What Is It?
Heralded for its heart-healthy actions, fish oils offer high concentrations of polyunsaturated fats called omega-3-fatty acids. While all fish contain these fats, cold-water fish–salmon, sea bass, tuna, trout, mackerel–are particularly rich sources because of their diet: plankton packed with omega-3s. Interestingly, the colder the water, the more omega-3s in the plankton. Cold-water fish also boast the most potent forms of omega-3s: the essential fatty acids known as eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Consumed as part of a fish-filled diet or in supplement form, omega-3s have myriad healing powers.
Scientists are constantly discovering new health benefits for fish oils and their essential fatty acids (EFAs, including omega-3s). In addition to their more notable properties as heart-healing substances, there’s evidence that these fatty acids ease menstrual cramps and the pain and heavy bleeding of endometriosis. Omega-3s may even aid mental disorders such as schizophrenia. Preliminary findings in people with manic depression (bipolar disorder) link fish oil supplementation to fewer mood swings. Some experts even contend that the rising tide of depression in the United States can be traced to the increasingly fish-poor diet people tend to follow.
Specifically, fish oils may help to:
Prevent and treat cardiovascular disease, including complications of high blood pressure. Several years ago scientists discovered why Greenland Eskimos suffer little heart disease despite their high-fat diets: They eat a lot of cold water fish. Closer examination revealed that it was the omega-3s in the fish that were protecting the hearts of these far-north inhabitants. Subsequent research revealed that the omega-3s discourage platelets in the blood from clumping together, reducing the risk that blood will clot and cause a heart attack. The omega-3s also ease strain on the heart and reduce the risk for angina (chest pain) by, among other things, reducing high blood pressure, keeping arteries flexible (they control inflammation within artery walls), lowering LDL (“bad”) cholesterol and triglycerides (blood fats), and possibly even raising HDL (“good”) cholesterol. Now there’s evidence that omega-3s can prevent heart-rhythm abnormalities (arrhythmias). In a large, recently published Lancet study, fish oil supplements (1 gram a day) significantly reduced the incidence of arrhythmias in heart attack survivors. There were many fewer deaths (and deaths from heart problems specifically) as a result.
Prevent certain cancers. Anticancer actions have been identified in omega-3s, with some recent studies reporting that even small amounts of fish (as part of the diet) can reduce the risk for colon, breast, prostate, and other cancers.
Treat rheumatoid arthritis. Joint stiffness and swelling caused by this painful condition may lessen because of the inflammation-fighting actions of omega-3s. Some sufferers find that they can even get by with lower doses of conventional medications. In one recent study, participants taking fish oil supplements daily for 12 weeks or more noticed that they were experiencing less morning stiffness and had fewer tender joints. Improvements increased even more after 18 to 24 weeks of taking fish oil supplements, with the benefit lingering for up to 8 weeks after the supplements were stopped.
Control diabetes. Nerve problems and heart disease are complications of this chronic condition. Fish oils may help by preventing nerve damage and possibly raising HDL (“good”) cholesterol. On a basic, cellular level they may also improve the body’s metabolic use of its own insulin.
Ease symptoms of lupus, psoriasis and eczema. In people with lupus, omega-3s appear to control inflammation in the joints, skin, kidneys, and other body tissues. Those suffering from psoriasis or eczema may find that the angry, itchy patches common to these ailments respond to treatment with fish oils after about a month. Interestingly, research indicates that psoriasis sufferers tend to have low levels of omega-3s.
Minimize Crohn’s disease symptoms. This often painful bowel condition tends to flare up and then subside in cycles over time. When taken long term for preventive purposes, the essential fatty acids in fish oils will keep inflammation in the digestive tract under control. In a recent Italian study, fish oil supplements (about 3 grams in enteric-coated form a day) significantly reduced the number of flare-ups in Crohn’s disease sufferers. All of the study participants were initially in remission but had signs of inflammation. By the end of the study, nearly 70% of the participants given a placebo had a relapse while only about 30% of those taking the fish oils capsules did.
Delay the onset of Raynaud’s disease symptoms. Omega-3s inhibit inflammation within vessels, making fish oils potentially useful in stalling the numbness, tingling, and other symptoms resulting from exposure to cold air. One placebo-controlled study of 32 Raynaud’s sufferers found that fish oil supplements slowed the appearance of such bothersome symptoms by an average of 15 minutes (often enough time to allow sufferers to avoid painful symptoms by getting to a warm place).
Note: Fish oils have also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for Fish Oils.
–To prevent side effects such as belching and flatulence, avoid taking the entire dose at one time. Try splitting a 3,000 mg daily dose into three 1,000 mg doses, and take throughout the day with meals.
–Side effects vary depending on the brand, so if you have trouble tolerating one fish oil supplement, try switching to another brand.
–Don’t buy cod liver oil as a source of omega-3s; the high amounts of vitamins A and D contained in these supplements can be toxic.
For preventing heart disease and related complications, lupus, psoriasis, eczema and Raynaud’s disease: Take 3,000 mg fish oils a day.
For rheumatoid arthritis: Take 6,000 mg fish oils a day.
For Crohn’s disease: Take 5,000 mg fish oils a day.
Be sure to check out our Dosage Recommendations Chart for Fish Oils, which lists therapeutic dosages for specific ailments at a glance.
Guidelines for Use
The best way to get fish oils–and omega-3s–is by packing your weekly diet with fish. Aim to put such delicacies as salmon, halibut, and cod on the table three or more times a week.
