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Choosing An Omega-3 Supplement: Go Fish

Jaris Swidrovich, BSP Candidate 2010

University of Saskatchewan

Prepared during Consumer Health Information Corporation Clerkship


Dorothy L. Smith, Pharm.D.

CEO and President

Consumer Health Information Corporation

McLean, Virginia


                                        Omega-3 Pill on Fish Hook         


On a trip through the grocery store, you may have noticed what seems like hundreds of products with omega-3.  Even dog and cat foods now have added omega-3.  So what is the big deal?


“Why should I take omega-3?”


Health benefits of omega-3

Health Canada has identified many benefits of omega-3 from fish sources. These include improving brain health and function and supporting healthy growth of the brain, eyes, and nerves in children up to 12 years of age.  Health Canada has also approved the use of omega-3 to reduce pain caused by a certain kind of arthritis in adults, as well as supporting a healthy heart and blood vessels.


Ongoing studies of omega-3 in over 100 medical conditions are currently being conducted.  Some of the medical conditions omega-3 is being studied in include depression, Alzheimer’s disease, psoriasis, eczema and more. 


Research has shown the benefit of omega-3 in lowering blood pressure and decreasing the amount of fats (triglycerides) in the bloodstream by 20-50%.  We also know omega-3 helps prevent future heart attacks, and even death, in people who have already had a heart attack. 


New research has found omega-3 may lower a woman’s risk of heart failure by about 25%, and lower a man’s risk by 33%. We still do not know the exact benefit or reason why omega-3 may lower the risk of heart failure.  More studies need to be done in this area.


“There are so many kinds - what is the best kind of omega-3 to take?”


Fish sources of omega-3 are best

Omega-3 fatty acids are called “essential fatty acids,” because the body cannot make them.  Omega-3 can come from different plants and nuts, but the best source of omega-3 is from fatty fish, such as salmon, tuna, and herring.  The kinds of omega-3 we get from fatty fish are called EPA and DHA.  Omega-3 from fatty fish has the most evidence for improving a number of different health conditions. 



Even though there are many benefits from eating fish and taking omega-3 supplements, there are still some risks with taking too much.  For example, high doses of fish oil or omega-3 should only be recommended by your doctor because it can increase your risk of bleeding.  The risk of bleeding is most important in people who are taking medications that “thin” the blood (anticoagulants).  It is important to follow the dosing instructions on the label of the product. 


Health Canada currently recommends eating at least 2 servings of fish each week. If you wish to take an omega-3 supplement from fish sources, your pharmacist or another health care professional can help you find a product that is best for you. 


Omega-3 supplements are generally well-tolerated but side-effects can include diarrhea, burping, and gas.  A fishy aftertaste is a common effect.  These side effects can be reduced by taking the fish oil or omega-3 supplement with meals or at bedtime and by starting at low doses.  Some people find that keeping the bottle of omega-3 capsules in the fridge or freezer helps prevent the fishy aftertaste. 

“What about flaxseed and flaxseed oil – are they good to take?”


Non-fish sources of omega-3 are not all good

The omega-3 we get from plants and nuts is called ALA (alpha-linolenic acid).  Our bodies can only convert a very small amount of ALA into the EPA and DHA fatty acids we get from fatty fish.  Sources of ALA include flaxseed, soy and canola oil, and walnuts. 



Omega-3 from fish can lower the amount of fats in our blood stream, but the ALA form of omega-3 does not.  Partially defatted flaxseed (an ALA form of omega-3) can increase the fats in our blood by 10%, which can lead to hardening of blood vessels.



Non-fish sources of omega-3 are a reasonable alternative for healthy people who do not like fish or fish oil capsules. Flaxseed is better than flaxseed oil. If you wish to take flaxseed as an omega-3 supplement, you may have some digestion problems.  Like other sources of fiber, flaxseed can cause gas, diarrhea or constipation.  Drinking fluids may help prevent constipation caused by flaxseed.


“What about omega-3-6-9? Is that better than just omega-3?”


Omega-3-6-9 products are not recommended

You may also have seen products with omega-6 and omega-9. Omega-6 is a different kind of fatty acid that is found in meat products, grains, and seeds. The average Canadian gets about 10-30 times more omega-6 than omega-3. A healthy diet is one that has only 2-4 times more omega-6 than omega-3. Too much omega-6 has been found to cause inflammation and other health problems. Omega-9 is commonly found in olive oil. Omega-9 occurs naturally in the human body and does not need to be supplemented. Therefore, omega-3-6-9 supplements are not normally recommended.


Keep eating a healthy diet and you will get both omega-6 and omega-9.


“Is halibut liver oil and cod liver oil just like an omega-3 supplement?”



Halibut liver oil and cod liver oil should not be taken as an omega-3 supplement. These products contain high levels of vitamin A. Too much vitamin A can be toxic and may lead to weak bones, hip fractures, and hair loss.


Choosing an omega-3 product can be confusing because there are hundreds of different omega products out there.  When you are ready to “go fish,” ask your pharmacist or another health care professional about the best product for you or your child to take.



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