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Question: Is fish oil safe? Is it contaminated with mercury and PCBs?
Answer: ConsumerLab.com's tests of fish oil supplements have found none to contain mercury and most, although not all, to have only trace levels of PCBs (which can't be fully avoided since PCBs are found in water everywhere). A serving of fish meat is likely to contain far more contamination than a fish oil supplement. However, we have found some supplements to contain less fish oil than listed and some to be spoiled. In addition, the enteric coatings on some supplements have not worked properly.
Clinical studies have shown fish oil to be safe, but it is recommended that you get no more than 2 grams (2,000 mg) of omega-3 fatty acids (EPA and DHA) from fish oil supplements per day.
For details, including our test results and comparisons of fish oil supplements and dosage recommendations, see our Fish Oil Supplements Review.
Question: Lovaza, a prescription omega-3 fish oil, is very expensive. Can I get the same omega-3 oils from a supplement that costs less?
Answer: Yes, you can get a similar amount of omega-3 fish oils from supplements as you can get from Lovaza. Lovaza provides 840 mg of EPA and DHA in about one gram of fish oil per capsule, of which approximately 465 mg is EPA and 375 mg is DHA. The suggested dose is 4 capsules daily. Many supplements can provide roughly the same amounts of EPA and DHA. This is discussed in our Product Review of Fish Oil Supplements.
To keep down the number of capsules (and oil) you need to take, Lovaza uses an extremely high concentration (about 84%) of EPA and DHA. If you want to achieve the same convenience, look for fish oils with "extremely high" concentrations. You'll find this information in the second column of our Results table, which shows you the concentration of EPA and DHA in each fish oil supplement. You'll also see our quality rating of each product and cost comparisons.
If you don't like capsules, there are liquids which can be taken by spoon -- several are included in the table. The taste of fish oil (that's not spoiled) is generally quite mild.
If you want to stay with a prescription product like Lovaza but are looking to save money, first be aware that an FDA-approved generic version containing approximately the same amounts of EPA and DHA in the same chemical form as in Lovaza is available at somewhat lower cost, as discussed in our Product Review of Fish Oil Supplements. By comparison shopping across pharmacies and asking about discounts and coupons, you may be able to get the generic for under $60 for 120 capsules. Lovaza is also sold in other countries under the name Omacor, and the generic is also available in other countries. Prices are often lower outside the U.S. You can check ConsumerLab.com's sister website, PharmacyChecker.com, for prices from online licensed pharmacies in Canada and other countries. Purchasing prescription medication like Lovaza from outside the U.S. remains technically illegal, but the U.S. government has not prosecuted individuals for doing this for themselves.
Question: What Is Marine-D3 and does it live up to anti-aging claims?
Answer: Marine-D3 is a supplement sold online by Marine Essentials which claims the product is effective at slowing down or reversing the main causes of aging and disease and will, among other things, reduce fat and increase energy. Unfortunately, no clinical studies have been published to back up these claims specifically for the Marine-D3 formula.
On the Marine-D3 website we were not able to find a list of the product's ingredients (i.e., its "Supplement Facts"), but a sales representative informed us through online chat that each capsule contains 1,000 IU of vitamin D3, 300 mg of EPA and DHA from calamari oil (Calamarine®), and 40 mg of an extract from brown seaweed (Seanol-P®). Two capsules daily are suggested. Each capsule costs 83 cents ($1.67 daily) based on purchasing four 60-capsule bottles at the "Private VIP" price of $199.80.
ConsumerLab.com has not tested this product to determine the amounts and quality of the claimed ingredients. Assuming it delivers what it claims, however, a daily dose of two capsules would provide a substantial 2,000 IU dose of vitamin D3 which could be appropriate for someone moderately deficient in vitamin D and could, for such a person, have a variety of benefits (See Vitamin D Product Review for more about vitamin D). Of course, if you are not deficient in vitamin D, this ingredient may be of no value. It is also important to note that this dose of vitamin D is much higher than the recommended daily intake for adults of 400 IU. Too much vitamin D (over 4,000 IU per day) may have negative effects.
The amount of EPA and DHA from calamari oil claimed in two capsules of Marine-D3 is also substantial -- 600 mg. If you are not already eating fish twice a week, there are a range of potential benefits from these omega-3 oils (see Fish Oil and Omega-3 Product Review for more information).
The third ingredient in Marine-D3 is an extract of brown seaweed (an algae known as Ecklonia cava) called Seanol®-P. Many of Marine-D3's medical claims appear to relate to this ingredient. The extract has anti-oxidant effects and, according to its manufacturer, BotaMedi, has been authorized by the FDA for use as a dietary ingredient. A recent 12-week double-blind, randomized clinical trial of 97 overweight men and women in Korea showed that a daily dose 144 mg of this extract experienced significant improvements in body weight, BMI, body fat ratio, and waist circumference, compared to those who received placebo -- although this comparative benefit was not found for those receiving a lower dose of 72 mg. However, both low- and high-dose groups showed significant reductions in total cholesterol and LDL cholesterol and increases in HDL ("good") cholesterol compared to people receiving placebo, with total cholesterol falling by 14.6 and 18.8 mg/dL in the low- and high-dose groups, respectively (Shin, Phytother Res 2012). The daily dose of Seanol-P in Marine-D3 (80 mg) is similar to the lower dose used in this study, suggesting that Marine-D3 may not reduce body fat but may improve cholesterol levels.
As for Marine-D's claim that it increases energy, one randomized, placebo-controlled study found that young men drinking a Ecklonia cava preparation before high intensity exercise had an increased time-to-exhaustion -- an extra 2 minutes (Oh, Int J Sport Nutr Exerc Metab 2010). This may suggest a benefit for exercise endurance but more studies are needed.
From a cost perspective, you can get the vitamin D3 and omega-3 fatty acids in Marine-D3 from individual supplements at much less cost than the $1.67 per day for Marine-D3. Choosing the best priced, quality-Approved supplements tested by ConsumerLab.com, you can get 2,000 IU of vitamin D3 for as little as 1 cent from liquid drops or (4 cents from a capsule or softgel), and you can get 600 mg of EPA and DHA from calamari oil for 30 cents (or from fish oil for just 6 cents). The bulk of what you are paying for in Marine-D3 is Seanol-P. Seanol is available in several other marketed supplements, although these products use what is called Seanol-F, which is apparently a less concentrated ingredient than Seanol-P. The Seanol-F products are generally targeted at the treatment of fibromyalgia. Nutricology Fibroboost® for example, provides 400 mg of Seanol-F per capsule (a total of 1,200 mg per the recommended 3-capsule serving), with each capsule costing around 70 cents ($2.10 per daily serving).
In short, Marine-D3 appears to be a clinically untested formulation and there is no evidence that it is effective as an "anti-aging" product. Its individual ingredients may offer selected benefits to specific individuals but buying this product means paying a large premium to get vitamin D, omega-3 fatty acids, and relatively new ingredient for which there is only preliminary and limited evidence of potential benefit.
Question: What supplements should I stop taking before surgery?
