fish oil
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Indications
- hypertriglyceridemia
- 2-4 g/day may diminish serum triglyceride by 45%[2]; also see Omacor
- may reduce risk of cardiac death 15-50%[2]
- may improve attention is subgroups of elderly men & apoE4 carriers[3]
- modest benefit in patients with heart failure[4]
- fish oil supplementation during pregnancy & lactation reduces risk for allergic sensitization to egg at 1 year (RR=0.69)[9]
- increases semen volume & total sperm count in young healthy men[12]
- fish oil supplementation & higher plasma n-3 PUFA levels, especially DHA, associated with lower risks of macrovascular complications & microvascular complications in patients with type 2 diabetes[16]
- beneficial role of fish oil in preventing diabetic nephropathy
- may be mediated by HbA1c, serum CRP & serum HDL-cholesterol[17]
- beneficial role of fish oil in preventing diabetic nephropathy
- may lower risk of certain cancers
- higher levels of omega-3s from fish oil associated with lower risk of colon cancer, stomach cancer & other GI cancers, lung cancer
- higher levels of omega-3s from fish oil associated with lower risk of brain cancer, melanoma, bladder cancer & others[18]
Contraindications
- does not improve age-related cognitive decline in elderly[11]
- does not prevent post-operative atrial fibrillation
- chemotherapy: fatty acid 16:4(n-3) in fish oil associated with resistance to chemotherapy, cisplatin specifically cited[8]
- 3000 mg QD no better than olive oil for treatment of xerophthalmia[10]
Dosage
- 2-4 g/day for treatment of hypertriglyceridemia[2]
Adverse effects
- may be a risk factor for atrial fibrillation & embolic stroke[15]
- marine omega-3 supplementation > 1 g/day is associated with an increased risk of atrial fibrillation (RR=1.25)[13]
Drug interactions
- fish oil increases risk of bleeding in patients taking anticoagulants[14]
Radiology
- may diminish CNS white matter hyperintensities[3]
Notes
Fatty acid composition of fish oil (%)
Common name | 18:3w3 | 20:5w3 | 22:5w3 | 22:6w3 |
---|---|---|---|---|
Cod, Atlantic | <1 | 18 | 1 | 38 |
Salmon, Chinook | 1 | 8 | 2 | 6 |
Salmon, Pink | 1 | 13 | 3 | 19 |
sardine | 1 | 10 | 3 | 8 |
haddock | <1 | 14 | 1 | 24 |
halibut | - | 13 | 2 | 19 |
snapper | - | 4 | 1 | 34 |
tuna, albacore | - | 6 | 1 | 18 |
trout, rainbow | 5 | 5 | 3 | 19 |
clam, littleneck | 2 | 10 | 2 | 14 |
crab, blue | 1 | 13 | 1 | 11 |
mussel | - | 14 | 1 | 28 |
oyster, Pacific | 2 | 22 | 1 | 20 |
scallop, sea | <1 | 21 | 1 | 26 |
- omega-3 fatty acid composition of farm-raised salmon is as high or higher than wild salmon
- fish oil apparently also contains fatty acid 16:4(n-3)[8]
More general terms
More specific terms
Additional terms
References
- ↑ Prescriber's Letter 12(7): 2005 Omega-3 Fatty Acids Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210709&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 2.2 2.3 Fish oil supplements: Do they contain mercury? http://www.mayoclinic.com/invoke.cfm?id=AN00797
- ↑ 3.0 3.1 3.2 van de Rest O et al. Effect of fish oil on cognitive performance in older subjects: A randomized, controlled trial. Neurology 2008 Aug 5; 71:430 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18678826
Virtanen JK et al. Fish consumption and risk of subclinical brain abnormalities on MRI in older adults. Neurology 2008 Aug 5; 71:439. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18678827 - ↑ 4.0 4.1 Prescriber's Letter 15(11): 2008 Statins and Fish Oil for Heart Failure Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=241103&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Mozaffarian D et al. Fish oil and postoperative atrial fibrillation: The omega-3 fatty acids for prevention of post-operative atrial fibrillation (OPERA) randomized trial. JAMA 2012 Nov 5 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23128104 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1389226
- ↑ Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
- ↑ Eslick GD1, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009 Jul 24;136(1):4-16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18774613
- ↑ 8.0 8.1 8.2 Daenen LGM et al Increased Plasma Levels of Chemoresistance-Inducing Fatty Acid 16:4(n-3) After Consumption of Fish and Fish Oil. JAMA Oncol. Published online April 02, 2015. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26181186 <Internet> http://oncology.jamanetwork.com/article.aspx?articleid=2212208
- ↑ 9.0 9.1 Garcia-Larsen V, Ierodiakonou D, Jarrold K et al Diet during pregnancy and infancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLOS Medicine. February 28, 2018 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29489823 <Internet> http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002507
- ↑ 10.0 10.1 The Dry Eye Assessment and Management Study Research Group n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 Apr 13. [Epub ahead of print] <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29652551 Free Article <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1709691
- ↑ 11.0 11.1 Danthiir V, Hosking DE, Nettlelbeck T et al An 18-mo randomized, double-blind, placebo-controlled trial of DHA-rich fish oil to prevent age-related cognitive decline in cognitively normal older adults. Am J Clin Nutr. 2018 May 1;107(5):754-762 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29722833
- ↑ 12.0 12.1 Jensen TK, Priskorn L, Holmboe SA et al. Associations of fish oil supplement use with testicular function in young men. JAMA Netw Open 2020 Jan 17; 3:e1919462. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31951274 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2758861
- ↑ 13.0 13.1 Gencer B, Djousse L, Al-Ramady OT et al. Effect of long-term marine omega-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: A systematic review and meta-analysis. Circulation 2021 Oct 6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34612056 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.055654
- ↑ 14.0 14.1 Incze M. Vitamins and nutritional supplements: what do I need to know? JAMA Intern Med. 2019;179:460. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30615020
- ↑ 15.0 15.1 Chen G, Qian ZM, Zhang J et al Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study. BMJ Med. 2024 May 21;3(1):e000451. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38800667 PMCID: PMC11116879 Free PMC article.
- ↑ 16.0 16.1 Choudry J Fish Oil Supplements Cut Diabetes Complication Risk. Medscape. July 23, 2024 https://www.medscape.com/viewarticle/fish-oil-supplements-cut-diabetes-complication-risk-2024a1000diz
Tian S, Guo T, Qian F et al Fish Oil, Plasma n-3 PUFAs, and Risk of Macro- and Microvascular Complications among Individuals with Type 2 Diabetes. J Clin Endocrinol Metab. 2024 Jul 12:dgae482. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38994586 https://www.medscape.com/viewarticle/fish-oil-supplements-cut-diabetes-complication-risk-2024a1000diz - ↑ 17.0 17.1 Ao Y, Ye H, Liu X et a; Fish oil supplementation in relation to the risk of chronic kidney disease among patients with diabetes. Diabetes Obes Metab. 2024 Aug 27. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39192528 https://dom-pubs.onlinelibrary.wiley.com/doi/abs/10.1111/dom.15880
- ↑ 18.0 18.1 Zhang Y, Sun Y, Song S Associations of plasma omega-6 and omega-3 fatty acids with overall and 19 site- specific cancers: A population-based cohort study in UK Biobank. Int J Cancer. 2024 Oct 17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39417685 https://onlinelibrary.wiley.com/doi/10.1002/ijc.35226