🐟
Fish Oil 
Quick Reference 🌢
Contents
⇩ Overall context for this topic
⇩ General information
⇩ Program target
⇩ Cautions
⇩ Supplement considerations
⇩ Product suggestions
⇩ Testing considerations
Page edition: 2024-04-14
⟲
Context
Omega 3 DHA and EPA, almost always from
fish oil, is a core program supplement.
Unless you consume ancestral amounts and
forms of wild-caught seafood and/or game
organs, your Omega 3 levels,
of these particular fatty acids, are
very likely suboptimal.
There are at least 11 Omega 3 (ω3)
fatty acids found in nature. Of these, only
three are significant food-sources of Omega 3s:
DHA: Docosahexaenoic acid
EPA: Eicosapentaenoic acid
ALA: alpha-Linolenic acid⇱ Return to ToC
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General Information
The need for DHA and EPA from fish oil has
been part of the program, going back two decades, and is extensively discussed
in all the books and program materials:
🖵🗏
Physiological Benefits of Omega-3s (members)
🖵🗏
What If You Don’t Like Fish Oil? (members)
📖
Super Gut:
starting page 188 of the U.S. print edition
📖
Wheat Belly R&E (2019):
starting page 252 of the U.S. print edition
📖
Undoctored:
starting page 287 of the U.S. print edition
📖
Wheat Belly 10-Day Grain Detox:
starting page 73 of the U.S. print edition
🅑
WBB: Some unexpected benefits of
omega-3 fatty acids (public)
🅑
WBB: Are you consuming enough
omega-3 fatty acids? (public)
The "fish oil" nomenclature is no accident.
The principal (economic) source of DHA and
EPA is from fish. Ancestrally, eating enough
seafood to meet ω3 needs sufficed.
Modern ocean toxins make that unwise.
Ancestrally, humans could also have gotten
these ω3s from game organ meats (and
game brains), but modern humans, eschew
those sources, some of which are now risky as well.
ALA is widely available from plant sources,
and humans do convert a small percentage of
it to DHA and EPA, but not enough, and consuming
excess ALA reportedly drives conversion down
(and may have independent health risks). There
is generally no need to supplement ALA.⇱ Return to ToC
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Program Fish Oil Targets
⟲
Intake targets:
Generally: 3000 to 3600 mg/day of DHA+EPA
With elevated Lp(a): 6000 mg/day
High seafood intake: adjust supplementation per
⇩test results
Divide the daily amount into 2 or 3 doses.
This is milligrams of DHA plus EPA
(combined, not each, and also not
the total amount of fish oil, which will be
higher). The ratio of DHA:EPA may be anywhere
between 1:2 and 2:1, or put another way, make
sure you get the total, and at least
1000 mg of each. For comparison, this is
about how much fish oil is present in
3 small cans of sardines.
⟲
Titer targets:
The actual DHA+EPA goal is for blood
levels of Omega 3 to be
10% of fatty acids, and for
Omega 6 levels to be no more than
twice that. See ⇩Testing
considerations below for further information.
Because an Omega 3 titer is the real goal, it
can be achieved by some combination of food and
fish oil supplementation. The challenge is the
hazards in modern food sources.
Non-coincidentally, the program’s standard
dose of DHA+EPA is in the same range as for the 🅑preposterous
prescription forms of fish oil (Lovaza®,
Omacor®, Omtryg™ and Vascepa®).
For anyone avoiding fish for any reason,
DHA and EPA are available from processing of
marine algae (the same place the fish get it),
and, from time to time, via industrial
fermentation. These sources, although often
costly, and obviously not ancestral, can meet
program requirements.
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Dose timing
Split the daily fish oil dose into two
or three portions, taken across the day. If
taking part of that as a fish oil+Vitamin D,
take the +D₃ variant in the morning.
“Fish oil is
best taken before breakfast and before dinner
to take advantage of its postprandial
lipoprotein-clearing effect.”
Store fish oil in a cool location out
of direct sun exposure. Fish oil can be
refrigerated or frozen to extend shelf life.
Capsules may be consumed while still frozen.
Take fish oil while fasting?
That depends on the reason for the fast.
Fish oil is 3.6 grams of fat, or
32 calories. Being a fat, however,
it would be no threat to ketosis, if
that’s the intent.⇱ Return to ToC
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Cautions
⟲
On a statin?
There is an interference between statin
drugs and fish oil benefits. Dr. Davis
wrote about this in a 2013 (then TYP) Blog post:
🅑Are
statins and omega-3s incompatible?
In addition to the paper linked there, here’s a later one:
NMCD: Intake
of polyunsaturated fat in relation to
mortality among statin users and non-users
in the Southern Community Cohort Study
⟲
Fish Allergy?
Anyone with an unresolved fish allergy,
or anaphylactic reaction to fish or shellfish,
needs to approach fish oil carefully. In that
situation, using a vegetarian source of
DHA+EPA might be the interim solution, but
current vegetarian sources of DHA+EPA tend to
be at least twice the price of fish oil, and
many of them have disqualifying ingredients.⇱ Return to ToC
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Supplement considerations
⟲
Blood thinning speculations
Site members are directed to this
remark by Dr. Davis from 2022:
“ The omega-3
fatty acids in fish oil normalize blood
thinning, a big difference. For instance,
it reduces high levels of fibrinogen that
promote blood clotting: normalization of
clotting, not blood thinning.
The only contribution omega-3s make
towards blood thinning is to reduce
excessive platelet activation that may
slightly prolong bleeding time, rarely
a clinically meaningful effect.”
⟲
Mega-dose fish oil?