Answer: There are a number of supplements and herbs that can interfere with anesthesia or increase the risk of bleeding, cardiovascular events, or other complications during and after surgery. Always tell your doctor and surgeon about the supplements you take; unfortunately, an estimated 70% of patients do not. For information about specific supplements to avoid before surgery, see the full answer >>
Question: Is it true that fish oil may help protect the body against air pollution?
Answer: Yes, a small, placebo-controlled study showed that fish oil supplementation blunted negative effects on the heart and blood lipids normally caused by air pollution. For certain other vascular effects of air pollution, olive oil supplementation may provide better protection than fish oil. For details about the study and the fish oil dosage used, see the Fish Oil Supplements Review>>
Question: Are enterically coated supplements better than non-enterically coated ones?
Answer: Enteric coatings help protect supplement ingredients from being released in the stomach and keep them away from stomach acid and enzymes. This allows the supplement to stay intact until it reaches the less acidic small intestine (where most nutrient absorption takes place). An enteric coating may also be desirable for ingredients which, for some people, otherwise cause an unpleasant aftertaste. Consequently, with ingredients that need protection it is sometimes worthwhile to purchase an enterically coated supplement. However, enteric coatings are not always necessary or beneficial, and, in some case, may just be an expensive gimmick. There are also some concerns about enteric coatings of which you should be aware. See the full answer (with information about enteric coatings for fish oil, marine oils, probiotics, garlic, and SAMe)>>
Question: The suggested daily serving for my fish oil supplement, three 1,000 mg softgels, seems like a lot. Do I really need to take this much?
Answer: First, it is very good that you are questioning the suggested dose on your supplement. Unlike OTC and prescription drugs, recommendations on supplements are not set or approved by the FDA and often vary widely from product to product, even among those which have the same ingredients. Supplements are actually classified as a food and not a drug. This is also why supplement labels don't refer to a "dose" but to a "serving size."
If you are taking fish oil for general cardiovascular health (as opposed to treatment for elevated triglycerides, for example), or because you think you might not be getting enough omega-3s from your diet, a single 1,000 mg softgel (providing about 300 mg EPA and 200 DHA) should be sufficient. This amount of EPA and DHA is roughly equivalent to the amount of omega-3s obtained from two servings of fish per week, as suggested by the American Heart Association. In fact, health agencies in some countries suggest that even half that amount may be adequate.
If you are taking fish oil for a specific health concern, a higher dose may be beneficial. Specific amounts for purposes such as the treatment of high triglycerides, improving mood, reducing anxiety, and even maintaining weight during chemotherapy, are listed in the ConsumerTips section of the Fish and Marine Oil Supplements Review. Be aware that there are safety concerns with high doses of fish oil, particularly a risk of bleeding and immune suppression (see the Concerns and Cautions section of the Review). The Review includes our tests and comparisons of dozens of fish oil supplements.
Question: When taking a statin drug like Lipitor or Crestor, are there supplements I should avoid, or be taking?
Answer: Atorvastatin (Lipitor), rosuvastatin (Crestor), and other cholesterol-lowering statin drugs can be affected by taking supplements and can affect your ability to absorb certain vitamins and minerals. Certain herbal supplements, such as St. John's wort, may decrease blood levels of some statin drugs, and when taken with atorvastatin, may actually result in increased cholesterol levels. Certain forms of magnesium may also decrease blood levels of statin drugs -- particularly Crestor. Red yeast rice, which contains a naturally occurring statin, should not be combined with prescription statin drugs without medical supervision.
Some fruit juices can also be a problem, particularly grapefruit juice, which impairs the body's normal breakdown of certain statins, allowing them to build up to potentially excessive levels in the blood. Since the effects of grapefruit juice may last as long as 3 days, it should be avoided if you are taking atorvastatin (Lipitor), lovastatin (Mevacor, Altoprev) or simvastatin (Zocor). However, some other statins do not seem to be affected by grapefruit juice, including pravastatin (Pravachol), fluvastatin (Lescol) and rosuvastatin (Crestor).
On the other hand, CoQ10 and fish oil may offer particular benefits to people on statin drugs.
These interactions are explained in the Statin Drugs article, which is part of the extensive Drug Interactions section of our website (where you can look up interaction for other drugs you may be taking), and in other reports (linked to above) on ConsumerLab.com.
Question: Is it safe to consume fish oil as a long-term food supplement?
Answer: Long-term use of fish oil is safe as long as the daily dose is not too high and the fish oil is not contaminated. In fact, long-term daily use of fish oil is safer than eating fish each day due to much higher amounts of mercury in many types of fish. In contrast, there is essentially no mercury in fish oil, as it binds to proteins and not oils. PCBs, however, can be found in fish oil as well as fish meat.
The concern with too much fish oil is the potential for suppression of the immune system, which may occur at daily doses above 2,000 mg of EPA and DHA. Be aware that fish oil may also have a blood thinning effect and may lower blood pressure.
Keep in mind that you may be better off eating fish twice a week than taking fish oil, as there is more evidence of cardiovascular benefit from eating fish than from taking fish oil. If you already eat fish twice a week, taking a fish oil supplement may offer no additional benefit, unless you are trying to reduce elevated levels of triglycerides with high-dose fish oil.
Of course, if you don’t eat fish twice a week, you should consider supplementing with fish oil, as the omega-3 fatty acids in fish oil may help with inflammatory diseases, eye disease, mental health disorders, and even the prevention of some types of cancer.
You can read more about the potential memory and cognition benefits of these supplements by using the links above. Also see ConsumerLab.com's Encyclopedia article about Enhancing Memory and Mental Function.
Question: Which supplements have been shown to be helpful for autism?
Multivitamins and minerals -- These are one of the most widely recommended supplements by physicians for children with autism. One randomized, double-blind, placebo-controlled study involving 141 children and adults with autism found supplementation with a specially formulated liquid multivitamin/mineral (see ingredients and amounts here) which also contained CoQ10, MSM and N-acetylcysteine (NAC), improved the nutritional and metabolic status of children with autism, and significantly reduced symptoms such as hyperactivity and tantrums (Adams, BMC Pediatrics 2011). The supplement was given in three equal doses at breakfast, lunch and dinner. For more about multivitamins, including our most recent product tests and reviews, see the Multivitamin Supplements Review >>
Melatonin -- Many children with autism have difficulty falling asleep or staying asleep. In fact, an estimated 50% to 80% of children with autism spectrum disorders may suffer from sleep difficulties or insomnia (Malow, J Autism Dev Disord 2013). Several studies have found individuals with autism to have lower levels of melatonin or melatonin metabolites than those without autism (Rossignol, Dev Med Child Neurol 2011). An analysis of 18 studies of people with autism (mostly children between the ages of 2- 18, although two studies included individuals over the age of 18) found that melatonin supplementation (in doses ranging from 0.75 mg to 25 mg daily) significantly improved the time it took to fall asleep and sleep duration, and, in some individuals, also improved daytime behavior (Rossignol, Dev Med Child Neurol 2011). Another study also found that a daily dose of 1 mg or 3 mg of melatonin improved sleep latency in children with autism spectrum disorder (Malow, J Autism Dev Disord 2013). For more about melatonin, including our most recent product tests and reviews, see the Melatonin Supplements Review >>
Probiotics -- Children with autism can experience significantly more gastrointestinal symptoms, including diarrhea, constipation and abdominal pain, than others (McElhanon, Pediatrics 2014), and probiotics may be helpful for some of these symptoms.
