Not all fish oil is created equal

Written By Paria Vaziri

A comprehensive guide on what to look for when purchasing a fish oil supplement.

In the world of supplements, there’s always a lot of confusion. At the top of the list, I often find most people feeling overwhelmed and confused about fish oil which isn’t surprising because in 2023 the fish oil market size was valued at 14.9 billion USD! With lots of product on the market, this newsletter will hopefully help you weed through what you should look for (along with my favorite brands).

The first question you might be wondering is, is it even necessary to take fish oil? Before we can get to a straight-forward yes or no, we need to chat about omega 6s and omega 3s.

Omega 6 and omega 3 fatty acids are essential fats found in our diet. Omega 3 fatty acids are high in EPA & DHA whereas omega 6 fatty acids are high in AA & LA. Historically speaking, research suggests that our ancestors consumed a ratio of 1:1 omega 6 to omega 3 fatty acids. With the onset of the industrial revolution (around 140 years ago), there was a huge shift in this ratio due to the introduction of vegetable oil and higher use of cereal grains for livestock. We went from a 1:1 ratio to now somewhere between 10:1 to upwards of 25:1 (omega 6 to omega 3)!

Why is this a huge issue? Because omega 6 fatty acids increase inflammation in the body whereas omega 3 fatty acids help decrease inflammation. In a modern world rampant with metabolic diseases, autoimmune conditions, menstrual disorders, and other inflammatory diseases we need to be mindful of how this skewed ratio is impacting our health! 

What foods are high in omega 6?

  • Corn oil

  • Safflower oil

  • Cottonseed oil

  • Sunflower oil 

  • Soybean oil 

I want to note, I personally don’t think omega 6’s stemming from whole fresh foods are a problem (like good quality meats, nuts, seeds). I find the issue to be these industrialized rancid oils that we encounter in processed foods and eating out that are contributing to the massive tilt we’re seeing in the omega 6 to omega 3 ratio.

What foods are high in omega 3?

  • SMASH fish: salmon, mackerel, anchovies, herring, sardines

  • Walnuts

  • Flaxseeds

  • Chia seeds

  • Hemp seeds

  • For my non-seafood eaters, I really encourage looking into a good quality algae oil 

In cases where diet alone is difficult to get the adequate ratio of omega 3 and omega 6, adding in a fish oil can be really helpful. EPA & DHA are the two components of fish oil that we want to be paying attention to. EPA is anti-inflammatory and can help with conditions like joint pain and menstrual cramps whereas DHA is more beneficial for brain development & cognition. 

What should you be looking for when it comes to fish oil? You want to take note of:

  • Composition: aim for an EPA to DHA ratio of 2:1 with an overall daily dose of 1-2 g of omega 3s. If you are looking to support brain health, you want to look for a higher ratio of DHA to EPA instead.

  • Purity: look for companies that readily offer a copy of their Certificate of Analysis in order to examine their product for various contaminants like heavy metals, PCBs, etc.

  • Freshness: you want to ensure that your fish oil is not rancid/oxidized (which will increase inflammation instead of lower it). A great way to check is to look at the Certificate of Analysis and see that the peroxide value is less than 5 meq/kg.

  • Sustainability: make sure the company you’re supporting is sourcing fish sustainably! 

With all that said, my two favorite fish oils are Trident 66:33 by Nutritional Fundamental of Health (2:1 EPA to DHA ratio - good for inflammatory conditions) and OmegaGenics Neuro 100 by Metagenics (3:1 DHA to EPA ratio - good for brain health & mood disorders). Both these companies adhere to high standards and readily share their Certificate of Analysis. You can purchase these brands directly off my Fullscript dispensary with 20% off using this link.

You might be wondering: what about cod liver oil? I love cod liver oil and often recommend the brand Rosita to my patients. Cod liver oil is a natural source of vitamin A and vitamin D in addition to EPA and DHA. Just be mindful that EPA and DHA tends to be lower in cod liver oil than in a fish oil supplement - the full dose of 3 caps a day only provides only 417mg of omega 3 fatty acids. Cod liver oil is a good option for someone who already has a higher omega 3 to omega 6 diet but is looking for an extra boost alongside naturally occurring vitamin A & D.

Paria Vaziri
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