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28 Benefits and Side Effects of Fish Oil (12 Contraindications To Be Noted)[Updated Feb/2023]

Fish oil is a common animal source of omega-3, because it contains essential fatty acids DHA and EPA, which are beneficial to the human body, and is easily converted and utilized by the human body compared to plant-derived omega-3 (such as ALA in flaxseed oil, only 5%-15% of it can be converted to DHA + EPA in the human body)Note 18, so it has become the first choice for supplementing omega-3 (other similar products are cod liver oil or krill oil)

In empirical medicine, what are the benefits of fish oil? Are there any side effects or contraindications? See text analysis for details.

What is Fish Oil (Omega-3)?

Omega-3 fatty acids are a nutrient mainly composed of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), because the human body cannot synthesize them effectively, so the main sources are dietary intake from fish, seafood, flaxseed, perilla oil, etc

These fatty acids are not only important sources of energy for the human body, but also the key structural components in maintaining the integrity and fluidity of cell membranes.

In addition, they act as precursors for bioactive mediators such as eicosanoids (prostaglandins, leukotrienes, and thromboxanes) and steroid hormones, and regulate gene expression, cell signaling pathways (apoptosis, inflammation, and cell-mediated immune responses)

Because omega-3 has excellent anti-inflammatory effects and does not have many side effects of anti-inflammatory drugs, it is known as the most effective natural anti-inflammatory drug. Note 19

Inadequate or unbalanced intake of omega-3 is thought to be associated with numerous health problems such as heart disease, cancer, schizophrenia, allergies, depression, Alzheimer’s disease, etc

What are the recommended proven benefits of fish oil (omega-3)?

  1. Fish oil increases resting metabolic rate

Resting Metabolic Rate (RMR), also known as resting energy expenditure, accounts for the largest portion of total energy demand. It is defined as the amount of energy required by the body in a resting state. This definition can be further refined to refer to the energy expended during the 12 hours when a person is awake in a heat-neutral state after nutrient absorption, without exercise.

Resting metabolic rate can be measured in a sitting or supine position with a minimum of 15 minutes of rest, sometimes one night’s rest. The resting metabolic rate and basal metabolic rate (BMR) are similar, the only difference is that the BMR is usually measured in the morning, after an overnight fast, no exercise for the first 24 hours, no emotional stress, and the subject is completely rested. In general, RMR may reflect daily energy requirements better than BMR.

A systematic literature review and meta-analysis (7 randomized controlled trials with 245 participants) noted that oral supplementation with omega-3 polyunsaturated fatty acids increased resting metabolic rate in adult participants, particularly women and those with a BMI greater than 25 kg/m2 (overweight and obese individuals). Note 1

*Conclusion: Omega-3 (fish oil) supplementation may be a healthy way to increase resting metabolic rate and thus prevent chronic metabolic diseases.

  1. Fish oil is beneficial for primary menstrual pain

Menorrhea refers to pain caused by uterine contractions during menstruation, and it is associated with cramping pain in the abdomen (without pelvic disorders) during menstrual bleeding.

The incidence of primary dysmenorrhea ranges from 42% to 95%. It is the main cause of absenteeism, quality of life and reduced ability to perform daily activities.

Various non-invasive nutritional and psychological interventions are suggested as treatments. These therapies include psychotherapy, yoga, hypnotherapy, massage, transcutaneous electrical nerve stimulation, vitamins, and nutritional supplements.

A systematic literature review and meta-analysis suggests that omega-3 polyunsaturated fatty acid supplementation can reduce the severity of primary dysmenorrhea in women. Note 1

In addition, meta-regression results showed that the improvement was affected by dose (increasing daily intake, decreasing therapeutic effect) and age (less effective with age).

*Conclusion: For primary dysmenorrhea, omega-3 (fish oil) supplementation may bring positive help, but due to heterogeneity between samples, further validation is needed

  1. Fish oil is beneficial for rheumatoid arthritis

The term rheumatoid arthritis was described more than 150 years ago to distinguish it from other forms of arthritis, such as acute rheumatism and gout, characterized by progressive destruction of the joints as well as extra-articular involvement, and is therefore classified as a systemic inflammatory disease.

While genetic factors are thought to be the main cause (about 50%), environmental factors, female sex hormones, and infections may also be triggers for rheumatoid arthritis.

The results of population-based studies show that rheumatoid arthritis is more common in women and the elderly, with the highest incidence in women over 65 years of age (3 times more common than men).