Because abnormal gut microbiota and gastrointestinal dysfunction in children with autism has also been associated with increased irritability, tantrums, aggressive behavior and sleep disturbances, researchers have proposed further study of the use of probiotics (Critchfield, Gastroenterol Res Pract 2011). One interesting, preliminary animal study found a specific bacterial strain, Bacteroides fragilis, improved gut permeability and autism-like behaviors in mice (Hsiao, Cell 2013). For more information about specific strains used to reduce abdominal pain, and our most recent product tests and reviews, see the Probiotic Supplements Review>>
N-acetylcysteine (NAC) -- This amino acid has been found to reduce irritability, but not other symptoms, in children with autism (Hardan, Biol Psychiatry 2012) and in children taking risperidone (an atypical antipsychotic drug sometimes prescribed for people with autism) (Ghanizadeh, BMC Psychiatry 2013). The dose in these studies ranged from 900 mg to 2,700 mg daily, which was generally well tolerated. (ConsumerLab.com will be testing NAC supplements later in 2014).
L-carnosine -- An 800 mg daily dose of L-carnosine for 8 weeks in children with autism was found to significantly improve scores on the Gilliam Autism Rating Scale in a small clinical study (Chez, J Child Neurol 2002).
L-carnitine -- One preliminary clinical trial found that L-carnitine, taken daily (50 mg per kg bodyweight) as a liquid supplement, significantly improved clinical measures of autism spectrum disorder in children (Geier, Med Sci Monit 2011).
Ubiquinol -- Some research on autism has proposed oxidative stress as a potential cause of neuronal dysfunction and clinical symptoms in autism (Gvozdjakova, Oxid Med Cell Longev 2014). Ubiquinol, which is the active form of CoQ10, taken at 50 mg twice per day, at morning and lunchtime, for three months, was found to improve communication, sleep, and decrease food rejection in a small study of children with autism, based on parental reports (Gvozdjakova, Oxid Med Cell Longev 2014). The authors noted that in the first days of supplementation, a small subset of children had increased anger, hyperactivity or sleep disturbance, which was managed by modifying the timing of the doses to morning and evening. For more about ubiquinol, including our most recent product tests and reviews, see the CoQ10 & Ubiquinol Supplements Review>>
Vitamin C -- One small study found significant improvements in behavior in autistic children who received a high dose of vitamin C (8,000 mg per 70 kg of body weight) daily when compared to placebo. (Dolske, Prog Neuropsychopharmacol Biol Psychiatry 1993). It is important to note, however, that taking such a large dose of vitamin C may cause diarrhea in some people. For more about Vitamin C, including our most recent product tests and reviews, see the Vitamin C Supplements Review >>
See ConsumerLab.com’s Encyclopedia article on Autism for more information about supplements that may or may not be helpful.
Question: I heard that some types of fish oil are esterified and can dissolve plastic foam (polystyrene or Styrofoam). Is this right and, if so, should I be concerned?
Answer: It is true that the ethyl ester form of fish oil will dissolve Styrofoam (polystyrene) -- going through the bottom of a cup, for example, in just a few minutes, while the re-esterified triglyceride form will not. This effect (due to differences in the polarities of the forms) is not a health concern, but there are slight differences between the forms in terms of how they are absorbed (up to a 76% difference), which you can learn about in the "Forms of Fish Oil" section of the Fish Oil Supplements Review. You can also find out which form of fish oil is claimed to be in each product by looking at the second column of the test results table of the Review.
Question: Is it true that taking a statin drug negates the benefits of taking fish oil supplements?
Answer: Although there is evidence that statins and other cholesterol-lowering drugs can alter the metabolism of omega-3 fatty acids in the body (reducing levels of DHA in the case of the drug fenofibrate, for example), this does not argue against taking fish oil when taking these drugs. In fact, taking fish oil can lower triglyceride levels and lower "bad" cholesterol levels when taken with cholesterol-lowering drugs. For more information, see the Cautions and Concerns Section of the Fish Oil and Omega-3 Fatty Acid Supplements Review >>
Question: How does the new prescription fish oil Epanova compare to Lovaza --and fish oil supplements?
Answer: Epanova and Lovaza, as well as Vascepa, are the three prescription fish oil drugs approved to lower high triglyceride levels in adults when taken in conjunction with a low-fat diet. However, there may be differences in how well they are absorbed, how they affect LDL cholesterol, and the dose needed to be effective. Fish oil supplements tend to be less expensive, and can provide similar amounts of omega-fatty acids, if taken at the right concentration and dose. Find out more about how Epanova, Lovaza, and Vascepa compare with fish oil supplements in the Fish Oil Supplements Review >>
Question: Are there any red flags to look for on the label when choosing a fish oil supplement?
Answer: Yes, there are some things to look out for on a fish oil label, as well labels of other omega-3 supplements, such as krill oil and algal oil. As discussed in our Review, avoid supplements that only list the total amount of oil, such as "fish oil," and do not list the amounts of the specific omega-3 fatty acids, EPA and DHA. Products listing identical amounts of total fish oil per serving can vary widely in terms of the amounts EPA and DHA, depending on how concentrated they are.
A variety of terms found on fish or marine oil supplement labels can be misleading. For example, some products claim to be "pharmaceutical grade," but this term is meaningless because the FDA has not defined what would constitute a pharmaceutical grade fish oil product.
Of course, there are also issues that can’t be resolved just from looking at the label - like whether the product contains the omega-3 fatty acids it claims, doesn’t exceed contamination limits for PCBs, is fresh or stale, and whether an enteric coating releases ingredients at the right time – which is why ConsumerLab.com tests for all these issues.
Question: What are omega-7 fatty acids? Do I need to take these if I already take fish oil?
Answer: Omega-7 fatty acids are unsaturated fatty acids found in certain fish, like salmon and anchovy, and oils such as olive oil, macadamia oil, and sea buckthorn oil. Palmitoleic acid is one of the most common omega-7s. One small, but placebo-controlled, study using a palmitoleic acid-rich supplement (made from specially-processed anchovy oil) found that it significantly lowered levels of CRP (a measure of inflammation in the body), triglycerides, and LDL ("bad") cholesterol, while increasing HDL ("good") cholesterol.
Interestingly, if you take a fish or krill oil supplement, you may already be getting significant amounts of omega-7s but this depends on the type of oil, with some containing no omega-7s. These amounts are typically not listed, but we checked omega-7 levels in the supplements we tested. You can find these amounts, as well as more information about omega-7 fatty acids in our Fish and Marine Oil Supplements Review >>
Question: I have low blood pressure. Are there any supplements I should avoid?
Answer: Certain supplements can cause decreases in blood pressure and should be used with caution if you already have low blood pressure. These are melatonin, arginine and large doses of magnesium. Calcium may also cause a very small decrease in blood pressure. Preliminary studies have found black cohosh may lower blood pressure in animals, but it is unclear whether it has this effect in people.
