EPA and DHA Amount?

[MSir24]

Hey everyone,

I was looking into the triglyceride form of omega 3's and was sort of unsure about the concentrations of EPA and DHA. I've read the labels of a few brands and some have equal amounts of EPA and DHA while others have a significantly higher amount of EPA than DHA. Any thoughts on which would be the most beneficial to my dry eyes and MGD? Also, has anyone had favorable results after consuming the triglyceride form instead of the ethyl ester form?

[kitty]

My healthcare provider recommended as close to 500 mg each as you can get. I find that simple cod liver oil has the max available of each, at least the brand I buy. I just buy the liquid and mix it in juice. I take about 4000mg/day.

[spmcc]

I've read the labels of a few brands and some have equal amounts of EPA and DHA while others have a significantly higher amount of EPA than DHA.

My (limited) understanding of omega 3s is that you should find one with the highest ratio of EPA to DHA. I think a lot of them are 3:2, but there are some as high as 7:1. I think that the higher ratio is supposed to be better for reducing inflammation. And my naturopath told me to take 3:2 or higher.

If someone has better info, please post!

[lulu]

EPA and DHA Amount?

Hey everyone,

I was looking into the triglyceride form of omega 3's and was sort of unsure about the concentrations of EPA and DHA. I've read the labels of a few brands and some have equal amounts of EPA and DHA while others have a significantly higher amount of EPA than DHA. Any thoughts on which would be the most beneficial to my dry eyes and MGD? Also, has anyone had favorable results after consuming the triglyceride form instead of the ethyl ester form?

My knowledge of Omega's is not that vast, however. I beleive that some research has shown it is far better to take the triglyceride form as opposed to the ethyl ester version, simply because the oil is being distilled by the use of the alcohols or ethyl's. If you take the other form you have a more "bio available" source, or in other words, your body will be able to absorb more of the available form of the omega. I did a lot of reading about this last year and to me it does seem logical. That said, the purer forms are more expensive and not always easy to get hold of, certainly not in the uk. The packaging does not always make it clear either, the price can be a indication but dont bank on it! My health food stores know absoulutely nothing about the distilling process and assume that all fish oil are equal which they are not. I know that the EEC where talking about banning the sale of ethyl ester fish oil, which comprises most of the stuff you buy in stores, but I am not sure how far that got. As for the USA I am not sure either. I know that a company "Nordic Naturals" produce only trig form so I am sure that others do in the USA, not sure where you are? I take another norwegian one as although it does not specify, those that are actually made in Norway, have to comply with the purer form. Just a clue, break some oil over a polysterene cup or packaging and if it leaks a hole through the bottom, its likely to be the ethyl form as the high alcohol content dissolves the cup! Cant remember what research that came from now but is was some paper or other.
Hope this helps.
Lulu

[abbygirl]

Hi Everyone,
I have been wondering the same thing about the quality of the various oils I have been taking. I am looking at my bottle of Nordic Naturals Ultimate Omega and it says on the bottle "Natural Triglyceride Form." I also take Barlean's Total Omege 3-6-9-in the Orange Cream flavor. I just called the company and they told me that the fish oil was also in the triglyceride form. Now I am wondering if I should be taking the 3-6-9-formulation. I do seem to notice an improvement since I added the Barleans about 2 months ago. How in the world do we know what is the right/healthy thing to take?? We need someone who can guide us on the nutritional aspects of dry eye!!

[DrGary]

Hi everybody.

Here's the down low on nutrition for dry eye and the eye in general.

There are 3 major useful forms of omega 3 fatty acids that humans need: alpha-linoleic (ALA), docosahexenoic acid (DHA), eicosopentaenoic acid (EPA). The former is found in plant sources such as flax and many nuts. It is healthy, however, the body is not efficient at using it. It needs an extra enzymatic step in its conversion. Therefore, as you guys have been saying, EPA/DHA is the more commonly omega 3 used for supplementation.

EPA/DHA naturally occur in a triglyceride form. This is a basically a structure that looks like an "E" picture the tails of the "E" as the fatty acid chains. During distillation and de-contamination, most processes necessitate the fatty acids to be freed from their glycerol backbone (the vertical part of the "E"). Cheaply made fish oil will leave them as free fatty acids (not very bio-available), but most will synthesize them into ethyl esters, as someone stated earlier. Again, these are not as bioavailable as the original triglyceride. However, now companies are realizing this and any fish oil "worth its salt" is now spending the extra money in their processing to convert them back to triglyceride units.

Fish oil capsules contain fish oil of course. You will see on the packaging how many total grams of fish oil it contains. This is relatively misleading. The standard is 1 gram of fish oil and will contain 30% combined EPA/DHA. Double strength will be close to 50-60%. The higher the proportion of EPA/DHA the better. The tradeoff: do you buy the more expensive supplement and take less or buy the cheap one and take twice as much? Well that is your economic prerogative. However, I am a firm believer in "you get what you pay for".

EPA is thought to be more active that DHA when it comes to its anti-inflammation properties. DHA is thought to be more cardio and neuroprotective as it is a major component of brain cells and the major fatty acid within the retina (neuro protective). Therefore, the relative amounts of EPA/DHA don't matter toooo much - both are highly beneficial.