Nothing in the program today suggests
consuming more than 6 grams per day.
Much higher doses are being used experimentally
in certain situations, such as TBI,
but chronic uses of mega-doses are basically
unexplored territory.
⟲
Supplement form
Gelcaps or bottled liquid oil are suggested.
With capsules, generally seek the highest potency per
capsule (not necessarily per
“serving”), to keep the capsule
count manageable. Favor the triglyceride form
of fish oil over the ethyl ester form,
depending on other priorities. Be cautious
about products containing anything other than
fish oil, and seek grain-free encapsulation.
Added ⇩vitamin D can be valuable, but mind
the IUs.⇱ Return to ToC
⟲
Product suggestions
This is not an exhaustive list. Other available products
may be satisfactory. Typical price for ~3300 mg/day
is shown for rough price comparisons,
using brand MSRP. Lower prices may be found at credible
resellers, and via subscription purchase.
Some general selection principles are
discussed below the list. Buy only from credible sources,
which today often ⚠excludes
on-line ‘marketplace’ sites.
⟲
Triglyceride forms
Carlson®
Maximum
Omega 2000 (soft gels)
DHA+EPA 875 mg/cap,
4/day = 3500 mg,
US$2.07/day
The
Very Finest Fish Oil (soft gels)
DHA+EPA 300 mg/cap,
11/day = 3300 mg,
US$2.45/day
The
Very Finest Fish Oil™ (500mL liquid)
DHA+EPA 260 mg per mL,
13 mL/day = 3380 mg,
US$1.43/day
Nature’s Way {formerly Ascenta}
NutraSea®
Omega-3 (500 mL liquid)
DHA+EPA 250 mg per mL,
13 ml day = 3250 mg/day,
US$1.56/day
Nordic Naturals®
Ultimate
Omega (soft gels)
DHA+EPA 550 mg/cap,
6/day = 3300 mg,
US$2.32/day
Ultimate
Omega (237mL liquid)
DHA+EPA 494 mg per mL,
7 mL/day = 3458 mg,
US$2.30/day
Barleen’s
Ideal
Omega® 3 Softgels - Orange Flavor
DHA+EPA 1000 mg per capsule,
3/day = 3000 mg,
US$2.50/day
innovixlabs:
Triple
Strength Omega-3 (soft gels)
DHA+EPA 840 mg/cap,
4/day = 3360 mg,
US$1.00/day
Kirkland Signature (Costco)
Kirkland
Signature Fish Oil 1000 mg., 400 Softgels
DHA+EPA: 250 mg per cap,
13 caps/day = 3250 mg,
US72¢/day
Natural Factors
RxOmega-3
Ultra Strength 2,150 mg
DHA+EPA 1015 mg per cap,
3 caps/day = 3045 mg,
US$3.40/day
Sam’s Club Member’s Mark:
Triple Strength Fish Oil Softgels, 150 ct.
DHA+EPA: 900 mg/cap,
4/day = 3600 mg,
UA53¢/day
Beyond those products, you may want to rely on
third party product evaluations. Subscription
site ConsumerLab
tests fish oil periodically. Industry site IFOS™
has open-access test data available, but doesn’t
really rate products, and only reports on
member products.
When checking product economy, be sure to
assess only the DHA+EPA content, and how
many capsules (or mL) are required to deliver
the label ‘portion’ amount (as
it is often 2 or more capsules, and often
only 5mL for liquid). Program amounts will
be much higher.
Avoid krill-based products on economy grounds
(just run the numbers some time). Avoid cod
liver oil due to marine toxins (Hg, PCBs), and
excess vitamin A at program intake levels.
Fish oil incidentally includes fatty acids other
than DHA and EPA, but avoid anything that is
mostly ALA (such as added flaxseed oil). Avoid
anything with added Omega 6 (adverse). If
the package touts Omega 6, that’s a
warning label. Avoid anything with added
Omega 9 (needless).
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Fish Oil with Vitamin D
Several brands of fish oil are available with
Vitamin D. This can be a way to take most,
or even all of the day’s 
Vitamin D₃
Here’s an example product:
Sam’s Club Member’s Mark
600mg
Omega-3 from Fish Oil with 50 mcg
Vitamin D3 Softgels, 200 ct.
DHA+EPA 540 mg
D₃ 2000 IU (50 µg)
per capsule
This product can’t typically be used as the
sole source of fish oil, as that would be
11,000 IU of D₃ per day. Perhaps
1-3 of these in the AM, and the balance
as the Triple Strength product could work. Run
these numbers for any fish oil with/D₃, as other
brands can present the same issue.⇱ Return to ToC
⟲
Testing considerations
If in doubt about fatty acid status, or
needing to dial-in supplementation due to high
seafood intake, two tests can be useful. These
are the most accurate when weight has been stable
for 30 days or more. If you are losing weight,
that includes a lot of stored fat — fat
which may represent prior diet (and is apt to be
low in ω3 and high in ω6).
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Test details
If these tests aren’t routinely covered by
your carrier (and they often aren’t), it’s
often cheaper to obtain them on your own,
nanny state permitting, from a mail-order or
walk-in lab, perhaps via a ⌬Omega-3 Index Plus Finger Stick
Test (LC100065, US$79-105) or ⌬Omega-3
Index Complete Finger Stick Test
(LC100066, US$79-105).
⟲
Test day considerations
Fasting status: Avoid fish
oil 12 hours before test.
Other supplements/meds:
may be taken before or after draw
Time of day for test:
anytime
Re-Test timing: wait
3-4 months⇱ Return to ToC