A systematic literature review and meta-analysis (20 randomized controlled trials, 717 patients with rheumatoid arthritis) noted that oral supplementation with omega-3 polyunsaturated fatty acids (i.e., EPA, DHA, and ALA, used for >3 months) significantly improved markers of disease severity, markers of disease severity, early morning stiffness, joint tenderness count, erythrocyte sedimentation rate, pain scale, health assessment questionnaire, grip strength, and left grip strength , Ritchie joint index, triglyceride level, and inflammatory index: leukotriene B4. Note 1

*Conclusion: For rheumatoid arthritis, omega-3 polyunsaturated fatty acid supplementation may be beneficial in disease improvement, but due to the high risk of bias and low quality of the available evidence, more large, precisely designed long-term trials are needed to support this

  1. Fish oil is beneficial for polycystic ovary syndrome

Polycystic Ovarian Syndrome, also known as hyperandrogenic anovulation, or Stein–Leventhal syndrome, is one of the most common endocrine disorders affecting women of childbearing age.

Described by Stein and Leventhal since 1935, it indicates the formation of 2 small cysts with a diameter of 9 to 10 mm on one or both ovaries or a volume of more than 10 ml in at least one ovary.

Patients may be at increased risk for a number of diseases, including obesity, insulin resistance, type 2 diabetes, cardiovascular disease, infertility, cancer etc..

A systematic literature review and meta-analysis (9 randomized controlled trials, 591 people with PCOS) showed that omega-3 fatty acids improved insulin resistance, increased adiponectin levels, and lowered total cholesterol, triglycerides, and LDL cholesterol compared with controls. Note 2

*Conclusion: For patients with polycystic ovary syndrome with insulin resistance and hyperlipidemia, omega-3 fatty acid supplementation may bring positive help, but limited by the small sample size and short execution period, further verification is still needed

  1. Fish oil is beneficial for schizophrenia

Schizophrenia is a chronic neuropsychiatric disorder that affects about 1% of the population, and the cause may be genetic, environmental, or both, often resulting in severe impairment of social functioning and inability to fully integrate into the home and workplace.

The clinical symptoms of schizophrenia include three groups of symptoms, positive symptoms, such as hallucinations, delusions, and other thought disorders, negative symptoms, including social withdrawal, apathy, and anhedonia, and cognitive deficits, such as memory and learning disabilities or attention deficits.

A meta-analysis (20 double-blind randomized controlled trials involving 1494 people with schizophrenia) suggested that the use of omega-3 polyunsaturated fatty acids significantly improved psychopathological symptoms, particularly general psychopathology and positive (non-negative symptoms). Note 1

In addition, the relevant improvement effect was especially in patients with severe disease, and the subjects taking omega-1 polyunsaturated fatty acids containing EPA/eicosapentaenoic acid (daily dose greater than 3 g) were the most significant.

*Conclusion: Oral administration of omega-3s may provide positive help for schizophrenia, but more research is needed to confirm the optimal dose and ratio

  1. Fish oil is beneficial for arteriosclerosis

Arteries not only provide blood flow from the heart to peripheral organs, but also play a major buffer role in hemodynamics, buffering the forward blood flow of the heart and the backward resistance of peripheral arterioles, maximizing cardiovascular efficiency.

Arterial stiffness has been recognized as a hallmark of cardiovascular disease, with age, high blood pressure, smoking, dyslipidemia, as well as diabetes, obesity and systemic inflammation all contributing to atherosclerosis and arteriosclerosis.

A systematic literature review and meta-analysis (14 randomized controlled trials) found that fish oil significantly reduced Pulse Wave Velocity (PWV) levels compared with controls. Note 1

Subgroup analysis found that PWV reductions were particularly significant at low doses (≤1.8 g/day), short duration (< 24 weeks), low DHA/EPA ratio (DHA/EPA<1), and younger participants (< 50 years).

*Conclusion: Fish oil may have a positive effect on arteriosclerosis, but more research is needed to support it

  1. Fish oil is beneficial for diabetic blood sugar control

Type 2 diabetes is a long-term metabolic disease characterized by insulin resistance and inadequate insulin secretion, and is a major risk factor for coronary heart disease, blindness, kidney failure, and various cancers.

It is predicted that by 2030, the prevalence of diabetes will reach 5 million. Current treatments for diabetes include exercise, diet, oral hypoglycemic drugs, and insulin therapy.

