Many adults and children take one or more supplements which contain different amounts of vitamin, mineral as well as herbs and enzymes. Supplements can come in a variety type of forms, such as tablets, capsules, liquid, powder and even gummies. Supplements can help to improve overall health especially if the consumption of various foods is insufficient in providing us the nutrients that we need. Most commonly consumed supplements include Vitamin C, Multivitamins, Calcium and Fish oil supplements. 

What are fish oils? 

Fish oils come from fatty or oily fishes such as salmon, trout, tuna and sardines. Fish oils contain two omega-3 fatty acids namely docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Both EPA and DHA are needed for many functions, ranging from muscle activities to cell growth. As omega-3 fatty acids cannot be synthesized by our body, we need to get these healthy fats via dietary consumption or through omega-3 supplements.  

Benefits of fish oil and how much should I take 

Many people take omega-3 supplements as part of their heart-healthy diet. In fact,the American Heart Associated (AHA) recommends the consumption of 2 servings of fatty fish that are high in omega-3 fatty acids twice a week. Research carried out on the use of fish oils in different health condition shows: 

• Prevention of heart disease. Multiple randomized controlled trial have shown that fish oil plays a role in the secondary prevention of heart disease among patients at high risk of cardiovascular disease (CVD), those with prevalent coronary heart disease (CHD) and those with diabetes and pre-diabetes. For the general healthy adult population, taking 500mg of omega-3 fatty acids per day can help to lower the risk of heart disease. AHA also recommends patient with documented coronary heart disease to consume omega-3 fatty acids approximately 1g per day of both EPA and DHA. 
• Management of Hypertriglyceridemia. Omega-3 fatty acids have shown to reduce blood triglycerides level. A slight improvement in the levels of high-density lipoprotein (HDL) can be seen as well. The recommended dosage for reducing triglycerides in patients with elevated triglycerides levels is at 2-4g per day.  
• Rheumatoid arthritis. The anti-inflammatory properties of omega-3 fatty acids have shown that it can help in reducing pain and joint tenderness in people with rheumatoid arthritis (RA). Studies recommended an intake of 2.7g per day to achieve anti-inflammatory effect on patients with RA. 
• Management of high blood pressure. Taking omega-3 supplements slightly reduce the systolic and diastolic blood pressure, and the beneficial effect might be slightly greater in those with moderate to severe high blood pressure.  

What Supplements can be taken with Fish Oil 

Generally, fish oil can be taken with most supplements. These are a few supplements that may complement the benefit of fish oil when taken together: 

• Vitamin D. Vitamin D is known to help regulate the amount of Calcium and Phosphate in our body. Vitamin D receptors are also found in most human cells and tissue. Vitamin D deficiency has been associated with various cardiovascular risk factors. Taking Vitamin D supplements or a combination of Vitamin D and omega-3 supplements might play a synergistic role in cardiovascular health. 
• Vitamin E. Vitamin E is a fat soluble antioxidant vitamin known to play many roles in protecting cells from the damaging effects of free radicals in different health conditions. Studies have shown that Vitamin E prevents low-density lipoprotein (LDL) oxidation, which suggests that it might prevent plague formation in our blood vessels. This lowers our risk of coronary heart disease. 
• Cod liver oil. Cod liver oil comes from the livers of cod, and it is a good source of fat soluble vitamins such as Vitamin A and Vitamin D. These vitamins are essential for the maintenance of good health. It also contains omega-3 fatty acids but the amount is lesser than those found in regular fish oils. .  
• Multivitamins. Multivitamin supplements contain various vitamins and minerals that help to fill the nutritional gaps when we do not obtain these nutrients sufficiently from food. Besides basic vitamin and mineral needs, we need to include healthy fats in our diet as well. Not all multivitamins provide a source of healthy fats and this is where fish oil supplement comes in. Taking both multivitamin and fish oil together can complement our diet. 

Safety of Fish Oil 

Consuming fatty fishes is another way of sourcing omega-3 fatty acids besides taking fish oil supplements. While it is safe to consume fish in general, many are actually most concerned about the toxic chemicals especially mercury content in these species of fish. All fish naturally contains traces of mercury with larger species having higher concentration. Good quality fish oil capsule that are molecularly distilled can help to remove potential harmful levels of contaminants such as mercury, heavy metals, PCB’s, dioxins and other contaminants. 

When taken as recommended, fish oils are generally safe. Some mild side effects of taking fish oils may include: 

• Heartburn 
• Nausea 
• Loose stools 
• Fishy breath 

Just like any other supplements, we should take the amount of omega-3 fatty acids in moderation that is required by our body. The AHA recommends that taking up to 3g per day of fish oil supplements is considered safe. Taking high doses of fish oil supplements might increase the risk of bleeding. Always seek medical advice before taking any supplements for your health. 

Reference

1. Fish oil supplements: do they have a role in the management of rheumatoid arthritis? (n.d.). NPS MedicineWise. Retrieved February 16, 2022, from https://www.nps.org.au/news/fish-oil-supplements-do-they-have-a-role-in-the-management-of-rheumatoid-arthritis#:%7E:text=If%20you%20have%20rheumatoid%20arthritis,include%20nausea%20and%20a%20rash 
2. American Heart Association | To be a relentless force for a world of longer, healthier lives. (n.d.). Www.Heart.Org. Retrieved February 14, 2022, from https://www.heart.org/ 
3. Saremi, Adonis; Arora, Rohit (2010). Vitamin E and Cardiovascular Disease. American Journal of Therapeutics, 17(3), e56–e65. doi:10.1097/MJT.0b013e31819cdc9a
   MediLexicon International. (n.d.). Cod Liver Oil: Health benefits, Facts and Research. Medical News Today. Retrieved February 14, 2022, from https://www.medicalnewstoday.com/articles/270071#benefits