Fish oils are fascinating nutrients. Almost every aspect of our health, physical and mental, is related to the types of fatty acids that make up our cells and tissue, including vision. And it appears that most of us are not ingesting the right kind of fatty acids, the ones found in fish and fish oils. I have discovered that fish oils supplements help eyesight. I have also discovered a combination of herbs and nutrients that improve eyesight within hours. See below. Fish oils are also beneficial for mental health and sexuality.

Fish oil supplements are dietary supplements that contain oil from the flesh of cold water fish such as mackerel, salmon, black cod, albacore tuna, sardines, and herring. The active ingredients in fish oil supplements are essential fatty acids known as omega-3 fatty acids. They typically include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fatty acids are converted by the body into the beneficial series 3 prostaglandins. Fish liver oils are derived from the livers of white fish, such as cod and halibut. Fish liver oils contain vitamins A and D and may have a different concentration of EPA and DHA than fish oils derived from flesh.


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Fish Oil Physical Benefits
Fish and fish oils may be beneficial in a variety of medical conditions (see the studies at bottom of page):

Fish oils may reduce the risk for heart disease by improving circulation.
Fish oils may be helpful to people with lupus since fish oils have anti-inflammatory properties.
Fish oils may reduce the risk of heart arrhythmias
They may reduce symptoms of arthritis and several autoimmune diseases.
Eating fish and perhaps taking fish oil supplements may also help reduce the risk for macular degeneration, a condition in the eye that could lead to blindness.
Fish oils are found in sperm, and these oils may support healthy sexual organ function.
     
Fish oil mental benefits
Fish oils may be of benefit for depression, either alone, or in combination with natural mood lifters or prescription antidepressants.
Dr. Malcolm Peet of the Swallownest Court Hospital in Sheffield, England and his colleague found that depressed patients who received a daily dose of 1 gram of an omega-3 fatty acid for 12 weeks experienced a decrease in their symptoms, such as sadness, anxiety and sleeping problems.
Fish oils are beneficial for vision. To improve vision, consider Eyesight Rx.
Fish oil supplements may be helpful in mild cases of Alzheimer's disease.
Perhaps fish oil supplements may help some children with ADHD symptoms.

Fish oil and depression
Taking fish oil supplements may have a role to play in improving mood. Fish oils can also be used in combination with natural or prescription anti-depressants.

Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder.
Aust N Z J Psychiatry. 2008 March. Roozbeh Psychiatry Hospital, Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine and a combination of them in major depression. Method: Sixty outpatients with a diagnosis of major depressive disorder based on DSM-IV criteria and a score >/=15 in the 17-item Hamilton Depression Rating Scale (HDRS) were randomly allocated to receive daily either 1000 mg EPA or 20 mg fluoxetine, or their combination for 8 weeks. Double dummy technique was used to double blind the study. Patients were assessed at 2 week intervals. Change in HDRS was the primary outcome measure. Results: Analysis of covariance for HDRS at week 8 across treatment groups was performed in 48 patients who completed at least 4 weeks of the study, with the last observation carried forward. Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8. EPA + fluoxetine combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment. Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms. Response rates (>/=50% decrease in baseline HDRS) were 50%, 56% and 81% in the fluoxetine, EPA and combination groups, respectively. Conclusions: In the present 8 week trial EPA and fluoxetine had equal therapeutic effects in major depressive disorder. EPA + fluoxetine combination was superior to either of them alone.

Fish oil as good as Prozac?
Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder.
Aust N Z J Psychiatry. 2008 March. Roozbeh Psychiatry Hospital, Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine (Prozac) and a combination of them in major depression. Sixty outpatients with a diagnosis of major depressive disorder were randomly allocated to receive daily either 1000 mg EPA or 20 mg Prozac, or their combination for 8 weeks. EPA plus Prozac combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment. Prozac and EPA appear to be equally effective in controlling depressive symptoms. In the present 8 week trial EPA and Prozachad equal therapeutic effects in major depressive disorder. EPA and Prozac combination was superior to either of them alone.

Eyesight Rx
Supports Healthy Vision - Works within days
Developed by Ray Sahelian, M.D.

Supplement Facts:
Vitamin C (Ascorbic acid)
Citrus bioflavonoids
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Mixed carotenoids
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Bilberry extract (Vaccinium myrtillus)
Eyebright extract (Euphrasia officianales)
Jujube extract (Zizyphus jujube)
Ginkgo biloba (Ginkgo biloba)
Mucuna pruriens extract (Cowhage)
Cinnamon (Cinnamomum zeylanicum)
Lycium berry extract (Lycium Barbarum)

Those who wish to improve their vision can take Eyesight-Rx along with one to three fish oil capsules a day.