A systematic literature review and meta-analysis (including 30 randomized controlled trials) showed that omega-3 supplementation had a significant effect on reducing fasting blood glucose and insulin resistance, but glycated hemoglobin had no significant effect. Note 1

*Conclusion: Omega-3 supplementation may have a protective effect on diabetic glycemic control, but more studies are needed to further validate

  1. Fish oil is beneficial for systemic lupus erythematosus

Systemic lupus erythematosus is a typical autoimmune disease that affects organs and tissues throughout the body, with the most common symptoms including rash, arthritis and fatigue, and severe cases causing nephritis, neurological problems, anemia, and thrombocytopenia.

The disease is common in women of childbearing age, with a male-to-female ratio of up to 15:44 among adults aged 13 to 1, compared with a ratio of only 2:1 for children and the elderly.

A systematic literature review and meta-analysis (5 randomized controlled trials of 274 patients with systemic lupus erythematosus) suggested that omega-3 fatty acid (fish oil) supplementation reduced disease activity in systemic lupus erythematosus (as measured by the SLE Disease Activity Index (SLEDAI) scale) compared with placebo. Note 1

*Conclusion: For systemic lupus erythematosus, omega-3 fatty acid supplementation may be a positive help in disease control and can be used as an adjunct to standard immunosuppressive therapy

  1. Fish oil is beneficial for acute lung injury

Acute lung injury is a clinically common progressive respiratory failure, caused by trauma, shock, acidosis, embolism, severe infection and other internal and external factors (such as drowning, inhalation of toxic gases). It is characterized by rapid onset, diffuse bilateral lung injury, severe hypoxaemia, noncardiogenic pulmonary edema, low alveolar ventilation/perfusion ratio, and abnormal oxygen physiologic shunts.

If left untreated, acute respiratory distress syndrome may progress to acute respiratory distress syndrome with a high mortality rate, with patients (approximately 75%) dying primarily due to multiorgan failure involving the lungs, cardiovascular system, kidneys, coagulation system, or liver.

A systematic literature review and meta-analysis (including 6 randomized controlled trials with 277 patients with acute lung injury) noted that omega-3 use significantly increased carbon dioxide partial pressure (PaO2), oxygenation index (PaO2/FiO2), total protein, and reduced mechanical ventilation and intensive care unit) Retention time. Note 1

*Conclusion: In patients with acute lung injury, omega-3 may improve respiratory function and promote recovery, but limited by the small sample size, more studies are needed to further validate

  1. Fish oil improves delayed onset muscle soreness

Delayed-onset muscle soreness (DOMS) describes an entity’s ultrastructural muscle injury caused by centrifugation-induced muscle contractions or unfamiliar forms of movement.

Clinical symptoms include decreased muscle strength, increased pain, limited mobility, stiffness, swelling, and dysfunction of adjacent joints.

While delayed onset muscle soreness is considered a minor injury, it is also one of the common causes that affect athletic performance.

A systematic literature review and meta-analysis (12 randomized controlled trials, 301 participants) noted that omega-3 (fish oil) supplementation did not achieve clinically significant reduction in muscle soreness after eccentric exercise, although statistically significant. Note 1

*Conclusion: Based on the limited evidence available, omega-3 (fish oil) is not significantly helpful in improving muscle soreness after eccentric exercise

  1. Fish oil is beneficial for perinatal depression

Perinatal depression, also known as perinatal depression, is defined as mild to moderate to severe depression that occurs during pregnancy or in the first year after birth, affecting an estimated 7 to 20 percent of women, with an incidence of up to 35 to 40 percent in low-income and minority women.

Perinatal depression is associated with many negative sequelae for women, children, and families, including poor mother-infant attachment, poor neonatal outcomes (low birth weight, preterm birth, small gestational age), poor infant attachment, stunted growth in young children, and relationship tension.

A meta-analysis (8 randomized placebo-controlled trials involving 638 perinatal women with depressive symptoms) suggested that omega-3 monotherapy improved perinatal depressive symptoms. Note 1

In addition, subgroup analyses showed that the relevant improvement effects were particularly pronounced with a higher EPA/DHA ratio (≥ 1.5), less than 8 weeks of use, and mild to moderate depression.

