While I think the article is good, it does not tell the reader that most of fish oil capsules sold over the counter are unregulated, and contain widely different ingredients and potency levels. They are mostly a waste of money. If you have health concerns, you need to consult an MD or a Registered Dietitian. Not a naturopath, homeopath, or other pseudoscience practitioner. Eat a diet rich in whole grains, nuts, and some oily fish. I take a multivitamin supplement made by CVS, formulated for my gender and age. Not from the food supplement shelves, which are unregulated, and might contain anything at all, or nothing but vegetable oil or cornstarch.

Findings  In this systematic review and meta-analysis of 19 clinical trials including 2240 participants from 11 countries, improvement in anxiety symptoms was associated with omega-3 polyunsaturated fatty acid treatment compared with controls in both placebo-controlled and non–placebo-controlled trials. The anxiolytic effects of omega-3 polyunsaturated fatty acids were also stronger in participants with clinical conditions than in subclinical populations.


Unsafe for children. Fish oil supplements are not considered safe for children. Too much of this fat in their system can lead to a chemical imbalance in the brain which could stunt healthy growth and development. Because of this, and the possible exposure to polychlorinated biphenyls, methylmercury and other toxins which are found in some sources of fish, it is not recommended that women who are pregnant take excessive amounts of fish oil. Servings of fish should be limited to six ounces per week and they should refrain from using fish oil or other fatty acid supplement pills. Children should not consume more than two ounces of fish per week to avoid overexposure to these chemicals. Now you know although fish oil can benefit human beings a lot, fish oil side effects should never be neglected for the sake of your safety. 
The Cochrane researchers found that increasing long-chain omega 3 provides little if any benefit on most outcomes that they looked at. They found high certainty evidence that long-chain omega 3 fats had little or no meaningful effect on the risk of death from any cause. The risk of death from any cause was 8.8% in people who had increased their intake of omega 3 fats, compared with 9% in people in the control groups.
Ramakrishnan, U., Stein, A. D., Parra-Cabrera, S., Wang, M., Imhoff-Kunsch, B., Juarez-Marquez, S., Rivera, J., and Martorell, R. Effects of docosahexaenoic acid supplementation during pregnancy on gestational age and size at birth: randomized, double-blind, placebo-controlled trial in Mexico. Food Nutr Bull 2010;31(2 Suppl):S108-S116. View abstract.

In a U.K. study, children of mothers who ate more than 12 ounces a week actually scored better on tests of verbal I.Q., social behavior, and development and communication than children of mothers who ate none. In the Seychelles Islands, where people average 12 fish meals -- not ounces -- a week, there are no reports of links between mercury exposure and poor outcomes in children. These studies suggest that eating less than 12 ounces of fish each week could do more harm to a child's developing neurological system than mercury poisoning.


Fish oil supplements are available as liquids or capsules. Some capsules are enteric-coated to pass through the stomach before dissolving in the small intestine, thus helping prevent indigestion and "fish burps". Poorly manufactured enteric-coated products have the potential to release ingredients too early. ConsumerLab.com, a for-profit supplement testing company, reported that 1 of the 24 enteric-coated fish oil supplements it evaluated released ingredients prematurely.[48]