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Metabolism of fish oils
Fish oils are made in the body from a fatty acid called alpha-linolenic acid (ALA). ALA is an omega-3 fatty acid found predominantly in flaxseed oil (also known as linseed) and hemp seed oil. Green leafy vegetables, soybeans, walnuts, and canola oil have small amounts of omega-3 fatty acids. Omega-3 fatty acids are beneficial because they provide fluidity to cell membranes and improve communication between brain cells. Omega-3s also reduce the clotting ability of platelets, thus potentially decreasing the incidence of heart attacks and strokes. Two very important omega-3 fatty acids are eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) which together are found in fish oils. These fatty acids are found in seafood, especially mackerel, salmon, striped bass, rainbow trout, halibut, tuna, and sardines.

How are fish oils available?
Supplements of fish oils that contain EPA and DHA are sold over the counter. DHA is also sold by itself. In the body, DHA is found mostly in the brain, retina, and in sperm. At this time I don't see a need to take DHA by itself. It's much cheaper and perhaps better to take both EPA and DHA together. Fish oil pills come in a variety of dosages. Common fish oil capsules include about 100 to 200 mg each of DHA and EPA.

Reduce the risk of sudden death with omega-3s
An editorial in Circulation: Journal of the American Heart Association suggests that increasing dietary omega-3 fatty acids, which come from fatty fish or flaxseed oil, and decreasing omega-6 fatty acids, found in plant seed oils such as corn, safflower, and sunflower, is a way to reduce the risk of sudden death from irregular heart rhythms or heart attacks.
   One cause of sudden death is ventricular fibrillation, in which the heart contracts in a fast and chaotic rhythm that makes it unable to pump blood to the rest of the body. A number of factors including cigarette use, fasting, diabetes, hyperthyroidism or heart attack can trigger the release of fatty acids from adipose tissue.
   Fats that we eat are stored in adipose (fat) tissue. When these fats are released from their storage sites, they become free fatty acids. But not all fatty acids are equal in their propensity to cause arrhythmias. High levels of omega-6 fatty acids may encourage arrhythmias if their levels aren’t balanced by omega-3 fatty acids.
   Dr. Sahelian says: A few years ago the American Heart Association revised its dietary recommendations to include advice to eat two meals of fatty fish – such as salmon or halibut – per week. I recommend those who don’t eat fish to take 3 to 5 fish oil capsules or a teaspoon of flaxseed oil per day and to try reducing their intake of omega-6 oils.

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Fish Oil Interactions with medicines
A diet high in oily fish like salmon, halibut, and mackerel may help improve inflammatory conditions such as arthritis. A key anti-inflammatory fat in humans is derived from a fatty acid found in fish oil. The researchers, from Harvard Medical School and Brigham and Women's Hospital, found the diet worked best when combined with low aspirin doses. The inflammatory response protects the body against infection and injury, but when it goes wrong it can lead to conditions such as arthritis, and cardiovascular disease. The Harvard team identified a new class of fats in the human body, called resolvins, which they showed can control inflammation. They do this both by stopping the migration of inflammatory cells to sites of inflammation, and the turning on of other inflammatory cells. Resolvins are made from the omega-3 fatty acids, found in high concentration in oily fish. Their production also appears to be stimulated by taking aspirin.
   Taking fish oil capsules can thin the blood even more when taken along with warfarin (Coumadin)... see study below.