There are also a number of supplements that have been shown to lower blood pressure in people with hypertension (high blood pressure). These include CoQ10, fish oil and omega-3 fatty acids, garlic, potassium, flaxseed, certain strains of probiotics, and green coffee bean extract. While much of the evidence for these is focused on people with high blood pressure, they could potentially lower blood pressure in others. So, if you take one of these supplements and find your low blood pressure becomes even lower, try eliminating the supplement and see if your blood pressure improves.
For more about using these supplements, including the evidence, potential side effects, and our tests of products, use on the links above.
Question: Is it better for a fish oil (or krill oil) supplement to have more DHA than EPA?
Answer: Although research continues to clarify the roles of DHA and EPA, some evidence suggests that DHA may be more important in certain situations, while EPA may be more important in others. Keep in mind, however, that participants in most studies were not eating diets rich in DHA or EPA (i.e., not eating fish at least twice a week). It’s not clear that any type of fish oil supplement will provide value if you are already getting substantial amounts of EPA and DHA naturally from foods. In fact, in terms of general cardiovascular benefit, it’s pretty clear that you are better off eating fish (not fried!) than taking a supplement. But if you won’t eat fish or other foods rich in EPA and DHA, consider taking a supplement.
Here are some of the benefits which have been seen with EPA and DHA supplementation:
Pregnancy -- DHA is important during pregnancy for normal development of the infant and may decrease premature births. Pregnant women should get at least 200 mg of DHA per day from a supplement or low-mercury fish.
Periodontitis -- High-dose DHA has helped improve periodontitis (inflammation around the teeth causing pocketing), although this was not seen with high-dose EPA.
Age-related Cognitive Decline -- Studies have shown a modest benefit with a supplement high in DHA. A supplement high in EPA did not have this benefit.
Depression -- Large amounts of EPA relative to DHA may help relieve depression in cases of moderate to severe depression (not mild depression).
Anxiety -- A supplement high in EPA helped reduce anxiety in students.
Chemotherapy -- A supplement providing a large amount of EPA has helped prevent weight loss during cancer chemotherapy.
Alzheimer's disease -- A supplement containing more EPA than DHA helped slow cognitive decline in patients with Alzheimer's disease. This has not been seen with supplements higher in DHA. However, no omega-3 supplement can reverse Alzheimer's disease.
EPA and DHA:
Acne -- A high-dose combination of EPA and DHA helped reduced the number and severity of acne in men and women.
Strength training -- More equal combinations of EPA and DHA have helped improve strength during strength training in a study of older women.
High triglycerides -- Very high doses of EPA and DHA from concentrated fish oil can lower triglyceride levels.
More details (including dosage) about each of these uses are found in the What It Does section of ConsumerLab.com's Fish Oil and Marine Oil Supplements Review>> In the Review, you'll also find ConsumerLab.com's tests and comparisons of supplements containing EPA, DHA and other fatty acids from fish, krill, algal, and other marine oils.
Question: I've tried a number of fish oil supplements, all of which make me nauseous. What is the best non-fish alternative? I am primarily interested in getting EPA.
Answer: Although there are a number of other marine sources of EPA, they tend to provide more DHA than EPA. These include oil from krill, algae, and squid. However, in our experience, all of these can, like fish oil, have a "marine" odor and taste. Seed oils, like flaxseed, contain another omega-3 fatty acid, ALA (alpha-linoleic acid) and a very small percentage of this may be converted to DHA and EPA in the body, but not in sufficient quantity to produce the same effects as oils that contain DHA and EPA.
This pretty much leads you back to fish oil as the best source of EPA. If it appears to make you nauseous, here are a few things to try assuming eating fish itself is not an option for you:
Take your fish oil in smaller, divided doses, with a meal not on an empty stomach.
Refrigerate your fish oil (even softgels). This will reduce the taste/aftertaste and help keep it from becoming rancid which, itself, can contribute to nausea. Be sure your fish oil is not already rancid when you buy it this is one of many things for which ConsumerLab.com tests fish/marine oil supplements.
Try an enteric-coated fish oil, as this is less likely to cause a fishy burp of aftertaste. A theoretical downside of these, however, is that absorption of the oil might be reduced as there is less opportunity for it to be broken down into smaller and more absorbable droplets in the stomach. You might also consider formulations with added flavors, such as lemon.
Hopefully one or more of these approaches will help you. ConsumerLab.com has tested, reviewed, and compared all types of fish and marine oils noted above, including enteric-coated supplements, which you can find in the Fish and Other Marine Oil Review >>
Question: Is it better to eat farmed salmon or wild salmon? Which one has more omega-3s and less contamination with PCBs, mercury, etc.?
Answer: Wild salmon is leaner than farmed salmon, which is fattier. Consequently, farmed salmon has tended to provide significantly higher amounts of the omega-3 fatty acids EPA and DHA per serving than wild salmon. However, farmed salmon must be fed fish oil in order for their meat to provide high levels of omega-3s (wild salmon get omega-3s from algae). With the demand for fish oil now outstripping supply, there is increasing use of vegetable oil in fish feed and levels of EPA and DHA in farmed fish are falling.
Farmed salmon will have higher, but still healthful, amounts of omega-6 fatty acids (mainly from vegetable oil), but less vitamin D than wild salmon.
Both types of salmon are low in mercury and tend to be low in PCBs (toxins which may increase the risk of cancer), although wild salmon may have even lower amounts of PCBs than farmed salmon. Of course, amounts of omega-3s and contaminants can be affected by many variables in both wild and farmed salmon, particularly the food which is fed to farmed salmon.
A standard serving of salmon provides about 2 to 5 times as much omega-3 as a regular fish oil capsule. Although fish oil in supplements is normally less contaminated than fish meat, the contamination levels in salmon are fairly low to begin and generally not of great concern.
Update: In 2015, the FDA approved a genetically-engineered farmed salmon (AquAdvantage Salmon) as safe for consumption, and noted that it will not require this type of salmon to be specially labeled. However, in 2016, the FDA reversed course, announcing that the sale of this salmon will not be permitted just yet. How this salmon compares with non-genetically engineered salmon, is discussed in the section about salmon in the Fish Oil Review.
Question: Can taking fish oil or calcium supplements increase my risk of prostate cancer? My doctor recommended that I stop taking them since I have an enlarged prostate.
Answer: The evidence regarding fish oil and prostate cancer is mixed: some observational studies have found an increased risk among men with high blood levels of omega-3 fatty acids DHA and EPA, but fish oil supplementation has not been found to increase the risk of prostate cancer. There are studies currently underway that are investigating this issue.
Similarly, the research on calcium supplementation and prostate cancer is far from conclusive. However, the evidence suggests that most men over the age of 50 can probably get all the calcium they need from foods, and should limit their total intake from foods and supplements.
Question: What is carrageenan? Should I be concerned that it is an ingredient in my supplement?