The hypotriglyceridemic effect of fish oil is well established and is related to both dose and baseline triglyceride level. Patients with triglycerides <90 mg/dL will be negligibly affected unless very high doses of omega-3 FA are used.67,68 However, in patients with triglycerides >200 mg/dL, who are treated with 4 g/d of fish oil, a 30% reduction in triglycerides is expected.17,69 For patients with triglycerides >500 mg/dL who are at risk for pancreatitis, the National Cholesterol Education Program Adult Treatment Panel III guidelines recommend using fish oil supplements as an adjunctive therapy to fibrates and nicotinic acid.70 Lovaza capsules have been shown to be effective, safe, and comparable to gemfibrozil in treating triglycerides at this range.71,72 The official label recommendation for Lovaza is for patients with triglycerides >500 mg/dL.73
Dry eye. Some clinical research shows that eating more fish oil is linked to a lower risk of getting dry eye syndrome in women. Other research shows that taking a specific fish oil product (PRN Dry Eye Omega Benefits softgels) daily modestly improves symptoms of dry eye such as pain, blurred vision, and sensitivity. Other research using other forms of fish oil products suggests that taking these supplements for 4-12 weeks modest improves some dry eye symptoms. However, the sensation of eye dryness is not always improved. Other research also shows that taking a specific combination products containing fish oil and other ingredients might improve some dry eye symptoms; however, this research is conflicted and poor quality.
Cardiovascular disease is the cause of 38% of all deaths in the United States, many of which are preventable (28). Chronic inflammation is thought to be the cause of many chronic diseases, including cardiovascular disease (29). EPA and DHA are thought to have antiinflammatory effects and a role in oxidative stress (30) and to improve cellular function through changes in gene expression (31). In a study that used human blood samples, EPA+DHA intake changed the expression of 1040 genes and resulted in a decreased expression of genes involved in inflammatory and atherogenesis-related pathways, such as nuclear transcription factor κB signaling, eicosanoid synthesis, scavenger receptor activity, adipogenesis, and hypoxia signaling (31). Circulating markers of inflammation, such as C-reactive protein (CRP), TNF α, and some ILs (IL-6, IL-1), correlate with an increased probability of experiencing a cardiovascular event (32). Inflammatory markers such as IL-6 trigger CRP to be synthesized by the liver, and elevated levels of CRP are associated with an increased risk of the development of cardiovascular disease (33). A study of 89 patients showed that those treated with EPA+DHA had a significant reduction in high-sensitivity CRP (66.7%, P < 0.01) (33). The same study also showed a significant reduction in heat shock protein 27 antibody titers (57.69%, P < 0.05), which have been shown to be overexpressed in heart muscle cells after a return of blood flow after a period of ischemia (ischemia-reperfusion injury) and may potentially have a cardioprotective effect (33).
As with other supplements, when it comes to quality, you get what you pay for. Life Time sources its omega-3 fish oil (both capsules and liquid) from sustainable fisheries off the coast of Chile. We only use oils from small, cold-water anchovy, sardine, and mackerel. It’s molecularly distilled to be sure it’s free of mercury, PCBs, and heavy metals. If your fish oil brand doesn’t name the species of fish it’s sourced from, or it lists larger, predatory species, the quality and purity of the oil could be less than optimal.
They also found that taking more long-chain omega 3 fats (including EPA and DHA), primarily through supplements probably makes little or no difference to risk of cardiovascular events, coronary heart deaths, coronary heart disease events, stroke or heart irregularities. Long-chain omega 3 fats probably did reduce some blood fats, triglycerides and HDL cholesterol. Reducing triglycerides is likely to be protective of heart diseases, but reducing HDL has the opposite effect. The researchers collected information on harms from the studies, but information on bleeding and blood clots was very limited. 
Pregnancy and breast-feeding: Fish oil is LIKELY SAFE when taken by mouth appropriately. Taking fish oil during pregnancy does not seem to affect the fetus or baby while breast-feeding. Women who are pregnant or who may become pregnant, and nursing mothers should avoid shark, swordfish, king mackerel, and tilefish (also called golden bass or golden snapper), as these may contain high levels of mercury. Limit consumption of other fish to 12 ounces/week (about 3 to 4 servings/week). Fish oil is POSSIBLY UNSAFE when dietary sources are consumed in large amounts. Fatty fish contain toxins such as mercury.

Abnormal cholesterol or fat levels in the blood (dyslipidemia). There is conflicting evidence about the effects of fish oil on cholesterol and fat levels in the blood. Some research shows that taking fish oil can lower triglyceride levels, low density lipoprotein (LDL or "bad") cholesterol, and increase high density lipoprotein (HDL or "good") cholesterol in people with abnormal cholesterol levels. However, other research shows that taking fish oil daily does not have this effect.


Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), precursors of certain eicosanoids that are known to reduce inflammation in the body,[1][2] and have other health benefits, such as treating hypertriglyceridemia, although claims of preventing heart attacks or strokes have not been supported.[3][4][5][6] Fish oil and omega-3 fatty acids have been studied in a wide variety of other conditions, such as clinical depression,[7][8] anxiety,[9][10][11] cancer, and macular degeneration, yet benefits in these conditions have not been verified.[12]
^ Jump up to: a b MacLean CH, Newberry SJ, Mojica WA, Khanna P, Issa AM, Suttorp MJ, Lim YW, Traina SB, Hilton L, Garland R, Morton SC (2006-01-25). "Effects of omega−3 fatty acids on cancer risk: a systematic review". JAMA: The Journal of the American Medical Association. 295 (4): 403–15. doi:10.1001/jama.295.4.403. PMID 16434631. Retrieved 2006-07-07.
Heterogeneity was examined using the Q statistic and the corresponding P values,41 and the I2 statistic was used to evaluate the proportion of variation resulting from among-study differences. Any possible publication bias was detected with both funnel plots and Egger regression in the main part of the meta-analysis.42 By using Duval and Tweedie’s trim-and-fill test, we adjusted the effect sizes for potential publication bias if there was evidence of publication bias detected by this test in the Comprehensive Meta-analysis statistical software, version 3.43 To investigate the potential confounding effects of any outliers within the recruited studies, sensitivity testing was conducted with the 1-study removal method to detect the potential outliers.44
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.
So why is an excess of DHA detrimental and an excess of EPA useful? DHA has a larger structure with two extra carbons and two extra double bonds, so it literally takes up more space in cell membranes than EPA. On the one hand, this is important because DHA plays a structural role in maintaining the fluidity of cell membranes ( essential for the normal function of proteins, channels and receptors that are also embedded in the membrane), but if a cell membrane becomes too saturated with DHA it can become too fluid, which can have a negative effect on cell function. EPA, on the other hand, is constantly utilised and always in demand.
Oe, H., Hozumi, T., Murata, E., Matsuura, H., Negishi, K., Matsumura, Y., Iwata, S., Ogawa, K., Sugioka, K., Takemoto, Y., Shimada, K., Yoshiyama, M., Ishikura, Y., Kiso, Y., and Yoshikawa, J. Arachidonic acid and docosahexaenoic acid supplementation increases coronary flow velocity reserve in Japanese elderly individuals. Heart 2008;94(3):316-321. View abstract.
I've done a lot of research on fish oil and Body Vega meets all of the important criteria. They have recommended levels of EPA and DHA and it is molecularly distilled, pharmaceutical grade. The price is reasonable and there are no fishy burps. I tried another brand in the past that met the criteria, but got tired of the fishy burps. I switched to Body Vega a few months ago and have been pleased. So yes, you can find an excellent fish oil without tasting it 30 minutes later. Another good thing about this fish oil compared to one I've tried in the past is that you only need 2 daily capsules compared to 3 with the other brand I tried.

