Most Americans have heard of fish oil and many have tried taking it.  Fish oil and other omega-3 fatty acids are even finding their way in to conventional medical doctors treatment recommendations for treatment of everything from joint pain to cardiovascular disease to depression.  A quick literature search pulls up over 15,000 studies published in the past 40 years documenting the benefits of omega-3 fatty acids.  In my practice, omega-3 fatty acid supplementation is a common prescription but it’s important that my patients understand why they’re taking it.

You’ve probably noticed on your omega-3 fatty acid supplement bottle the words DHA and EPA.  To think about it simply, DHA helps support structural roles (like brain and nervous system development) and EPA supports functional roles.  Depending on your medical condition, a different ratio of these components might be recommended.  Together EPA+DHA decrease inflammation which we understand contributes to nearly all disease processes including cardiovascular disease and chronic pain, improves mood, relieves dry eyes, and increases good cholesterol (HDL) and decreases bad cholesterol (triglycerides), just to name a few.

Flax Oil vs. Fish Oil: 

Omega-3 fatty acids are polyunsaturated fatty acids (PUFA).  Plants contain PUFA in an alpha-linolenic acid (ALA) form, a precursor to the EPA and DHA molecules.  Thus, vegetarians can get therapeutic doses of these fatty acids through oil sources like flaxseed, hemp, sunflower, corn, safflower, canola, borage, or evening primrose.  The body can only take these precursors and turn them into the health promoting fatty acids under the right conditions, however.  The body needs to be supplied with adequate levels of cofactors like B vitamins, magnesium, zinc, and vitamin C to complete the process.  If the body is under stress (diabetes, high alcohol consumption, high cholesterol, or psychological stress) or doesn’t have the cofactors it needs, it will favor a pathway of inflammation and ALA then becomes the pro-inflammatory fatty acid, arachidonic acid (AA).  Seafood, including algae, is the only substantial source of anti-inflammatory EPA and DHA that can not be converted into pro-inflammatory agents.  Research has shown that conversion of plant sources of ALA to EPA and DHA is actually pretty low.  Intake of 2 grams of ALA equate to about 160 mg EPA and 10 mg DHA in the body.  You would have to take about 7 grams of flaxseed oil to even come close to recommended doses of EPA and DHA.  This is why fish oil tends to be favored over things like flaxseed oil.

How Much to Take?

The American Dietetics Association recommends healthy adults consume 250-500 mg per day of EPA + DHA from fish oil and vegetarians consume 2-4 grams per day of ALA plus 100-300 mg per day of DHA.  These numbers increase if you have health conditions that benefit from omega-3 fatty acids, which nearly all conditions do since it modulates inflammation, a common underlying cause of disease.  The American Heart Association is recommending 1 gram of EPA+DHA daily in people with cardiovascular disease and 2-4 grams in people who have elevated triglycerides (cholesterol).  My typical recommendation as long as I’m not trying to modulate cholesterol levels is consistent with Health Canada’s recommendation of 3 grams EPA+DHA daily to reduce inflammation.

Can’t Fish Oil Be Contaminated?

Before you start taking omega-3 fatty acid supplements, check with your licensed naturopathic physician regarding supplement quality and dosages that are right for you. It is important that the source of fish oil be third party tested for quality and contaminants and NDs have access to physician quality supplements that are known for their purity.  If you don’t live in an area that has access to a naturopathic physician, Carlson’s fish oil products or Nordic Naturals can be found at health food stores and undergo thorough testing for quality.

Oh, and that recent study suggesting a link between fish oil and prostate cancer?  That was a horribly flawed study.  A rebuttal can be found here:




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