Posted by Rick on August 20, 2002, at 12:46:54
In reply to Re: Fish Oil - A Silly Question, posted by Dinah on August 18, 2002, at 19:51:19
Here's a boatload of info on dosages, safety issues and more from the Natural Medicines Comprehensive Database, which is an evidence- based refeference compiled by pharmacists. They don't sell anything. The numbers in parentheses are usually hyperlinks to Medline studies-- can't use them here. It looks like there are (surprise!) many potential benefits AND many potential watchouts/risks. Buried in the effectiveness section is a statement that fish oils do seem to help in depression, except for manic symptoms in bipolar depression:
Safety:
LIKELY SAFE ...when used orally and appropriately. Doses of 3 grams per day and less can be safely used by most people. Fish oils have Generally Recognized as Safe (GRAS) status in the US (5703,7376).
POSSIBLY UNSAFE ...when used orally in high doses. Doses greater than 3 grams per day can inhibit blood coagulation and potentially increase the risk of bleeding. Doses greater than 3 grams per day might also suppress immune response (1313,7376,7383,7384).
CHILDREN: POSSIBLY SAFE ...when used orally and appropriately (5708,5711).
PREGNANCY AND LACTATION: LIKELY SAFE ...when used orally in amounts found in foods (5703). There is insufficient reliable information available about the safety of fish oils when used in amounts greater than those found in foods during pregnancy and breast-feeding.Effectiveness:
LIKELY EFFECTIVE ...when used orally for hypertriglyceridemia. Fish oils from supplements or from dietary sources can reduce triglyceride levels by 20-50% (1024,2299,2300,2301,2302,2315,2317,5702,5705) (5706,6394,6399,7368,7369,7380). This effect appears to be dose-dependent (5706,7380). However, fish oil supplements in doses of 4 grams per day do not seem to be as effective as gemfibrozil (Lopid) 1200 mg per day (7377).
POSSIBLY EFFECTIVE …when used orally from dietary sources to reduce the risk of death from coronary heart disease. Epidemiological research suggests that long-term consumption of a diet that regularly includes fish reduces the risk of death from death from coronary heart disease, possibly by decreasing ventricular ectopic beats (7360). Consumption of one to two servings per week of fish oils from dietary sources appears to reduce the risk of coronary heart disease death by 25% (2309). ...when used orally to reduce cardiovascular events and mortality after myocardial infarction (MI). Fish oils 1 gram daily starting within 3 months after MI and continued for at least a year appears to reduce the risk of total cardiac events, non-fatal MI, and total cardiac mortality by 15% (1007,2307). There is also some evidence that consuming dietary fish oil from 2 to 3 servings of fish each week seems to reduce the risk of death after myocardial infarction (7359). Fish oil supplements do not seem to reduce the risk of post-MI cardiovascular events in people whose diet already includes fish (7361). …when used orally to reduce the risk of stroke. Consuming fish oils from dietary sources at least once a week seems to reduce the risk of ischemic stroke by 27% (7373). Higher serum levels of fish oils are also associated with decreased risk of stroke (7372). Dietary fish oils don’t seem to further reduce stroke risk in people who already take aspirin (7373). It’s not known if fish oil supplements have any effect on stroke risk. ..when used orally for mild hypertension. Fish oil seems to produce modest, but significant reductions in systolic and diastolic blood pressure in patients with mild hypertension with or without type 2 diabetes (1001,1020,2301). …when used orally to decrease the incidence of vein graft occlusion following coronary artery bypass grafting. Supplemental fish oil appears to reduce the frequency of vein graft occlusions after coronary artery surgery (2314). ...when used orally for rheumatoid arthritis. Fish oils alone or in combination with naproxen (Naprosyn) seem to significantly decrease the duration of morning stiffness in patients with rheumatoid arthritis (1017,1039,1041). Use of fish oils might also allow reduction of non-steroidal anti-inflammatory drug (NSAID) requirements when used concomitantly (1031). ...when taken orally in combination with conventional therapy for bipolar disorder. Using fish oils with conventional therapies seems to improve symptoms of depression and increase length of remission (7202). However, fish oil does not seem to have beneficial effects on manic symptoms in bipolar patients (5713,7202). …when used orally in combination with garlic for hypercholesterolemia. Combining fish oil 12 grams plus garlic 900 mg daily seems to lower total cholesterol, triglycerides and the ratios of