BLOGS Ask the Pharmacist Ask the Pharmacist: November 2016

Q: Should I take fish oil capsules?

A: A couple of essential fatty acids, omega-6 linoleic acid (LA) and omega-3 alpha-linolenic acid (ALA), need to be in your diet because your body cannot synthesize them. Then there is the hope that we have sufficient nutrients to convert ALA to DHA (docosahexaenoic acid) and EPA (eicosapentanaenoic acid). We can get ALA from flax seeds, chia seeds and other plants, but the conversion to the important DHA and EPA is dependent on adequate zinc, B6 and iron and even with these nutrients, the production is dismal.

DHA and EPA reduce inflammation and inhibit the inflammatory action of other fatty acids. They can regulate your cholesterol triglyceride levels and reduce cancer cell growth. A shortage of DHA and EPA can cause joint pain, rheumatoid arthritis, asthma, heart disease, allergies, kidney stones, blood sugar dysregulation, brain fog, depression, MS, and skin issues. But good news from this confusing alphabet soup, DHA and EPA just happen to be found in fish and other grass fed animal protein.

Because of the concerns about mercury contamination in fish and the hazards of farmed salmon, many people are trading in seafood, a perfect source of DHA and EPA, for fish oil capsules. Eating fish that contains more selenium than mercury can be safely consumed.

A good sourced fresh fish, such as sardines or wild caught salmon, is more beneficial than supplements, but pregnant women and small children should not eat more than 2-3 servings of oily ocean fish per week. Since the human brain is nearly 60%fat, a deficiency in omega -3 fatty acids can impair brain function and cause devastation in the developing brains of young children. A prenatal vitamin with sufficient DHA and a children’s supplement with DHA can be extremely important in brain development for memory and behavior. They are powerful additions to a nutrient dense diet and the correct choice of supplement is essential. Choose one that has strict shipping and handling requirements.

Fish oil supplementation for the rest of us can be the wisest investment if our diet is not balanced in omega- 6 and omega -3 consumption. The omega 6 foods are oils, nuts, seeds, pastured meats and other whole foods which contain valuable nutrients like niacin, Vitamin E, B6, magnesium, phytosterols and more. While the standard American diet (SAD) generally shifts the ratio from the preferred 4:1, staying away from prepared foods (fast/boxed foods) and industrial oil (canola/corn) can keep inflammation down and the immune system balanced.

A good fish oil source can be fermented cod liver oil (contains K2), a liquid oil or an omega-3 combination product that is molecularly distilled and purified. If you are using EPA and DHA to reduce inflammation, support your immune system or enhance cognitive function, supplements or combining fish oil and sustainable fish as a meal are the best option.

The doses recommended by health care providers can vary. From 500mg to 20 grams, this discrepancy can depend up the intended outcome. Ideally 1-2 grams of fish oil per day should be sufficient.

One more element comes into play when choosing your source-fish oil or krill oil. Krill oil is from phospholipid rich tiny crustaceans also known as “whale food”. Purported to provide the best absorption of DHA and EPA, it also contains astaxanthin and other antioxidants. It is more expensive and yet may be worth the extra investment considering the added benefits to sports performance, eye and cardiovascular health. Dr. Mercola recommends that the krill oil should come from Antarctic krill, be cold processed, free of heavy metals and the company should have a sustainability certificate.

It goes without saying that something as important as a nutrient for your brain should come from a reputable source and not be an oxidized poor quality product. Look for a COA (certificate of analysis) associated with your supplement manufacturer which will confirm their purity claims.

Deidre (Dee) Kohley, Rph, works at Watkins Pharmacy, is a graduate of Ferris University and has lived all her life in Muskegon. She continues to find ways to reach women who genuinely want to get well or live an optimal life. Dee loves digging into research to find new ways to help people. She is married and has seven children and nine grandchildren who keep her busy. She loves the beach and spending time outside enjoying the seasons. You can contact her by going to her website or

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