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Member Forum >> Fish Oil and Omega-3 Fatty Acids >> Fish Oil Quick Reference
 Fish Oil Quick Reference
Reference

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Posted: 6/20/2018 9:58:36 PM
Edited: 4/14/2024 1:32:22 PM (11)
 

🐟 Fish Oil Fish Oil Quick Reference Quick Reference 🌢

Contents

⇩ Overall context for this topic
⇩ General information
⇩ Program target
⇩ Cautions
⇩ Supplement considerations
⇩ Product suggestions
⇩ Testing considerations

Page edition: 2024-04-14

Context

Omega 3 DHA and EPA, almost always from fish oil, is a core program supplement. Unless you consume ancestral amounts and forms of wild-caught seafood and/or game organs, your Omega 3 levels, of these particular fatty acids, are very likely suboptimal.

There are at least 11 Omega 3 (ω3) fatty acids found in nature. Of these, only three are significant food-sources of Omega 3s:
DHA: Docosahexaenoic acid
EPA: Eicosapentaenoic acid
ALA: alpha-Linolenic acid⇱ Return to ToC

General Information

The need for DHA and EPA from fish oil has been part of the program, going back at least a decade and a half, and is extensively discussed in all the books and program materials:
🖵🗏 Physiological Benefits of Omega-3s (members)
🖵🗏 What If You Don’t Like Fish Oil? (members)
📖 Super Gut: starting page 188 of the U.S. print edition
📖 Wheat Belly R&E (2019): starting page 252 of the U.S. print edition
📖 Undoctored: starting page 287 of the U.S. print edition
📖 Wheat Belly 10-Day Grain Detox: starting page 73 of the U.S. print edition
🅑 WBB: Some unexpected benefits of omega-3 fatty acids (public)
🅑 WBB: Are you consuming enough omega-3 fatty acids? (public)

The "fish oil" nomenclature is no accident. The principal (economic) source of DHA and EPA is from fish. Ancestrally, eating enough seafood to meet ω3 needs sufficed. Modern ocean toxins make that unwise. Ancestrally, humans could also have gotten these ω3s from game organ meats (and game brains), but modern humans, eschew those sources, some of which are now risky as well.

ALA is widely available from plant sources, and humans do convert a small percentage of it to DHA and EPA, but not enough, and consuming excess ALA reportedly drives conversion down (and may have independent health risks). There is generally no need to supplement ALA.⇱ Return to ToC

Program Fish Oil Targets

Intake targets:
Generally: 3000 to 3600 mg/day of DHA+EPA
With elevated Lp(a): 6000 mg/day
High seafood intake: adjust supplementation per ⇩test results
Divide the daily amount into 2 or 3 doses.

This is milligrams of DHA plus EPA
(combined, not each, and also not the total amount of fish oil, which will be higher). The ratio of DHA:EPA may be anywhere between 1:2 and 2:1, or put another way, make sure you get the total, and at least 1000 mg of each. For comparison, this is about how much fish oil is present in 3 small cans of sardines.

Titer targets:
The actual DHA+EPA goal is for blood levels of Omega 3 to be 10% of fatty acids, and for Omega 6 levels to be no more than twice that. See ⇩Testing considerations below for further information. Because an Omega 3 titer is the real goal, it can be achieved by some combination of food and fish oil supplementation. The challenge is the hazards in modern food sources.

Non-coincidentally, the program’s standard dose of DHA+EPA is in the same range as for the 🅑preposterous prescription forms of fish oil (Lovaza®, Omacor®, Omtryg™ and Vascepa®).

For anyone avoiding fish for any reason, DHA and EPA are available from processing of marine algae (the same place the fish get it), and, from time to time, via industrial fermentation. These sources, although often costly, and obviously not ancestral, can meet program requirements.

Dose timing
Split the daily fish oil dose into two or three portions, taken across the day. If taking part of that as a fish oil+Vitamin D, take the +D₃ variant in the morning. “Fish oil is best taken before breakfast and before dinner to take advantage of its postprandial lipoprotein-clearing effect.

Store fish oil in a cool location out of direct sun exposure. Fish oil can be refrigerated or frozen to extend shelf life. Capsules may be consumed while still frozen.