total cholesterol to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) to HDL in patients with hypercholesterolemia (2318,2319). The addition of garlic appears to prevent the typical rise in LDL normally seen when fish oil is used alone (2318). …when used orally to prevent cyclosporine-induced hypertension following cardiac transplant. There is some evidence that fish oils can maintain pre-cyclosporine blood pressures in patients taking cyclosporine (507,1012). ...when used for preventing cyclosporine-induced nephrotoxicity. There is some evidence that fish oil can significantly improve glomerular filtration rate (GFR) and renal blood flow in individuals taking cyclosporine (1021). …when used orally to prevent recurrent miscarriage in patients with antiphospholipid syndrome. There is some evidence that fish oils can increase live birth rate in pregnant women with a history of recurrent miscarriage associated with antiphospholipid syndrome (1032). ...when used orally to reduce albuminuria in individuals with diabetic nephropathy (1025). …when used orally to improve appetite and increase lean body mass in patients with advanced pancreatic cancer (5701). …when used orally to improve night vision in children with dyslexia. Dyslexic children who take fish oils seem to develop significantly better dark adaptation (5708). …when used orally in combination with evening primrose oil, thyme oil, and vitamin E to improve movement disorders in children with dyspraxia (5708). …when used orally with simvastatin to decrease postprandial hemostatic risk factors in hyperlipidemia (5704). …when used orally for migraine headache prophylaxis in adolescents. There is some preliminary clinical evidence that fish oil preparations containing eicosapentaenoic acid (EPA) 756 mg and docosahexanoic acid (DHA) 498 mg daily for 2 months can significantly reduce frequency of migraine headaches. When migraine headaches do occur, duration and severity seems to be less in patients taking fish oil (5097). …when used orally to treat dysmenorrhea. Fish oils, alone or in combination with vitamin B12 seem to decrease pain and interference with daily activities in adolescent girls and women with dysmenorrhea (7574,7575). …when used orally to treat Raynaud’s syndrome. There’s some evidence that fish oils can improve tolerance to cold and delay the onset of vasospasm in people with primary Raynaud’s syndrome. People with Raynaud’s syndrome caused by progressive systemic sclerosis don’t seem to respond to fish oil supplements (7573). …when used orally from dietary sources for weight loss. There is some evidence that ingestion of fish oils from dietary fish sources can improve weight loss and decrease blood glucose and insulin concentrations in overweight and hypertensive patients (2049). ...when used orally from dietary sources to reduce the risk of age-related maculopathy. There is some evidence that people who ingest fish oils from dietary fish sources more than once per week have a reduced risk of developing age-related maculopathy (6260). …when used orally from dietary sources to reduce the risk of prostate cancer. Population studies indicate that prostate cancer risk is 2 to 3 times lower in men who regularly include fish oils in the diet (7378). Men who have higher serum levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), fatty acids that are in fish, seem to have a lower risk of developing prostate cancer (6395). ...when used intravenously for certain types of acute and chronic psoriasis. There is some evidence that giving intravenous fish oils can decrease severity of symptoms in patients with acute, extended guttate psoriasis and chronic plaque psoriasis. Fish oils seem to be superior to omega-6 fatty acids for this use (1004,1034). However, fish oil taken orally does not seem to have this benefit (1035).
POSSIBLY INEFFECTIVE ...when taken orally to reverse progression of atherosclerosis. Long-term use of fish oils appears to have no effect on decreasing plaque size or increasing the luminal diameter of coronary arteries in patients with coronary atherosclerosis (1022,2311). …when taken orally for systemic lupus erythematosus (SLE) and lupus nephritis (507). Fish oils do not seem to reduce disease activity or improve renal function when taken for a year (7571). There’s some weak evidence that fish oils plus a low fat-diet might reduce lupus symptoms, but it’s too preliminary to recommend this combination (7572). …when taken orally for atopic dermatitis (507). …when taken orally for gingivitis (1005). ...when taken orally for renal impairment associated with advanced cirrhosis (1013). …when taken orally for stable claudication. Fish oils appear to have no effect on walking distance in patients with claudication (1002).