*Conclusion: Oral omega-3 (fish oil) supplementation may be beneficial for perinatal depression/weekly obsteia, but more studies are needed to support this due to the heterogeneity of the included studies and the small sample size

  1. Fish oil reduces the risk of cardiovascular disease

Cardiovascular diseases, considered the most expensive disease, surpass even Alzheimer’s disease and diabetes, have an annual indirect cost of $2370 billion and are expected to increase to $2035 billion by 3680.

Risk factors associated with this disease include smoking, alcoholism, low levels of physical activity, inadequate intake of vegetables and fruits, and on the other hand, non-modifiable factors such as family history, age, and sex have different meanings.

Family history, particularly first-degree relatives diagnosed with cardiovascular disease or death from cardiovascular disease before age 55 (male) or 65 years of age (female) is considered an independent risk factor.

A meta-analysis (13 randomized controlled trials, 127477 participants) noted that marine omega-3 supplementation (daily doses ranging from 376 mg to 4000 mg, mean follow-up of 5 years) significantly reduced the risk of myocardial infarction, total coronary heart disease, and total cardiovascular disease. Note 1

In addition, the reduction in associated risk appears to be linearly related to omega-3 doses.

*Conclusion: Marine omega-3 supplementation may have a positive effect on reducing the risk of cardiovascular disease, especially in people using larger doses, but more large trials are needed to support the results

  1. Fish oil is beneficial for psoriasis

Psoriasis is the most autoimmune multisystem inflammatory disease mainly in the skin and joints, the most common is chronic plaque type psoriasis, affecting more than 80% of patients. Characterized by erythema of the skin covered with silvery-white scales (well-defined and symmetrical).

Its prevalence ranges from 0.1% to 11.8% in different populations, with an average of 2% to 3%, with a bimodal age of onset (16 to 22 years and 57 to 60 years), with the same incidence in men and women.

In addition to the physiological effects of the disease, psoriasis has a wide range of emotional and psychosocial effects on the patient, it can lead to stigma, low self-esteem, increased stress, affect social functioning and interpersonal relationships.

A meta-analysis (3 randomized controlled trials with 625 psoriasis participants) found that fish oil supplementation did not significantly reduce the severity of psoriasis (as measured by the Psoriasis Area and Severity Index score). Note 2

*Conclusion: To date, there is no clear evidence to support the use of fish oil supplements for the treatment of psoriasis/psoriasis, and further research is needed

  1. Fish oil is beneficial for allergies

Allergy, defined as the result of an immune response to a specific type of antigen, primarily protein antigens (called allergens), affects about 30% of the world’s population.

It is characterized by the production of specific IgE, which binds to mast cells and initiates a series of molecular and cellular events that in turn affect multiple allergens in the respiratory tract (rhinitis and asthma), skin (dermatitis, urticaria) and multiple systems (allergic reactions), including pollen, mold spores, animal dander, insect bites, food and drugs.

A systematic literature review and meta-analysis (5 randomized controlled trials) noted that omega-3 fatty acid supplementation in childhood did not reduce the incidence of allergic diseases (including any specific reactions, asthma/wheezing, eczema, specific reactive rhinitis, food allergy, sensitization). Note 1

*Conclusion: Due to the limited number of studies and heterogeneity between studies, omega-3 fatty acid supplementation in childhood has not significantly helped to prevent allergy-related diseases, and more large-scale studies need to be further validated

  1. Fish oil improves insulin sensitivity

Insulin has a variety of physiological functions, of which lowering blood sugar is the main function. In addition, insulin can stimulate the synthesis of fatty acids and glycogen, promote mitochondrial function, improve microcirculation, and induce cell proliferation.

Insulin resistance occurs when insulin-sensitive tissues lose their response to insulin and are the leading cause of type 2 diabetes, often years before type 2 diabetes develops.

In the insulin sensitivity test, insulin resistance has the following characteristics: hyperinsulinemia on fasting, hyperglycemia, increased glycosylated hemoglobin, postprandial hyperglycemia, hyperlipidemia, impaired glucose tolerance, impaired insulin tolerance, slowed glucose infusion rate, increased glucose production in the liver, decreased first-stage insulin secretion, hypolipidadiponectinemia, and elevated plasma inflammatory indicators.

A systematic literature review and meta-analysis (17 randomised controlled trials, 672 participants) noted that, overall, fish oil supplementation (daily doses ranging from 1 to 4 grams and intervention duration ranging from 4 weeks to 24 weeks) had no effect on insulin sensitivity compared with placebo. Note 1

However, subgroup analysis showed that fish oil supplementation may be beneficial for insulin sensitivity in subjects with at least one metabolic syndrome, and short-term interventions (within 12 weeks) are more effective in the long term.

