Diabetes Self-Management Blog

We’ve covered a lot of information about omega-3 fatty acids over the past two weeks. Today we’ll wrap up the three-part series by looking at fish-oil supplements, as well as the potential side effects and safety issues that surround them.

Why would someone want to take fish-oil supplements? Well, if you’re like me, I happen to dislike seafood, with the exception of a tuna sandwich and the occasional piece of swordfish. Or maybe you love fish but live in an area where it’s hard to get fresh, high-quality seafood. Or it may be that you take fish-oil supplements for “health insurance” purposes. Remember, too, that if you have heart disease or have high triglycerides, the amount of omega-3s that you need can be difficult to get from eating fish alone. Whatever the reason, more and more people are turning to supplements (of all kinds).

How do you go about choosing a fish-oil supplement? First off, stay clear of taking cod-liver oil. This oil, which some of you may remember having to choke down during your childhoods, is a highly concentrated source of both vitamins A and D. Too much of either of these fat-soluble vitamins can be dangerous. Also, cod-liver oil is obviously made from the cod’s liver. The liver is the body’s filter and can harbor toxins, such as polychlorinated biphenyls (PCBs), organic pollutants that are frequently found in the fatty tissue of animals and fish.

Second, make sure you choose a supplement that contains both EPA and DHA, the two types of omega-3 fatty acids found in fish oil. Menhaden, sardines, anchovies, halibut, salmon, and mackerel are commonly used to make supplements. Most fish-oil supplements come in gelatin capsule form and are usually odorless, tasteless, and easy to swallow. (However, avoid taking any supplement that smells rancid or fishy.) If you have trouble swallowing capsules, look for a pudding-like supplement, such as Coromega, or try a liquid version. Most supplements are considered to be safe and toxin-free; choose brands that say they’ve been distilled or deodorized, which means that any contaminants have been removed.

Some “fish oil” supplements are actually not made from fish. Algae are used to make supplements, although if you take an algae-based supplement, it may not contain EPA. Also, some supplements are made from krill oil. Krill are tiny crustaceans that happen to contain a good amount of omega-3 fatty acids. Krill oil also contains antioxidants.

Third, make sure you read the label on whichever supplement you choose to determine how much you need to take. For example, if you’re aiming for 1000 milligrams (or 1 gram) of both EPA and DHA each day, you may have to take anywhere from one to four “softgels” each day, depending on the brand. Prices can vary, too, from brand to brand, which is another good reasons to figure out the dosing before you buy a particular supplement. (Check out www.consumerlab.com for a list of popular brands.) Higher-quality supplements tend to be more concentrated in omega-3s than the local grocery store brands. Always keep your fish-oil supplements in a cool, dry, dark place. Refrigerating them is not a bad idea.

Fish-oil supplements can cause side effects in some people, such as belching (along with a fishy flavor) and heartburn. If this happens, spread your dose throughout the day or switch to another brand. Take your supplements with food for better absorption. Because fish oil has blood-thinning properties, be very careful about taking it if you also take aspirin or prescription anticoagulants such as warfarin (brand name Coumadin), or if you’ve had a hemorrhagic stroke, or will be having surgery. Talk to your physician first. Fish oil may be beneficial for kidney function in people taking cyclosporine, a medicine used to prevent organ transplant rejection, but discuss your situation with your physician before using it.

Your physician may prescribe Omacor, a prescription version of omega-3 fatty acids, if you have very high triglyceride levels. This “drug” contains a highly concentrated blend of EPA and DHA. The dose of this medicine is 4 grams per day (don’t take this much of a nonprescription supplement unless you’ve checked with your physician first).

Finally, if you prefer to get your omega-3s from vegetarian sources, try taking flaxseed oil or flaxseed oil capsules. One tablespoon of flax seed oil or 3–6 flaxseed oil capsules is the typical dose. Pregnant women should not take flaxseed oil, by the way.

I hope you feel more comfortable and confident about these important omega-3 fatty acids. Aim to fit more fish into your diet and consider taking a supplement if you’re not a fan of fish.

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Fabulous Fish Oil Findings: Part 1
Fabulous Fish Oil Findings: Part 2
Fabulous Fish Oil Findings: Part 3


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