How Much Fish Oil Should You Take?

A WSJ article doesn’t reach much of an answer:

Hardly a month goes by without a study suggesting that the omega-3 fatty acids in fish oil can fend off disease — including heart attacks, strokes, Alzheimer’s disease, depression, rheumatoid arthritis, asthma, psoriasis and even attention-deficit hyperactivity disorder.

The problem is, to get the health benefits seen in clinical trials, you probably need to take fistfuls of capsules.

“The kind of benefits seen in most of the clinical trials with omega-3 generally have involved much higher doses than you see recommended on supplement labels,” says Charles Serhan, a Harvard Medical School expert on omega-3’s activity.

Which raises a little-discussed point. For practical purposes, it’s not enough to show that a drug works; you also need to find out the minimum dose that produces near-optimal results. In layman-speak, you need to find “the right dose.” Studies that compare drug and placebo are no help; much better would be studies that compare dosages (e.g., Group A gets one dose, Group B gets a different dose).

Here are three more useful comments:

1. I found that about 3 Tablespoons/day of flaxseed oil was enough to produce the best brain performance. As I’ve said, the amount that optimizes brain performance is likely to be a good amount for everything else. For the same reason that the best voltage pattern for your TV is likely to be a good voltage pattern for your other electrical appliances.

2. You can choose the minimum dose of fish oil that makes your gums perfectly pink. The transition from reddish gums (a sign of inflammation) to pink gums (no inflammation) takes about a week.

3. You can do mental tests to choose your dose, as I have done. The big problem here is practice effects — you will get better at the test just from doing it. So you will need several weeks of doing the test before the practice effects become small. You have to be a little bit sophisticated at data analysis — at least, able to plot your data — to take this approach.

In the future I can imagine people repeatedly measuring their mental ability with short (2-3 minute) tests, just as diabetics measure their blood sugar today.

Thanks to Santosh Anagol.

14 Replies to “How Much Fish Oil Should You Take?”

  1. For the same reason that the best electrical current for your TV is likely to be a good amount for your other electrical appliances.
    Seth, let me preface by saying that I have an enormous amount of respect for you, love your writing, and think that you’re right over 99% of the time.

    However, at least part of this statement isn’t one of them (as you don’t have a Physics/EE background). In fact, appliances DO NOT draw the same amount of current (i.e., electrons/second). What is standardized, at least from the outlet, is voltage, or at least the voltage pattern (120V, 60 Hz), which is roughly equivalent to the amount of momentum each electron has, or, to analogize to water flow, the vertical drop of the pipe in a section. Various appliances all have different wattages (e.g., Computer power supply at 300-500 W, Gen1 Foreman Grill at 1500, lightbulbs at their rating), but they achieve this by drawing different amounts of current at the given voltage, not by varying the current.

    So no, the amount of current that a TV requires will be vastly different than the amount of current that everything else draws — largely because power systems are designed to have a standard voltage and have the current be variable. It’s much easier to get more electrons when you need them than it is to alter their potential energy. A TV will operate at the same voltage input as other appliances because they are all designed to operate from that 120V 60 Hz source voltage.

  2. Thanks, Loweeel. By “current” I meant “voltage pattern”. I should have at least said “type of current” rather than “current”. I will correct my post.

  3. In the future I can imagine people repeatedly measuring their mental ability with short (2-3 minute) tests, just as diabetics measure their blood sugar today.

    This is very thought-provoking. By what sort of mechanism do you posit this sort of testing?

    1) An automated test, similar to the ones you have experimented with?

    2) A blood test to check for levels of XYZ?

  4. i tried the flax seed oil Seth, I really did. It was awful – I felt as though I had just gargled furniture polish for 10 minutes after taking 1 tablespoon. I am using one that requires refrigeration – heard that is really the only way to get the “real benefit”.
    Is your flax seed oil refrigerated? Is there a particular brand that has a more mild and tolerable taste? Otherwise I am going to have to bypass these benefits due to my gag reflex.

  5. Texas Rep-Carlson Labs
    Is flaxseed oil a risk for men?

    Dr. Andrew Weil
    Calgary Herald

    Monday, June 18, 2007

    CREDIT: Richard Arless Jr./Montreal Gazette
    Dr. Andrew Weil says men should avoid flaxseed oil, unless it has added lignans.

    Q: Several years ago you indicated that you do not recommend flaxseed oil for men due to potential for prostate tumour growth. Does this research still hold?

    A: Freshly ground flaxseeds are an excellent source of alpha-linolenic acid (ALA), a type of omega-3 fatty acid. The human body needs long-chain omega-3s (EPA and DHA), which are found in salmon and other oily, cold water fish.

    It can make them from ALA, but the conversion is not efficient and is inhibited further if the diet is rich in the omega-6 fatty acids, which are found in most vegetable oils and processed foods.

    As you know, omega-3s are associated with reduced risks of heart attacks and stroke and also may decrease the risk of macular degeneration (a leading cause of age-related blindness) as well as breast, prostate and colon cancers.

    If you don’t like fish (and don’t eat the recommended three servings of cold water fish per week), ground flaxseeds can help fill the gap. I recommend buying whole flaxseeds, storing them in the refrigerator and grinding a half-cup (125 mL) at a time in a coffee grinder. You can then sprinkle a tablespoon or two (15 to 25 mL) over salads, cereals or potatoes or add them to baked goods such as breads and muffins.

    In addition to providing some omega-3 fatty acids, flaxseeds are an excellent source of fibre, which helps prevent constipation, and of lignans, compounds with beneficial estrogen-like effects that offer protection against breast and prostate cancer.