*Conclusion: For people with metabolic syndrome, short-term fish oil supplementation may have a positive effect on improving insulin sensitivity, but more studies are needed to support this due to small sample sizes and methodological quality in trials

  1. Fish oil is beneficial for depression

Major depressive disorder is characterized by persistent low mood accompanied by changes in behavior, cognition, sleep and appetite, impaired social and occupational functioning, and an increased risk of self-harm or suicide.

Although short-term treatment for acute episodes of depression is usually effective, many patients relapse after short-term improvement or remission.

Within 10 years of the onset of depression, the recurrence rate exceeds 85%, and if initially effective treatment is not continued, the recurrence rate averages about 6% or more within 50 months of significant clinical remission.

A meta-analysis (26 randomized controlled trials involving 2160 adults diagnosed with clinical depression) suggested that omega-3 polyunsaturated fatty acids had a positive therapeutic effect on melancholic symptoms. Note 1

In addition, subgroup analysis found that the associated improvement effect was most pronounced in EPA daily dose≤ 1 g, EPA-pure (100% EPA), and EPA-major formulation (≥60% EPA).

DHA-pure and DHA-major formulations did not help significantly.

*Conclusion: The use of fish oil/omega-3 (at certain EPA doses and ratios) may have a positive effect on the improvement of depression symptoms, but more research is needed due to potential heterogeneity

  1. Fish oil improves Alzheimer’s disease

Alzheimer’s disease is by far one of the most common causes of dementia (80% of all dementia diagnoses) and is characterized by progressive decline in more than several cognitive functions (including memory, language, executive and visuospatial functions, personality, and behavior), leading to loss of basic mobility.

Currently available treatments include cholinesterase inhibitors and memantine, drugs that have been shown to improve the quality of life for patients and caregivers, however, drugs do not alter the course of the disease or the rate of decline

A systematic review (seven randomized, double-blind, placebo-controlled trials of Alzheimer’s disease) found that fish oil supplementation was not significantly helpful in symptom improvement compared with placebo, and that improvement was seen only on a few cognitive assessment scales and in mild or early stage patients. Note 2

*Conclusion: To date, there is no consistent evidence to support the effectiveness of fish oil supplementation in improving Alzheimer’s disease in the short and medium term

  1. Fish oil is good for dry eyes

Dry eye disease, also known as dry keratoconjunctivitis, is a multifactorial disease of the ocular surface, characterized by loss of osteogenesis of tear film homeostasis, accompanied by ocular symptoms such as tear film instability and high osmotic pressure, ocular surface inflammation and neurosensory abnormalities.

Known risk factors include aging, female, hormonal changes (such as postmenopausal), eyelid disease, refractive surgery, autoimmune diseases, and smoking.

Environmental risk factors include wearing contact lenses, low humidity (e.g., air-conditioned environments), exposure to sunlight, dust and air pollution, drugs, etc

A meta-analysis (17 randomized clinical trials with 3363 dry eye patients) showed that omega-3 fatty acid supplementation (fish oil) helped reduce dry eye symptoms and corneal fluorescence staining values compared with placebo, and increased tear film break-up time (BUT) and Schirmer tear secretion test values. Note 1

*Conclusion: Omega-3 supplementation (fish oil) may have a positive effect on dry eye improvement, but more rigorous research is needed due to the heterogeneity of the included studies

  1. Fish oil is beneficial for male infertility

Infertility is a psychological, economic and medical problem that causes trauma and stress, especially in a social structure that places special emphasis on succession.

It is estimated that nearly 72.40 million couples worldwide have fertility problems, of which 40% to 50% of infertility is “male factor” infertility, with the most common factors being low sperm concentration (hypospermia), poor sperm motility (asthenospermia) and abnormal sperm morphology (malspermia).

A systematic literature review and meta-analysis (3 randomized, double-blind, placebo-controlled trials of 275 men with infertility) showed that oral administration of omega-3 (fish oil) significantly improved sperm motility and semen DHA concentration. Note 1

The mechanism behind it may be related to the fact that omega-3s can maintain the structural integrity of phospholipids in sperm cell membranes and reduce oxidative stress.