Thanks for the informative article. You mentioned that those taking high doses of DHA should supplement it with trace amounts of GLA. What GLA source would you recommend, and how much per day? I will be taking around 3400 mg of epa and 2200 mg DHA per day. I've heard that Borage Oil is more potent in GLA than evening primrose, but that it can lead to increased clotting and increased risk of heart attack, stroke, etc due to increased thromboxane B2. The main reason I want to stay away from the primrose is because it is extremely rich in linoleic acid. Thanks.
Our scientists also focused on each oil’s freshness, measured by the degree of oxidation. Oxidation occurs in two phases: primary (measured by peroxide values) and secondary (measured by p-anisidine values). Total oxidation is formalized into a quantitative score, TOTOX. While Labdoor conducted tests of both primary and secondary oxidation, advances in rancidity testing confirm that added flavors–particularly added citrus flavors prevalent in liquid formulations–skew p-anisidine values and result in false positive outcomes. Until analytical techniques measuring p-anisidine values that are able to account for added flavors are established, Labdoor will use peroxide values as the primary indicator of freshness. All products recorded measurable levels of oxidation, with the average product recording a peroxide values of 3.7 meq/kg. 14/51 products recorded peroxide levels at or above the upper limit (10 meq/kg).
This systematic review and meta-analysis of clinical trials conducted on participants with clinical anxiety symptoms provides the first meta-analytic evidence, to our knowledge, that omega-3 PUFA treatment may be associated with anxiety reduction, which might not only be due to a potential placebo effect, but also from some associations of treatment with reduced anxiety symptoms. The beneficial anxiolytic effects of omega-3 PUFAs might be stronger in participants with specific clinical diagnoses than in those without specific clinical conditions. Larger and well-designed clinical trials should be performed with high-dose omega-3 PUFAs, provided as monotherapy and as adjunctive treatment to standard therapy.
The number, location, and orientation of the double bonds determine the health effects of fatty acids on the body. One aspect of this is their effect on triglycerides and LDL and HDL types of cholesterol, which in turn affect how much cholesterol gets deposited on the inside of blood vessels. There are also subtypes of LDL and HDL which are also likely important to their health effects.

A study in 2013, (Stafford, Jackson, Mayo-Wilson, Morrison, Kendall), stated the following in its conclusion: "Although evidence of benefits for any specific intervention is not conclusive, these findings suggest that it might be possible to delay or prevent transition to psychosis. Further research should be undertaken to establish conclusively the potential for benefit of psychological interventions in the treatment of people at high risk of psychosis."`[56]

Schilling, J., Vranjes, N., Fierz, W., Joller, H., Gyurech, D., Ludwig, E., Marathias, K., and Geroulanos, S. Clinical outcome and immunology of postoperative arginine, omega-3 fatty acids, and nucleotide-enriched enteral feeding: a randomized prospective comparison with standard enteral and low calorie/low fat i.v. solutions. Nutrition 1996;12(6):423-429. View abstract.
Most leafy green vegetables have significant amounts of omega-3, and spinach is no exception. Despite its villainous reputation, raw spinach actually has a mild flavor, making it an ideal base for salads or a crunchy addition to sandwiches. Many people add spinach to eggs, soups, or pasta dishes without impacting flavor. If you’re dealing with a particularly picky eater, though, try some of the recipes in Jessica Seinfeld’s Deceptively Delicious — her spinach and carrot brownies are tasty, healthy, and chocolaty to boot!
Pregnancy and breast-feeding: Fish oil is LIKELY SAFE when taken by mouth appropriately. Taking fish oil during pregnancy does not seem to affect the fetus or baby while breast-feeding. Women who are pregnant or who may become pregnant, and nursing mothers should avoid shark, swordfish, king mackerel, and tilefish (also called golden bass or golden snapper), as these may contain high levels of mercury. Limit consumption of other fish to 12 ounces/week (about 3 to 4 servings/week). Fish oil is POSSIBLY UNSAFE when dietary sources are consumed in large amounts. Fatty fish contain toxins such as mercury.
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