Doses for depression range from less than 1 g/day to 10 g/day, but most studies use doses between 1 and 2 g/day. In my practice, I recommend 1 to 2 g/day of an EPA+DHA combination, with at least 60% EPA, for major depression. I am more cautious in patients with bipolar depression, because the omega-3s may bring on mania, as can most antidepressants. In these individuals, I recommend using omega-3 cautiously, and preferably in combination with a prescription mood stabilizer.
We included 79 RCTs (112,059 participants) in this review update and found that 25 were at low summary risk of bias. Trials were of 12 to 72 months’ duration and included adults at varying cardiovascular risk, mainly in high‐income countries. Most studies assessed LCn3 supplementation with capsules, but some used LCn3‐ or ALA‐rich or enriched foods or dietary advice compared to placebo or usual diet.
Tanaka, K., Ishikawa, Y., Yokoyama, M., Origasa, H., Matsuzaki, M., Saito, Y., Matsuzawa, Y., Sasaki, J., Oikawa, S., Hishida, H., Itakura, H., Kita, T., Kitabatake, A., Nakaya, N., Sakata, T., Shimada, K., and Shirato, K. Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial. Stroke 2008;39(7):2052-2058. View abstract.
Gajos G1, Rostoff P, Undas A, et al. Effects of polyunsaturated omega-3 fatty acids on responsiveness to dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: the OMEGA-PCI (OMEGA-3 fatty acids after pci to modify responsiveness to dual antiplatelet therapy) study. J Am Coll Cardiol. 2010 Apr 20;55(16):1671-8. View abstract.
If you find yourself in a position where you are just not eating any of these foods, and you want to get enough omega-3 fatty acids, then I think fish oil is okay, but I would limit not the amount of fish oil but the amount listed on the label of EPA and DHA combined. I would limit that amount to around 250 milligrams per day because I don’t think most people need more than that. Some signs that you might not be getting enough omega-3 fatty acids include chronic low-grade inflammation, poor visual acuity, slower mental processing, trouble learning, and possibly Alzheimer’s disease and psychiatric conditions, like depression, anxiety, and attention deficit and hyperactivity disorder, ADHD.
You “beat me to the punch.” despite labels, cured meats , aged fats, as well as those heated to a high enough temperature all have trans bonds. Fish that offer high amounts of Omega-3 also often are high in mercury. I was fortunate to have a very good teacher for experimental design. One should be careful to assume that a study actually measures what it claims to and without “confounders” Confounders are parts of the study that complicate the the “logic” of the design. Also, were other fat contents measured or controlled? It would be reasonable to suspect that those with higher levels of Omega-3 could have higher levels of Omega-6, fats in general , High levels of protein, higher levels of testosterone, or lower levels of certain hormones. In addition, statistical studies do not and have never indicated a causal relationship. I have a fear of how much we have begun to rely on statistical correlational studies which are at the end of the day”soft” science.
For dry eye: Fish oil supplements providing EPA 360-1680 mg and DHA 240-560 mg have been used for 4-12 weeks. Some people used the specific product (PRN Dry Eye Omega Benefits softgels). A specific combination product containing EPA 450 mg, DHA 300 mg, and flaxseed oil 1000 mg (TheraTears Nutrition, Advanced Nutrition Research) has been used once daily for 90 days.
Fish oil is a commonly used dietary supplement, with sales in the U.S. alone reaching $976 million in 2009. Problems of quality have been identified in periodic tests by independent researchers of marketed supplements containing fish oil and other marine oils. These problems include contamination, inaccurate listing of EPA and DHA levels, spoilage and formulation issues.
16. Saito Y, Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, et al. Effects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors: sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS). Atherosclerosis. 2008;200:135–40. [PubMed]
Gajos, G., Zalewski, J., Rostoff, P., Nessler, J., Piwowarska, W., & Undas, A. (2011, May 26). Reduced thrombin formation and altered fibrin clot properties induced by polyunsaturated omega-3 fatty acids on top of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention (OMEGA-PCI Clot). Arteriosclerosis, Thrombosis, and Vascular Biology 111.228593. Retrieved from http://atvb.ahajournals.org/content/early/2011/05/26/ATVBAHA.111.228593.abstract
Protects Vision: Our eyes' retinas are a membranous structures and the whole eye is covered in a soft double layer of membranes, making your eyes' health dependent on the liver (who knew?). The liver helps metabolize fat-soluble vitamins that feed and maintain those membranes. If you're deficient in DHA, it affects how we see by delaying the system that converts light into neural energy in the retina.
