Fish oil supplements have been around for decades. As research on the essentiality of the omega-3 fatty acids continues to grow, it’s safe to say the benefits of fish oil supplements are legion, ranging from things like enhancing skin tissue to improving cardiovascular health and even supporting healthy cognitive function.
However, not all fish oil supplements and omega-3 fatty acids are created equal. In fact, choosing the right fish oil supplement can make all the difference in regards to the benefits you experience (or lack thereof).
Read on as this guide will walk you through how fish oil and omega-3 supplements work, the research-based evidence behind them, and everything to consider before purchasing these products.
What Are Fish Oil Supplements?
Fish oil supplements, as you likely inferred, are nutritional products that contain omega-3 essential fatty acids (EFA) derived from freshwater fish (e.g. salmon, cod, mackerel, etc.).
Fish are the densest natural source of two critically important omega-3 fatty acids - EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). After continuous use of fish oil supplements, EPA and DHA become enriched with blood lipids, cells and tissues, thereby influencing many aspects of your physiology which are implicated in improving health and reducing the risk of myriad diseases.1
A third, shorter-chain omega-3 fatty acid called alpha-linoleic acid (ALA) is also generally present in fish oil supplements. However, the health benefits of ALA aren’t comparable to those seen with EPA and DHA. ALA is abundant in many land plants, particularly nuts and seeds. The body can convert ALA into EPA and DHA, but only in negligible amounts (as little as 0.3% of ALA is converted to EPA and DHA according to extant research).2
While you may be able to consume a sufficient amount of EPA and DHA daily by eating fatty fish, research suggests that this may increase the risk of heavy metal toxicity (due to ingestion of elements like arsenic and mercury that accumulate in marine environments). Thus, supplementing with fish oil is a prudent way to ensure you get enough EPA and DHA while minimizing intake of noxious chemicals.
What Are Omega-3 Supplements?
Omega-3 supplements are nutritional products that supply EPA, DHA, and/or ALA. As such, fish oil supplements are a source of omega-3 fatty acids and may also be classified as omega-3 supplements.
However, it is possible for an omega-3 supplement to derive essential fatty acids from non-fish sources (such as plants, algae, breast milk, or crustaceans - which are technically not a type of fish). In fact, research in recent years has been investigating the importance of neonatal DHA provided in breastfeeding.
You might come across a variety of infant formulas at food and nutritional supplement stores that are DHA-enriched due to the growing evidence that this particular essential fatty acid encourages healthy nervous system development and bodily growth.3
What Is EPA and DHA?
Chemically speaking, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are forms of long-chain polyunsaturated fatty acids that humans must consume through diet and/or supplementation as the body does not produce them endogenously. These fatty acids are called omega-3 fatty acids because of the position at which carbon-carbon double bonds exist in their chemical structure.
EPA and DHA are incorporated in many parts of the human body, especially cell membranes, making them imperative for a multitude of physiological processes. These particular omega-3 fatty acids are also precursors to key metabolites in the body that may help prevent/treat many diseases.4 While many omega-3 fatty acids are important for human health and longevity, clinical findings suggest that EPA and DHA are the most beneficial.1
Fish Oil Benefits
The following subsections will detail the vast range of evidence-based fish oil benefits. Since research is always evolving, all of the therapeutic properties of fish oil remain to be elucidated; as such, this page will be updated accordingly as new scientific literature and clinical findings are published.
Arguably the most promising benefit of fish oil supplements is improving cardiovascular health. Research continuously demonstrates that EPA and DHA found in fish oil are potent mediators of blood lipids, blood pressure, and inflammation (all risk factors for cardiovascular disease).5 It may surprise you, but cardiovascular disease (CVD) is consistently the leading cause of death in the United States (accounting for upwards of 40% of all deaths).6
By reducing blood triglycerides, LDL cholesterol, and inflammatory markers associated with CVD - such as C-reactive protein - fish oil supplements can significantly enhance cardiovascular health and reduce the risk of CVD. In fact, a clinical study of 89 patients demonstrated that those given fish oil had nearly 67% less serum C-reactive protein than patients not receiving fish oil.7
Moreover, research published by the American Heart Association (AHA) shows that fish oil use in those who have experienced acute myocardial infarction are at nearly 50% less relative risk of experiencing recurrent coronary artery complications and sudden cardiac failure.8
As such, it behooves most anyone with cardiovascular issues to use a proper fish oil product in conjunction with MPA HeartSolve and MPA CardioSolve for supporting heart health and healthy blood lipids.