LIKELY INEFFECTIVE …when taken orally in combination with evening primrose oil for preventing pre-eclampsia, preterm labor, and intrauterine growth retardation (1026,1027,1042). …when taken orally to prevent restenosis after percutaneous transluminal coronary angioplasty (PTCA) (1028,1038,2320). …when taken orally for type 2 diabetes. Fish oil appears to have no effect on fasting plasma glucose levels or serum hemoglobin A1c levels at doses less than 6 grams per day (2299,2300,2302,7368,7369). Several clinical studies have used fish oil products containing specific proportions of the fatty acids eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Most commonly products have contained 35% EPA and 25% DHA.
There is insufficient reliable information available to rate the effectiveness of fish oils for other uses. However, there is some evidence fish oils might be helpful for inflammatory bowel disease (IBD), but evidence is conflicting (1037,1040,5709,6257,6258,6259). There is some conflicting evidence about the use of a proprietary combination of fish oils and evening primrose oil (Efamol Marine) to reduce the symptoms chronic fatigue syndrome (1019,7564). More information is needed to rate fish oils for these uses.Mechanism of Action:
Fish such as herring, kipper, mackerel, menhaden, pilchard, salmon, sardine, and trout contain oils with high amounts of long-chain, polyunsaturated fats called omega-3 fatty acids. These fish oils are especially high in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (See separate listings for EPA and DHA).
Omega-3 fatty acids from fish oil have anti-inflammatory effects because they compete with arachidonic acid in the cyclooxygenase and lipoxygenase pathways and inhibit leukotriene synthesis. Fish oils can also suppress mediators of immune function by reducing the production of cytokines such as interleukin-1(IL-1), interleukin-2 (IL-2), and tumor necrosis factor (TNF). Fish oils also suppress T- and B-cell proliferation and decrease delayed-type hypersensitivity skin response (DTH). They also decrease antibody production and increase free radical activity (7376,7383,7384).
Due to fish oil’s anti-inflammatory effects, they are tried for a variety of inflammatory conditions, including psoriasis, systemic lupus erythematosus (SLE), inflammatory bowel disease, and others.
Fish oils seem to be beneficial in rheumatoid arthritis due to anti-inflammatory effects and epidemiological data that suggests EPA levels are decreased in total plasma fatty acids and synovial fluid, and DHA is decreased in the synovial fluid of patients with rheumatoid arthritis (5710).
Fish oils are also used for cardiovascular conditions, including stroke and heart disease, due to anti-inflammatory and antithrombotic effects. Fish oils decrease blood viscosity and increase red blood cell deformability. The antithrombotic activity of fish oils results from increased prostacyclin synthesis and vasodilation, reduction of platelet adhesiveness, and reduced platelet count. Fish oils also seem to have an antiarrhythmic effect. Fish oils might regulate calcium movement through calcium channels in the heart and suppress intracellular calcium activity, which has been associated with arrhythmias. There’s also some evidence that it might affect sodium channels and inhibit ischemia-induced arrhythmias (7360,7362,7363).
In hypertriglyceridemia, fish oils are thought to lower triglycerides by decreasing secretion of very low-density lipoproteins (VLDLs), increasing VLDL apolipoprotein B secretion, possibly by increasing VLDL clearance, decreasing VLDL size, and reducing triglyceride transport (5707). In addition, fish oils appear to decrease synthesis of VLDL by inhibiting 1,2-diacylglycerol-sterol o-acyltransferase or phosphatidate phosphatase (6394). Fish oils also seem to decrease chylomicron concentrations. More lipoprotein lipase becomes available due to decreased VLDL levels, which causes increased hydrolysis of chylomicrons (6394). Fish oils also increase fatty acid oxidation by peroxisomal and mitochondrial routes, reduce fatty acid synthesis, divert fatty acids into phospholipid synthesis, increase hepatic uptake of triglycerides, and down regulate fatty acid esterifying enzymes (5707). Fish oils also seem to decrease cholesterol absorption from the gut and decrease cholesterol synthesis (5707). Fish oils also might increase high-density lipoproteins (HDL) (2318,5707) and improve flow-mediated arterial dilation (5702). Fish oils also seem to increase low density lipoprotein (LDL) concentrations but the mechanism is unknown (2299,2318). It is thought that fish oils may cause a more buoyant LDL to be formed, which might be less atherogenic (2299).
