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The truth about fish oil pills 2/12
(This article is adapted from ConsumerReports.org)

People are snapping up more fish oil supplements than ever. They're taking them to treat a long list of ailments: menstrual cramps, heart disease, asthma, bipolar disorder, high blood pressure, depression, psoriasis, attention deficit hyperactivity disorder (ADHD), and pregnancy complications.

But the supplements—made from mackerel, herring, and other fish rich in omega-3 fatty acids, especially EPA and DHA—aren't a cure-all. And based on Consumer Reports latest tests including some top-selling brands, some of them aren't as pure as you might expect.

Who should take fish oil?

Most healthy people can get enough omega-3s by eating fatty fish—such as salmon and sardines, which are also low in mercury—at least twice a week. But supplements could help people who have high levels of triglycerides, an artery-clogging fat that increases the risk of heart attack and stroke. Fish oil may reduce those levels by 20 to 50 percent.

People who have coronary heart disease also should consider taking it. Fish oil may lower their risk of a second heart attack, possibly because it slows or slightly reverses hardening of the coronary arteries. But check with your doctor before taking fish oil supplements because they can interact with some medications. If you decide to take fish oil supplements, choose a product that passed the Consumer Reports tests (see below) meaning they met quality standards.

How much?
People with heart disease should consume 1 gram of EPA and DHA, the two fatty acids, a day, either from eating 3.5 ounces of fatty fish, such as salmon, lake trout, or sardines, or from capsules, after consultation with a physician. Those with high triglycerides may need as much as 4 grams of combined EPA and DHA from capsules a day, used under a doctor's care.

Women who are or may become pregnant, and nursing mothers, should avoid eating fish that is high in mercury, such as shark, swordfish, and tuna, and should eat only up to 12 ounces of fatty fish a week.

Who else might benefit?
Although the evidence isn't overwhelming, the supplements may modestly lower high blood pressure, ease menstrual and rheumatoid arthritis pain, and improve the symptoms of ADHD and asthma in children. They might also help with osteoporosis, kidney disease, bipolar disorder, and Raynaud's syndrome, a disorder that affects the arteries to the fingers and toes.

Who shouldn't bother?
Fish oil is unlikely to lower blood sugar in people with type 2 diabetes or help gum infection, liver disease, migraines, allergic skin rashes, and stomach ulcers. There isn't enough evidence to say whether it protects against Alzheimer's disease, heart arrhythmia, depression, dry eyes, inflammatory bowel disease, chronic fatigue syndrome, pregnancy complications, or cancer.

Is fish oil fattening?
A capsule containing 500 milligrams of omega-3 fatty acids in 1 gram of oil has about 13 calories.

Who should never take it?
Fish oil is probably safe for most people in doses of 3 grams or less per day. Higher amounts might increase the risk of bleeding, increase LDL (bad) cholesterol, and impair immune function. And talk to a doctor before taking it if you have liver disease, bipolar disorder, depression, or diabetes, or if you take a blood pressure-lowering drug or a blood-thinning drug such as aspirin, or if you're getting chemotherapy treatments for cancer.

It's always a good idea to tell your doctor about all the supplements you take, whether you have one of those conditions or not. Skip fish oil supplements if you're allergic to fish or seafood, or if you have an implanted defibrillator to prevent irregular heartbeat.

5 products that didn’t meet quality standards

Consumer Reports’ secret shoppers bought bottles of three lots of top-selling brands of fish oil supplements online and at stores near the Yonkers, New York national testing and research center of Consumer Reports. Then the products were sent to a lab to check whether they contained the listed amounts of the omega-3 fatty acids EPA and DHA, whether they properly disintegrated, whether they showed signs of spoilage, and whether they contained any contaminants, such as lead, mercury, dioxins, or polychlorinated biphenyls (PCBs).

The results: Many products didn’t meet one of the standards, including the cheapest, Kirkland Signature Enteric 1200 (Costco), which didn’t pass a disintegration test for pills with enteric coatings (designed to prevent fishy aftertaste). Others that didn’t pass one of standards were: CVS Natural, GNC Triple Strength, Nature’s Bounty Odorless and Sundown Naturals.

8 products that met quality standards

Even the brands that passed the tests contained detectable levels of most of the contaminants, though many have labels claiming that they’re free of impurities such as mercury and PCBs. The reason they are still recommended is that the levels didn’t exceed USP and other regulatory limits or raise concerns.

The products that passed the tests are listed below in order of lowest price, based on the cost per day of taking 1,000 milligrams of EPA and DHA, which is the dose recommended for those with heart disease. Note: To avoid ‘fish burps’ a common fish oil pill complaint, you should keep them in the freezer, or take them with a meal.
Spring Valley Omega-3 (Walmart)17 cents/day
Finest Natural (Walgreens)23 cents/day
Walgreens Omega-3 Concentrate25 cents/day
Barleans’s Organic Oils26 cents/day
Nature Made 1,200 MG28 cents/day
The Vitamin Shoppe Meg-332 cents/day
Carlson Super Omega-3 Gems46 cents/day
Norwegian Gold Ultimate Critical Omega47 cents/day
Related links

What's behind our dietary supplements coverage? 1/11

Supplements to consider. 9/10

American Heart Association: Fish and Omega-3 Fatty Acids.

The National Institutes of Health's Office of Dietary Supplements.

The FDA, for alerts, advisories, and other actions.
Copyright © 2003-2012 by Consumers Union of United States., Inc., 101 Truman Avenue, Yonkers, NY 10703, a nonprofit organization. No downloading, transmission, photocopying, or commercial use permitted. Visit www.GreenerChoices.org.