*Conclusion: For male infertile patients, omega-3 (fish oil) can help improve sperm motility and have a positive effect on infertility, but due to small sample size and heterogeneity, more studies are needed to support it

  1. Fish oil is beneficial for non-alcoholic fatty liver

Nonalcoholic fatty liver disease usually refers to secondary hepatic fat accumulation without a clear cause (when liver cells contain more than 5% fat) and excludes conditions such as congenital metabolic abnormalities, Wilson’s disease, excessive alcohol consumption, hepatitis, toxins, iron toxicity, or hepatoxin drugs).

Nonalcoholic fatty liver disease (NAFLD) can generally be divided into two subtypes: nonalcoholic fatty liver disease (NAFL, simple steteaosis) or nonalcoholic steatohepatitis (NASH). Compared to NAFL, NASH has a much higher risk of developing cirrhosis.

A literature review and meta-analyses (18 studies) showed that omega-3 fatty acid supplementation significantly improved 6 of the 13 metabolic risk factors (including Body Mass Index, HOMA-IR, total cholesterol, LDL-C, HDL-C, Triglyceride) in patients with nonalcoholic fatty liver disease (NAFLD). 2 of the 3 liver enzymes (ALT and GGT) and steatosis score. Note 1

In addition, for nonalcoholic steatohepatitis (NASH), omega-3 fatty acid supplementation was not found to be helpful in liver histological parameters (including: fibrosis, hepatocyte ballooning, steteaosis, lobular inflammation, and nonalcoholic fatty liver activity).

*Conclusion: Supplementation with omega-3 fatty acids (sources including fish oil and algal oil) may be beneficial for milder nonalcoholic fatty liver disease

  1. Fish oil is beneficial for fetal brain development

Omega-3 (EPA + DHA) intake during pregnancy is very important for fetal development, especially in the third trimester (28 to 40 weeks of pregnancy), DHA will accumulate in large quantities in the brain and retina, which has a decisive influence on normal development.

In a small double-blind controlled study, fetuses born to pregnant women who received DHA achieved higher scores on problem-solving tests (tested at 9 months of age compared to those who did not)Note 27

Another trial also found that omega-20 intake (3.2 g DHA + 2.1 g EPA daily) during pregnancy (from 1 weeks to before delivery) was significantly better on hand-eye coordination test scores at age 2 Note 28

  1. Fish oil reduces the rate of preterm birth

Preterm delivery events are defined primarily as births before a full pregnancy cycle (37 weeks or 259 days), and it is estimated that 1500% to 10% of the approximately 11 million births born globally each year are preterm.

There are generally many factors that contribute to childbirth, which may be related to socioeconomic status, prolific prolificness, previous miscarriage experience, mental illness, prepartum haemorrhage, vaginal infection, psychological stress, smoking, alcoholism, and illicit drug use.

A meta-analysis of 21 randomized controlled trials involving 10,802 pregnant women found that fish oil supplementation during pregnancy not only helped increase the gestational age of newborns, reduce the chance of early preterm birth (22%) and preterm birth (10%), but also had better birth weight, birth length, and head circumference ratio (but did not reduce intrauterine growth restriction and stillbirth events) compared with the unsupplemented control group. Note 1

*Conclusion: Fish oil supplementation during pregnancy can help reduce preterm birth events and lead to better neonatal body size

  1. Fish oil reduces the the risk of hip fracture

With the aging of the population, hip fractures caused by falls in the elderly are the main reasons for the decline in quality of life, mainly related to the decline of bone density, muscle atrophy, and sensory nerve degeneration.

The mortality rate of hip fracture surgery in the first and second years is as high as 22% and 47%, and nearly 5% of patients cannot return to the state before the fracture.

A meta-analysis (9 studies with nearly 300,000 participants) pointed out that higher fish intake and dietary intake of omega-3s had a protective effect on bone mass and reduced the risk of hip fracture. Note 1

The mechanism behind it may be related to the ability of omega-3 fatty acids to increase intestinal calcium absorption, inhibit bone resorption, reduce urinary calcium excretion, and regulate inflammatory response.

*Conclusion: Omega-3 intake from fish or other seafood foods can reduce the incidence of hip fracture

  1. Fish oil is beneficial for chronic kidney disease

Chronic Kidney Disease (CKD), also known as chronic renal failure, is a condition in which kidney function is gradually lost and is estimated to affect approximately 10% to 16% of the global adult population. Note 1

As the disease progresses, chronic kidney disease can lead to serious complications such as cardiovascular disease, hyperlipidemia, anemia, metabolic bone disease, and dialysis or even kidney transplantation is often required in the stage of end-stage renal failure.

