Top 6 Tips to Buying Fish Oil | Austin Family Medicine

Top 6 Tips to Buying Fish Oil (Omega‑3):

If your doctor has recommended fish oil, you probably have gone to the pharmacy to look at your options and immediately became overwhelmed. This blog will be geared towards helping you choose a good fish oil supplement that works for you and your budget.

Avoid cheap fish oil products. Fish oil products are one of the few products that go rancid if poorly stored. Here in Texas, a fish oil product may sit in a hot warehouse for days to months before being shipped to your local pharmacy and put on the air conditioned shelf. You cannot usually tell if the fish oil has turned rancid until you begin taking it. If you get side effects like stomach upset or fishy burps, it may be a sign that it turned rancid. A cloudy fish oil capsule is also a bad sign. The more expensive products are usually stored and shipped in proper conditions to avoid turning rancid.
It is important to find a pure Fish Oil supplement. The label does not always tell the truth. In order to determine if a supplement is pure fish oil, look at how many milligrams they are claiming is in each fish oil tablet. Then, flip the bottle over and look at the ingredients label. Some fish oil products display the total fish oil content, others you have to add EPA + DHA to find out the total amount.
I have taken photos of a fish oil bottle at a local warehouse store to serve as an example. You will see that they claim each capsule has 1400mg of Fish Oil. However, when you read the label, there is only 900mg of Omega‑3 in each capsule. This means 500mg of other contaminants and fillers: fish guts, fish eyes, unhealthy oils, etc.

In order for a fish oil capsule to be considered pure 100% Omega‑3 fish oil, the amount per capsule needs to equate to the amount of EPA + DHA.
Here is an example of a pure fish oil produced by Metagenics (one of the brands that we carry in our office). They claim 720mg per capsule. When you read the ingredients label, it includes 2 capsules per serving. Therefore, EPA + DHA should equal 1440mg per capsule. There is 860mg of EPA and 580mg of DHA. When added, this equals 1440mg which means that it is a pure fish oil. Metagenics is one of the few companies that tests their fish oil products for purity. You can look up the LOT number on each bottle and determine where your fish were caught, and the
numbers to prove its purity.
EPA is more important than DHA in Omega‑3 supplements. A good Omega‑3 supplement contains 50% or more EPA of the total Omega‑3 content. For example, a 1000mg Fish Oil capsule should have more than 500mg of EPA.
Why is EPA more important than DHA?
There is a complicated biochemical reason for this, and I will do my best to simplify it. To put it plainly, Arachidonic acid (AA) is used to create inflammation. The body creates a chemical reaction which turns AA into inflammatory molecules. The reaction of AA into inflammation is also blocked by Ibuprofen and Naproxen which is why they relieve pain – because they decrease inflammation. However, EPA and DHA work to lower the amount of inflammatory markers that are created.
EPA is a much more powerful regulator of AA production because it directly blocks the enzyme that creates AA, then it also blocks the next step of production into inflammatory molecules. EPA directly reduces inflammation, and it is much more powerful than DHA. EPA is also heavily used in the brain. Unfortunately, it is rapidly broken down by the brain, so the brain requires higher levels of EPA to work to decrease brain or nerve inflammation. In a row of dominoes, EPA stops the first domino from ever falling.
DHA on the other hand, works to stop one of the last dominoes from falling. It still prevents inflammation from occurring, but it happens much further downstream with les potency. Because it works further downstream, inflammation can still be created through other pathways. DHA is important for other reasons that are still being investigated. It is also useful in nerve structure and function.
Using the dominoes metaphor, you can see that stopping the first domino from falling (EPA) prevents more inflammation than stopping a different domino further downstream (DHA).
Fish Oil versus Krill Oil. I currently feel that there is a lot of controversy surrounding which product is better. I am currently recommending fish oil over krill oil mainly because of the amount of Omega‑3 found in each is so drastically different. Krill Oil usually has only 10-20% of each capsule as actual Omega‑3. The remainder is antioxidants and other substances, some of which is not needed: Omega‑6 and Omega‑9. For instance, a high quality 500mg Krill Oil capsule only contains 110mg of Omega‑3. It has a very high ratio of EPA to DHA which is great. But, it requires many more capsules per day to achieve the same benefit as a high quality fish oil pill. If you compare it to the fish oil above, it would require 7 capsules per day in order to be equivalent to 1 capsule of a high quality fish oil. That being said, Krill Oil is supposed to be more bioavailable to the body, meaning that less Omega‑3 is needed to achieve the same level. I will let you decide which to take.
Take home message: Choose one, take it daily, and check your levels in 6 months! If it works, then you should keep taking it.
Advantages of Krill Oil: Less mercury and toxin exposure. Smaller capsules. More antioxidants. Better delivery of Omega‑3.
Advantages of Fish Oil: More Omega‑3 per capsule. Less pills per day. Better levels on blood work.
Avoid Omega‑6 and Omega‑9. This is marketing at its finest. Since Omega‑3 is helpful, Omega‑6 and Omega‑9 must be even better! WRONG! Omega‑6 and Omega‑9 are found in abundance in the American diet. It is found in butter, cheese, fried foods, etc. Moreover, your body can actually produce its own Omega‑6 and Omega‑9 fatty acids as it needs them. Your body cannot create Omega‑3 fatty acids, no matter how hard it tries.
Skip the Omega‑6 and Omega‑9. Do not listen to marketing. You already have plenty of them. If it is in a Fish Oil supplement, then they are using it as a filler to give you less of what you actually need: Omega‑3!
Plant-based Omega‑3 are not equal to Marine Sources of Omega‑3. Yet another marketing problem. Plant-based Omega‑3 sources like flax, hemp, and chia seeds do contain plenty of Omega‑3 fatty acids. However, they are in the form of ALA, and low in EPA and DHA (see above). ALA is converted into EPA and DHA by the body, but it happens in very small amounts. Your body requires large amounts of ALA in order to make any credible budge in your actual Omega‑3 levels. These plant-based Omega‑3s are still very healthy for you, and they are much healthier than other Omega‑6 and Omega‑9 fatty acids that I mentioned above (butter, cheese, fried foods), but you cannot expect plant-based Omega‑3 to improve inflammation or Omega‑3 blood levels.