Omega-3 Fatty Acids (EPA/DHA)

Effects and Benefits

Core Identification

Common Names:
- Fish Oil
- Omega-3s
- Essential Fatty Acids (EFAs)
- Marine Oils
- Cod Liver Oil (includes vitamins A and D)

Latin Name: N/A (Derived from various fish species and algae)

Category: Other Supplement (Essential Fatty Acid)

Uses

Traditional Uses

• Cod liver oil used historically in Northern European cultures for general health and to prevent rickets (vitamin D content)
• Traditional consumption of fatty cold-water fish in coastal communities for overall vitality
• Nordic and Inuit cultures consumed fish oils as a dietary staple for survival in cold climates

Modern Uses

• Cardiovascular Health - Reduces triglycerides, lowers blood pressure, and reduces risk of abnormal heart rhythms | Research quality: Strong
• Key findings: Strong scientific evidence suggests omega-3s reduce risk of heart attack and death from abnormal heart rhythms in people with coronary artery disease; may reduce second heart attack risk

• Source citations: Merck Manual, Brewer Encyclopedia of Vitamins, Moyad Supplement Handbook

• Anti-Inflammatory Support - Reduces systemic inflammation in joints, blood vessels, and throughout the body | Research quality: Strong

• Key findings: 1,000-2,000 mg/day may reduce aches and pains in back, knee, hip, and other joints; 70% remission rate in Crohn's disease patients

• Source citations: Moyad Supplement Handbook, Brewer Encyclopedia of Vitamins

• Brain & Cognitive Function - DHA is essential for brain structure and development; supports memory and learning | Research quality: Strong

• Key findings: DHA is the main structural component of brain cell membranes; people eating fish 3x weekly reduce dementia risk by 47%; deficiency linked to depression, anxiety, ADHD

• Source citations: Weil Eating Well for Optimum Health, Stewart Living the Good Long Life, Moline Doctors Book of Natural Health

• Mood Support - May help reduce symptoms of depression and anxiety | Research quality: Moderate

• Key findings: EPA particularly beneficial; 3,000-6,000 mg daily recommended for depression; omega-3 deficiency correlates strongly with depression

• Source citations: Gladstar Herbs for Long-Lasting Health, Moline Doctors Book of Natural Health, Cordain Paleo Diet

• Rheumatoid Arthritis - Modest benefit for reducing joint inflammation and pain | Research quality: Moderate

• Key findings: Doses of 6g daily recommended for inflammatory conditions; may allow reduction in steroid medications

• Source citations: Merck Manual, Brewer Encyclopedia of Vitamins

• Eye Health - Supports dry eye relief and may reduce macular degeneration risk | Research quality: Moderate

• Key findings: 800-1,500 mg EPA/DHA daily shown beneficial for dry eyes; DHA vital for eye development

• Source citations: Moyad Supplement Handbook, Stewart Living the Good Long Life

• Pregnancy & Infant Development - Critical for fetal brain and eye development | Research quality: Strong

• Key findings: DHA essential during last trimester and breastfeeding; deficiency may impair learning ability and intelligence
• Source citations: Weil Eating Well for Optimum Health, Hartwig Whole30, Brewer Encyclopedia of Vitamins

Active Compounds

Primary Active Ingredients:
- EPA (Eicosapentaenoic Acid) - Powerful anti-inflammatory; supports heart health, circulation, and immune regulation; particularly beneficial for mood and joint health
- DHA (Docosahexaenoic Acid) - Primary structural fat in brain cell membranes; essential for memory, learning, brain development, and eye function; reduces depression and anxiety
- ALA (Alpha-Linolenic Acid) - Plant-based omega-3 found in flaxseed, walnuts, chia seeds; body converts less than 5% to EPA and less than 0.5% to DHA; less potent than marine sources

Dosage Information

Standard Dosage:
- Form: Softgel capsules, liquid oil
- Amount: 1,000-2,000 mg combined EPA/DHA per day
- Frequency: Once or twice daily with food

Therapeutic Dosage:
- Form: High-potency fish oil or prescription omega-3
- Amount: 3,000-4,000 mg EPA/DHA for high triglycerides; up to 6,000 mg for severe inflammatory conditions
- Purpose: Cardiovascular support, mood disorders, inflammatory conditions
- Duration: Ongoing; benefits typically seen within 3 months

Maximum Safe Dosage:
- Daily maximum: Generally 3,000-4,000 mg without medical supervision
- Warning threshold: Higher doses should be monitored by healthcare provider due to potential blood-thinning effects

