Q: Is there an Optimum Dose of Fish Oil?
PLEASE,PLEASE Take the Time to Read this. I know you are selective in the Q's
I only saw two references to Omega 3 out of all the archive Q's. I have read
extensively on the subject and all the current clinical trials that are in the
works. It appears you are familiar with Dr. Andrew Stolls findings and I am
willing to try Omega 3 to see if it will help, however I am very afraid of who
to buy from. Of course I know you can't endorse conclusively one brand over
another but I noticed you had Kirkland Brand on your Web-site as well as
Country-Life. I stumbled across Puritan's Pride and they have gel caps that are
1200 mg in 2 caps. You mentioned that you have recommended or told your patients
it is ok to take Omega 3 and I was wondering if you personally have an opinion
about what might be to little or too much? Maybe that's not something you can
divulge in this forum. I have been through the ringer concerning meds. I have
tried combinations of about 30 different kinds over the past 18 years and am
still struggling to get stabilized so I am desperate to try something that
"COULD" help even if there aren't conclusive and consistent findings related to
the Omega 3's. I just am worried about over doing it with the mg's/gm's. I don't
even know where to begin.
Can you please give me any feedback? My daughter was also diagnosed with BP 2
years ago and her Med- managment Doc referred us to you and highly recommended
you and said you are really good and responding. I understand that you probably
get thousands of emails and Q's but I am hopeful that My email will be one that
you respond to.
Thank you for all your hard work and effort in educating and providing a way
to get informed for those of us who live with this and for those who put up with
us. I appreciate your valuable time.
Dear Giselle --
Thanks for your very polite approach in your letter.
Happy to respond. In this case, that's fairly easy because I have already
collected many of the relevant studies (all of the research that I know of, to
date) in the
table you probably saw on my website. Obviously,
the doses used in these studies vary tremendously. Indeed, the range goes from
about 1 g of fish oil to about 10 g.
Note that several studies used doses in the range of 8-10
g of fish oil. More recently, investigators have reported concentrations
of the two omega-three forms, EPA and DHA. Since most of the patients I treat
have some version of bipolar disorder, the study most relevant in this respect
was led by Dr.
Frangou. Her team compared 1 g of EPA versus 2 g,
versus placebo. 1 g was better than placebo, but 2 g was not better than 1
g. So, I have generally recommended to my patients that when trying this
approach, they shoot for 1 g of EPA.
Unfortunately, unless you spend extra money on a very concentrated form of fish
oil, getting that much EPA requires quite a handful of pills per day. As
you saw, using the cheapest version, which so far does not appear to have any
disadvantages compared to more expensive versions (except in the words of those
who make or can profit from the expensive pills), one must take about seven fish
oil capsules per day of the Kirkland brand to reach 1 g of EPA. "Three
with breakfast, 4 with dinner", I tell my patients.
However, at this point I think it is safe to say that the optimum dose of fish
oil has yet to be determined. Note that these studies are relatively short
in duration. So the safety of taking very large doses of fish oil, for
years, has yet to be conclusively established. Of course, that will take
an extremely long time. Like any other medication, the lowest dose that
does the job is probably best. Figuring that out with fish oil could be
very difficult: in my patients, at least, it is difficult to see a clear impact
from fish oil. It may indeed have some effect in the long run, but trying
to tell the difference between 1 g of EPA, and 2 g, would likely be tricky.
Good luck figuring it all out.
Published August, 2008