Brain Health & Cognitive Function
Mental diseases resulting from cognitive decline, such as Alzheimer’s disease, are some of the most debilitating health conditions for humans. The brain is your center of control, and without proper cognitive function it becomes nearly impossible to take care of yourself.
Fish oil has been shown to significantly improve mental state examination scores in patients with cognitive dysfunction.9 While the mechanisms through which fish oil works to enhance brain health remain to be elucidated, both EPA and DHA are present in neuron membrane phospholipids. Therefore, fish oil can help ensure healthy nervous system function and reduce age-related neurodegeneration.
Fish oil supplements have been shown to drastically decrease the production of lipopolysaccharide (LPS)-induced pro-inflammatory cytokines, with some research revealing greater than 50% reductions in cytokines compared to placebo treatments.10 Fish oil is therefore postulated to protect against autoimmune disease, like inflammatory bowel disease (IBD), and significantly reduce systemic inflammatory response.
Using fish oil for skin health is ostensibly the most desirable benefit for the majority of consumers. Fish oil has been shown to enhance skin complexion and vitality by mitigating inflammation induced from ultraviolet (UV) irradiation and topical inflammatory agents.11 It is therefore thought that EPA and DHA act as photoprotective agents and are essential for healthy skin tissue.
Help Inflammatory Skin Conditions & Protect Against Skin Aging
Maintaining healthy nutritional balance for skin tissue is crucial to reduce the photoaging process and minimize inflammation in the epidermis. Omega-3 fatty acids in fish oil are surmised to be some of the most potent anti-inflammatory nutrients for human skin.
Research shows that fish oil helps interfere with inflammatory cascades in the skin by inhibiting the synthesis of key proinflammatory substances, like prostaglandin E2 (PGE2) and leukotriene B4 (LTB4).12 Moreover, EPA and DHA are thought to reduce oxidative stress in the skin by attracting free radicals (since EPA and DHA are relatively unstable).
Reduce Skin Acne & Oily Skin
It is known that inhibition of PGE2 and LBT4 by synthetic drugs leads to significant improvement in acne.13 As such, it is extrapolated that EPA and DHA from fish oil supplements are beneficial for reducing skin acne.
A 12-week study in 13 subjects with acne classified as “severe” showed that fish oil supplementation decreased the acne to “mild” levels in 8 individuals.14
Furthermore, fish oil can control the production of sebum by effectively inhibiting LTB4 (which works to up-regulate sebum production). A study including over 1000 teenagers found that signs of acne (e.g. papules, pustules, and oily skin) were significantly reduced in those who consumed the largest amount of seafood and fish.15 While this study doesn’t necessarily equal a causative effect, it’s safe to draw a strong positive association between skin health and fish oil intake.
When joint regions are subject to physiological and biomechanical stress, the concurrent increase in cytokines can lead to excessive inflammation and chronic pain. Research suggests that omega-3 fatty acids found in fish oil effectively mitigate the production of proinflammatory cytokines (specifically interleukin-6 and tumor necrosis factor alpha), thereby reducing inflammation of articulations.16
How Much Fish Oil Should I Be Getting?
Daily intakes of combined EPA and DHA in people not consuming oily fish are likely to be less than 100 mg per day, which is far below the recommended minimum of 1000 mg per day.17 EPA and DHA are typically well-tolerated and safe in doses upwards of 5000-6000 mg per day (combined).
Research recommends that a combined intake of EPA+DHA in the range of 1000-3000 mg per day (with a 2:1 ratio of EPA:DHA) is sufficient for health and longevity purposes.17
Should I Take A Fish Oil Supplement?
Due to the multiplicity of health and longevity properties that omega-3 fatty acids (especially EPA and DHA) have, and the lack of these particularly EFAs in the diet, most people stand to benefit by using a fish oil supplement.
It is especially pertinent to consider using a fish oil supplement if you rarely consume fatty freshwater fish. Many people find that, for practicality purposes, taking a fish oil supplement is the best way to ensure that they meet their EPA and DHA needs.
What Should I Look For In A Quality Fish Oil Supplement?
First and foremost, you want to find a fish oil supplement that has evidence-based potency. Some fish oil supplements may contain a large amount of “fish oil” but lack sufficient amounts of key omega-3 fatty acids (namely EPA and DHA). Remember, most of the research on the benefits of fish oil supplements concludes that EPA and DHA are the key EFAs for health and longevity.