A meta-analysis (9 randomized controlled trials of 444 people with chronic kidney disease) suggested that omega-3 supplementation (fish oil) helped reduce the risk of proteinuria and end-stage kidney disease (ESRD) (but creatinine clearance and glomerular filtration rate had no effect). Note 2

*Conclusion: Omega-3 fatty acid supplementation can delay the progression of slow nephropathy and reduce the incidence of End Stage Renal Disease

  1. Fish oil prevents post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) was first discovered during war (due to lingering mental symptoms in soldiers after war), and these conditions often occur in various natural disasters, terrorist attacks, and various violent incidents.

It is estimated that approximately 60.7% of men and 51.2% of women experience PTSD after trauma or catastrophe, and symptoms usually occur within 1 month of the event, with most recovering within 6 months, but may last longer. Note 21

Common symptoms of post-traumatic stress disorder include: repeated horror memories, avoidance of related topics, forgetting important details, alcohol dependence, etc. Emotionally, patients lose feeling anything, alienate from others, forgetful, and become irritable, anxious, guilty, and even sleep disorders.

According to preliminary research by Japanese psychiatrist Yutaka Matsuoka, omega-3s are currently the best natural ingredient for preventing post-traumatic stress syndrome

One of the effective mechanisms of omega-3 is to stimulate the growth of BDNF (brain-derived nerve growth factor) in the hippocampus, which can promote nerve differentiation and regulate neurotransmitters, thereby reducing the solidification of panic emotions (similar to eliminating fear memories of hippocampal gyrus in the human brain)Note 22

  1. Fish oil reduces suicidal intent

In the modern high-pressure society, suicide has become one of the new ten causes of death, and several of the daily news headlines are often related to suicide, not only undisguised, but also nakedly publicizing suicide methods and pictures, which may not only bring imitation effect, but also become a promoter of suicide.

Large-scale epidemiological observations have shown that lower fish intake is significantly associated with depression and suicidal behaviour Note 23 while lower levels of DHA in the brain may increase suicidal intent by 5 to 6 times.

Omega-3 deficiency can increase certain stress-related psychiatric symptoms such as suicide, adjustment disorders, depression, violentimpulses, etc. Note 24

A survey of U.S. military personnel found that both suicide and attempted suicide had lower blood levels of omega-3 (mainly DHA), and those with the lowest blood concentrations had a 62% higher suicide rate than those with higher DHA Note 25

In addition, a double-blind controlled study (in patients with recurrent self-harm) found that 2 grams per day (EPA + DHA) for 12 weeks reduced suicidal thoughts by 45% and depression by 30%.Note 26

  1. Fish oil reduces cancer incidence

Statistics in the past ten years have found that men suffering from colorectal cancer and prostate cancer are on the rise, while women are dominated by breast cancer and colorectal cancer, and these cancers are closely related to our daily diet, in fact, the proportion of cancer caused by diet and life and rest has long been as high as 9%, and less than 1% is related to genetics and viruses.

Related studies have also found that women with pre-stage breast cancer who consume more omega-3 (DHA+EPA) from fish can reduce the recurrence rate of breast cancer by 25% Note 9

Another 15-year observation also found that patients with both pre-stage breast cancer and aggressive breast cancer who consumed more fatty fish (such as tuna) could reduce mortality from all causes by up to 34% (compared to those who did not eat fish)Note10

For male prostate cancer, although no association between fish intake and prostate cancer incidence was found, it reduced prostate cancer mortality by 63%.Note 11

  1. Fish oil improves acne

Acne is one of the most common skin diseases, regardless of race and age, it is estimated that about 11% of people aged 30 to 80 suffer from various degrees of pimples, which makes patients have an inferiority complex in appearance and seriously affects interpersonal relationships.

A recent small controlled study (in men and women aged 18 to 33 with mild to moderate acne) significantly improved the number and severity of pimples (42.6% reduction in the number of inflammatory pimples, 29% reduction in severity and no side effects) with either omega-3 (DHA+EPA) or omega-6 (GLA) Note16

How do you eat fish oil? What is the dose?

Studies have found that fish oil with a fat-rich diet can increase absorption rate several times, so it is the best time to take it with meals. Note 3

The Reference Daily Intake (RDI) for total omega-3 is generally 1100 mg for women and 1600 mg for men, and it will vary according to age and health status.