Unlike some other kinds of dietary fat, omega-3 fatty acids from fish oils do not seem to impair endothelial function, which is thought to be a precursor to atherogenesis (5702,7382). In some patients fish oils actually seem to improve arterial compliance (1029,5707).
Omega-3 fatty acids compete metabolically with omega-6 fatty acids, which are found in vegetable oils. Omega- 6 fatty acids seem to inhibit the incorporation of omega-3 fatty acids into tissue lipids. Omega-3 fatty acids inhibit the conversion of the major omega-6 fatty acid in vegetable oils, linoleic acid, into arachidonic acid. There is some concern that dietary vegetable oils in the diet might negate the beneficial cardiovascular effects of fish oils, but omega-3 fatty acids from fish oil seem to reduce cardiovascular risk factors despite concurrent omega-6 fatty acid ingestion. The total dose of omega-3 fatty acids, rather than the ratio of omega-6 fatty acids to omega-3 fatty acids seems to determine efficacy (7381).
Fish oils have been proposed as a treatment for attention deficit hyperactivity disorder (ADHD) due to epidemiological data that suggests symptoms of ADHD might be inversely related to the omega 3-fatty acid phospholipid content (5711). In individuals with bipolar disorder, the fatty acids in fish oils are thought to have an effect similar to lithium or valproate, slowing nerve signaling (7202).
Some researchers think fish oils might also help prevent some forms of cancer. People with high EPA and DHA levels in their erythrocytes seem to have decreased rates of prostate cancer (6395). EPA and DHA might compete with arachidonic acid as substrates for cyclooxygenases that produce prostaglandins that can enhance tumor growth (6385,7378). There is also preliminary evidence that high levels of EPA and DHA can be beneficial for prolonging cancer remission. Fish oils might decrease production of lactic acid by tumor cells. Lactic acidosis is a marker of unfavorable metabolic conditions associated with many cancers (6398). There is also some evidence that fish oils might be cytotoxic to some cancer cells (1008).Adverse Reactions:
Orally, fish oils are generally well-tolerated at doses of 3 grams or less per day. Fish oils sometimes have a fishy taste and can cause belching, halitosis, and heartburn (507,6258). High doses can cause nausea and loose stools. Some gastrointestinal side effects can be minimized if fish oils are taken with meals and if doses are started low and gradually increased.
At doses greater than 3 grams per day, fish oils can inhibit platelet aggregation and could cause bleeding and potentially increase the risk for hemorrhagic stroke (7376).
There’s also some evidence that fish oils in doses greater than 3 grams per day might adversely affect immune function. Fish oils appear to suppress T- and B-cell function and to reduce the production of cytokines, which might be detrimental to elderly people and people with suppressed immune function such as patients with human immunodeficiency virus (HIV) infection (7376,7383,7384).
In some patients fish oils can increase low-density cholesterol (LDL) (7376). There is also some concern that polyunsaturated fatty acids, such as omega-3 fatty acids, might increase the oxidation of low-density lipoprotein (LDL), which could increase the risk of atherosclerosis (1011,2322,2323,7366). Although thiobarbituric acid reacting substances (TBARS) rise during fish oil supplementation, TBARS is now thought to inaccurately reflect LDL oxidation. More specific indicators of lipid peroxidation, such as F2-isoprostanes and malondialdehyde (MDA), suggest that fish oil is unlikely to have a negative effect on LDL and the risk for atherosclerosis (2323).
Some fish oil preparations (e.g., cod liver oil) contain large amounts of vitamin A and vitamin D. If these preparations are used long-term or in large doses, there is a risk of vitamin A and D toxicity (See separate listing for Cod Liver Oil) (6872,6874).
There is some concern that fish oil products might be contaminated with toxins or pesticides if the fish were caught in contaminated waters (6873,6875). Heavy metals, especially mercury, are a particular concern (259). However, laboratory analysis of some fish oil supplements found no detectable levels of mercury in the 20 products tested. Fish typically contain 10 to 1000 parts per billion of mercury. Mercury accumulates in fish meat much more so than fish oil, which might explain the lack of detectable mercury in fish oil supplements (7379).