Fish and Fish Oils Could Help Your Eyesight
The rods and cones of the retina in the eyes are very rich in DHA, one of the fatty acids found in fish oils. Hence, a deficiency in dietary fish oils will reduce the photoreceptor activity of retinal cells, and thus reduce visual acuity. On the other hand, supplementation with fish oils (or flaxseed oil) could lead to visual improvement with enhanced color perception.
   Since levels of DHA in the brain decline with age, it is likely that the levels of DHA also decline in the retina. Is it possible that daily intake of fish oils can improve vision in older individuals? Hopefully future research can give us some answers. Do the types of fats and oils we consume have an influence on how well we see as we age? An epidemiological research study completed recently in Australia and published in Archives of Ophthalmology indicates that the incidence of age related macular degeneration (ARMD) is reduced in those who consume fish.
   ARMD is the leading cause of severe vision loss in people over age 50 and this eye disease is currently incurable. In this condition, central vision is lost, but peripheral vision almost always remains intact. Today an estimated 12 million Americans have some form of the disease.
   The retina lies in the back of the eye and is composed of cells called rods and cones. The retina gathers light and visual information from the outside world. This information is then transmitted through a special nerve bundle, called the optic tract, to an area in the back of the brain called the visual cortex. The visual cortex, in turn, interprets this information.
   The macula is the special central area in the retina used for fine focus such as reading, driving, watching television, and recognizing people. There is a gradual loss of visual acuity as the macula degenerates with age, eventually leading to blindness.
   The study, done by researchers at the Australian National University, evaluated 3654 individuals aged 49 and over. The participants completed a detailed food questionnaire and had photographs taken of their macula. A higher frequency of fish consumption was associated with a decreased incidence of ARMD. It was also found that those with very high levels of cholesterol intake were more likely to have ARMD.
   Why would eating fish be beneficial to the macula? The answer is not fully understood. Ray Sahelian, M.D., author of Mind Boosters: A Guide to Natural Supplements That Enhance Your Mind, Memory, and Mood (St. Martin's Press, 2000, $13.95), says, "We do know that the retina is chock full of omeg-3 fatty acids, particularly those found in fish oils. These omega-3 fatty acids are known as EPA (eicosapentanoic acid) and DHA (docosahexanoic acid). Those who eat little fish or whose dietary intake is deficient in omega-3 oils may, over time, develop a shortage of these fatty acids in their macula." He adds, "I often recommend fish oil supplements to individuals whose fish intake is very low. Clinically, I have noticed that fish oil supplements improve focus, color perception and clarity of vision." Dr. Sahelian also recommends his patients consume adequate amount of fruits and vegetables that contain carotenoids and flavonoids, nutrients with antioxidant properties.
Reference: Smith W, Mitchell P, Leeder SR. Dietary fat and fish intake and age-related maculopathy. Arch Ophthalmol 2000 Mar;118(3):401-4; National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory.

Fish OIls versus cardiac defibrillators
Fish oil could potentially save more lives than cardiac defibrillators. Past research has linked the EPA and DHA fatty acids found in oily fish to a lower risk of fatal heart rhythm disturbances. A study in the American Journal of Preventive Medicine, October 2006, tried to estimate the potential public health impact of raising adults' omega-3 levels with fish oil supplements. Using a computer-simulated community of 100,000 Americans and data from past medical studies, the researchers calculated that raising omega-3 levels would save 58 lives each year. This amounts to a 6 percent total death reduction -- mostly by preventing sudden cardiac death in apparently people, according to the study authors, led by Dr. Thomas E. Kottke of the Heart Center at Regions Hospital in St. Paul, Minnesota. Even if automated external defibrillators (AEDs) were available in every home and public area, the devices would lower a community's annual death rate by less than 1 percent. If fish oil is as effective against fatal heart arrhythmias as evidence suggests, it would have more widespread benefits than either AEDs or implanted defibrillators.

Fish OIls for Alzheimer's Disease
It appears Omega-3 fatty acids, in the form of Fish Oils, are able to help patients who have mild Alzheimier's disease. Since current drugs used for Alzheimer's disease are not very helpful, and potentially dangerous, perhaps doctors should initially try omega-3 fatty acids in mild cases of AD rather than cholinesterase inhibitors.

Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD study: a randomized double-blind trial.
Arch Neurol. 2006 Oct;63(10):1402-8. Department of Neurobiology, Caring Sciences and Society, Section of Clinical Geriatrics, Karolinska University Hospital Huddinge, Stockholm.
Epidemiologic and animal studies have suggested that dietary fish or fish oil rich in omega-3 fatty acids, for example, docosahexaenoic acid and eicosapentaenoic acid, may prevent Alzheimer disease (AD). Two hundred four patients with AD whose conditions were stable while receiving acetylcholine esterase inhibitor treatment and who had a Mini-Mental State Examination (MMSE) score of 15 points or more were randomized to daily intake of 1.7 g of docosahexaenoic acid and 0.6 g of eicosapentaenoic acid (omega-3 fatty acid-treated group) or placebo for 6 months, after which all received omega-3 fatty acid supplementation for 6 months more. Administration of omega-3 fatty acid in patients with mild to moderate AD did not delay the rate of cognitive decline according to the MMSE or the cognitive portion of the Alzheimer Disease Assessment Scale. However, positive effects were observed in a small group of patients with very mild AD.

Fish oil side effect
Besides bad breath, there is a possibility that very high doses could excessively thin the blood and cause bleeding. It's also possible that high doses of fish oils could interfere with the optimal functioning of natural killer cells, white blood cells, or other cells in the immune system. It is probably best not to take more than 3 fish oil capsules a day for prolonged periods until we determine how fish oil supplements influence the immune system. Another possible fish oil side effect is increased alertness which could cause shallow sleep if more than 5 fish oil capsules are taken daily for a week or longer.