According to the European Food Safety Authority, it is safe to consume 5000,3 mg of omega-<> fatty acid supplements per day, but such a high intake may be unnecessary and potentially risky for most people.

It is recommended that eating two servings of fat-rich fish (8 ounces or 224 grams) per week will provide you with enough omega-3 fatty acids, otherwise you may be deficient in EPA and DHA.

What are the side effects of fish oil (omega-3)?

For most people in good health, fish oil is safe at the right dose (3 grams or less per day).

Possible side effects or adverse effects reported include: acid reflux, flatulence, hiccups, indigestion, dizziness, headache, bad breath, heartburn, nausea, loose stools, weakness in hands and feet, dyspnea, difficulty swallowing, rash, nosebleeds, red or dark brown urine, chest urgency, facial swelling, night sweats.

May fish oil supplementation increase the incidence of atrial fibrillation?

Atrial fibrillation is the most common cardiac arrhythmia, defined as an uncoordinated start of the atrial leading to ineffective atrial contractions, which increases the risk of stroke and heart failure by nearly 5 times and increases the risk of death by more than 1.5 times.

Symptoms of atrial fibrillation are highly variable, about 10% to 40% asymptomatic, and common symptoms include fatigue, shortness of breath, palpitations, chest pain, and dizziness, negatively affecting functional status and quality of life.

Atrial fibrillation becomes more common with age, occurring in about 65% of adults over the age of 8 and more than 85% of adults over the age of 14.

In addition to advanced age, a number of comorbid conditions and lifestyle factors increase the risk of developing atrial fibrillation, including: hypertension, coronary artery disease, heart failure, valvular heart disease, diabetes, obesity, hyperlipidemia, sleep apnea, hyperthyroidism, moderate to heavy alcohol consumption.

A systematic literature review and meta-analysis (5 randomized controlled trials of 50,277 people at high risk of high triglycerides and cardiovascular disease) suggested that omega-3 fatty acid supplementation (2 to 7.4 years follow-up, doses ranging from 0.84 g to 4 g per day) was associated with a significantly increased risk of atrial fibrillation compared with placebo. Note 1

*Conclusion: Oral administration of omega-3 fatty acids (fish oil) is associated with a higher risk of atrial fibrillation in “high triglycerides” and “high risk of cardiovascular disease” subjects, and further research is needed to confirm the potential effects of these components in “high triglycerides” and “high risk of cardiovascular disease”.

safety precautions

1. It may not be safe to consume large amounts of fish oil from certain natural food sources, such as some large deep-sea fish species, especially tuna, sailfish, oilfish, sharks may be contaminated with mercury or industrial and environmental chemicals, and regular consumption of contaminated fish can cause brain damage, mental retardation, blindness and epilepsy in children.

2. Patients with familial colorectal polyposis/adenomatous polyposis should use with caution, there have been suspected cases that long-term use will increase the risk of cancer. Note 18

3. Fish oil may increase the risk of arrhythmias in patients with defibrillator implants, so please avoid fish oil supplements for safety reasons.

4. If you have been allergic to fish, shrimp and any seafood protein, please avoid or use fish oil supplements with caution (although fish oil has been refined and is said to be protein-free, it cannot be guaranteed to cause allergies)

5. Patients with abnormal immune function should not take too much, because animal experiments have found that supplementation with high doses of fish oil may cause immunosuppressive symptoms (converted to a human dose of about 2.2g to 22g). Note 17

6. Fish oil has a blood pressure-lowering effect, so patients with low blood pressure or taking blood pressure lowering drugs should use it with caution, the relevant drug names are: captopril (metcaptopropionic acid), enalapril, losartan, valsartan, sartan, diltiazem, Amlodipine, hydrochlorothiazide, furosemide (furaniline)

7. Use with caution if you are diabetic, as high doses of fish oil may raise blood sugar levels, which may make blood sugar control more difficult.

8. Please use with caution with cirrhosis or chronic liver disease, as patients may have impaired blood clotting function and taking fish oil may increase the risk of bleeding

9. Do not use it in combination with birth control pills, it may affect the effectiveness of fish oil in reducing triglycerides, related drug ingredients are: ethinyl estradiol, levonorgestrel, norethindrone

10. Do not combine with the diet drug Orlistat, which may affect the absorption efficiency of fish oil

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