Answer: Carrageenan is a substance derived from red algae, or seaweed, which is used to create a smooth texture and thicken foods such as pudding, yogurt, ice-cream, whipped toppings, milk (including almond and soy milk), soups, and processed meats.
Carrageenan is sometimes also added to supplements to improve texture or thicken ingredients. It can be found in some multivitamins, vegan and vegetarian sources of omega-3 fatty acids, such as algal oil supplements, nutrition bars and protein drinks. It was also an ingredient in one cocoa product tested by ConsumerLab.com, although it was removed from the formulation in late 2014.
Food-grade carrageenan is considered safe by most regulatory agencies; however, some researchers who study carrageenan have raised concerns that carrageenan may be carcinogenic and cause inflammatory reactions. See the full answer >>
Question: I drink organic milk with added DHA Omega-3, but it is expensive. Is it worth paying extra for the added DHA?
Answer: Not really. To get milk with added DHA costs about 50 cents extra per half-gallon based on the local price in our area for Horizon Organic Milk with DHA Omega-3. That product, by the way, claims to provide 32 mg of DHA per cup. This is a fairly small dose of DHA. A typical daily dose of omega-3's from a supplement is approximately 250 mg (and often more). So you'd need to drink an entire half-gallon of this DHA-added milk to get what's often in a single softgel.
In ConsumerLab.com's tests of omega-3 oils from fish, krill, and algae, we found that you could get 250 mg of high-quality omega-3's (DHA and EPA, combined) from fish oil or algal oil for as little as 13 to 18 cents. If you specifically want this amount of DHA from algal oil with very little EPA, you can get this for about 33 cents. So, from a cost perspective, you pay roughly twice as much to get DHA from milk than from a well-priced supplement.
Of course, there is a convenience in getting DHA from your milk and it may be easier to swallow than a supplement and lack a fishy aftertaste. But if you want 250 mg of DHA, it would not be convenient, or advisable, to drink an entire half-gallon of milk to get it. You're better off buying milk without DHA and purchasing a separate supplement which gives you a higher dose of DHA while saving some money.
One other important point to consider in all of this is whether getting extra DHA in your diet is beneficial or not. That depends on what you are hoping to achieve from taking DHA and is a question addressed in great detail in the "What It Does" section of the Fish Oil and Omega-3 Fatty Acid Supplements Review >>
Question: Is Rhodiola rosea effective for depression and does it have other uses? Will ConsumerLab.com be testing these supplements?
Answer: Evidence from small studies (including one recently supported by the National Institutes of Health) suggests that extracts made from Rhodiola rosea (also known as roseroot) may have a modest benefit in depression. It is not as effective as anti-depressant medication but poses less risk of side-effects. There is some preliminary evidence it may also be modestly helpful for people with mild anxiety. Support for some of its other proposed uses - such as fighting fatigue and improving mental acuity - has not been well established. For more about Rhodiola rosea, including the type and dosage used to treat depression, see the full answer >>
ConsumerLab.com has tested popular R. rosea supplements for quality and purity. See the results (including our top picks among Approved products), plus more about the evidence for these and other uses, such as reducing fatigue and improving athletic performance, in the Rhodiola Rosea Supplements Review.
Question: Is it true that there is no point in taking fish oil supplements for heart health?
Answer: High-dose fish oil supplements can lower triglyceride levels in people with very high triglyceride levels, which is a risk factor for cardiovascular disease. However, taking fish oil supplements has not been shown to prevent heart attacks or stroke in people who have heart disease, nor has it been shown to prevent heart disease in healthy people.
On the other hand, eating at least two servings per week of fish high in omega-3s - like anchovies, salmon and mackerel - is associated with a reduced risk of stroke. And in one long-term study, healthy older people who were not taking fish oil supplements but had higher blood levels of omega-3s were found to be 40% less likely to have a heart attack. While it's still unclear why eating fish seems to be more beneficial for cardiovascular health than taking fish oil supplements, it could be that fish contains other nutrients or fatty acids that are not present in concentrated fish oil.
ConsumerLab.com has found that when oils are concentrated for their omega-3 (EPA and DHA) content, other fatty acids get removed. This includes omega-7, which some studies suggest has a beneficial cardiovascular effect. It is possible that less concentrated fish oil, which includes a wider spectrum of fatty acids, could be more beneficial than concentrated fish oil. You can find out how much omega-7, as well as omega-3 (from EPA and DHA) are in dozens of fish oil supplements on the market and their quality ratings, in ConsumerLab.com's Fish Oil and Omega-3 Fatty Acid Supplements Review (Including Krill, Algae, Calamari, Green-lipped Mussel Oil) >>
Keep in mind that there is evidence for other uses of fish oil supplements, including inflammatory diseases, eye disease, and mental health disorders. The details (and dosage for each) are included in the Review noted above.
Question: Do any supplements help relieve stress?
Answer: Fish oil may blunt some of the effects of mental stress, such as increased heart rate and nervous activity. Several clinical studies show ashwagandha may help to relieve symptoms in people with anxiety. And, interestingly, a particular probiotic has been shown to lower levels of the "stress" hormone cortisol, and measures of psychological distress such as depression and anger.
L-theanine, an amino acid found in black and green tea, has been shown to reduce stress responses without causing drowsiness, and there is some evidence that the herbs passionflower and lemon balm may be helpful for anxiety.
One clinical trial found 500 mg of holy basil leaf extract taken twice daily significantly reduced measures of anxiety in men and women (Bhattacharyya, Nepal Med Coll J 2008). See the Encyclopedia article about Ayurvedic medicine for other uses for this herb - which is listed by its scientific name, Ocimum sanctum.
Ginseng is sometimes promoted for reducing stress, although one clinical study found it did not have an effect on cortisol levels. There is weak evidence that valerian supplements may produce a calming effect in stressful situations.
Be aware that low blood levels of iron and vitamin B6 have been associated with stress responses such as hyperventilation and panic attacks in women (Mikawa, Acta Med Okayama 2013), so be sure you're getting sufficient intake of these nutrients. There is some evidence that daily supplementation with a multivitamin-multimineral supplement may help people to cope with stressful situations.
For more information, use the links above, and see the Encyclopedia article about Stress.
Question: Is quercetin helpful for a specific condition? I see it as an ingredient in several different types of supplements.
Answer: Quercetin is a flavonoid that occurs in small amounts in foods like apples, onions, and grapefruit and in drinks like black tea and red wine. It also naturally occurs in plants, like Ginkgo biloba, St. John's wort, and sea buckthorn.
As discussed in more detail in the Quercetin article in the encyclopedia on our website, preliminary evidence suggests that quercetin may be helpful to men with prostatitis, which why it is added as an ingredient in some prostate supplements, although these combinations have typically not been clinically tested.
One small clinical study found that quercetin helped improve word-recall memory when taken with resveratrol.
Although quercetin is commonly promoted for a wide range of other uses - including allergies, asthma and cardiovascular disease - the evidence supporting these uses is limited. As noted above, more about this is found in the Encyclopedia article about Quercetin.
Question: Is it better to take fish oil, flaxseed oil -- or both?