Other things to look for in a quality fish oil supplement are things such as sustainable sourcing, purity testing, shelf-life, and assurance that the product is free from environmental contaminants.
Pros & Cons of Fish Oil Supplement Blends
EPA Only Supplements
Some evidence suggests that EPA is particularly crucial for preventing inflammatory conditions, especially in older individuals.18 However, a recent clinical trial contends that DHA is the more effective omega-3 for reducing inflammation.19
Moreover, it is suggested that excessive DHA can effectively ‘cancel out’ therapeutic benefits of EPA, particularly with regards to cognitive enhancement.20 As such, EPA-only supplements are most beneficial for people who eat a few servings of fatty fish per week (to meet their DHA needs) and are looking to get the necessary EPA for enhancing brain health.
DHA Only Supplements
DHA-only supplements tend to be crucial for children under the age of 5 and women who are pregnant. DHA is essential for the growth of newborns, and appears to play a key role in the development of central nervous system. A small amount of EPA is converted to DHA in the body, but supplementing with a DHA-only product is wise if you rarely eat fatty fish and are prone to excessive inflammation.
EPA + DHA Combination Supplements
In general, fish oil supplements that contain a 2:1 ratio of EPA:DHA are best for people looking for a basic, effective way to meet their omega-3 EFA needs. This 2:1 ratio is supported by research.18
EPA/DHA + Synergistic Nutrient Supplements
It is suggested that certain micronutrients may enhance the benefits and stability of EPA and DHA. These nutrients typically include vitamin E, vitamin C, vitamin D, and astaxanthin. You may find other fish oil supplements that target brain health by adding cognitive-support ingredients such as L-theanine and 5-HTP.
Pros & Cons of Fish Oil Supplement Forms
Some fish oil supplements, particularly cod liver oil, come in liquid form. These liquid fish oil supplement may be flavored or unflavored and generally are similar in consistency as olive oil. Due to the larger volume, liquid fish oil supplements tend to provide more total omega-3 fatty acids per serving than capsule fish oil supplements.
A major drawback of some liquid fish oil supplements is the taste, limited shelf-life, and inconvenience of having to measure out doses. They also tend to be far from ideal for on-the-go use.
The most common form of fish oil supplement is softgel capsules. The advantage of softgel capsules is that they allow the fish oil to be readily absorbed and without taste (unless they are flavored). A relatively new form of fish oil supplement is vegetable capsules containing wax.
For the majority of consumers, capsules are the most practical and efficient form of fish oil supplement to use. The only notable con of some capsule fish oil supplements is what’s colloquially known as “fish burps,” which are fishy odor burps that may occur in the immediate hours after ingestion.
Fish oil is liquid by nature and thus does not come in a solid pill or tablet form.
Flavored Fish Oil
Due to the inherent fishy taste that many fish oil supplements have, many companies are taking the initiative to add flavoring to their fish oil products. Flavored fish oil supplements can be especially useful for children and adults who don’t like the taste of fish.
Fish oil powders are becoming more prevalent, with some companies offering microencapsulated fish oil powder and even non-microencapsulated fish oil powder. The benefits of fish oil powder are high bioavailability, no fishy aftertaste, ease of use, and longer shelf-life (with no refrigeration required).
The vast body of evidence discussed throughout this guide demonstrates that omega-3 essential fatty acids, especially EPA and DHA, are crucial for optimal health and longevity. Remember, you must consume these particular fatty acids through diet/supplementation as the body does not produce them endogenously.
Due to the alarming rate at which health conditions, such as cardiovascular disease, Alzheimer’s disease, and autoimmune disease increase each year, it is imperative to consider using a fish oil supplement if you currently experience risk factors such as cognitive dysfunction, hypertriglyceridemia, hypertension, acne, chronic inflammation, etc.
If you are pregnant, nursing, or taking medication, consult your healthcare practitioner before using fish oil and/or omega-3 supplements. Excessively high doses (>10 g/day) of EPA/DHA may reduce your body’s immune defenses and ability to clot blood; therefore, it is advised to avoid consumption of omega-3s and fish oil consumption prior to surgery and other medical procedures.
- Swanson, D., Block, R., & Mousa, S. A. (2012). Omega-3 fatty acids EPA and DHA: health benefits throughout life. Advances in nutrition, 3(1), 1-7.
