat no meat/ chicken/fish. JUST VEGGIES.
I don't know if my kid who is just 2 and 1/2 should get some kind of fish oil/suppliment or not and i feel just rice, veggie and milk may not be enough - Do u think a 2 and 1/2 year old can be given some kind of fish oil suppliment? if so what?


Neil Harvey said...

I found your post very informative, I've been taking fish oils for sometime now.

But I didn't realise the RDA is 1200 mg! the current fish oils (Eskimo-3) I take are 240 mg EPA. So even 3 capsules per day I'm way off the RDA :(

Thanks for the info Taraneh. I'll look out for Omacor in the UK, but still I think it's better to take some fish oils then none at all!


Anonymous said...

Dr. R: Please comment on the question about Costco, if you can. A naturopath told me that Costco's supplements are substandard--and I can hardly stand to pay the prices for supplements from other sources! Thanks!

Dr. Taraneh Razavi said...

I will research your question further, but as far as I know Costco's Kirkland brand has been evaluated and been found to be quite adequate. I will look up the reference though to be certain.

Anonymous said...

Technically couldnt you just increase the number of capsules you take of the costco brand to increase EPA to 1200mg?

Eg. On the costco they recommend only 3 per day (3*180mg=540mg) but you could take 7 caps (7*180mg=1260mg).

Dr. Taraneh Razavi said...

Yes, it would be fine to increase the tablets to reach 1200 mg EPA.

Anonymous said...

The FDA has the lowest standards in terms of acceptable environmental pollutants.

steve said...

"Yes, it would be fine to increase the tablets to reach 1200 mg EPA." -

If you are taking a suppliment with 1000 mg, then change the dose to 7 capsules to get the RDA of EPA...... you need to recognize the fat level you are taking in. Considering more than half of the capsule is pure saturated fat, you really are taking in too much fat with that.

1000 mg is 3% of your daily sat fat, and 2% of cholesterol.

that's 21% of saturated fat and 14% of cholesterol...... My pills are 180/120 mg as well and I'm considering throwing them out (I boutht 1,000 capsules), to get something where it is actually benificial.

kinmokuse said...

Greetings Dr. Razavi

Is the DHA as good as or better than EPA? Can our body produce the EPA by breaking off the two carbon atoms from the DHA?

harsh said...

hi i stay in india...we have little choices of cod liver oil capsules available...although m taking 2 capsules of 300 mg each of cod liver oil it sufficient??

Russ said...

I have heard that the Kirkland fish oil tablets (with Omega 3) have failed some testing. Is this true and are they still recommended.
Secondly, I've been taking 4 1000mg daily. Should this be increased?
Thank You.

crentz said...

My dr gave me a RX for Lovaza (fish oil) it is 135.00 for 100 pills. Will the Omega 3 over the counter work just as good. My triglycerides are 256