Mother's fish oil intake influences breast milk
The Effects of Fish Oil Supplementation in Pregnancy on Breast Milk Fatty Acid Composition Over the Course of Lactation: A Randomized, Controlled Trial.
Pediatr Res. 2007 Oct 12; Dunstan JA, Mitoulas LR, Dixon G, Doherty DA, Hartmann PE, Simmer K, Prescott SL.
School of Paediatrics and Child Health [J.A.D., G.D., K.S., S.L.P.], Biochemistry and Molecular Biology [L.R.M., P.E.H.], School of Women’s and Infants Health [D.A.D., K.S.], The University of Western Australia, Crawley WA 6009.
Ninety-eight women received fish oil supplements that had 2.2 grams docosahexaenoic acid (DHA) and 1.1 grams eicosapentaenoic acid (EPA) from 20 weeks of gestation until delivery. Compared to the control group who receive olive oil, breast milk from women who received fish oil had proportionally higher DHA and EPA levels at 3 d and 6 wk after delivery, but this difference was no longer apparent by 6 months. Both EPA and DHA in breast milk were positively correlated with Griffith's developmental scores in the babies including hand and eye coordination. Thus, supplementation with fish oils in pregnancy was associated with increased n-3 long-chain polyunsaturated fatty acids in breast milk, particularly in early lactation, and this was positively associated with infant DHA status at 1 year.

Fish Oils Research Update
In elderly people, omega-3 fatty acids contained in fish oil increase a measure of heart-healthiness called heart rate variability.  Taking a daily omega 3 fish oil supplement may therefore reduce the risk of developing irregular heart rhythm or succumbing to sudden cardiac death.

Dietary supplements of fish oil may be helpful to people with lupus. Copper supplements, however, make no difference. Fish oil and copper have shown beneficial effects in rat studies of lupus, Dr. Aubrey L. Bell, of Musgrave Park Hospital in Belfast, Northern Ireland, and colleagues explain in the Journal of Rheumatology. The researchers studied 52 lupus patients. The participants were randomly assigned to take various combinations of fish oil capsules and extra copper -- both, one or the other, or none -- for 24 weeks. Those given fish oil supplements took three capsules a day of MaxEPA -- "roughly equivalent to two oily fish-based meals per week." The researchers measured disease activity using a scale called the revised Systemic Lupus Activity Measure (SLAM-R). Compared to patients given inactive placebo capsules, those taking fish oil experienced a significant decline in SLAM-R score from 6.12 to 4.69 points at the end of the trial. All patients who received an active supplement reported feeling better than those who were given a placebo. Journal of Rheumatology, August 2004.

New studies show that fish oil supplements lack the contaminants found in commonly consumed fish, such as mercury in albacore (“white”) tuna and PCBs in farmed salmon. The studies were conducted by ConsumerLab, which gathered 41 samples from numerous companies and put them through a rigorous laboratory analysis.

Fish Oil Supplementation in Pregnancy Modifies Neonatal Progenitors at Birth in Infants at Risk of Atopy or allergy.
Pediatr Res. 2004 Dec 7;
Fish oils may represent a mode of allergy prevention. Cord blood (CB) CD34(+) hemopoietic progenitors are altered in infants at risk of atopy. We therefore studied the effects of fish oils supplementation during pregnancy on numbers and function of progenitors in neonates at high risk of allergy or atopy. In a double-blind study, atopic, pregnant women (n = 83) were randomized to receive fish oil capsules (n = 40) or placebo (n = 43) from 20 wk gestation until delivery. Conclusion: Fish oil supplementation during pregnancy in atopic mothers alters infant cord blood hemopoietic progenitor phenotype. Fish oils may have an impact on development of allergy and atopic disease.

Omega-3 fatty acids from fish oils and cardiovascular disease.
Mol Cell Biochem. 2004 Aug;263(1-2):217-25.
Fish and fish oils contain the omega-3 fatty acids known as eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). Epidemiological studies have shown an inverse relation between the dietary consumption of fish containing EPA/DHA and mortality from coronary heart disease. These relationships have been substantiated from blood measures of omega-3 fatty acids including DHA as a physiological biomarker for omega-3 fatty acid status. Controlled intervention trials with fish oil supplements enriched in EPA/DHA have shown their potential to reduce mortality in post-myocardial infarction patients with a substantial reduction in the risk of sudden cardiac death. The cardioprotective effects of EPA/DHA are widespread, appear to act independently of blood cholesterol reduction, and are mediated by diverse mechanisms. Their overall effects include anti-arrhythmic, blood triglyceride-lowering, anti-thrombotic, anti-inflammatory, endothelial relaxation, plus others. Current dietary intakes of EPA/DHA from fish oils in North America and elsewhere are well below those recommended by the American Heart Association for the management of patients with coronary heart disease.