For preventing and reversing the progression of hardening of the arteries after angioplasty: 6 grams of fish oil daily starting one month before angioplasty and continuing for one months after, followed by 3 grams daily for 6 months thereafter has been used. Also, 15 grams of fish oil has been taken daily for 3 weeks before angioplasty and for 6 months thereafter.
Higdon JV, Liu J, Du S, et al. Supplementation of postmenopausal women with fish oil rich in eicosapentaenoic acid and docosahexaenoic acid is not associated with greater in vivo lipid peroxidation compared with oils rich in oleate and linoleate as assessed by plasma malondialdehyde and F(2)- isoprostanes. Am J Clin Nutr 2000;72:714-22. View abstract.
Back in 2013, a study came out that made a lot of people concerned about fish oil supplements and cancer. The study, published in the Journal of the National Cancer Institute, showed that men who consume the largest amount of fish oil had a 71 percent higher risk of high-grade prostate cancer and a 43 percent increase in all types of prostate cancer. The study was conducted on 2,227 men, of which 38 percent of the men already had prostate cancer. (39)
In my opinion, the key benefit of DHA lies in its unique spatial characteristics. As mentioned earlier, the extra double bond (six in DHA vs. five in EPA) and increased carbon length (22 carbons in DHA vs. 20 in EPA) means that DHA takes up takes up a lot more space than does EPA in the membrane. Although this increase in spatial volume makes DHA a poor substrate for phospholipase A2 as well as the COX and LOX enzymes, it does a great job of making membranes (especially those in the brain) a lot more fluid as the DHA sweeps out a much greater volume in the membrane than does EPA. This increase in membrane fluidity is critical for synaptic vesicles and the retina of the eye as it allows receptors to rotate more effectively thus increasing the transmission of signals from the surface of the membrane to the interior of the nerve cells. This is why DHA is a critical component of these highly fluid portions of the nerves (7). On the other hand, the myelin membrane is essentially an insulator so that relatively little DHA is found in that part of the membrane.
Henriksen, C., Haugholt, K., Lindgren, M., Aurvag, A. K., Ronnestad, A., Gronn, M., Solberg, R., Moen, A., Nakstad, B., Berge, R. K., Smith, L., Iversen, P. O., and Drevon, C. A. Improved cognitive development among preterm infants attributable to early supplementation of human milk with docosahexaenoic acid and arachidonic acid. Pediatrics 2008;121(6):1137-1145. View abstract.
In lab experiments, animals given krill showed improved navigation skills. What this means is that they achieved higher levels of cognition and memory required to navigate complex territory.28 In addition, research shows that animals supplemented with krill oil showed significantly fewer signs of depression and resignation. This improvement in mood was equivalent to the effect of the prescription anti-depressant drug imipramine (Tofranil®).29
It is well known that fish oil has the ability to improve vision. It also helps in avoiding age-related macular degeneration. The National Eye Institute at the National Institute of Health in the United States plans to conduct a nationwide study to evaluate the effect of fish oil in treating macular degeneration. This study will provide strong scientific evidence regarding the benefits of fish oil for eye care, thereby allowing government agencies and physicians to strongly recommend fish oil for macular degeneration.
Fish oil is also used for diabetes, prediabetes, asthma, a movement and coordination disorder called dyspraxia, dyslexia, eczema, autism, obesity, weak bones (osteoporosis), rheumatoid arthritis (RA), osteoarthritis, psoriasis, an autoimmune disease called systemic lupus erythematosus (SLE), multiple sclerosis, HIV/AIDS, cystic fibrosis, gum disease, Lyme disease, sickle cell disease, and preventing weight loss caused by some cancer drugs.