Take fish oil while fasting?
That depends on the reason for the fast. Fish oil is 3.6 grams of fat, or 32 calories. Being a fat, however, it would be no threat to ketosis, if that’s the intent.⇱ Return to ToC

Cautions

On a statin?
There is an interference between statin drugs and fish oil benefits. Dr. Davis wrote about this in a 2013 (then TYP) Blog post:
🅑Are statins and omega-3s incompatible?
In addition to the paper linked there, here’s a later one:
NMCD: Intake of polyunsaturated fat in relation to mortality among statin users and non-users in the Southern Community Cohort Study

Fish Allergy?
Anyone with an unresolved fish allergy, or anaphylactic reaction to fish or shellfish, needs to approach fish oil carefully. In that situation, using a vegetarian source of DHA+EPA might be the interim solution, but current vegetarian sources of DHA+EPA tend to be at least twice the price of fish oil, and many of them have disqualifying ingredients.⇱ Return to ToC

Supplement considerations

Blood thinning speculations
Site members are directed to this remark by Dr. Davis from 2022:
“   The omega-3 fatty acids in fish oil normalize blood thinning, a big difference. For instance, it reduces high levels of fibrinogen that promote blood clotting: normalization of clotting, not blood thinning.
    The only contribution omega-3s make towards blood thinning is to reduce excessive platelet activation that may slightly prolong bleeding time, rarely a clinically meaningful effect.

Mega-dose fish oil?
Nothing in the program today suggests consuming more than 6 grams per day. Much higher doses are being used experimentally in certain situations, such as TBI, but chronic uses of mega-doses are basically unexplored territory.

Supplement form
Gelcaps or bottled liquid oil are suggested. With capsules, generally seek the highest potency per capsule (not necessarily per “serving”), to keep the capsule count manageable. Favor the triglyceride form of fish oil over the ethyl ester form, depending on other priorities. Be cautious about products containing anything other than fish oil, and seek grain-free encapsulation. Added ⇩vitamin D can be valuable, but mind the IUs.⇱ Return to ToC

Product suggestions

This is not an exhaustive list. Other available products may be satisfactory. Typical price for ~3300 mg/day is shown for rough price comparisons, using brand MSRP. Lower prices may be found at credible resellers, and via subscription purchase. Some general selection principles are discussed below the list. Buy only from credible sources, which today often excludes on-line ‘marketplace’ sites.

Triglyceride forms

Carlson®
Maximum Omega 2000 (soft gels)
DHA+EPA 875 mg/cap, 4/day = 3500 mg, US$2.07/day
The Very Finest Fish Oil (soft gels)
DHA+EPA 300 mg/cap, 11/day = 3300 mg, US$2.45/day
The Very Finest Fish Oil™ (500mL liquid)
DHA+EPA 260 mg per mL, 13 mL/day = 3380 mg, US$1.43/day

Nature’s Way {formerly Ascenta}
NutraSea® Omega-3 (500 mL liquid)
DHA+EPA 250 mg per mL, 13 ml day = 3250 mg/day, US$1.56/day

Nordic Naturals®
Ultimate Omega (soft gels)
DHA+EPA 550 mg/cap, 6/day = 3300 mg, US$2.32/day
Ultimate Omega (237mL liquid)
DHA+EPA 494 mg per mL, 7 mL/day = 3458 mg, US$2.30/day

Ethyl ester (or unstated) forms

Barleen’s
Ideal Omega® 3 Softgels - Orange Flavor
DHA+EPA 1000 mg per capsule, 3/day = 3000 mg, US$2.50/day

innovixlabs:
Triple Strength Omega-3 (soft gels)
DHA+EPA 840 mg/cap, 4/day = 3360 mg, US$1.00/day

Kirkland Signature (Costco)
Kirkland Signature Fish Oil 1000 mg., 400 Softgels
DHA+EPA: 250 mg per cap, 13 caps/day = 3250 mg, US72¢/day

Natural Factors
RxOmega-3 Ultra Strength 2,150 mg
DHA+EPA 1015 mg per cap, 3 caps/day = 3045 mg, US$3.40/day

Sam’s Club Member’s Mark:
Triple Strength Fish Oil Softgels, 150 ct.
DHA+EPA: 900 mg/cap, 4/day = 3600 mg, UA53¢/day

Beyond those products, you may want to rely on third party product evaluations. Subscription site ConsumerLab tests fish oil periodically. Industry site IFOS™ has open-access test data available, but doesn’t really rate products, and only reports on member products.

When checking product economy, be sure to assess only the DHA+EPA content, and how many capsules (or mL) are required to deliver the label ‘portion’ amount (as it is often 2 or more capsules, and often only 5mL for liquid). Program amounts will be much higher.

Avoid krill-based products on economy grounds (just run the numbers some time). Avoid cod liver oil due to marine toxins (Hg, PCBs), and excess vitamin A at program intake levels. Fish oil incidentally includes fatty acids other than DHA and EPA, but avoid anything that is mostly ALA (such as added flaxseed oil). Avoid anything with added Omega 6 (adverse). If the package touts Omega 6, that’s a warning label. Avoid anything with added Omega 9 (needless).

