Omega 3's - EPA/DHA

As many Americans know, Fish Oils have many health benefits. However, the problems with these oils have been numerous, including poor quality oils with heavy metal and man made chemical problems, absorbability challenges and most commonly taste and "fish burps", making patient compliance a challenge. I have used fish oil products with patients for 25 years, however I have usually reserved them for situations where they were really critical.

Now with the advent of the Best Tasting Fish Oil in the World (see my note on Omega 3.6.9 below), I can recommend them to every patient and everyone in their family. More on our taste treat later.

First let me list the key areas where fish oils rich in EPA and DHA have strong or very strong evidence for their benefits: Cardio-Vascular Health and Mortality, Chronic Pain and Inflammation, Age Related Dementia and Alzheimer's Disease, Mood, Age related Macular Degeneration, and lastly Neurological Development and Intelligence in Infants and Children.

Cardio-Vascular Mortality reduction is without a doubt the single greatest benefit of fish oils. When your red blood cells are rich in EPA and DHA your mortality risk from Sudden Cardiac Death is as much as 90% reduced when compared to individuals with low levels of red blood cell EPA/DHA. This kind of mortality benefit is rarely seen in any single component research, and given this is the number one killer in America, this is a very dramatic and important result. In fact of all the many products I can recommend to my patients with risk of Cardio-Vascular problems, this is the one product that will make the biggest difference in reducing their risk.

Chronic Pain and Inflammation: High levels of EPA/DHA can approach the effectiveness of prescription drugs in chronic pain patients, including those with Rheumatoid Arthritis, without any of the adverse affects (like increased risk of heart disease from the NSAID's), while at the same time reducing cardio-vascular risk. Additionally, chronic inflammatory processes like inflammatory bowels and inflammation associated with Dysmenorrhea have shown improvement.

All age related Dementia, including Alzheimer's, as well as significant benefits for mood and in one recent, well done psychiatric research project even strongly reduced the tendency to Psychosis.

However, with the Dementia and Alzheimer's, the benefits are most realized when fish oils have been used long term, thusly reducing the risk of these conditions, rather than reversing them. This is not so surprising when you realize our brains and nervous systems are approximately 50% fat, and 50% of this fat is DHA.

Regarding Mood benefits, a study in New Zealand in 2005 of "healthy individuals" showed adolescents over 15 years and adults, with just one month of Omega EPA/DHA supplementation, had measurable improvements of Increased Vigor and Reaction Time, with Decreases in Anger and Anxiety.

Age related Macular Degeneration (AMD) is the number one cause of blindness in the elderly. A number of research projects have shown that individuals with the highest intake of EPA/DHA have a significant reduction in the risk of AMD.

For the Developing Fetus, Infants and Children, EPA/DHA rich fish oils have shown a marked affect at increasing brain development, coordination and even I.Q. levels. Many of these benefits are realized by mom's intake of EPA/DHA during pregnancy and while breast-feeding. Then while the child is developing their neurological development also benefits from these oils. Remember the brain is 50% fat and 50% of that fat is DHA.

There are other conditions and tissues in the body that have shown benefit over the years from higher levels of Fish Oils and EPA/DHA. These include skin, prostate, numerous female hormonal issues, athletic performance, circulation and many more. However, the above conditions have the strongest evidence.

Regarding Quality: As I mentioned above historically there have been huge variations in the amount of heavy metal and man made chemicals like PCB's in fish oils. There are actually legal limits on PCB's and recently lawsuits were announced against numerous companies for exceeding these limits in their fish oil products.

The vast majority of the companies that I use only sell directly to Licensed Health Care Professionals. They are very careful about testing all products for quality assurance and exceed the government standards that are set for purity. They are not like retail companies who can survive a reputation problem. As doctors who do nutritional work are their primary customers, they know we will not tolerate their coming up short. Additionally, most of the companies I use actually are at least partially owned by active practitioners who want the absolute best for their patients. I am very proud to say that the quality of our products have never been shown to be problematic.

Now very recently a new form of fish oil, rich in Omega 3's and EPA/DHA has solved all of the challenges of getting patients to take this important product on a regular basis. In fact in the first two months of providing this product to patients in the clinic the one problem some families have faced is a shortage of their Omega 3.6.9 as some of their children like it so much they are sneaking it over and above their recommended amounts.

To be honest the clear consensus is that Omega 3.6.9 Emulsion taste like (depending on the age group), Lemon Meringue Pie!, Lemon Pudding! Or Lemon Star Bursts! I'm not kidding this stuff tastes great! With no fish taste whatsoever! It's a little shocking that they could get this to taste so good.

Here's the other great news, emulsifying this product was the starting point for it's creation, as research has demonstrated that it improves absorption by 50% for the EPA fraction and 70% for the DHA fraction. That's huge and solves one of the other issues with fish oils that we have had in the past. Also, no "fish burps" hours later.

Recommended dosages vary depending on why one is taking it. For Cardio-Vascular mortality risk reduction, Pregnant or Breast Feeding Moms, Family History or maximizing reduction of Age Related Dementia, Alzheimer's or Macular Degeneration, and for Chronic Pain I recommend, 1 T., 2x's per day.

If none of the above are issues or concerns then 1 Tablespoon per day.

For Children: after breast feeding until age three one half teaspoon per day; from 3 - 7 one teaspoon per day; 7 - 16 two teaspoons per day, from age 16 on 1 Tablespoon per day. For children who are very active athletes I would recommend doubling their dosages starting at age 10 or check with me regarding your child.

Can one get too much fish oil? Research has shown that fish oil is safe at least up to 7 grams per day. They have not tested it beyond that. The Eskimos of Iceland averaged over 13 grams of fish oil per day! However, as with any product of any kind if you ever notice an unusual symptom after starting something new, always check with me.

Please let me know if you have any questions.

Yours in Health, Dr. Dale