February 18th, 2010
02:17 PM ET

How do I pick a fish oil supplement?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Stanley in New Jersey:

“With all the different information available on the Web, how does one determine what to look for in a fish oil supplement?


Stanley, I’m glad you’re being proactive about your health and considering fish oil. It’s actually one of the few vitamins and supplements I take and there’s plenty of scientific evidence to show it can be a powerful tool in preventing disease. Fish oil supplements contain omega-3 fatty acids, which have been shown to reduce a person’s risk of heart attack and heart disease and protect against stroke, dementia and other cognitive problems.

The American Heart Association even recommends that people with high triglyceride levels take 2 to 4 grams of fish oil supplements containing EPA & DHA. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two fatty acids in fish oil thought to have the biggest benefits.

However, before taking any supplement you should speak with your health care provider. In the case of fish oil supplements, the FDA warns not to take more than 2 grams of fish oil per day. If you take high doses there can be side effects such as excessive bleeding or possibly an interaction with another medication you’re taking.

To get specifics on what you should look for when choosing your supplement I asked Dr. Brent Bauer. He’s the director of the complementary and integrative medicine program at the Mayo Clinic. He said he recommends three things to his patients:
No. 1 Go big. Look for large manufacturers, which will most likely have been in the business longer and are not a “fly-by-night” outfit you might solely on the Internet.
No. 2 Look for the seal. Companies including USP and NSF analyze supplements for the real vitamin level and for any impurities. The seal on the label tells you an independent company has reviewed the supplement.
No. 3 Check them out. There are groups that offer independent reports (for a fee) of different brands on the market.

I should also add that all the experts I’ve talked to say, if possible, it’s better to get your omega-3s from fatty fish such as salmon and tuna rather than from a supplement.

soundoff (39 Responses)
  1. M. McIntyre

    People keep saying that it's better to eat fish than use a supplement, but I find it hard to balance that advice with the warnings about mercury levels. Is it really safe to eat that much salmon or tuna?

    And how do we know that the supplements themselves are uncontaminated? The manufacturer of my supplements assures me that the fish they use are safe, but there's really no way to be sure.

    I would love a follow-up answer that addresses these issues. BTW, I keep CNN Health as my homepage so that I can check your advice every day. Thanks!

    February 21, 2010 at 12:38 | Report abuse | Reply
  2. Von Wenzel

    M.Mcintyre – neither salmon nor tuna are exceptionally high in mercury levels, and salmon (which is a cold water fish) is actually very low in mercury. Tuna is not a fatty fish, so eat it because it's delicious, but not for the fatty oils. Salmon is fatty, high in Omega 3s, and again, very low in Mercury levels.

    February 22, 2010 at 22:53 | Report abuse | Reply
  3. Dr Bill Toth

    For those who may not know what USP or NSF mean, here's the links;



    These are good starting points...and when you consult your or A healthcare provider – make certain they're knowledgable about nutrition.
    Finally – each of us is an experiment of one...so just because the label says it's the latest and greatest – each of us responds uniquely.

    Live With Intention,

    February 26, 2010 at 08:35 | Report abuse | Reply
  4. Matt

    With all do respect Mr. Gupta, your reply to Stanley's answer is very inadequate. "Go big", "Look for the seal," and "Check them out," is the best advice you can given when shopping around for the best fish oil supplement?

    Fish oil supplements all have different EPA and DHA levels (The two fatty acids by your admission are the most important). What you should be pointing out to readers is how to read a label on the back of fish oil supplements and what to look for on the label. For example, how much EPA and DHA should a good fish oil supplement contain? If I purchase 1200 mg capsules, and each capsule only contains 200 mg of EPA and DHA, that means only 16.6% of the capsule contains EPA and DHA. What would a reasonable percentage of EPA and DHA in a fish oil capsule be? More importantly, what would be a healthy amount of EPA and DHA for an individual to consume on a daily basis? This is probably the single most important questions that need to be answered.

    These are the facts that are important in choosing a fish oil supplement. On the other hand, I could ignore this important information and just "go big." Doing that would ensure I am getting the proper EPA and DHA levels.

    February 26, 2010 at 09:15 | Report abuse | Reply
  5. alfredoe

    Hi All. If you are going to start supplementing with fish oil, it is important to remember 2 things. First, you need a minimum dosage at a certain frequency in order to get the fish oil benefits. This dosage is 3.000 mg of fish oil per day(close to 900 mg of omega 3 fats, EPA plus DHA, from the label).

    You also need to lower the ingestion of omega 6 fats (grains and grain oils) as you raise your omega 3 fats. Otherwise you won't get the benefits of fish oil.

