Supplements have long been controversial, and fish oil is no exception. For years, knowledgeable nutritionists were enthusiastic about the benefits of marine omega-3 fatty acids, as fish oil is technically termed. Then several studies had disappointing results, and fish oil fell out of favor. Now, though, doctors may be reconsidering. Does quality fish oil have health benefits?
Q. I’ve taken fish oil successfully for years for lupus, osteoarthritis, dry eye, and cardiovascular benefits. Three different specialists recommended it. Even if they changed their minds about it tomorrow, their updated opinion wouldn’t alter my opinion on the benefits of fish oil.
I’ve found that quality matters for fish oil, as it does in many things in life. The amount and ratio of EPA and DHA are also important.
A. A recent review of three large randomized controlled trials concluded that marine omega-3 fats (fish oil) can reduce the risk of cardiac complications and death from cardiovascular causes (Mayo Clinic Proceedings, Oct. 15, 2019). One of these trials (REDUCE-IT) used a prescription pharmaceutical EPA product, Vascepa.
“Marine omega-3s should be used in high doses for patients with CHD on statins who have elevated triglycerides and at about 1 gram/day for primary prevention for individuals who do not consume at least 1.5 fish or seafood meals per week.”
A different meta-analysis published in the Journal of the American Heart Association (Oct. 1, 2019) also concluded that fish oil supplements can reduce the risk of heart attacks and death from cardiovascular disease. In the thirteen trials analyzed here, higher doses of quality fish oil were linked to more protection.
In addition, there is evidence that omega 3 fats have potential in treating autoimmune diseases like yours (Frontiers in Immunology, Sept. 27, 2019). Although your joint pain is caused by osteoarthritis, quality fish oil has beneficial effects in rheumatoid arthritis (Nutrition, Jan. 2018).
You mentioned that fish oil helps ease your dry eyes. A systematic review of 15 studies suggests that supplements with omega-3 fatty acids may improve symptoms of dry eyes (Acta Ophthalmologica, Dec. 2017). While the scientific evidence is not perfect, it makes sense for you to continue with something that appears to be helping you.
A few of the studies included in these analyses used pharmaceutical-grade fish oil, including icosapent ethyl (Vascepa) as mentioned above and omega-3 acid ethyl esters (Lovaza). The downside of these prescription products is price.
If your physician does not prescribe one of these prescription quality fish oil supplements, you will want to choose carefully at the drugstore or online. We like to consult ConsumerLab.com when we contemplate an important supplement purchase. In the latest analysis (Oct. 2019), the organization found that Kirkland Signature Fish Oil 1000 mg was a top pick. Another brand that it rated highly include Life Extension Omega Foundations Super Omega-3 EPA/DHA With Sesame Lignans & Olive Extract. For more information on these and other fish oil supplements, you may wish to purchase the report from ConsumerLab.com.
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What about blue-green algae? This was recommended previously by People’s Pharmacy.
I buy Nature Made fish oil because it is approved by USP.
Can I take too much fish oil? I take 1000 mg per day, but still have dry eyes.
You could take more; some people take as much as 4000 mg per day. We don’t know if it will solve the dry eye problem, though.
Is flaxseed oil comparable and as good? If so, dose per day?
While flaxseed oil does contain omega-3 fats, they are not in the form our bodies utilize best and we don’t convert them efficiently. We’ve not seen a comparable dosing schedule.
How does fish oil compare with Flax seed oil for the ailments you mention in the article–Cardiac benefits, RA, and dry eye?
In one clinical trial of flaxseed oil for rheumatoid arthritis, 3 months of flaxseed oil produced no benefits: https://www.ncbi.nlm.nih.gov/pubmed/7597378
There is some promising data on dry eye, however:
https://www.ncbi.nlm.nih.gov/pubmed/17906762
Have used Vitamin A palmitate for over 30 years now for adult acne, 4 pills a day. Even though I’m old I have major salicylate allergies, and it keeps my skin from breaking out if I eat a tomato or orange or other foods high in salicylates. I get this from an online lab. Was told to do this by a dermatologist in Atlanta many years ago, thank goodness he knew what to do instead of regular visits to another dermatologist who’d pick my skin and make it look worse.