Fish oil is rich in fatty acids and omega-3s. Besides supporting the brain, eyes, and heart, fish oil can also fight inflammation. Healthcare professionals recommend taking it daily, but it's important to ensure proper dosage and timing. Consuming too much fish oil can harm your health and lead to side effects such as high blood sugar and increased risk of bleeding.
1. Why should we supplement with fish oil?
Omega-3 fatty acids have many health benefits.
The best way to get omega-3 fatty acids is to eat fatty fish at least twice a week, but if you don't eat fatty fish regularly or are allergic to fish, 1 you should consider taking fish oil supplements.
It is important to ensure that you get enough EPA and DHA. These are the most beneficial types of omega-3 fatty acids and are found in fish and algae.
2. How to take fish oil correctly?
There are no specific recommendations for the amount of fish oil you should take. However, there are recommendations for the total amount of omega-3, as well as EPA and DHA.
Although recommendations may vary, most health organizations recommend at least 250 milligrams of combined EPA and DHA - the two essential forms of omega-3 fatty acids - per day.
According to the European Food Safety Authority, omega-3 fatty acid supplements can be safely consumed 1 at doses up to 5,000 mg per day.
When buying fish oil, remember to read the instructions on the label to determine the amount of EPA and DHA provided. Typically, 1,000 mg of fish oil provides about 300 mg of combined EPA and DHA.
Most people get some omega-3 in their diet from foods like flaxseed, soybean oil, and walnuts - but these contain ALA.
Although your body can convert ALA to EPA and DHA, you may not produce adequate levels of these fatty acids on your own. Unless you're eating about two servings (8 ounces or 224 grams) of oily fish 2 each week, you may be deficient in EPA and DHA.
In general, up to 3,000 mg of fish oil per day is considered safe for adults to consume.
For certain individuals, taking fish oil correctly can provide the following benefits:
For patients with heart disease
A study following 11,000 people who took a combined dose of 850mg of EPA and DHA daily for 3.5 years showed a 25% reduction in heart attacks and a 45% reduction in sudden death.
The American Heart Association, along with several other organizations, recommends that people with coronary heart disease take 1,000 mg of combined EPA and DHA daily, while those with high triglycerides need 200-2,200 mg daily.
For patients with depression and anxiety
Studies have shown that high doses of omega-3, ranging from 200 to 2,200 mg per day, can reduce symptoms of depression and anxiety. In cases of mood and mental disorders, supplementing with higher amounts of EPA than DHA may be optimal.
For cancer patients
Consuming high amounts of omega-3 fatty acids has been linked to a reduced risk of breast, prostate, and colorectal cancer. However, the correlation is not necessarily causal. Further research is needed to confirm whether the amount of omega-3 fatty acids in the body affects the risk of cancer.
For children and pregnant women
Research has shown that omega-3 fatty acids, especially DHA, are very important before, during, and after pregnancy. Almost all official guidelines recommend supplementing with 200 mg of DHA during pregnancy and breastfeeding in addition to your regular intake. Some global and national organizations have published guidelines for supplementing 50-100 mg per day of combined EPA and DHA for infants and children.
3. Potential Side Effects of Excessive Fish Oil Consumption
While fish oil has been shown to reduce blood triglycerides, decrease inflammation, and even alleviate symptoms of conditions like rheumatoid arthritis, consuming excessive amounts can actually do more harm than good.
Here are 8 potential side effects that may occur when you consume too much fish oil or omega-3 fatty acids:
Elevated Blood Sugar:
Some studies suggest that high doses of omega-3 fatty acids may increase blood sugar levels in people with diabetes. For instance, a small study found that taking 8 grams of omega-3 fatty acids daily led to a 22% increase in blood sugar levels in people with type 2 diabetes over an 8-week period. This is because high doses of omega-3s may stimulate glucose production, which can contribute to long-term high blood sugar levels.
However, other research has yielded conflicting results, suggesting that only very high doses affect blood sugar levels. In fact, another analysis of 20 studies found that daily doses of up to 3.9 grams of EPA and 3.7 grams of DHA – the two main types of omega-3 fatty acids – had no effect on blood sugar levels in people with type 2 diabetes.
Bleeding
Bleeding gums and nosebleeds are two of the hallmark side effects of consuming excessive fish oil. A study in 56 people found that supplementing with 640 mg of fish oil daily for four weeks reduced blood clotting in healthy adults. Additionally, another small study found that taking fish oil may be associated with a higher risk of nosebleeds, reporting that 72% of adolescents taking 1 to 5 grams of fish oil daily experienced nosebleeds as a side effect.
For this reason, it’s often recommended to stop taking fish oil before surgery and to talk to your doctor before taking the supplement if you’re on blood-thinning medications such as Warfarin.
Low Blood Pressure
The blood pressure-lowering potential of fish oil has also been documented. A study in 90 people on dialysis found that taking 3 grams of omega-3 fatty acids daily significantly reduced both systolic and diastolic blood pressure compared to a placebo.
Similarly, an analysis of 31 studies concluded that taking fish oil can effectively lower blood pressure, particularly in people with high blood pressure or high cholesterol levels.
Diarrhea
Diarrhea is one of the most common side effects associated with taking fish oil, and it can be particularly prevalent at high doses. In fact, one report assessed that diarrhea is one of the most common side effects of fish oil, alongside other digestive symptoms such as bloating.
Acid Reflux
Although fish oil is known for its powerful effects on heart health, many people report experiencing heartburn after starting fish oil supplements. Other acid reflux symptoms – including belching, nausea, and stomach upset – are common side effects of fish oil largely due to its high fat content.
Stroke
Hemorrhagic stroke is a condition characterized by bleeding in the brain, often caused by the rupture of weakened blood vessels. Some animal studies have found that high amounts of omega-3 fatty acids may reduce the blood’s clotting ability and increase the risk of hemorrhagic stroke. These findings are also consistent with other research suggesting that fish oil may inhibit clot formation.
However, other studies have yielded mixed results, reporting no association between fish and fish oil intake and the risk of hemorrhagic stroke. Further human studies should be conducted to determine how omega-3 fatty acids may affect the risk of hemorrhagic stroke.
Vitamin A Toxicity
Some types of omega-3 fatty acid supplements are high in vitamin A, which can be toxic if consumed in large amounts. For example, just one tablespoon (14 grams) of cod liver oil can provide up to 270% of your daily requirement for vitamin A in a single serving.
Vitamin A toxicity can cause side effects such as dizziness, nausea, joint pain, and skin irritation. In the long term, it can also lead to liver damage and even liver failure in severe cases. For this reason, it’s best to pay attention to the vitamin A content in your omega-3 supplements and keep your dosage moderate.
Insomnia
Some studies have found that taking fish oil in moderate doses may improve sleep quality. For instance, a study of 395 children found that taking 600 mg of omega-3 fatty acids daily for 16 weeks improved sleep quality. However, in some cases, taking too much fish oil can actually interfere with sleep and contribute to insomnia.
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