    Read more at http://www.omega-3-fish-oil-wonders.com/fish-oil-benefits.html

    Best wishes,

    February 27, 2010 at 15:41 | Report abuse | Reply
  6. Logo

    Hello, Dr Gupta,


    This is not a commetory, but rather a questions about a supplement product called Thera-M – 130 CAPLETS. I bought this product at a local shop. I don't have any health care adviser at the moment.

    1. Is this product a viable supplement?

    2. Why do I suffer from stomach uppsets after taking a dose?

    3. Should I discontinue its usage?

    I am in my early 30s, work at a local school, and think I do not eat sufficient nutritive foods.

    Kindly reply through my e-mail: logo_zisuh@yahoo.ca



    April 1, 2010 at 20:35 | Report abuse | Reply
  7. Aaron Bolesta

    Yes I think getting the omegas from the fish itself is preferred, but some of our waters are testing pretty high in toxins. I would suggest looking to see if the omega 3 oil is from a concentrate or not. If trying to keep it as natural as possible, avoiding concentrated oils seem to make sense.

    I have found Carlson's brand to be a good "big" brand that passes all the safety tests. I've used it personally and with some of my patients with good results. Some more info is provided at http://www.true-healthy-foods.com/fish-oil-supplements.html

    Good luck,

    April 21, 2010 at 19:17 | Report abuse | Reply
  8. Ryan Jones

    I must mention one issue that should be taken into consideration when supplementing with fish oils, currently it's not a requirement to publish the levels of PCBs and heavy metals such as mercury in fish oil supplements. I think this should be a requirement as it can affect people's health and oversupplementation with supplements containing high levels of these could be dangerous.

    It has been shown in studies that there can be a variance of as much as 50x the levels between different supplement brands, this is something that people should do their own research into though, a good starting point would be http://www.fishoils.org.uk which has some information on the effects of these.

    All the best,

    May 8, 2010 at 07:42 | Report abuse | Reply
  9. Ethan Thompson

    I am just concerned about the main source of Omega 3 which is the liver of fish. as you can see, fishes can accumulate mercury and pcb. `."

    May 18, 2010 at 13:06 | Report abuse | Reply
    • Lisa Morgan

      That's why some people prefer krill oil over fish oil it is really important to have a certain knowledge about the supplements you are planning to take especially these days wherein numerous of supplements are available but only few of them actually work check out this article about fish oil vs krill oil http://krilloil.com/fish-oil-vs-krill-oil.html to give you more idea about this supplements.

      January 14, 2011 at 04:06 | Report abuse |
  10. Isaac Harrison

    Omega 3 oil can really help your heart and arteries so take a sip of it regularly.;-'

    July 26, 2010 at 23:50 | Report abuse | Reply
  11. Marshall Sontag

    I maintain at blog about fish oil, and have become an expert on fish oil supplements. In my view, choosing a fish oil supplement comes down to 5 factors:

    1. Purity – How pure, or free of toxins, is the fish oil supplement? Many brands claim purity, but there's no regulation of this claim. I only recommend supplements from the third-party International Fish Oil Standards (IFOS) testing program.

    2. Potency – What's the concentration of omega-3 for gram of fish oil? Most high quality fish oil supplements will be 55% or higher. But some are as low as 10%! Cod liver oil, while marketable, is a very low-potency source of omega-3s.

    3. Bioavailability – Is the fish oil Triglyceride-based, or Ethyl Ester? Fish oil in nature appears as a triglyceride. This is how our bodies are designed to absorb them. When a fish oil undergoes molecular distillation, it turns into an Ethyl Ester. Studies show the absorption of EE fish oils are impaired over TG fish oils, and yet this is the form of most fish oils in the US! This makes them illegal in Canada, UK, Norway and Denmark! You can convert EE oils back into TG, but most supplement companies in the US don't because it adds about 30% to the cost.

    4. Sustainability – Does the manufacturer of the fish oil supplement avoid overfishing? This is particularly a problem with Krill Oil, as krill are severely being overfished.

    5. Freshness – Has the supplement been tested and certified for oxidation? A fish oil should never smell fishy. If it does, throw it out! This means the oils have gone rancid.

    You can read more at my website if you'd like: http://www.goodfishoil.net/

    July 27, 2010 at 19:36 | Report abuse | Reply
  12. Kaitlyn Rogers

    omega3 really helps in preventing clogged arteries and cardiovascular diseases',`

    September 12, 2010 at 22:49 | Report abuse | Reply
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    December 20, 2010 at 14:33 | Report abuse | Reply
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    January 5, 2012 at 02:16 | Report abuse | Reply
  16. Sunny

    is it 2 gram fish oil or 2 gram of Omega-3? as fish oil typically conatins 1200 mg of fish oil and 360mg of omega-3. Please suggest.

    March 21, 2012 at 14:53 | Report abuse | Reply
  17. Sunny

    correcting my self, as fish oil capsule typically conatins 1200 mg of fish oil and 360mg of omega-3.

    March 21, 2012 at 14:54 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.