Can’t I just eat fish?

Fish oil is one of those great supplements that I try to recommend to everyone. The research behind fish oil is enormous. I think the last time I pulled all the studies I could find, about 5 years ago, I took up a huge conference room table and still had piles of research on the floor. Fish oil has been studied for a lot of different conditions: high triglycerides, high blood pressure, cardiovascular disease prevention, rheumatoid arthritis, stroke prevention, atherosclerosis, angina, cardiac arrhythmias, cancer prevention, ulcerative colitis, Crohn’s disease, lupus, psoriasis, eczema, asthma, schizophrenia, depression, and diabetes, among others. That doesn’t mean it works for everything, but it does have a lot of great benefits. 


What’s the Bottom Line on Fish Oil Supplements?  


Can’t I just eat fish? Sure, eating fish 1-2 times a week can provide a good dose of fish oils. My question is about the sustainability of the fish eaten, and the possible toxicity (mercury, mostly) in large quantities of fish. If we’re over-fishing our oceans to feed us fish, what then? 


Fish oil contains EPA and DHA. EPA is eicosapentanoic acid and DHA is docosahexanoic acid. Both are omega-3 fatty acids. Alpha linolenic acid (ALA) is also an omega-3 fatty acid found in certain plants and nuts. I tend to not recommend ALA because our body isn’t efficient at converting it to EPA and DHA, the primarily studied components for the conditions listed above. 
I live in the middle of the country and our supply of fresh fish isn’t always the best. It has to be frozen and shipped by truck or flown in, using a lot of resources to get it here. Some days living near an ocean would be great….  
Fish oil has even been made into a prescription medication in the US. Lovaza contains 1 gram of fish oil with approximately 840 mg of EPA plus DHA per capsule. It’s much more potent than most other fish oils, but finding a good brand can get you close. Lovaza is indicated for the treatment of extremely high triglycerides (>500 mg/dL). 
Lovaza isn’t indicated to be used for any other purpose other than high triglycerides so most people go to non-prescription fish oil for other purposes. Lovaza can also be expensive. For general health, taking 1000 mg of EPA plus DHA daily is recommended. Some treatments need higher doses and should be taken under the supervision of a qualified health professional. Check the back of the label for details on exactly how much EPA & DHA is in each capsule of your chosen fish oil. Even if the front of the bottle says “1200 mg fish oil” it may only have about 360 mg of EPA and DHA per capsule. I recommend basing the amount you’re taking on the EPA and DHA content as opposed to the fish oil content because EPA and DHA is what has been researched in the multitude of studies. 
The most common adverse effect of taking fish oil is the fish burps that can occur after taking the capsules. Some people are susceptible to this regardless of which brand they use. Others find less of a problem with some brands. Taking it with food, separated from carbonated and warm beverages, or keeping the capsules in the refrigerator or freezer can also help. 
Taking too much fish oil can cause a blood thinning effect and increase the risk of bleeding, especially over 3000 mg of EPA plus DHA daily. Always consult with your health care providers when trying to determine how much is the right amount for you to take. 


What’s the Bottom Line on Fish Oil Supplements?


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