    I often recommend supplementing the diet with fish oil as an omega-3 source, but I’m less enthusiastic about flaxseed oil.

    One tablespoon (15 mL) flaxseed oil daily will give you seven to eight grams of ALA, but little of that will be converted to EPA and DHA. Flaxseed oil spoils easily, so be sure to keep it refrigerated (it should be refrigerated when you buy it).

    If you notice that it tastes like oil paint, throw it away. Rancidity is oxidation, and oxidized fats are toxic.

    Although flaxseed oil seems to be safe for women, I still haven’t seen any data showing that it is safe for men.

    In October 2004, Nutrition Journal published an analysis of nutrition and cancer.

    One meta-analysis included in that publication reviewed nine studies that revealed an association between flaxseed oil intake or high blood levels of alpha-linolenic acid and increased risk of prostate cancer.

    The author speculated that the lignans in flaxseed are a major component of its anti-cancer effects and that the lack of lignans in most brands of flaxseed oil may explain why flaxseed oil is not beneficial.

    Until we know more about the risk flaxseed oil appears to present, I recommend that men avoid it, or at least stick to brands that put the lignans back in.

    Flaxseeds, however, present no danger to men.

  6. SJ: I find Barleans quite tolerable, the high lignan kind. I just mix two tablespoons with about 3 ounces of water and put my tongue outside of the glass at the bottom and swallow it; then drink more water or have some tea to get rid of any lingering taste. The taste is not so bad anyway, but I want to do it tasteless, so I can get the benefit of calories without taste, and lower hunger levels.

    I have not done any precise self experimentation but I can say that I am quite happy with my mental abilities since I’ve been on it… And there seems to be powerful effects on my gums — this based on comments from my dentist and periodontist.

  7. “The test of mental ability would be automated. A series of problems, measuring how fast and accurately you response.”

    There are game collections for portable game players (like the PSP) that are quite popular in Japan that are intended to improve mental acuity, but that would work well to test it.

    I’ll note that the WSJ article noted that a fairly small amount of fish oil in elderly men protected brain function — about two capsules worth. Triglyceride suppression varies, some people are more sensitive than others. I dropped mine from 300 to 100 pre-SLD on a capsule a day for six months. Surprisingly, my mother on more, over a longer time, got much milder results (though measurable ones).

    For a humor article on Applied Nutrigenomics (the science of calculating how different people react differently to the same input) see:

    http://www.t-nation.com/readArticle.do;jsessionid=F32229025A924E1A2D4F0469D93754FE.hydra?id=1885110

    Ok, parts of the interview are serious, e.g.:

    ” first became interested in this field about 10 years ago, which is before the term “nutrigenomics” was actually coined. At the time, I was working on my PhD in nutritional sciences and was researching the effects of cholesterol on cancer using rodent models.

    One of my experiments gave totally unexpected results. In fact, they were completely the opposite of those published by other researchers. It turned out, however, that the strain of rat that I used metabolizes cholesterol quite differently than other strains that were used in previous experiments.

    The study design was virtually identical to previous ones, but the only real difference was the genetic background of the animals. I realized the importance of considering genetics when studying nutrition and it occurred to me that genetic differences between humans could also explain why some people respond differently than others.”

    I’ll have to look at the flax seed oil I bought, it hasn’t resonated for me, so I’ve been just using the ELOO and taking a few grams of fish oil and flax oil with my vitamins, though I really enjoy the flaxseed bread I’ve taken to eating.

    I might try to find the seeds some place and eat them (or mix them into a morning smoothie).

  8. I would try looking for Japanese Shiso (a.k.a. Perilla or Beefsteak) oil if you can’t stomach flaxseed oil. The omega-3 levels are equivalent and the flavor isn’t as strong. I’ve found it to be easier on the stomach as well.

  9. You can mix flaxseed oil with all sorts of stuff (two examples: yogurt and guacamole) if the taste bothers you. If you are trying to have it alone because of the SL diet, then I feel for you.

  10. I use hempseed oil personally. And I try to take it tastelessly as per the SLD, but if you don’t then I think it probably has a better flavour than flaxseed oil.

    As for the mental benefits of reduced inflammation, I can agree with that wholeheartedly. I have rheumatoid arthritis and so have high levels of inflammation on an ongoing basis.

    I’ve been playing the Nintendo DS brain training game daily recently and it graphs your progress. I’ve been altering my daily dose of prednisolone (a powerful anti-inflammatory) lately as I’ve been trying to taper my dose, and it’s absolutely obvious that on my high dose days my brain training scores are higher and on my low dose days, my brain is functioning considerably less well, with lower scores. I received this gadget as a Christmas present, so this is a fairly recent discovery for me, but ties in with my subjective experience that my brain fog is significantly lessened when my arthritis is controlled. It sounds like common sense I know, but doctors don’t tell you this.

    Also, I read an article this week that claims that etanercept (aka enbrel), an anti-tnf rheumatoid arthritis drug, made miraculous improvements to an alzheimer’s sufferer when injected into his spinal column. He went from not knowing the day or date, to knowing these things in under 10 minutes! Here’s the link to the story on the BBC: http://news.bbc.co.uk/1/hi/health/7179060.stm

    So perhaps reducing inflammation in the brain is the key to improved mental ability, in healthy people as well as in alzheimer’s and rheumatoid arthritis sufferers. And maybe in healthy people, a daily dose of omega 3 via flaxseed oil or similar is enough to do that.

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