The fatty acids found in fish may slightly lower a man's risk of prostate cancer, but another type of fatty acid found in a range of foods may raise the risk, a large study suggests. Researchers found that among nearly 48,000 U.S. men followed for 14 years, those with the highest intakes of two fatty acids found in oily fish were 26 percent less likely than men with the lowest intakes to develop advanced prostate cancer. The opposite was true, however, when it came to alpha-linolenic acid, or ALA. Like the two fish-oil fats, ALA is an omega-3 unsaturated fatty acid that is thought to promote heart health; it is found in vegetable sources such as soybeans, canola oil, walnuts and flaxseed, and to a lesser extent in meat and dairy products. In this study, men with the highest intake of ALA were about twice as likely as those with the lowest intakes to develop advanced prostate cancer. And the risk was increased regardless of whether the ALA came from vegetable or animal sources, according to findings published in the American Journal of Clinical Nutrition.

Dietary intake of n-3 (fish oils) and n-6 fatty acids and the risk of prostate cancer.
Leitzmann MF, Stampfer MJ. Department of Health and Human Services, Bethesda, MD 20892, USA.
Am J Clin Nutr. 2004 Jul;80(1):204-16.
Laboratory studies have shown that n-3 fatty acids (mostly in fish oils) inhibit and n-6 fatty acids stimulate prostate cancer growth, but whether the dietary intake of these fatty acids affects prostate cancer risk in humans remains unclear. We prospectively evaluated the association between intakes of alpha-linolenic (ALA; 18:3n-3), eicosapentaenoic (EPA; 20:5n-3), docosahexaenoic (DHA; 22:6n-3), linoleic (LA; 18:2n-6), and arachidonic (AA; 20:4n-6) acids and prostate cancer risk. A cohort of 47 866 US men aged 40-75 y with no prostate cancer history in 1986 was followed for 14 y. During follow-up, 2965 new cases of total prostate cancer were ascertained, 448 of which were advanced prostate cancer. ALA intake was unrelated to the risk of total prostate cancer. In contrast, the multivariate relative risks (RRs) of advanced prostate cancer from comparisons of extreme quintiles of ALA from nonanimal sources and ALA from meat and dairy sources were 2.02 and 1.53, respectively. EPA and DHA intakes (fish oils) were related to lower prostate cancer risk. Increased dietary intakes of ALA may increase the risk of advanced prostate cancer. In contrast, EPA and DHA (fish oils) intakes may reduce the risk of total and advanced prostate cancer.

Immediate effects of n-3 fatty acid infusion on the induction of sustained ventricular tachycardia.
Schrepf R. linikum der Universitat Munchen, 80336 Munich, Germany.
Lancet. 2004 May 1;363(9419):1441-2.
Increased consumption of n-3 fatty acids reduces mortality from sudden cardiac death, indicating that such acids have anti-arrhythmic effects. We did electrophysiological testing in ten patients with implanted cardioverter defibrillators who were at high risk of sudden cardiac death. To assess their immediate effects on the induction of sustained ventricular tachycardia, n-3 fatty acids were infused. Such tachycardia was not induced in five of seven patients. Our findings show that infusion of n-3 polyunsaturated fatty acids does not induce arrhythmia, but did result in a reduction of sustained ventricular tachycardia in some patients.

Fish oil interaction with warfarin.
Buckley MS, Goff AD,Shawnee Mission, KS of Arizona, Tucson, AZ 85724
Ann Pharmacother. 2004 Jan;38(1):50-2.
To report a case of elevated international normalized ratio (INR) in a patient taking fish oil and warfarin. A 67-year-old white woman had been taking warfarin for 1(1/2) years due to recurrent transient ischemic attacks. Her medical history included hypothyroidism, hyperlipidemia, osteopenia, hypertension, and coronary artery disease. She also experienced an inferior myocardial infarction in 1995 requiring angioplasty, surgical repair of her femoral artery in 1995, and hernia repair in 1996. This patient has her INR checked in the anticoagulation clinic and is followed monthly by the clinical pharmacist. Prior to the interaction, her INR was therapeutic for 5 months while she was taking warfarin 1.5 mg/d. The patient admitted to doubling her fish oil dose from 1000 to 2000 mg/d. Without dietary, lifestyle, or medication changes, the INR increased from 2.8 to 4.3 within 1 month. The INR decreased to 1.6 one week after subsequent fish oil reduction, necessitating a return to the original warfarin dosing regimen. Fish oil supplementation could have provided additional anticoagulation with warfarin therapy. Fish oil, an omega-3 polyunsaturated fatty acid, consists of eicosapentaenoic acid and docosahexaenoic acid. This fatty acid may affect platelet aggregation and/or vitamin K-dependent coagulation factors. Omega-3 fatty acids may lower thromboxane A(2) supplies within the platelet as well as decrease factor VII levels. Although controversial, this case report illustrates that fish oil can provide additive anticoagulant effects when given with warfarin. This case reveals a significant rise in INR after the dose of concomitant fish oil was doubled. Patients undergoing anticoagulation therapy with warfarin should be educated about and monitored for possible drug-herb interactions. Pharmacists can play a crucial role in identifying possible drug interactions by asking patients taking warfarin about herbal and other alternative medicine product use.

