I’m not asking for medical advice, just trying to understand this.
For years, I’ve been taking non-prescription Omega-3 fish oil capsules to help lower my triglycerides. I’ve been taking four capsules per day. According to the label, each capsule contains:
Fish Oil 1,000 mg
EPA (Eicosapentaenoic Acid)
DHA (Docosahexaenoic Acid)
Total Omega-3 Fatty Acids 300 mg
That’s exactly the way it’s written on the label. It doesn’t say how much EPA vs. DHA.
Now my doctor is replacing these capsules with a more potent (and expensive) prescription medication called Lovaza, also four capsules per day. According to this site,
“Each 1-gram capsule of LOVAZA contains at least 900 mg of the ethyl esters of omega-3 fatty acids sourced from fish oils. These are predominantly a combination of ethyl esters of eicosapentaenoic acid (EPA - approximately 465 mg) and docosahexaenoic acid (DHA - approximately 375 mg).
It looks like four fish oil capsules are giving me 1,200 mg of Omega-3 per day, while four Lovaza capsules add up to 3,360 mg per day.
My question is: What is the advantage in taking four Lovaza capsules per day, as opposed to 11 (or 12) fish oil capsules per day? Cost is not a factor for me (ironically, my insurance is covering the Lovaza, but not the fish oil, so it’s cheaper for me to get the Rx).
I am not a doctor, but I did look this up recently. I think that I have this correct.
Regular fish oil contains a large amount of alpha-linolenic acid. In fact, I think the majority of the omega-3’s in the OTC pills is basically that fatty acid. Within the body some of this fatty acid is converted to omega-6 fatty acids, which can be bad because of the inflammatory response the omega-6 acids set up in the cardiovascular system.
The two omega-3 fatty acids with which Lovaza has been enriched have anti-inflammatory properties within the CV system. They are basically what you were taking the regular fish oil to get.
Lovaza is supposed to work better than plain fish oil because you do not have the deleterious affects from the excess of alpha-linolenic acid.
There have also been at least a few studies that say that the OTC supplements often don’t actually have what they claim.
I know that I recentlyh bought some Omega3 pills that’re supposed to be flax oil - but they give me exactly the same fishy burps that the fish-oil pills do. :dubious:
I am sorry if this comes off snarky, but, no, you do not.
ALA is not in fish oil, it comes primarily from vegatable sources, and is thought to also have cardioprotective effects (although the data is nowhere near as good as it is for fish oil).
Don’t trust your tastebuds too much with that, the same ester in different concentrations tastes like bananas and like pears; there’s several oils which are present in both fish oil and flax oil and it may be that those happen to dominate for you.
I recently started Lovaza and it has provided a significant improvement. I am a fan. That said, OTC capsules probably do the same thing. However I have found that the side effects-primarily in my case the fish smell aftereffects, are noticably reduced with Lovaza. To me, Lovaza has two advantages-more highly refined and hence fewer side effects, and the company put the money into the FDA studies to prove it works. My numbers show it certainly does work and I am all in favor of the prescription.
I have been taking Omega 3 capsules for about one month, four capsules per day, two in the morning, and two in the evening. They came from Sam’s Club, brand is Member’s Mark. UPC Code is 787421022902. They are “enteric coated” for no after taste.
This morning, after a bowel movement, I stood up and turned to flush the toilet. To my surprise, there were two complete Omega 3 capsules floating in the water. They had not dissolved. It looks as though they have been “passing through”! I suggest that these capsules be avoided.
You have to get a quality fish oil supplement. I get the Nordic Naturals liquid (lemon flavor only!) and my wife takes the gel caps. I have zero afertaste with the liquid and my wife fish and does not complain about a fishy after taste which is one of the ways you can make sure it’s a high quality fish oil.
For all the cheap fish oils you have to worry about:
If you are getting what they claim and
Which is very tricky of those companies, that you shouldn’t care about how much fish oil your are getting but how much omega 3. Costco brand claims 1000 mg of fish oil, but if you look at how much omega 3 it’s only like 300 mgs. In contrast, my Nordic Naturals liquid gets 1700 mgs per teaspoon.
So, you must look at total omega 3 and NOT how much fish oil they advertise.
But to answer the original question, if you are getting over 3000 mgs and your insurance is paying for it then theres no reason to switch. But if your insurance is not paying for it two teaspoons of the Nordic Naturals will get you 3400 mgs for about 30 dollars a month.
According to my pharmacist ( PhD pharmacist at my hospital, not the guy working the counter at Walgreens ), in order to lower triglycerides specifically you should be shooting for ~3,000 mg of EPA + DHA a day. He said OTC is perfectly fine as long as you carefully peruse the labels to make sure that the dosage adds up to roughly that amount. However you have to be aware of several potential dodges:
1.) EPA and DHA are not the only Omega-3 fatty acids. ALA may have its uses, but not so much for triglycerides - it does convert to EPA and DHA in the body, but only at a very low rate. So a bottle that says “1,000 mg Omega-3 fatty acids” but doesn’t specifically list the amounts of EPA and DHA, other than to note that they are present, is not entirely trustworthy for adding up to that 3,000 goal.
2.) Dosage. One supplement I am currently taking reads Omega-3 870 mgs ( EPA = 520, DHA= 350 ), however that is for TWO softgels. If you add it up that means SEVEN soft gels to reach 3,045 mg. That’s a lot :). It does the job, but it means ingesting a lot of oil capsules ( 6160 mgs total ). I’m using this one only because another I prefer was sold out when I was last shopping.
3.) And it goes without saying that something just labeled “fish oil” with no specific breakdown is not at all trustworthy. Common constituents like Omega-6 fatty acids are again of no particular use for triglycerides.
We did this back in '08 when the world was new. We never resolved it to my satisfaction, and it kind of petered out. Some people thought there wasn’t a difference, some swore by the Rx stuff.
Lovaza, in my non-expert opinion, has several advantages:
As a Rx pharmaceutical the quality control is reliable.
Fewer pills/capsules/gelcaps per day
There is research to back up that it does what it says it does
Our insurance will pay for it, but not OTC supplements.
Could you duplicate 1-3 with OTC? Possible - but it will take you some effort to do the research, and you’ll have to re-research it periodically to make sure nothing changes.
My spouse got some benefit from the OTC capsules, but not as much as his doctor would like. Our insurance required that the OTC route be tried and documented before prescribing Lovaza, but that done, he got the Rx. His triglyceride levels are MUCH improved.
Enterics are designed to not dissolve until they’re past the stomach and in the intestines. Not everyone can use enterics, and some people do pass them undissolved. That said, the manufacturer may have been a bit too judicious in creating a coating that was impervious to dissolution…
If you haven’t thrown the bottle out, can you post the name of the manufacturer? Should be on the label close to the nutrition facts box and instructions. A number of manufacturers make Wal-Mart/Sam’s Club nutritional supplements (including big names in the vitamin/supplement category like Rexall/Sundown, Natrol, Weider), and WM is unusual in typically requiring the manufacturer’s name on the label. WM takes customer complaints in the OTC categories pretty seriously, and there’s a good chance that I can send this up the chain of command. (As it is, I can send the UPC up, but it’d help to know the manufacturer so that the e-mail can get forwarded more quickly.)