The strongest evidence for the heart-healthy powers of the omega-3s comes from studies in which participants actually ate cold water fish regularly. Consider supplements for heart-related conditions only if you eat fish less than twice a week.
Inflammatory conditions such as rheumatoid arthritis require fish oils in supplement form. The reason for this is that considerably high doses of omega-3s–more than what you’d get by eating three or more servings of fish a week–are needed to decrease inflammation.
Take fish oil supplements with meals.
Fish oil supplements can rapidly go rancid; store the pills in the refrigerator and avoid buying them in bulk.
Omega-3s may intensify the blood-thinning effect of anticoagulants (blood thinners), including aspirin when taken long term. Internal bleeding–and excessive bleeding–is a risk.
Note: For information on interactions with specific generic drugs, see our WholeHealth Chicago Drug/Nutrient Interactions Chart.
Possible Side Effects
Belching, flatulence, nausea, diarrhea, and bloating may occur. Sometimes these reactions develop as a result of poor quality in the supplement manufacturing–try switching brands if you suspect this is the cause. In other cases the body has problems processing oils in general due to poor bile acid production or other intestinal problems; try reducing the dose dramatically (to about 180 mg a day) and slowly increasing it over time.
High doses impair the body’s ability to form blood clots, raising concerns that the supplements could cause internal bleeding. However, no such reaction was detected in a study of heart disease sufferers who took 8,000 mg of fish oil supplements in addition to aspirin (an anticoagulant).
Very high doses of fish oils may cause your body to emit a slightly fishy odor.
Anyone with high triglycerides, a potentially serious situation, should get their cholesterol levels checked regularly.
If you have diabetes, don’t take fish oil supplements unless your doctor recommends it; some studies indicate that they may make it more difficult to control blood sugar levels.
Because omega-3s inhibit blood clotting, avoid taking fish oil supplements two weeks before and one week after surgery. Consult a doctor before taking the supplements if you have a chronic blood disorder.
Aging 1,000 mg twice a day
Angina 2,000 mg fish oils 3 times a day
Arrhythmia 1,000 mg 3 times a day
Asthma 1,000 mg 3 times a day
Cancer 3 capsules twice a day
Crohn’s Disease 2,000 mg twice a day
Diabetes 2,000 mg 3 times a day
Eczema 1,000 mg 3 times a day
Gout 1,000 mg 3 times a day
Heart Disease Prevention 1,000 mg 3 times a day
High Blood Pressure 1,000 mg 3 times a day
Lupus 2,000 mg 3 times a day
Psoriasis 2,000 mg 3 times a day
Raynaud’s disease 1,000 mg 4 times a day
Stroke 1,000 mg 3 times a day
David Edelberg, M.D.
Populations that consume a lot of cold-water fish have fewer heart attacks. Now isn’t that a club you’d like to be a member of? In fact, dozens of well-designed clinical studies have demonstrated just how heart-healthy fish oil really is: It eases the strain on this hard-working muscle, lowers cholesterol, and reduces the risk for blood clots and chest pain. All fish actually contain high concentrations of the key polyunsaturated fats called omega-3-fatty acids. But the cold water fish–salmon, sea bass, tuna, trout, mackerel–are particularly rich sources because they feed on plankton packed with omega-3s. These cold-water fish also boast the most potent forms of omega-3s: the essential fatty acids known as eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA).
HOW IT HELPS HIGH BLOOD PRESSURE
Studies have shown that eating a lot of fish–or taking fish oil capsule supplements–floods your system with beneficial omega-3 fatty acids that help your blood pressure. Exactly how they do this is still being explored, but there seems to be a variety of actions at work. For example, the omega-3s appear to both inhibit compounds that constrict vessels, and stimulate compounds that dilate the vessels–both qualities that will reduce a person’s high blood pressure. At the very least, fish oils also lower cholesterol levels, a positive development in anyone with heart problems and high blood pressure.
WHAT TO LOOK FOR
The strongest evidence for omega-3s comes from studies in which participants ate cold water fish regularly. If you opt for fish oil capsules, I suggest you base your selection on cost, quality, and the “burp factor.” This last consideration can be just as unpleasant as it sounds: mild gastrointestinal upset, followed by a nice fishy burp that causes (believe me!) your toes to curl.
There are essentially two ways to get fish—and it’s healing compounds—into your system. Pack your weekly diet with fresh fish. The smartest way by far to get fish oils—and omega-3s—is to eat fish often. Aim to put such delicacies as salmon, sea bass, and trout on the table three or more times a week. Fish oil softgel capsules are the way to go if eating fish just isn’t your thing—meaning you can’t seem to tolerate the food more than once or twice a week, if at all. Rather than taking the entire dose at one time, try splitting the 3,000 mg daily dose into three 1,000 mg doses, and take them throughout the day with meals to prevent side effects such as belching and gas.
You can probably cut down on the number of fish oil capsules you take if you add some fresh fish to your diet. I mean, even the most incompetent cooks can actually make good salmon. Store the pills in the refrigerator and avoid buying them in bulk because fish oil supplements can rapidly go rancid. Try switching brands, if you have trouble tolerating one particular product or fish oil supplement. Steer clear of cod liver oil as a source of omega-3s; the high amounts of vitamins A and D contained in these supplements can be toxic.
Omega-3s inhibit blood clotting, so avoid taking fish oil supplements two weeks before and one week after surgery. Consult a doctor before taking the supplements if you have a chronic blood disorder.
David Edelberg, MD