With regards to the ratio of omega 3-6-9. In my view it seems odd to take a supplement that includes any omega 6, although I admit I know less about all the omega 6 FA's. BUT, in general, the American or western diet is VERY VERY high in omega 6's as is (varies but thought to be generally 20:1). It is thought that this major imbalance in omega 6: omega 3 is a major cause of many chronic illnesses and disease. Omega 6's and omega 3's utilize the SAME enzyme but end with different bi-products. The products of the omega 6's are inflammatory prostaglandins and leukotrienes, whereas the omega 3's are anti-inflammatory in nature. Therefore, by shifting the diet intake of omega 6: omega 3 to higher omega 3, much of the inflammation is alleviated. More studies and evidence is emerging that low grade inflammation and immune system activation plays a role in many diseases of the body.

With specific supplementation, you must be careful. With all the buzz around fish oil, many companies are now making some form of fish oil (most are capsules). Consumerlabs.com reports that many of the tested brands did not contain reported amounts. I am not a paying member of the site, but you can check it out and decide if you would like to buy the report yourself. I have heard from my many readings etc that nordic naturals is a good company, as well as Carlson cod liver oil.

A second thing to think about with fish oil supplements: oxidation of the fatty acids. Omega 3's contain multiple double bonds that are highly susceptible to oxidation (DHA contains 6? and EPA 5? of the top of my head). If oxidized fish oil is ingested (especially in large quantities) it actually will have the opposite effect you were hoping for. Yet another reason to make sure yours "is a good one" so to speak. Companies combat this in multiple ways during processing, handling, and shipping. Using nitrogen, vitamin E and some proprietary distillation methods I am not privy to. Make sure your supplement is handled and packaged with care. How can I tell if my fish oil supplement is oxidized? A better way to describe this is RANCID. How do I tell if my capsule is rancid if it is in a gel cap? BREAK IT OPEN and chew it. Buy knowing what pure and fresh fish oil tastes like, you should occasionally check your supplements for rancidity. Make certain to keep the cap on tight and an additional tipis to keep the capsules in the freezer, and any liquids in the fridge.

I have to get back to work. Hope this helps.

DrMatter

[shanku]

Any opinion/experience on using Lovaza (prescription fish oil), other than its cost. Thanks

[DrGary]

Shanku,

Lovaza is a prescription "drug" that basically consists of fish oil. The major difference between "supplements" and "drugs" is more to do with title and what the FDA has to say about it.

Supplements legally cannot claim that they treat, cure etc etc any diseases. Their manufacture is less regulated (hence the myriad of fish oil supplements available, many of which stated earlier do not contain the proper amounts). Drugs, on the other hand, are formulated specifically for treatment of a disease or condition. They are required to go through rigorous clinical trials, and their manufacture is highly regulated making certain that what the active ingredient in said drug is actually true.

So the basic difference is that Lovaza is used to treat hypertriglyeremia and cardiac disease, is contaminant free, and contains 85% combined EPA/DHA in 1 gram pills. Note, this is approximately THREE times more pure than the average fish oil pill. Goes without saying that it must be prescribed my a doctor.

Other forms of omega 3's are usually OK. Like I mentioned earlier, by taking some precautions with regards to which brand you choose, a non-prescription fish oil will have the same benefits.

In addition to the original question asked MSir24, which I lost time to reply to, I will try address dosing/amount. Lovaza is generally recommended for once or twice daily consumption. This would give a total of 850mg and 1700mg combined EPA/DHA, respectively. The latter is a good amount. I know there are many out there, but even some of the research and studies that use "fish oil" or "omega 3's" do not do so in a way I feel is... as scientific as it could be. Using off the shelf brands etc which brings a host of problems. However, that being said, most of the research being done, many of the dosing regimens are 1g fish oil OR 1g combined EPA/DHA. There are also plenty of studies that use "mega-doses" up and above combined 4g EPA/DHA. Since no decision shoud be based on one study alone, it does not seem prudent to only take 1 gram. The whole body of evidence suggests that there is a dose dependent response up to about 4g combined EPA/DHA. Aim for about 2 grams combined EPA/DHA. I know some physicians that advocate 1 TABLESPOON of Carlson Cod Liver oil daily with a meal. This gives a little over 2.7 g EPA/DHA. "with a meal" is very important. Lipids in the digestive track are better absorbed when food is present (and less water - use orange juice instead).

Good quality omega 3 supplementation is rarely ever contra-indicated. Warnings are given about blood thinning drugs, some blood disorders, aspirin use, and fish allergy. However, in studies, these rates are so ridiculously low (compared to most prescription drug standards) that it is deemed as very safe. As always, consult your doctor and voice any concerns.

DrMatter

[spmcc]

The LipiFlow doctors in Toronto are recommending 4000mg (i.e., 4 gms) of omega 3s per day.

Again, get the highest ratio of EPA to DHA.

Also, if you plan to have IPL, you might want to ask them if you should stop taking omega 3s before treatment. Typically, prior to IPL, they tell you to avoid aspirin etc. They also want to know if you're on any blood thinners so just mention to them that you're taking omega 3s and how much. Then they can tell you how far in advance you should stop.

[mmc51264]

I have been using Lovaza for many months now and it has helped my dry eyes immensely! I am lucky that my husband had good insurance. I only take 2g/day instead of 3 b/c it was making me feel weird. Tummy issues. i find that I have gotten enough relief to justify the cost.

[sazy123]

Interesting article about malabsorbtion, please read

http://www.healio.com/optometry/blog...-whole-picture