Smart Eating for a Smarter Baby
The brain is largely made of fat, and the types of fat we consume can have an influence on how well our brain functions. Most studies show that fish oils (DHA and EPA) are essential to optimal brain function. But does maternal diet influence brain development of the child? There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months, with a large increase in the cerebral content of DHA. The fetus and the newborn infant depend on maternal supply of DHA. Sometimes maternal intake of DHA during pregnancy and lactation is marginal. Researchers at the University of Oslo in Norway examined the effect of supplementing pregnant and lactating women with cod liver oil on mental development of the children, compared with maternal supplementation with corn oil. The study was randomized and double-blinded. A total of 590 pregnant women were recruited in week 18 of pregnancy to take daily 10 mL of cod liver oil or corn oil until 3 months after delivery. The cod liver oil contains DHA and EPA. The corn oil contains linoleic acid and alpha-linolenic acid. All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age. As part of the protocol, 135 subjects from this population were invited for intelligence testing with the Kaufman Assessment Battery for Children (K-ABC) at 4 years of age. The K-ABC is a measure of intelligence and achievement designed for children aged 2.5 years through 12.5 years. Children who were born to mothers who had taken cod liver oil during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken corn oil. Dr. Sahelian says: Women who are pregnant may consider eating more fish, taking cod liver oil or fish oil supplements in consultation with their obstetrician.

Fish oil supplements contain no mercury
ConsumerLab.com, an independent evaluator of dietary supplements and nutrition products, released results of its product review of Omega-3 Fatty Acids (EPA & DHA) from fish oils.  EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are fatty acids that have been shown to help reduce cardiovascular disease, reduce the pain associated with rheumatoid arthritis, as well as showing promise in the treatment of a number of other conditions. A concern with fish oil products has been potential contamination with mercury. ConsumerLab.com purchased 20 dietary supplements containing EPA and/or DHA and tested them for their claimed levels of these ingredients as stated on the label, as well as for mercury contamination and evidence of decomposition. Although six of the products had lower levels of EPA/DHA as stated on the label, none of the twenty products showed evidence of decomposition and none were found to contain detectable levels of mercury.

Fish oil versus Flaxseed oil
Q. What is your opinion on fish oil supplements, and why not just take flaxseed oil since it has omega 3s? How much is needed to take daily?
   A. There are several Omega 3 fatty acids. They are named ALA (alpha linolenic acid ), EPA (eicosapentaenoic acid) and DHA (docosahexanoic acid). ALA is found in flaxseed oil whereas EPA and DHA are found in fish oils. ALA is able to convert into EPA and then into DHA, but this takes several enzymatic steps in the body, and not everyone efficiently converts ALA into EPA and DHA, particularly with aging. So, the bottom line, I prefer fish oils to flaxseed oil, although a small amount of flaxseed oil is also good to take. For those of you who don't want to take any fish products, DHA, extracted from algae, is sold by itself.

Fish oil supplement emails
Q. What's the difference between fish oils and cod liver oil?
   A. Fish oil supplements are dietary supplements that contain oil from the fatty flesh of cold water fish such as mackerel, anchovy, and sardines. The active ingredients in fish oil supplements are essential fatty acids known as omega-3 fatty acids. They typically include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Cod liver oil is derived from the livers of white fish, such as cod and sometimes halibut. Cod liver oil contains vitamins A and D and has a different concentration of EPA and DHA than fish oils derived from the fat of cold water fish. Cod liver oil has a higher ratio of DHA to EPA, while fish oils have a higher ratio of EPA to DHA. But, overall, fish oils have almost twice the amount of total EPA plus DHA than cod liver oil per same size capsule or teaspoon. To summarize, cod liver oil has additional Vitamins A and D, a higher ratio of DHA to EPA, but almost half the total EPA plus DHA content than fish oils. Practically speaking, they are both healthy to ingest, but if you want a more concentrated form of EPA and DHA per capsule, you would go with fish oils.

Q. Thanks for having this wonderful insightful website. You mentioned fish oils in your last newsletter. I’ve heard a lot of talk about limiting fish intake because many of them contain high levels of mercury these days. I take a fish oil supplement daily. Is there any reason for concern that I may be ingesting mercury with these as well?
   A. Of all the studies I have seen thus far, it does not seem that mercury is found to any level that would be of concern in fish oil supplements. I take fish oil supplements myself almost daily without concern.