Answer: Fish oil and flaxseed oil each provide omega-3 fatty acids, but only fish oil contains the omega-3s EPA and DHA, and has been shown to be helpful for conditions such as rheumatoid arthritis, inflammatory bowel disease, and depression. High-dose fish oil may help to lower very high triglyceride levels.
Flaxseed oil, on the other hand, contains the omega-3 fatty acid ALA (alpha-linolenic acid) -- a very small percentage of which is converted into EPA and, to a lesser extent, DHA in the body. For this reason, it may be useful as a dietary supplement for people who are not getting EPA or DHA from fish/marine oils, however, because such small amounts are converted, it will not provide the clinical benefits shown for oils containing EPA and DHA. Studies show flaxseed oil may help to improve dry eye symptoms in people with the autoimmune disease Sjogren's syndrome, and may help to lower "bad" cholesterol in some people, but there is little evidence it's helpful for any other specific conditions.
Neither fish oil from supplements nor flaxseed oil appear to reduce the risk of cardiovascular disease or stroke. In contrast, eating fish does lower the risk of cardiovascular disease and eating ground flaxseeds (not just the oil) may help lower high blood pressure.
Be aware that fish oil and flaxseed oil may have each have potential blood-thinning effects, which might be increased if you are taking both.
Question: Do any supplements help with nerve pain, like sciatica or diabetic neuropathy?
Answer: Several supplements have been shown to be helpful for nerve pain caused by conditions such as sciatica or diabetic neuropathy. These include fish oil, curcumin, alpha-lipoic acid (ALA) and GLA, and benfotiamine. Read the full answer for details and dosage >>
Question: Do any supplements help with gum disease or periodontitis?
Answer: Several different types of supplements may be helpful in improving gum disease and/or periodontitis -- the inflammation around the teeth causing pocketing -- such as DHA from algal oil, gamma-linolenic acid (GLA), lycopene, green tea, cranberry extract, and a certain type of probiotic. For details, including dosage, see the full answer >>
Question: Which supplements can help to lower blood pressure?
Answer: There are many supplements, including CoQ10, fish oil, curcumin, certain probiotics, cinnamon and others, which may lower blood pressure. However, if you already take medication to lower blood pressure, always consult your physician before using these supplements, as they may lower your blood pressure too much, or interfere in some other way with your current medication. Be aware that a number of supplements can increase blood pressure. Sign in to see the full answer >>
See the Encyclopedia article about Hypertension for more information.
Question: Is it true that fish oil supplements may contain soy? I'm allergic!
Answer: Yes, a number of fish oil supplements (as well as krill and cod liver oil supplements) contain soy, which may be added as a source of tocopherols and tocotrienols (vitamin E). However, since it is a common allergen, manufacturers are required to list this on the label, under "Other Ingredients."
To find a fish oil that does not contain soy and has passed testing by ConsumerLab.com (which checks for levels of the omega-3 fatty acids EPA and DHA, freshness, and lack of contamination), see our reviews of fish oil and/or cod liver oil supplements: Click on the "Ingredients" link in the first column of the results table (under the product name), which provides a complete list of ingredients for each product.
Question: What is the difference between fish oil and krill oil? Is one better than the other?
Answer: As discussed in ConsumerLab.com's review of omega-3 supplements, both fish oil and krill oil can provide significant amounts of the omega-3 fatty acids EPA and DHA. Overall, there are more clinical studies investigating the effects of fish oil, however, preliminary studies indicate that krill oil, like fish oil, has a beneficial effect on cholesterol and triglyceride levels, as well as anti-inflammatory applications.
Krill oil supplements, are generally a much more expensive source of EPA and DHA. It would not be unusual to spend 50 cents or more for dose of krill oil providing the same amount of EPA and DHA available from fish oil for as little as 5 to 10 cents.
Perhaps due to the higher cost, krill oil capsules tend to be much smaller than fish oil capsules and provide smaller amounts of EPA and DHA. (Be aware that some products labeled "krill oil" may actually contain a mixture of krill and fish oil.) One might justify the higher cost of krill on the basis of it containing phospholipids, which may enhance absorption, and the red-colored antioxidant astaxanthin. However, absorption of EPA and DHA from krill has not definitively been shown to be better from fish oil (at best, it may be 30% to 100% greater), and the benefit of astaxanthin is not clear. That is, even if you absorbed twice as much EPA and DHA from krill oil, that would not seem to justify paying ten to twenty times as much for it. Also, as noted in our tests of popular omega-3 supplements, krill oil supplements cannot be tested for spoilage the same way that fish oil supplements are tested, since the deeply colored astaxanthin can interfere with the results.
Both fish oil and krill oil supplements have been reported to have similar side effects, although one study found that krill oil caused more frequent gas/bloating and flatulence.
Question: Which supplements are helpful for age-related macular degeneration (AMD)?
Answer: As discussed in the Vision Supplements Review, lutein, zeaxanthin and zinc supplements may help to slow the progression of age-related macular degeneration, but won't improve the condition. People with age-related macular degeneration who have low blood levels of lutein may be more likely to benefit from lutein supplements. There is also evidence that lutein and zeaxanthin may only help in people with low macular pigment density.
Two of the largest studies on supplements for eye health, known as the Age-Related Eye Disease Study (AREDS and AREDS 2), have helped narrow in on the best combination of ingredients for AMD. ConsumerLab.com has found that many supplements promoted as "vision formulas" do not necessarily contain the right formula. However, we've identified one product that most closely resembles this formula, as well as several others which may be helpful.
Interestingly, while it has been shown that people with higher intakes of the omega-3 fatty acids EPA and DHA from their diet (i.e. from one or more servings of fish per week) are 42% less likely to develop age-related macular degeneration compared to those who eat less than one serving of fish per month, adding EPA and DHA from fish oil to the AREDS formulation did not provide additional benefit.
For more information about the evidence, dosage, tips for choosing and using supplements for age-related macular degeneration — as well as our tests and reviews of popular products, see the Vision Supplements Review >>
Question: Do any supplements help for irritable bowel syndrome (IBS)?
Answer: Several different types of probiotics have been found to reduce symptoms of IBS, but the appropriate probiotic may depend on whether the IBS is causing predominantly diarrhea or constipation. (See the "What It Does" section of the Probiotic Supplements Review for details.)
Prebiotics have also been promoted for IBS, although the evidence is mixed.
Interestingly, several small studies suggest melatonin may improve symptoms of IBS, possibly by affecting the nervous system in the digestive track. (See the "What It Does" section of the Melatonin Review for details).
Preliminary evidence suggests psyllium, a type of fiber, may be helpful for people with IBS with constipation.
Information about other potentially helpful supplements, including peppermint oil and flaxseed, is found in the Encyclopedia article about IBS.
Be aware that a number of supplements, including fish oil, magnesium, high doses of vitamin C, berberine and turmeric/curcumin can cause diarrhea, so you may want to avoid these or reduce your dosage if you find they are exacerbating IBS symptoms. See the "Concerns and Cautions" section in each review for details.
Question: Are there negative interactions between the following supplements I take twice each day, as well as 60 mg of beta-sitosterol with dinner: Vitamin C (500 mg), CoQ10 (100 mg), grape seed extract (100 mg), fish oil (500 mg), vitamin D3/calcium/magnesium/zinc (200 IU/333 mg/113 mg/5mg)?