- Hussein, N., Ah-Sing, E., Wilkinson, P., Leach, C., Griffin, B. A., & Millward, D. J. (2005). Long-chain conversion of [13C] linoleic acid and α-linolenic acid in response to marked changes in their dietary intake in men. Journal of lipid research, 46(2), 269-280.
- Bernardi, J. R., Escobar, R. D. S., Ferreira, C. F., & Silveira, P. P. (2012). Fetal and neonatal levels of omega-3: effects on neurodevelopment, nutrition, and growth. The Scientific World Journal, 2012.
- Serhan, C. N., Chiang, N., & Van Dyke, T. E. (2008). Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nature Reviews Immunology, 8(5), 349.
- Kelley, D. S., Siegel, D., Fedor, D. M., Adkins, Y., & Mackey, B. E. (2009). DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. The Journal of nutrition, 139(3), 495-501.
- AHA Heart disease and stroke statistics: 2007 update. AHA. Sept 25, 2007 [cited 2008 2 Sept]. Available from: www.americanheart.org.
- Ebrahimi, M., Ghayour-Mobarhan, M., Rezaiean, S., Hoseini, M., Parizade, S. M. R., Farhoudi, F., ... & Shakeri, M. T. (2009). Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity. Acta cardiologica, 64(3), 321-327.
- Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. circulation, 106(21), 2747-2757.
- Kidd, P. M. (2007). Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Alternative medicine review, 12(3), 207.
- Liao, Z., Dong, J., Wu, W., Yang, T., Wang, T., Guo, L., ... & Wen, F. (2012). Resolvin D1 attenuates inflammation in lipopolysaccharide-induced acute lung injury through a process involving the PPARγ/NF-κB pathway. Respiratory research, 13(1), 110.
- Danno, K., Ikai, K., & Imamura, S. (1993). Anti-inflammatory effects of eicosapentaenoic acid on experimental skin inflammation models. Archives of dermatological research, 285(7), 432-435.
- Boelsma, E., Hendriks, H. F., & Roza, L. (2001). Nutritional skin care: health effects of micronutrients and fatty acids–. The American journal of clinical nutrition, 73(5), 853-864.
- Zouboulis C, Saborowski A, Boschnakow A: Zileuton, an oral 5-lipoxygenase inhibitor, directly reduces sebum production. Dermatology. 2005, 210: 36-8. 10.1159/000081481
- Khayef, G., Young, J., Burns-Whitmore, B., & Spalding, T. (2012). Effects of fish oil supplementation on inflammatory acne. Lipids in health and disease, 11(1), 165.
- Hitch JM, Greenburg BG: Adolescent acne and dietary iodine. Arch Dermatol. 1961, 84: 898-911.
- Kremer, J. M., Lawrence, D. A., Petrillo, G. F., Litts, L. L., Mullaly, P. M., Rynes, R. I., ... & Bigaouette, J. (1995). Effects of high‐dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs clinical and immune correlates. Arthritis & Rheumatism, 38(8), 1107-1114.
- Kris-Etherton, P. M., Grieger, J. A., & Etherton, T. D. (2009). Dietary reference intakes for DHA and EPA. Prostaglandins, Leukotrienes and Essential Fatty Acids, 81(2), 99-104.
- Cawood, A. L., Ding, R., Napper, F. L., Young, R. H., Williams, J. A., Ward, M. J., ... & Shearman, C. P. (2010). Eicosapentaenoic acid (EPA) from highly concentrated n− 3 fatty acid ethyl esters is incorporated into advanced atherosclerotic plaques and higher plaque EPA is associated with decreased plaque inflammation and increased stability. Atherosclerosis, 212(1), 252-259.
- Allaire, J., Couture, P., Leclerc, M., Charest, A., Marin, J., Lépine, M. C., ... & Lamarche, B. (2016). A randomized, crossover, head-to-head comparison of eicosapentaenoic acid and docosahexaenoic acid supplementation to reduce inflammation markers in men and women: the Comparing EPA to DHA (ComparED) Study–3. The American journal of clinical nutrition, 104(2), 280-287.
- Richardson, A. J. (2004). Clinical trials of fatty acid treatment in ADHD, dyslexia, dyspraxia and the autistic spectrum. Prostaglandins, leukotrienes and essential fatty acids, 70(4), 383-390.