Fish oils also contribute to caloric intake and may cause weight gain if used long-term. One gram of fat or oil provides 9 kcal (6871,6872). Fish oil capsules containing 500 mg omega-3 fatty acids in 1 gram of oil would supply about 13.5 kcal per capsule (6871,6874). Fish oil supplements also contain cholesterol in amounts from 1 to 6 mg per gram of fish oil (3022,6871).Interactions with Herbs & Supplements:
HERBS WITH ANTICOAGULANT/ANTIPLATELET POTENTIAL: Concomitant use of herbs that have coumarin constituents or affect platelet aggregation could theoretically increase the risk of bleeding in some people. These herbs include angelica, anise, arnica, asafoetida, bogbean, boldo, capsicum, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, horseradish, licorice, meadowsweet, prickly ash, onion, papain, passionflower, poplar, quassia, red clover, turmeric, wild carrot, wild lettuce, willow, and others (4,19).
VITAMIN E: Fish oils can reduce vitamin E levels. The mechanism is unknown, but might result from reduced vitamin E absorption or increased vitamin E utilization by other tissues to block free radicals and prevent peroxidative damage (7384).Interactions with Drugs:
ANTICOAGULANTS/ANTIPLATELET DRUGS: Concomitant use with anticoagulant or antiplatelet drugs can increase the risk of bleeding (9,507). Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
ANTIDIABETES DRUGS: Theoretically, concomitant use of fish oil at doses greater than 6 grams per day might interfere with blood glucose control. However, lower doses do not seem to affect blood glucose. (7368,7369).
ANTIHYPERTENSIVE DRUGS: Fish oils can lower blood pressure and might have additive effects in patients treated antihypertensives (1001,1020,1030,1033); use with caution.
CYCLOSPORINE: Fish oils can reduce cyclosporine-induced hypertension in individuals after heart transplants, and may help protect against cyclosporine-induced nephrotoxicity (507,1012,1021).
ETRETINATE: Concomitant use of etretinate with eicosapentaenoic (EPA) can enhance the effects in psoriasis treatment (1000).
Interactions with Foods:
No interactions are known to occur, and there is no known reason to expect a clinically significant interaction with fish oils.
Interactions with Lab Tests:
BLOOD PRESSURE: Fish oils can moderately lower blood pressure and reduce blood pressure readings in patients with hypertension (1001,1020,1030,1033).
ELECTROCARDIOGRAM (ECG): Fish oils might normalize ECG readings in some patients with ventricular ectopic beats. Fish oils might decrease ventricular ectopic beats (507).
INTERNATIONAL NORMALIZED RATIO (INR), PROTHROMBIN TIME (PT): High doses of fish oils, greater than 3 grams per day, might decrease blood coagulation, increase INR and PT, and increase the risk of bleeding (1313).
TRIGLYCERIDES: Fish oils can reduce serum triglyceride concentrations and test results by 20% to 50% in patients with elevated triglycerides (1003,1009,1014,1024).
Interactions with Diseases or Conditions:
ASPIRIN-SENSITIVE INDIVIDUALS: Fish oils should be used with caution because omega-3 fatty acids can decrease pulmonary function in aspirin-sensitive individuals (507).
BIPOLAR DISORDER and DEPRESSION: Symptoms of hypomania can develop in patients taking fish oils who have bipolar (5713,7202) or major depressive disorders (6396).
CIRRHOSIS: Theoretically, use of fish oils may lower mean arterial pressure (MAP) to hypotensive levels, and may increase risk of bleeding (1013); use with caution.
DIABETES: Fish oils in doses greater than 6 grams per day can increase blood glucose levels. However, lower doses don’t seem to effect blood glucose. Tell patients with diabetes to avoid exceeding a dose of 3 grams per day (7368,7369).
FAMILIAL ADENOMATOUS POLYPOSIS: Fish oils might further increase the risk of cancer in people with familial adenomatous polyposis. Three people, who had pre-existing familial adenomatous polyposis, were diagnosed with malignant lesions during the course of long-term use of fish oils (999).
HYPERTENSION: Fish oils can lower blood pressure and might have additive effects in patients treated with antihypertensives (1001,1020,1030,1033).
IMMUNODEFICIENCY: Higher doses of fish oils might cause suppression of immune and inflammatory response (7376,7383,7384). Tell immunocompromised patients (e.g., patients with HIV/AIDS) to avoid exceeding a dose of 3 grams per day.