Q. Is there a blood test that I can take to see how much epa or dha is in my blood? I would like to know this before taking fish oils.
   A. There is, but it is not routinely available. We don't see the need to take this test since blood levels vary depending on diet. Just eat more fish or take fish oil supplements if you don't get enough fish in the diet.

Q. Could you describe the proper dosage of 1000mg fish oil tablets to treat arthritis, that you may have experience with? I am taking 3 - 1000mg capsules daily, but I have read that you need much more than that, perhaps 6 to 12 per day. Is that accurate, and is that safe? What migh be the max # per day before you need to think of safety? Thank you for your work.
   A. Each person is different in their response to fish oils and therefore we are not in a position to give a specific number of fish oil pills or dosage since there is a very wide range of response.

Q. I've been taking fish oil supplements for a few weeks now and I notice visual clarity and more pronounced colors like you said in the book.

Q. I have bipolar disorder. I have tried fish oil and found it useful.

Q. Do I need to take more vitamin E if I'm supplementing with fish oils?
   A. Most likely yes, but only small anounts are needed. Since fish oils are highly unsaturated, it would seem cautious to supplement with at least 5 to 10 units of vitamin E a day if you're taking a gram or more of an epa / dha combination.

Q. I just purchased your book Mind Boosters and find it very interesting. I have already noticed an improvement in my vision from taking fish oil.
   A. Thank you for the feedback.

Q. I am 24 years old and have just recently started wearing glasses because I can't see far. You mention [in the Mind Boosters book] that fish oil supplements can improve focus, color perception and clarity of vision. Is fish oil use recommended to individuals 50 years and older or do you think I would benefit by adding fish oil supplements to my diet?
   A. If your diet lacks adequate amounts of omega-3 oils, and you don't eat enough fish, it is possible that fish oil capsules could  help with your vision, although do not expect dramatic results at your age. The best way to find out if it works for you is to try the fish oils for a period of a month and observe any improvements.

Q. Let me compliment you very highly on Mind Boosters. It has been wonderful to read & implement your research. I realized after reading it that I didn't eat any fish. After taking 3 fish oil capsules per day (1000mg) for two weeks I have found my blood pressure is reduced from 140/90 to 125/80. I take this myself and have very structured measurements, due to having worked with many different blood pressure meds (and unwanted side effects) over the years. Have you seen this effect elsewhere? If this is long term I am VERY happy. Live long & prosper.
   A. I am surprised that a small dose of fish oils within two weeks could have made such a difference in your blood pressure. I usually don't see such a dramatic response in my patients.

Q. Do fish oil supplements increase sperm volume?
   A. I am not sure, but from what I know so far, fish oils may increase sperm volume.

Q. My question pertains specifically to fish oils. I read that fish oil supplements, even the new FDA approved medical grade fish oil can elevate liver enzymes. Is this true to any degree? And if so, why would they be toxic to the liver, assuming the supplements are pure.
   A. We have seen no evidence that reasonable amounts of fish oil capsules, one to three a day, cause liver problems or are toxic.

Q. I can't take fish oil because prolonged administration supresses my immune system. Then i read something on your informative website and i started to take 100 to 200 IU of vitamin E (D-alpha tocopherol) every alternate day. Guess what its been 6 months and i haven't got a single outbreak of throat infection or flu. I also take 500 - 1000mg of Vitamin C ...although Vitamin C protects to certain extent ...but you are right ...if we are taking fish oil then a fat soluble vitamin like natural E may save the day! I can say that your website cured me in a way...thanks for that.
   A. This is interesting, we will see if others notice the same.

Q. Fish oil dilemma...How does one get the benfits of fish oil supplements without ingesting harmful contaminants ad pollutants? Dr. Udo Erasmus (author of Fats That Heal, And Fats That Kill) claims that there are no fish oils that have acceptable levels of contaminants, and he states that based upon his research, plant-derived omega-3s are just as effective (in producing DHA and EPA in the body) as the long chain omega3s found in fish. But Dr. Barry Sears says that fish oil is much more effective, but he states that it has
to be pharmaceutical-grade fish oil, which he says has most of the contaminants removed. He also states that eating fish is not a good option, because he says that almost all seafood is contamintated with pollutants. So he says you have to remove the contaminants. He sells his own brand of pharmaceutical-grade fish oil, and LEF sell one too. But as stated, Dr. Udo Erasmus recently claimed that NO fish oils have acceptable levels of contaminants.
   A. There are a number of opinions out there regarding fish oils. My opinion is that one or two fish oil capsules are safe when the source is wild caught oily fish such as salmon, halibut, anchovies, etc. Omega3s from plants may not be easily metabolized to the longer chain epa and dha as easily as some people think. Eating fish in reasonable amounts from various sources is a healthy thing to do, and hardly any of the food we eat or air we breathe is completely free of contaminants, so we really can't strive for perfection. The body is able to detoxify certain toxins we ingest.

