Using Omega-3 Fish Oils
Pretty much everyone (including your family doctor and cardiologist) now know the benefits of fish oil supplementation. I wanted to give you a quick review and some recommendations about the issue of EPA/DHA supplementation.

The strongest data supportive of benefits from fish oil is in the area of cardiovascular disease. The omega-3’s are unique to marine life and are synthesized from ocean micro-organisms, and then make their way up the food chain to people. The recommended dose for heart protection is 1000mg. Many capsules available over-the-counter vary in dosage so  read the labels and don’t assume all fish oil is the same.

Although you can obtain your 1000mg of EPA/DHA by eating a 3 ounce serving of salmon or sardines, or 4 ounces of tuna, I would not recommend that you do so. If you do, you will also be getting something you do NOT want to eat every day, the toxic metal MERCURY. Large body fish and most fish oil capsules do contain mercury, and salmon and tuna are among the most contaminated fish. Fish oil helps normalize blood fats, and in higher doses (2 to 4 grams per day) is an especially effective therapy for elevated triglycerides.

Supposedly the Consumer’s Union studied fish oil caps for accuracy in labeling and contents of contaminants, and did not find a significant problem with mercury. If they are going by the EPA’s published standards, those conclusions may not be trustworthy. They do make the interesting point that the more toxic form of mercury is methyl mercury which is water, but not oil soluble. This means that theoretically it should not be found at all in the oil capsules, but should remain behind in the fish meal itself. I will give you more feedback about this issue after I research other resources for capsule toxicity and contamination data.

The main concern with higher dose fish oil therapy is the risk of it thinning the blood too much, thus causing abnormal bleeding. Fortunately, a recent study of bypass and angioplasty patients proved that doses up to 7000mg of EPA/DHA, even when combined with aspirin or coumadin, did NOT increase the risk of bleeding. The major complaint about fish oil therapy is burping up a fishy after-taste. The purer more refined products will cause this less often, and with the others, you can lessen this problem by taking the oil with food or digestive enzymes, and perhaps try keeping the caps in the freezer. The common vegetarian alternative to fish oil is flax seed oil. This is a vegetable oil that is rich in alpha linoleic acid (ALA), which is a shorter chain omega-3 oil. The problem is that although ALA is essential, it does not easily convert to EPA/DHA in the body, has not been shown to lower triglycerides, an evidence for a protective role in heart disease is weaker than with fish oil. Thus I must conclude, and so advise my patients, that ALA in flax is NOT an effective substitute for EPA and DHA. There are some researchers who are now saying that the pendulum is swinging to the opposite side of the extreme. It has always been felt that Americans eat far more omega-6 fats than omega-3 fats. These researchers say tests of many individuals (who now are often on fish oil supplementation) can reveal abnormally high levels of EPA. The ideal ratio of omega 6 to 3 fats has not been fully worked out. Statistic do suggest that red blood cell levels of EPA and DHA (which can be measured in the office) greater than 8% are protective, while levels less than 4% place patients at increased risk.