Answer: You may want to cut back on the vitamin C. The required daily intake is not even 100 mg and if you already get that, taking another 500 mg or 1,000 mg may actually reverse vitamin C's ability to reduce the risk of cataracts, as noted in the Vitamin C Supplements Review.
The amounts of the other supplements you take are generally safe and are at doses which may be helpful -- depending on your health conditions. It is also good that you have broken up your intake of calcium over the day, since you can't absorb more than 500 mg at a time, as discussed in the Calcium Supplement Review.
If you have high blood pressure, be aware that one study found the combination of vitamin C and OPCs (the active component of grape seed extract) to increase blood pressure (as noted in the Safety Issues section of the article on OPCs).
The beta-sitosterol which you take is at a dose which may help with symptoms of an enlarged prostate. Be aware that beta-sitosterol is also used at a much higher dose for lowering cholesterol (by competing with cholesterol for absorption in the gut) and, at this higher dose, you would not want to take it at the same time you take the fat-soluble supplements -- vitamin D and CoQ10, both of which are best taken with a meal containing some fat.
If you take also take prescription medications, be sure to look up the supplements with which they may interact using our Drug Interactions information.
Note: ConsumerLab.com staff is not able to regularly respond to requests from members to evaluate their supplement regimens. However, it tries to do so from time-to-time and often responds to questions of more general interest, such as those below.
Question: Which supplements help with Raynaud's phenomenon?
Answer: As discussed in the Raynaud's phenomenon article in the Encyclopedia, fish oil, Ginkgo biloba, inositol hexanicotinate (a form of the B vitamin niacin), and ginseng have shown some benefit in Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold). Several other types of supplements have been tried without success. For more information, including dosage and clinical evidence, use the links above, and see the Encyclopedia article about Raynaud's phenomenon.
You can also find information for many other medical conditions in the Conditions section of the Encyclopedia, and by searching our index of Health Conditions.
Question: What are the most common, potentially dangerous interactions between supplements and drugs?
Answer: Fifteen percent of men and women ages 62 to 85 in the U.S. are potentially at risk for a dangerous interaction between a prescription drug, over the counter drug (OTC), and/or supplement they are taking, according to a study published in 2016 (Qato, JAMA Intern Med 2016).
The most common drug and supplement combinations with the potential for harmful effects, according to that study, are warfarin (Coumadin) interacting with fish oil or garlic; the ACE inhibitor drug lisinopril (Zestril) interacting with potassium; and statin drugs like atorvastatin (Lipitor) and rosuvastatin (Crestor) interacting with niacin.
For more about these drug interactions, use the links above. You may also check for others in the extensive Drug Interactions section in the Encyclopedia.
Question: Which supplements can help lower or control my blood sugar?
Answer: Many different supplements may help lower or control blood sugar in people with prediabetes or type 2 diabetes who experience hyperglycemia (when blood glucose rises higher than normal). These supplements are discussed below. More details about each, including dosage, drug interactions, potential side effects, and ConsumerLab.com's reviews of products on the market, can be found by clicking on the links.
Due to the seriousness of hyperglycemia, it is important to consult with your physician regarding use of these supplements.
Cinnamon supplements may modestly improve blood sugar in people with type 2 diabetes whose blood sugar is not well controlled with medication. In addition, one small study found that a branded cinnamon extract reduced fasting blood sugar by an average of about 10 mg/dL in prediabetic men and women with metabolic syndrome. Keep in mind, however, that only certain varieties of cinnamon have been shown to have this effect, and long-term safety studies have not been conducted.
Curcumin (from turmeric) may improve blood sugar levels, according to preliminary studies, and one study found curcumin to dramatically lower the chances of prediabetes in middle-aged, slightly overweight men and women with somewhat higher than normal blood sugar levels.
Alpha lipoic acid may improve insulin sensitivity and blood sugar control in people with type 2 diabetes, although it may only slightly reduce levels of glycosylated hemoglobin (HbA1c).
Chromium picolinate may help some people with type 2 diabetes decrease fasting blood glucose levels as well as levels of insulin and glycosylated hemoglobin (HbA1c). However, be aware that high doses may worsen insulin sensitivity in healthy people who are not obese or diabetic.
Having adequate blood levels of vitamin D may reduce the risk of insulin resistance in people who are obese. There is some evidence that a certain blood level of vitamin D is needed for normal glucose metabolism in women who are overweight and obese (but not diabetic), but it is not clear whether any further benefit is gained with higher blood levels.
In healthy people, consuming a moderate amount of olive oil with a meal has been shown to reduce increases in blood sugar after the meal compared to the same meal consumed with corn oil. In people with type 1 or type 2 diabetes, olive oil may improve glucose metabolism.
Increasing dietary fiber, especially insoluble fiber from cereal and grains, is associated with a reduced risk of diabetes and has been shown to reduce fasting blood glucose and modestly lower HbA1c in people with type 2 diabetes (Martin, J Nutr 2008; Post,J Am Board Fam Med 2012). In people with type 1 diabetes, 50 grams of dietary fiber per day has been shown to significantly improve blood sugar control and reduce hypoglycemic events (Giacco, Diabetes Care 2000). The American Dietetic Association states that "diets providing 30 to 50 g fiber per day from whole food sources consistently produce lower serum glucose levels compared to a low-fiber diet. Fiber supplements providing doses of 10 to 29 g/day may have some benefit in terms of glycemic control." (Slavin, J Am Diet Assoc 2008). Although ConsumerLab.com has not tested fiber products, we have produced a webinar about that provides more information.
Ginseng, both American and Korean Red ginseng (from Panax ginseng), may reduce blood sugar levels in people with diabetes, according to preliminary research.
Drinking whey protein before a high glycemic meal may help to lessen increases in blood sugar after the meal in people with well-controlled type 2 diabetes.
Silymarin, a component of milk thistle, may decrease blood sugar and hemoglobin A1c in people with type 2 diabetes, and reduce insulin resistance in people with coexisting diabetes and alcoholic cirrhosis.
Inulin, a type of prebiotic, may improve measures of blood sugar control in women with type 2 diabetes, although it did not improve blood sugar levels or insulin resistance in a study of prediabetic men and women.
Berberine (a compound found in plants such as barberry, Oregon grape and goldenseal) may reduce blood sugar levels in people with metabolic syndrome or type 2 diabetes, according to a few small studies.
Fenugreek may help to lower blood sugar, according to preliminary studies, and one study found fenugreek extract to significantly improve some measures of blood sugar control and insulin response in people with type 2 diabetes.
White mulberry (Moruns alba or Morus indica) has been traditionally used in Asia to help treat type 2 diabetes, and there is some preliminary evidence to support this use. Mulberry leaf extract (species not given) may lessen increases in blood sugar after ingestion of table sugar in healthy people and people with type 2 diabetes (Mudra, Diabetes Care 2007). Among people with type 2 diabetes, taking 1 gram of powdered white mulberry leaf three times daily (after breakfast, lunch and dinner) for four weeks was found to lower fasting blood sugar by 27%, while taking 5 mg of the anti-diabetes drug glibenclamide lowered fasting blood sugar by only 8% (Andallu, Clin Chim Acta 2001).