Q. I was told as a child that I was severely allergic to tuna fish. I have been reading about the benefits of taking fish oils but have always been afraid of what type of fish the oil was coming from. Are you aware of any possible allergic reactions to taking fish oils? Also will flaxseed oil provide the same nutrients as fish oil?
   A. The answer to your second question, flaxseed oil versus fish oil is discussed a few paragraphs above. As to where fish oils come from, different companies have different methods of extraction and use different types of fish.

Q. I am afraid to supplement with fish oil because of the blood thinning warnings. I use a few other herbs that thin the blood too, i.e.; greens supplement with garlic, green tea, alfalfa, grasses, turmeric, etc. I also drink extra green tea and ginger tea. Is it ok to take fish oil along with all this without danger of blood getting too thin? Also, if I east salmon once per week, should I not take fish oil that day or if I eat salmon once per week, should I even take fish oil at at all.
   A. This is a decision you would make in consultation with your doctor.

Q. I am taking fish oil capsules (2 x 1000 mg per day). I am also receiving BCG treatments in the bladder. I understand that this treatment (BCG) boosts your immune response. Could the fish oil be counteracting the immune boosting benefit of the BCG treatments?
   A. It's very difficult to say since we have not come across any studies regarding the interaction between BCG treatment and fish oil consumption. There probably is not interaction, but this is an educated guess.

Q. I understand that fish oil capsules can increase the LDL (bad) cholesterol. I have high cholesterol and am interested in taking fish oil, but do not want to increase my LDL. Is there a better way to take fish oil?
   A. We have not seen any reliable research that fish oils raise LDL cholesterol.

Q. I have been taking fish oils to assist with a dry eye condition. It has helped greatly. Recently a pharmacy friend of mine mentioned that there may be contraindications to taking oral contraception and fish oils together. Are there any studies that show the impact of this and will taking fish oils lessen the effectiveness of the pill?
   A. We have not seen any studies regarding fish oil use and birth control pills. However, taking more than 5 fish oil capsules a day could have effects that we are not yet aware of. It's best to limit fish oil use to 1 to 3 capsules a day.

Q. Thank you very much for the great information about fish oil. I give my son eye Q, can you tell me about it? It seems to be very good for him. He had a couple of episodes of psichosis, althoulgh there has not been a proper diagnosis from the specialists. He is taking Zyprexa 2.5 mg daily. He was taking fish oil capsules before but, it seems that the liquid Eye Q work better. Please can you write about it?
   A. Eye Q contains EPA, DHA, evening primrose oil and vitamin E. We can't see how Eye Q would be that much better than regular fish oil or krill oil.

Q. i would like to try fish oil, but i noticed that the vitamin e content of the fish oil is very small, is that enough to prevent oxidation and do i need additional vitamin e if i take fish oil, i heard the vitamin e level in the body lowers if one is taking fish oil.   
   A. It takes tiny amounts of vitamin E to protect the fish oils, it is only when massive amounts of fish oils are consumed that vitamin E levels become of concern.

Q. I read that the potential blood thinning effect of fish oils may theoretically increase the risk for bleeding.
   A. Clinical trial evidence has not supported increased bleeding with reasonable amounts of fish oil intake, even when combined with other agents that might also increase bleeding such as aspirin and warfarin ( Coumandin ).

Q.  Much appreciation for your medical website in educating the public about a number of health issues and supplements. This will surely help us make better decisions on getting suitable health products for our consumption.
I'm thinking of getting some fish oil supplements, and would like to ask which is more effective for cognitive functions -- the capsule or the liquid forms?
   A. Either the liquid or the capsules would be fine as long as the dosage is the same.

Q. I've noticed that by taking fish oil, 3-6 capsules a day that it has helped the weaning process of getting off Prednisone for my auto-immune disorder-(hemolytic anemia) - This isn't the first time I've tried weaning from the steroid medicine, so I know that the fish oil supplement is helping some with the withdrawal symptoms. One of the biggest setbacks from weaning from Prednisone is the lack of energy. I find fish oil supplements keep me stable. This could be yet another interesting effect from fish oil and maybe could be used in the future for other patients that need to wean off medicines.  I read in another post about allergies and fish oil. I can tell you that fish oil supplements definitely helps with making my eyes feel better. All in all, fish oil has been great for me.
   A. The improvement of your hemolytic anemia with fish oil supplements is interesting. We will see if studies confirm this benefit.