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More fish (oil) stories
(revised 6/2007)

Since we'll never have big drug-company funded studies of this stuff, we may just have to accumulate stories to supplement the smaller research studies being done (see my table-summary of those studies on the fish-oil main page).

Here are some more details from users and from what I've found surfing around.  

Safety: heavy metals (e.g. mercury), PCB's, dioxin
Is Dr. Barry Sears right about the risk of regular fish oils? His blog is very loud about the risks of his competitors. Is he correct? I've asked him to comment, but for now, it appears that he is marketing, not speaking the truth. His oft-repeated phrase "the sewer of the sea" is scary and surely making him a pile of money -- but appears to me to be false advertising.  Consumer Reports studied a bunch of the common brands and found no heavy metals, PCB's or dioxin (you can pay for their report; or you can read an excerpt here.)  

Worse yet, it looks like the International Fish Oil Standards (IFOS) has tried to establish itself as a neutral third party for testing various brands -- yet it is marketing itself to manufacturers as a means of showing off their product, so I wouldn't trust them either (even though Dr. Sears makes a big deal of their approval.  But look at the number of times he's submitted products for testing there. They probably love him. Seems to be a nice mutual arrangement. Of course, I have a similar mutual arrangement with the pharmaceutical companies who sponsor my talks (see Funding) so you just have to be careful about all these relationships). 

Update 11/2006: at least two more fish oil manufacturers have contacted me wanting me to raise alarm about heavy metals in the cheapest fish oil brands. They strongly disagree with the safety reports I've quoted, which come from a review article in a respected heart journal (see my main fish oil page, Safety section). So, who to trust? Seems to me that a heart journal review author and Consumer Reports are more trustworthy than a manufacturer who stands to make money by trying to convince you the cheaper brands are dangerous. But I'm open to people trying to convince me otherwise: just show me the data, where it came from, who did the study and why, and I'll listen (by email please). 

For now, however, it appears that most fish oils have no risk, even at the doses being used in some of the current research. 

Are there any alternatives to fish oil as a source of omega-3 fatty acids?  This is tricky, because although the answer is yes, these other sources have different mixtures of omega-3 and omega-6, in the case of flaxseed oil; or less omega-3 overall, in the case of emu oil; or different omega-3 percentages (of DHA and EPA), in seal oil.  So, for now, although you might be able to find a different source, there's nothing cheaper or less "fishy" that can be relied upon to match the existing research on omega-3's for mood purposes.  Since the results of this research are rather flimsy -- so far, anyway -- I'd hesitate to move on to some other oil source and potentially reduce the already uncertain benefit even further.  Here's a review of these other sources.  

Flaxseed oil as an alternative?   Flaxseed oil does indeed have an omega-3 oil, but not the same one as fish.  The flax one is ALA, which our bodies can convert to DHA and EPA (the fish ones).  But this conversion is limited and maybe more limited if your diet is high in another omega-oil, omega-6.  Flaxseed oil also contains omega-6's.  More flaxseed details... 

Cheapest, or fewest pills 
You might wonder if you could just eat a lot of fish, rather than pills. Here is a table (from the Mayo Clinic omega-3 pages) summarizing how much is in each kind of fish. Below that you'll find my best effort to summarize what's out there in pill form. 

Amounts of seafood necessary to provide 1 gram of DHA + EPA (based on USDA Nutrient Data Laboratory information): cod (Pacific): 23 ounces; haddock: 15 ounces; catfish: 15-20 ounces; flounder/sole: 7 ounces; shrimp: 11 ounces; lobster: 7.5-42.5 ounces; sardines: 2-3 ounces; crab: 8.5 ounces; cod (Atlantic): 12.5 ounces; clams: 12.5 ounces; scallops: 17.5 ounces; trout: 3-3.5 ounces; salmon: 1.4-4.5 ounces; herring: 1.5-2 ounces; oysters: 2.5-8 ounces; tuna (fresh): 2.5-12 ounces; tuna (canned, light): 12 ounces; tuna (canned, white): 4 ounces; halibut: 3-7.5 ounces; mackerel: 2-8.5 ounces. Cod liver oil: 5 grams; standard fish body oil: 3 grams; omega-3 fatty acid concentrate: 2 grams.

Write me if you find a cheaper approach than the versions described below, or one which will provide the same dose in fewer pills -- but if you write, please do the math so that anyone can understand it.  I hope the numbers below meet that criterion. These are not guaranteed to be the best deal, or even correct, but might give you a place to start in a comparison value for whatever you find.

