THE MEDS I TAKE AND WHY
PART 2 – Fish Oil
FISH OIL OR KRILL OIL
What are the major benefits of fish oil?
1. May support heart health:
A. Research shows that people who eat a lot of fish have much lower rates of heart disease.
B. Multiple risk factors for heart disease appear to be reduced by consuming fish or fish oil.
The benefits of fish oil for heart health
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include helping:
A. Lower cholesterol:
Fish oil does not effectively lower overall cholesterol and may, in some cases, increase “bad” (LDL) cholesterol. While it significantly reduces triglycerides and can modestly boost “good” (HDL) cholesterol, it is not recommended for managing high LDL. It is best used to improve overall heart health or manage triglycerides.
Key Findings on Fish Oil and Cholesterol:
Dietary Sources vs. Supplements: Eating fatty fish (like salmon or mackerel) twice a week is recommended, notes this HeartCentral article, as it offers heart benefits beyond just lipid management
Triglycerides & HDL: Fish oil is highly effective at lowering triglycerides (fat in the blood) and can slightly increase HDL “good” cholesterol.
LDL “Bad” Cholesterol: Studies show fish oil often has little to no benefit on LDL and may even increase it.
Recommendation: Major health guidelines, such as those discussed in a Verywell Health report, often do not recommend it for lowering LDL.
B. Lower triglycerides: See Above
C. Reduce blood pressure:
Yes, taking fish oil supplements containing omega-3 fatty acids (EPA and DHA) can modestly reduce blood pressure, particularly in individuals with existing high blood pressure or hypertension.
Studies suggest an optimal dosage of roughly 2–3 grams of EPA/DHA daily to see benefits, such as reducing systolic/diastolic pressure by about 2-5 mmHg.
Key Findings on Fish Oil and Blood Pressure:
Most Effective for Hypertensive Patients:
Individuals with untreated hypertension tend to see the most significant reductions
Optimal Dosage:
Consuming about 3 grams of omega-3 fatty acids per day is the most effective dosage for lowering blood pressure.
Mechanism:
Omega-3s may work by improving endothelial function (vessel relaxation), reducing inflammation, and reducing blood flow resistance.
Combination Risks:
Fish oil can enhance the effect of high blood pressure medications, which might lead to blood pressure that is too low ($hypotension), requiring medical supervision.
Important Considerations:
Moderate Impact:
While beneficial, fish oil should not replace standard blood pressure medications or prescribed lifestyle changes (diet, exercise).
Effect on Normal Blood Pressure:
Studies show little to no impact on the blood pressure of people with normal (normotensive) readings.
Potential Side Effects:
High doses may cause a fishy taste, bad breath, heartburn, or nausea.
It is recommended to consult with a doctor to determine if fish oil supplements are safe for your specific situation, especially if you are already taking blood pressure medication.
D. Prevent the formation of plaques that harden arteries:
Fish oil, rich in omega-3 fatty acids (EPA/DHA), may help stabilize existing plaque and potentially slow its buildup, reducing the risk of plaque rupture. Studies suggest it reduces atherosclerosis by lowering inflammation and reducing triglyceride levels. It is most effective as part of a healthy lifestyle for heart health.
Key Findings on Fish Oil and Plaque:
Plaque Stabilization: Rather than simply removing plaque, fish oil helps make existing plaque more stable and less likely to rupture, which helps prevent heart attacks and strokes.
Reduced Progression:
Omega-3 fatty acids can reduce the inflammation and cell migration that contribute to the formation of plaque in arteries.
Triglyceride Reduction:
Fish oil is highly effective at lowering triglycerides, a type of fat in the blood that contributes to artery hardening.
Dosage Matters:
Evidence suggests that higher doses (3-4 grams per day) are typically needed for significant cardiovascular benefits, such as reducing blood pressure and improving artery flexibility.
Overall Impact:
While some studies show minimal impact on reducing established, significant blockage, others indicate that it can slow the progression of coronary artery disease.
Disclaimer: Consult a doctor before starting high-dose fish oil supplements, especially if you are on blood thinners or have a bleeding disorder.
E. There’s moderate evidence (Trusted Source) that omega-3 may help reduce the severity of and mortality from heart disease.
More research is needed (Trusted Source) to determine if omega-3 has any association with preventing stroke or reducing mortality from stroke.
F. May help treat certain mental health conditions:
{If you measure the weight of the brain without any fluid, it will contain about 20% Trusted Source polyunsaturated fatty acids, which include omega-3. Therefore, omega-3s are essential} (Trusted Source)
for typical brain function.