Dosage/Administration:
ORAL: For lowering triglycerides, studies have used 1-4 grams of fish oils per day (5707,6394,6399). For lowering blood pressure, studies have used either 4 grams of fish oils or fish oils providing eicosapentaenoic acid (EPA) 2.04 grams and docosahexaenoic acid (DHA) 1.4 grams daily (1001,1020). For hypertension secondary to cyclosporine in heart transplant patients, 4 grams per day has been used (1012). For cyclosporine nephrotoxicity, 12 grams per day containing 2.2 grams EPA and 1.4 grams DHA has been used (1021). For reducing mortality after a myocardial infarction, a daily oral dose of fish oils providing EPA 850 mg-1.08 grams with or without 882 mg DHA, or a daily serving of 1.25 ounces or more of fish has been used (1007,2307). For improving endothelial function in individuals with hypercholesterolemia, 4 grams per day has been used (5702). For decreasing duration of morning stiffness secondary to rheumatoid arthritis, fish oils providing EPA 3.8 grams and DHA 2 grams per day have been used (1039). For preventing miscarriage in women with antiphospholipid antibody syndrome and a history of recurrent miscarriage, 5.1 grams fish oils with a 1.5 EPA:DHA ratio has been used (1032). For treating dysmenorrhea, a daily dose of EPA1080 mg and DHA 720 mg has been (7574). For treating primary Raynaud’s syndrome, a total daily dose of 3.96 grams EPA and 2.64 grams DHA has been used (7573). As an adjunct to standard therapy for bipolar disorder, fish oils providing EPA 6.2 grams and DHA 3.4 grams daily have been used (7202). For weight loss, a daily serving of 2-7 ounces of fish containing approximately 3.65 grams omega-3 fatty acids (0.66 gram from EPA and 0.60 gram from DHA) has been used (2049). For improving appetite in individuals with pancreatic cancer fish oils providing EPA 2.2 grams and DHA 1.4 grams daily have been used (5701). For improving dark vision adaptation in dyslexic individuals, fish oils providing DHA 480 mg daily have been used (5708). For improving movement disorders in children with dyspraxia, fish oils providing DHA 480 mg combined with 35 mg arachidonic acid and 96 mg gamma-alpha linoleic acid from evening primrose oil, 24 mg thyme oil, and 80 mg vitamin E (Efalex) have been used (5708). For decreasing the frequency of vein graft occlusion after coronary bypass grafting, 4 grams of fish oil per day containing EPA 2.04 grams and DHA 1.3 grams has been used (2314). For combined hypertriglyceridemia and hypercholesterolemia, fish oil providing EPA 1800-2160 mg and DHA 1200-1440 mg combined with garlic powder 900-1200 mg daily has been used to lower total cholesterol, LDL, triglycerides, and the ratios of total cholesterol to HDL, and LDL to HDL (2318,2319). Fish oil supplements often contain small amounts of vitamin E as an antioxidant to prevent spoilage. They might also be combined with calcium, iron, or vitamins A, B1, B2, B3, C, or D (507). Fish that are good sources of omega-3 fatty acids, including mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout, and menhaden, provide about 1 gram of omega-3 fatty acids per 3.5 ounces of fish.
INTRAVENOUS: For chronic plaque psoriasis, a daily 200 mL intravenous dose of parenteral fish oil-based lipid emulsion (Omegavenous), containing 4.2 grams EPA and 4.2 grams DHA, has been used for 14 days (1004). For acute, extended guttate psoriasis, a daily intravenous dose of a parenteral fish oil product, containing 2.1 grams EPA and 21 grams DHA, has been used for 10 days (1034).Comments:
Fish oils come from a variety of marine life including mackerel, herring, tuna, halibut, salmon (945), cod liver, whale blubber, and seal blubber (1048). Products that are commercially available contain varying amounts and ratios of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) (507). Researchers are investigating oils containing stearidonic acid (SDA) from genetically modified plants as an alternative to fish oil as a source of omega-3 fatty acids. SDA is metabolized to DHA and EPA in animals. However, further research is needed on the effects of SDA in humans (6129).
Patient Handout References Brand Names Search Results
3120 W. March Lane, PO Box 8190, Stockton, CA 95208, Tel:209/472-2244 Fax:209/472-2249
Copyright © 1995-2002 Therapeutic Research Faculty, All rights reserved.
poster:Rick
thread:116721
URL: http://www.dr-bob.org/babble/20020814/msgs/117115.html