Expert: Dr. Kristina Conner - 12/20/2008

Question
Hello Dr. Conner,

I noticed Dr. Oz who appears on the "Oprah" show and public television mentioning that a person with cardiovascular disease should be taking 2 grams of Omega 3 fish oil per day.

I purchase mine at Walgreens as a Rexall brand delivering 2400 mgs. per serving,(2 gel caps). That means to receive 2 grams per day, I'd need to take 16 gel caps daily. I've been taking 8 in the morning and 8 at night for a week now with no side effects. I'm just wondering if the gelatin in the gel caps might not be good for me?

Are there any other more economical methods to get this 2 grams of fish oil daily? Would it be healthier for me to get it in a liquid? Also, would cod liver oil suffice?

Thank you very much.

Best,

Mike E.

Answer
Hello Mike,
Thanks for writing.  Fish oil is an excellent intervention for prevention and treatment of cardiovascular disease.  I am a bit confused by your question.  There are 2 main omega 3s in fish oil--EPA and DHA.  A typical ratio is 360 mg EPA to 240 Mg DHA in one gram (1000 mg) of fish oil.  I am guessing that the recommendation is 2000 mg EPA, with 1200-1500 mg DHA total.  That would be about 6 capsules of a normal fish oil capsule, which I would consider a therapeutic amount.  Dr. Oz is not an expert in natural medicine, but he does follow the research, and that is a typical amount that has been researched.  2 grams of fish oil total is a low amount, I would only recommend this for prevention in someone who has an excellent diet & other supportive lifestyle habits.  4-6 is more typical, especially if there is already established cardiovascular disease.  The 6 capsules can be taken all together or split up.  The gelatin is not enough to be hamful, mostly, but there are liquids which are easier to take and less expensive over time.
Which raises the issue of quality, very important when it comes to fish oil.  Cheaper brands of fish oil are often in a form that is not very absorbable, and the poor quality ones can even be rancid, turning a beneficial supplement into a harmful one.  I recommend brand names such as Nordic Naturals, Carlson, Barlean's, and Enzymatic Therapies, because I know their products & quality standards.  I would be cautious and gather as much information as you can about whatever brand you buy, because it does make a large difference.  The most expensive brand is not always the best, but the cheapest one is usually one of the worst.  Cod liver oil is a possible source, just be cautious that you do not get too much vitamin A; this is typically only in higher amounts, for those who take multiple supplements with vitamin A, or those with compromised liver function.  
In health,
Dr Conner