Bioavailability Notes:
- Triglyceride form better absorbed than ethyl ester form
- Take with fat-containing meals for optimal absorption
- Plant-based ALA converts poorly to EPA/DHA (less than 5%); direct fish or algae sources preferred
- Enteric-coated capsules may reduce fishy aftertaste and stomach upset

How to Take It

Timing:
- Best taken with meals containing fat to enhance absorption
- Can be divided into two doses (morning and evening) for higher amounts
- Refrigerate liquid oils after opening to prevent rancidity

Synergies - What It Works Well With

Complementary Supplements:
1. Vitamin E - Prevents rancidity of fish oil; antioxidant protection for omega-3 fats
2. Vitamin D - Often combined in cod liver oil; both support cardiovascular and bone health
3. GLA (Omega-6) - May enhance anti-inflammatory effects when omega-3s alone insufficient; 50-100 mg GLA with omega-3s
4. CoQ10 - Both support heart health; complementary cardiovascular protection
5. B Vitamins (B12, Folate) - Support mood and brain function alongside DHA
6. Zinc - Supports omega-3 metabolism; both important for brain function

Avoidance - What NOT to Combine With

Supplement Interactions:
1. High-dose Vitamin E - In very high amounts, may theoretically increase bleeding risk alongside fish oil
2. Ginkgo Biloba - Both have blood-thinning properties; combined use may increase bleeding risk

Drug Interactions:
1. Anticoagulants (Warfarin, Heparin) - May enhance blood-thinning effects and increase bleeding risk | Severity: Moderate to Severe
2. Antiplatelet Drugs (Aspirin, Clopidogrel) - Additive blood-thinning effects | Severity: Moderate
3. Blood Pressure Medications - May enhance blood pressure lowering effects | Severity: Mild
4. Cyclosporine - Fish oil may help prevent kidney toxicity from this immunosuppressant | Interaction: Potentially beneficial

Food Interactions:
- No significant food interactions
- Best absorbed with dietary fat

Safety Information

Contraindications:
- Fish or shellfish allergy (consider algae-based DHA)
- Bleeding disorders
- Scheduled surgery (discontinue 1-2 weeks prior)
- Cod liver oil specifically contraindicated in pregnancy due to high vitamin A content

Side Effects:
- Common: Fishy aftertaste, belching, mild nausea, diarrhea
- Less common: Skin reactions, acne exacerbation
- Rare: Easy bleeding/bruising at very high doses

Long-Term Use:
- Generally considered safe for long-term use
- Quality fish oil supplements have good quality control and low mercury contamination
- No serious side effects documented with appropriate dosing
- Monitor blood sugar in diabetics (some research suggests possible elevation)

Special Precautions:
- Surgery: Discontinue 1-2 weeks before elective surgery due to blood-thinning effects
- Pregnancy: DHA particularly important during pregnancy; avoid cod liver oil (high vitamin A); consult healthcare provider about appropriate fish oil supplementation
- Aspirin-sensitive asthma: May exacerbate symptoms in sensitive individuals
- Diabetics: Monitor blood sugar levels carefully

Primary Uses At-a-Glance

Primary: Heart health, triglyceride reduction, brain function, anti-inflammatory support, mood support

Secondary: Dry eye relief, joint pain, rheumatoid arthritis, cognitive decline prevention, pregnancy/infant development, menstrual pain

Sources

Local Library:
- Gladstar, Rosemary - Herbs for Long-Lasting Health
- Moyad, Mark - The Supplement Handbook
- Merck - The Merck Manual Home Health Handbook
- Moline, Peg - The Doctors Book of Natural Health Remedies
- Brighten, Jolene - Beyond the Pill
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Gaby, Alan R. - A-Z Guide to Drug-Herb-Vitamin Interactions 2nd Ed
- Hartwig, Melissa - The Whole30
- Tessmer, Kimberly - Your Nutrition Solution to Type 2 Diabetes
- Yates, Claire - Optimum Health the Paleo Way
- Weil, Andrew - Eating Well for Optimum Health
- Cordain, Loren - The Paleo Answer
- Stewart, Martha - Living the Good Long Life
- Mars, Brigitte - The Home Reference to Holistic Health and Healing
- Balch, Phyllis - Prescription for Herbal Healing

General Knowledge:
- American Heart Association omega-3 recommendations
- National Institutes of Health omega-3 fatty acid research
- Clinical research on EPA/DHA cardiovascular benefits