There is mixed evidence as to whether CoQ10 may lower blood sugar. To be safe, people with diabetes or who take medication to lower blood sugar should consult a physician before using.
There are a few supplements which may worsen blood sugar control or insulin sensitivity in certain people: excessive amounts of niacin may elevate blood sugar levels, and prescription digestive enzymesmay cause an increase or decrease in blood sugar levels in people with exocrine pancreatic insufficiency. CLA (conjugated linoleic acid), a popular supplement for slimming, may worsen blood sugar control in diabetics and in obese people without diabetes.
Although fish oil does not appear to adversely affect blood sugar levels in people with diabetes, one study reported that a large daily dose of krill oil (providing a modest amount of EPA and DHA) reduced insulin sensitivity in overweight, middle-aged men by about 27% -- which could potentially increase the risk of diabetes.
Also note that high doses of vitamin C may increase blood sugar or interfere with certain blood sugar tests.
Question: I've read that fish oil supplements may help with gout, but I've also been told to avoid oily fish because it can increase my uric acid levels. Are fish oil supplements safe for me to take and do they really help with gout?
Answer: Eating fish low in purines may be helpful for people with gout, but there is no evidence that taking fish oil supplements is helpful for gout. For more about this, plus information about fish oil for other forms of arthritis and inflammatory conditions, see the "What It Does" section of the Fish Oil and Omega-3 Fatty Acids Supplements Review >>
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Product Review:Fish Oil and Omega-3 and -7 Fatty Acid Supplements Review (Including Krill, Algae, Calamari, Green-lipped Mussel Oil, and Sea Buckthorn)
Posted: 9/10/16 Last Update: 10/25/16
Best Fish Oil? Our Tests and Comparisons Will Help You Find the Right Form and Amount of Omega Fatty Acids
Supplements for Adults, Children, and Pets Reviewed
Find Out Now If Yours Passed!
Alphabetical list of fish oil, krill oil, algal oil, calamari oil, green-lipped mussel, and sea buckthorn oil supplements in report
1-800-PetMeds Omega 3 for Dogs & Cats
Metagenics OmegaGenics EPA-DHA 500 EC
Renew Life Omega Smart Kids DHA - Fruit Punch
21st Century Fish Oil
Minami Nutrition MorEPA Platinum - Orange Flavor
Schiff MegaRed Extra Strength 500 mg Omega-3 Krill Oil
Dr. Sears' Private Label Primal Force Omega Rejuvenol
Vitacost KriaXanthin Antarctic Krill Oil
Finest Nutrition (Walgreens) Fish Oil
Vitamin World Ester-Omega
GNC Triple Strength EPA 1000
Ora Nothing Fishy Here - Organic Pineapple Burst
Viva Labs Krill Oil
GNC Triple Strength Fish Oil
Viva Labs Ultra Strength Omega-3 Fish Oil
Life Extension Super Omega-3
Pure Encapsulations O.N.E. Omega
Wellsona Brain Health Omega
Members Mark [Sam's Club] Fish Oil
Puritan's Pride Premium Mini Gel Omega-3 Fish Oil
Zesty Paws Pure Salmon Oil
Make sure the supplement you take passed our tests and is right for you!
Isn't your health worth it?
Supplements containing the omega-3 fatty acids EPA and DHA offer a wide range of potential benefits for improving mental health, treating inflammatory disease, and even for cancer prevention. There is also emerging evidence that omega-7s, another type of fatty acid found in fish, may have health benefits. But with so many different supplements to choose from, how do you know which one is right for you — and which offers the best value?
ConsumerLab.com's tests of 44 omega-3 and omega-7 fatty acid supplements - including fish oil, krill oil, algal oil, calamari oil, green-lipped mussel oil and sea buckthorn oil — revealed problems with the quality of three products. We also found that a widely promoted "Omega" supplement actually contained only a tiny amount of the omega-3 oils EPA and DHA.
Fortunately, ConsumerLab.com also identified regular softgels, enteric-coated softgels, and liquids which contained what they claimed and were not contaminated with lead, mercury, cadmium, arsenic or PCBs. Among these, a substantial daily dose of EPA and DHA could be obtained for as little as a few cents a day. ConsumerLab.com also compared the quality, value, and cost for each to select its Top Picks.
You must be a member to get the full test results for fish oil and other marine oil pills and liquid supplements along with ConsumerLab.com recommendations and quality ratings. You will get results for 28 supplements selected by ConsumerLab.com, 16 others that passed voluntary, quality certification testing, and information about one product similar to one which passed testing.
In this comprehensive report, you'll discover:
Which fish oil and omega-3 and omega-7 supplements failed or passed testingand why.
The latest information on benefits of fish oil and omega-3s and -7s, as well as what they cannot do.
Direct comparisons (including amounts of EPA and DHA) and quality ratings for fish, krill, algal, calamari, green-lipped mussel, and sea buckthorn oil supplements -- including those for pregnant women, other adults, children, and pets.
Which products provide the best value and which are most concentrated (so you can take fewer or smaller pills) including softgels, liquids, and enteric-coated pills.
Differences in the forms of fish oil in each product: natural triglyceride, ethyl ester, re-esterified triglyceride, and phospholipid.
The dose of the omega-3s (EPA and DHA) and omega-7s (palmitoleic acid) for specific uses -- and how much is too much.
Side-effects and cautions with supplements made with fish oil, krill oil and other marine oils.
Question: Do any supplements help with nerve pain, like sciatica or diabetic neuropathy? Get the answer >>
Question: Do any supplements help with gum disease or periodontitis? Get the answer >>
Question: My dog is getting older and his veterinarian recently recommended giving him a glucosamine supplement for his joints. Has ConsumerLab.com tested these, or other supplements for pets? Get the answer >>
Question: Is it true that fish oil supplements may contain soy? I'm allergic! Get the answer >>
Question: What is the difference between fish oil and krill oil? Is one better than the other? Get the answer >>
Question: Which supplements are helpful for age-related macular degeneration (AMD)? Get the answer >>
Question: Do any supplements help for irritable bowel syndrome (IBS)? Get the answer >>
Question: Are there negative interactions between the following supplements I take twice each day, as well as 60 mg of beta-sitosterol with dinner: Vitamin C (500 mg), CoQ10 (100 mg), grape seed extract (100 mg), fish oil (500 mg), vitamin D3/calcium/magnesium/zinc (200 IU/333 mg/113 mg/5mg)? Get the answer >>
Question: Which supplements can help with indigestion and/or heartburn? Get the answer >>
Question: What are the most common, potentially dangerous interactions between supplements and drugs? Get the answer >>
Question: Which supplements can help lower or control my blood sugar? Get the answer >>
Question: I've read that fish oil supplements may help with gout, but I've also been told to avoid oily fish because it can increase my uric acid levels. Are fish oil supplements safe for me to take and do they really help with gout? Get the answer >>