Fish Oil with Vitamin D

Several brands of fish oil are available with Vitamin D. This can be a way to take most, or even all of the day’s Vitamin D Quick Reference Vitamin D₃ Here’s an example product:

Sam’s Club Member’s Mark
600mg Omega-3 from Fish Oil with 50 mcg Vitamin D3 Softgels, 200 ct.
DHA+EPA 540 mg D₃ 2000 IU (50 µg) per capsule

This product can’t typically be used as the sole source of fish oil, as that would be 11,000 IU of D₃ per day. Perhaps 1-3 of these in the AM, and the balance as the Triple Strength product could work. Run these numbers for any fish oil with/D₃, as other brands can present the same issue.⇱ Return to ToC

Testing considerations

If in doubt about fatty acid status, or needing to dial-in supplementation due to high seafood intake, two tests can be useful. These are the most accurate when weight has been stable for 30 days or more. If you are losing weight, that includes a lot of stored fat — fat which may represent prior diet (and is apt to be low in ω3 and high in ω6).

Test details

Omega
Marker Name
Target Value Range
(See cell footnotes for target value references (📖 indicates from a book)
Further Information
 
ω3 Index
Omega-3 Index
CPT Code 82542 (suite)
10.0 to 12.0%¹
1. 📖Undoctored, page 191 of print edition)
This is percentage of serum fatty acids that are Omega 3. “Complete” or “plus” tests may also report details on DHA and EPA as line items, which can be useful.
ω6:3 Ratio
Omega-6/Omega-3 Ratio
CPT Code 82542 (suite)
0 to 2:1¹
1. 📖Undoctored, page 191 of print edition)
“Complete” or “plus” tests may also report details on specific ω6 fatty acids as line items, which can be useful.

If these tests aren’t routinely covered by your carrier (and they often aren’t), it’s often cheaper to obtain them on your own, nanny state permitting, from a mail-order or walk-in lab, perhaps via a ⌬Omega-3 Index Plus Finger Stick Test (LC100065, US$79-105) or ⌬Omega-3 Index Complete Finger Stick Test (LC100066, US$79-105).

Test day considerations

Fasting status: Avoid fish oil 12 hours before test.
Other supplements/meds: may be taken before or after draw
Time of day for test: anytime
Re-Test timing: wait 3-4 months⇱  Return to ToC


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Tags: dha,epa,fish,oil,Omega,Omega 3

Bob Niland

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Posted: 6/21/2018 6:27:42 AM
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Posted: 6/21/2018 7:18:12 AM
 
 
Hi Bob - what about triglyceride vs. ethyl-ester forms? Triglyceride form used to be recommended over EE for enhanced-absorption qualities. What say you?

Thanks,
Pete
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Posted: 6/21/2018 8:31:09 AM
 
 
Great. Thanks. Your work always so appreciated and helpful. Amazing really.

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Posted: 8/11/2018 4:37:00 AM
 
Thanks, Bob. Tremendous reference. Now we only need to add this to a FAQ list of References so that others can benefit.


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Posted: 1/9/2019 6:45:15 PM
 
Great post!!! 
Would love to see this with other supplement references! 

I appreciate all you do!!! Thank you! 

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WOW, Bob!!!! Thank you! 
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What does elevated LPA mean?

And is the 3,600 mg, both the combination of EPA and DHA?


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Vitamin D in gel caps comes packed with olive oil


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Posted: 3/24/2020 6:24:57 AM
 
Thanks, Bob. I had missed that


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Posted: 6/27/2020 8:38:26 PM
 
Thank you Bob, this helps point me in the right direction.
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Posted: 3/7/2022 6:58:19 AM
 
Thanks, Bob. Good to know. 


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Bob Niland

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Posted: 10/28/2022 3:40:00 PM
 
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Posted: 10/29/2022 9:18:14 AM
 
Bob, thank you.  That RequestATest site includes LabCorp and Quest tests (which look to be the same), both of which operate in my neighborhood.
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Posted: 10/29/2022 12:26:12 PM
 
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Posted: 10/29/2022 12:49:54 PM
 
Proprius--many thanks. That’s good to know.
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Posted: 11/9/2022 7:40:44 AM
 
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Posted: 11/9/2022 10:12:31 AM
 
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Posted: 11/10/2022 8:09:22 AM
 
Bob--Very helpful.  As I assumed.  Many thanks indeed.


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Posted: 3/20/2023 9:29:27 PM
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Posted: 3/20/2023 10:04:36 PM
 
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Posted: 7/3/2023 12:47:49 AM
 
Thanks for this!! ... what about from Dr. Mercola’s market: https://www.mercolamarket.com/search?type=q&keywordoption=CUSTOM&search=Fish%20Oil
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Posted: 4/14/2024 1:41:34 PM
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Posted: 4/14/2024 6:19:41 PM
 
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Posted: 4/14/2024 6:44:14 PM
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