Make sure you read the label closely. For some of the versions below, "serving size" is 2 capsules (a mean trick).  Therefore all the numbers for EPA or DHA that you can see on the bottle are for two capsules per day! 

  1. Cheapest: still Kirkland brand from Costco. But each only has 150 mg EPA per capsule, so that you'll need 7 capsules per day (3 with breakfast, 4 with dinner), for $.21 per day. 
  2. Fewest pills:  the Omega 3 Mood by Country Life. 

    (I have not verified that the dose claim here is for real; the concentration of the EPA is so high, I am a little skeptical) 

    There's 500 EPA/ 75 mg DHA in each pill, so it's two/day.  They come 90 softgels to a bottle for $13.29 per bottle at Swanson's; although one reader said they sell for more like $10 at country-life.com, I could not verify a price when I visited there myself. Shipping  at Swanson's is $4.95 for orders under $65, so as long as at least two bottles are purchased the price per day is less than .40  . Shipping is free on orders over $65, so orders of 5 bottles or more would bring the price down to about .30/day (may be much less if that price at Country-Life is for real). 

Testimonials 

Here are some stories people have sent that just don't sound to me as though they could be placebo responses, although with a single case, the only way to tell about that would be to go on the agent (fish oil in this case) and off it, probably several times. With fish oil that would be tricky as presumably the body supply of this stuff takes several months to pump up and probably several months to run down, so it would be mighty tough to know if something really changes as a result of starting it, or stopping it (because it won't be a sudden or rapid change, you see?) 

However, here are some stories from people who've had symptoms for years and/or tried many other solutions, none of which worked like this. 

Arthur: "For twenty years I had another problem. As the darkness of night came on, it always upset my nerves, sometimes badly. But this problem seems to have also gone. I don't know if it was the fish oil, I just hope it never comes back."

A woman with presumed "Borderline Personality Disorder": 

My diagnosis hx (20 years):

Axis I: Bipolar II, Rapid Cycling Type

Axis II: Borderline Personality D/O

Axis III: Premenstrual Dysphoria

I've never responded well to medication. I "self-medicated" for years with alcohol and drugs, and have never had an enduring stable relationship with anyone until recently. I am [around 40] years old, a master's level social worker, and, as an aside, very physically fit (exercise being another "self-medication" technique).

In addition to the above, I've tried everything to stabilize my moods, including psychotropic medications and a multitude of supplements. Over a year ago I stopped drinking and became an active member of AA. Though the fellowship has helped to reinforce my confidence in practicing new learned behavior, my mood lability, borderline and PMS symptoms, have persisted.

Four months ago, I began taking Omega-3 fatty acids (360 mg/EPA and 240 mg/DHA twice daily (after breakfast and after dinner). In this past 4 months my relationships with others have improved in ways I could not have imagined, and the emotional reactivity and instability. 

I have always experienced in response to the smallest of stressors has all but disappeared. I have thought of stopping the supplements just to prove a point, but I hate to look a gift horse in the mouth. For the first time in my life, I don't swing up and down and I am dumbfounded. 

There are times I feel like I must be a poster child for Omega 3's. I realize that I have been more conscious of my behavior and have worked to be more mindful of my emotional reactions. But I'm not convinced I could have arrived at this relatively neutral/rational emotional place without the inclusion of Omega-3's.

At my request she wrote back, giving permission for me to use this statement, and added: 

Medications tried: Lithium - 6 months (11 years ago); Zoloft, Prozac, Lexapro, Depakote (various times over past 10 years, but no one drug for more than 1 month). I'm very sensitive to drugs and too health conscious and yes, cynical, to take them. Out of the drugs mentioned, Lithium helped me the most, but had the most side effects, as I'm sure you're aware. With meds, I've not tried them long enough to make any significant observations, but I can say that in general they made me feel physically unwell.

Exercise has always been my primary mood stabilizer. On average, I have exercised 4-5 times per week for 45-90 minutes duration over the past 25 years. For me, exercise has been a quick fix for mood stabilization, but only effective temporarily, and only during the 2-3 weeks of non-PMS cycle. Compared with my response to Omega-3's, I'd have to say that exercise has had negligible impact overall (within the context of borderlne personality behavior especially), though no doubt it has been and continues to be physically beneficial and very uplifting.

The primary difference between exercise and O-3's has been the sustained mood stability, which has prompted a radical change in my behavior.

Recently, I heard that the indigenous peoples of Greenland, who eat primarily O-3 rich fish, are "even keeled" and rarely experience mood fluctuations. As soon as this information registered, it hit me that I had not experienced any real mood fluctuation in several months. I continue to be amazed.