In fact, research suggests that people with certain mental health conditions have lower omega-3 blood levels, and having more omega-3s may help prevent the onset or improve the symptoms of some mental health conditions like depression.
G. May support eye health:
Evidence shows that people who don’t get enough omega-3s have a greater risk of eye diseases, with the exception of dry eye disease.
Furthermore, eye health begins to decline in old age, which can lead to age-related macular degeneration (AMD). Eating fish is linked to a reduced risk of AMD, but the results from fish oil supplements are less convincing.
H. May reduce inflammation:
Because fish oil has anti-inflammatory properties, it may help treat chronic inflammatory conditions. For example, increased weight or stress can sometimes contribute to higher levels of inflammation.
When it comes to inflammatory bowel disease (IBD), however, the role of omega-3 still isn’t fully determined.
That said, fish oil supplements can help reduce joint pain, stiffness, and medication needs in people with rheumatoid arthritis, which causes pain in the joints.
I. May support healthy skin:
Your skin is the largest organ in your body, and it contains (Trusted Source)
a lot of omega-3 fatty acids. Fish oil supplements may be beneficial in a number of skin disorders, including psoriasis and dermatitis.
J. May support pregnancy and early life:
Omega-3s are important for early growth, particularly during the first trimester of pregnancy, as well as beyond.
Taking fish oil supplements while pregnant or nursing may help improve
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the child’s cognitive development, though more research is necessary to determine this definitively.
That said, taking fish oil supplements during pregnancy and nursing may also improve
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infant visual development and help reduce the risk of allergies.
K. May reduce liver fat:
Your liver processes most of the fat in your body and can play a role in weight gain. Fish oil supplements can improve liver function and inflammation, which may help reduce (Trusted Source) symptoms of nonalcoholic fatty liver disease (NAFLD), and the amount of fat in your liver.
L. May improve attention and hyperactivity in children:
A number of neurodevelopmental conditions in children, such as attention deficit hyperactivity disorder (ADHD), involve hyperactivity and inattention.
Fish oil supplements may improve perceived hyperactivity, inattention, impulsiveness, and aggression in children. This may benefit (Trusted Source)
early life learning. But more research is needed.
M. May help prevent symptoms of mental decline:
People who eat more fish tend to experience (Trusted Source) a slower decline in brain function in old age.
According to a 2023 meta-analysis of 48 studies, omega-3 supplements may help reduce dementia and age-related cognitive decline by as much as 20%.
N. May improve asthma symptoms and allergy risk:
Asthma, which can cause swelling in the lungs and shortness of breath, is becoming much more common. Research suggests that omega-3 may help with reducing asthma-related inflammation, the severity of symptoms, and even the need to use asthma medications. That said, more research is needed to confirm this effect.
O. May improve bone health:
Calcium and vitamin D are very important for bone health, especially in older age, but some studies suggest that omega-3 fatty acids can also be beneficial.
People with higher omega-3 intakes and blood levels may have better bone mineral density (BMD). However, it’s unclear whether fish oil supplements improve BMD.
If there is a benefit, it may depend on the type of fish oil the supplements are made of and how it’s made.
How to supplement:
Natural – eating your fish oil:
If you do not eat 1–2 portions of oily fish per week, you may want to consider taking a fish oil supplement.
Below is a list of things to consider when taking a fish oil supplement:
Dosage:
The 2020-2025 American Dietary GuidelinesTrusted Source
recommend you eat at least 8 ounces (oz) of seafood per week for a 2,000-calorie diet. If you are pregnant or nursing, you’ll need to eat up to 12 oz.
Form:
Fish oil supplements come in a number of forms, including ethyl esters, triglycerides, reformed triglycerides, free fatty acids, and phospholipids. Your body doesn’t absorb ethyl esters as well as other forms.
Concentration:
Read the label and choose a supplement that contains at least 500 milligrams (mg) of EPA and DHA per 1,000 mg of fish oil.
Purity:
To make sure the supplement contains the ingredients it lists on its labels, choose one that’s third-party tested or has a seal of purity from the Global Organization for EPA and DHA Omega-3s (GOED).
Freshness:
Omega-3 fatty acids are prone to oxidation, which makes them go rancid. To avoid this, choose a supplement that contains an antioxidant, such as vitamin E. Don’t use a fish oil supplement that has a rancid smell or is out of date
