Written by Lisa Allen | Edited by Dr Mark Kapnoudhis
Okay, I don’t want to be over dramatic here, but trust me when I tell you that this is one area you don’t want to buy “the cheapest” fish oil supplement. Why do I say that? Because when you are taking fish oil supplements in the doses that we recommend for your health, the possibility of long term toxicity is very high. Understanding a bit more about how fish oil supplements are produced will help you.
All Fish Oils Are Not Created Equal
There are two major types of fish oil supplements you need to know about:
Pharmaceutical Grade Fish Oil has been available only since about the year 2000, and was possible only because of new manufacturing techniques that led to the development of ultra-refined EPA/DHA concentrates. To give you a small idea of how ultra-refined it is, it takes about 100 gallons of health food grade fish oil to produce 1 gallon of ultra-refined EPA/DHA concentrate. In the process of making pharmaceutical grade fish oil, nearly all of the previous toxicities that plagued earlier versions of fish oil supplements are removed. You will not find ultra-refined fish oils at health food stores, no matter what it says on the label.
Health Food Grade Fish Oil is the type that you will find at most health food stores. Many of the odors and impurities have been removed, but no where near enough if you are going to be taking the high doses recommended below.
What Type Of Fish Oil Supplement Should You Buy?
So, here’s the low down. If you can afford the higher price, always take pharmaceutical grade, ultra-refined, low toxicity fish oil supplements. If you cannot afford it, then never take any more than 1250 to 2500 mg of EPA plus DHA of health food grade fish oil.
IMPORTANT NOTE: A typical health food grade fish oil capsule will have 1000mg of fish-oil in it. Within this 1000mg capsule, about 250mg may be EPA (Eicosapentanoic Acid) and 125mg may be DHA (Docosahexanoic Acid). The only portion that “counts” towards your daily requirement is the EPA + DHA. In this case, one 1000mg capsule will give you 375 mg of EPA + DHA. So if you were going to supplement 1250 mg a day, you would need to take about four 1000mg capsules to get 1500 mg of EPA + DHA (375mg x 4 = 1500).
The best source to verify the purity of fish oil supplements is a website called IFOS or International Fish Oil Standards. When you click on this link, go to the bottom of the page and look for the 5-Star batches of fish oil. These are the highest quality and if you’re taking the higher doses (>1250mg per day of DHA + EPA), I recommend you only use 5-Star companies. The fish oil batch is listed by the company name, which you can then look up online.
If you want to do what I do, which is simpler, I always just order the fish-oil supplements produced by the Canadian Institute of Functional Medicine. It’s affordable and of the highest quality standards available.
One other option, is to have your doctor write you a prescription for the first prescription-only pharmaceutical grade fish oil supplement called Lovaza. Lovaza is FDA approved for the treatment of high triglycerides and my experience is that most insurance companies are not going to cover it. It is more expensive than other pharmaceutical grade ultra-refined, non-prescription forms of fish oil. But, if your doctor will write you a prescription and if it’s covered by your health insurance, then you’re in luck!
What Dosage Is Right For You?
The range is somewhere between 2.5 grams per day to 8 grams per day of EPA and DHA in a 2:1 ratio. Taken from Barry Sears’ work, here’s a great guideline:
- If you have no existing chronic disease, take 2.5 grams of EPA plus DHA.
- If you are obese, have heart disease or type 2 diabetes, take 5 grams per day.
- If you have existing chronic pain that hurts you, take 7.5 grams per day.
- If you have an existing neurological condition, you may need more than 10 grams per day.
CAUTION: A typical fish oil capsule is 1000mg and has on the label a breakdown of the amount of EPA and DHA. For example, the label may say: Total Weight: 1000mg, EPA: 250 mg, DHA: 125 mg. In this case, that one capsule has 375mg (250 of EPA and 125 of DHA) of EPA + DHA. So in order to get 5 grams a day, you would need 13 capsules a day.
When The Blood Test Is Necessary?
I caution you, do not take more than 2500mg of EPA+DHA per day, without getting a monthly blood test of your Arachidonic Acid/Eicosapentanoic Acid ratio, called the AA/EPA ratio. It is critical that you adjust the daily dose of fish oil based upon accurate blood testing. The gold standard test is the ratio of arachidonic acid (AA) to eicosapentanoic acid (EPA): (AA/EPA).
This ratio alerts you to silent inflammation years to decades in advance of the development of any chronic or degenerative illness. An ideal AA/EPA ratio is between 1 and 3. Anything above or below that puts you at risk for all the consequences of silent inflammation that is out of balance.
“How could that be?” you ask.
If 1 to 3 is ideal, wouldn’t 0.5 be better? The answer is a resounding “NO.” Remember, in the body, as in life, balance is everything. Your body needs some pro-inflammatory eicosanoids to help it fight off infectious disease and to help your body repair damaged tissues.
If your AA/EPA ratio is high (>3.0), you are at greater risk of developing a heart attack, getting cancer or developing Alzheimer and more. (Studies show that for each 1% drop in your AA/EPA ratio, the risk of dying from heart attack is reduced by 2%)
Here’s a nice risk rating based on Dr. Sears work: 1-3: Low risk 3-8: Moderate risk 9-15: High risk and Greater Than 15: Very High Risk.
Barry Sears, Ph.D., researcher and renowned scientist, believes that the AA/EPA ratio is the single most powerful blood test you can take. In his own words, I firmly believe that it predicts your likelihood of developing cancer, Alzheimer’s and heart disease decades before these diseases manifest themselves. Unfortunately, most doctors do not know about this test and where to get it and there are only a few places that do it well.