| Fish oil side effects updated on January 9, 2007. |
Meat-lover diets are overwhelmed by saturated animal fat and
omega-6 fatty acids. Saturated fats from mammal products
contribute to many chronic inflammatory and autoimmune diseases.
Omega-6 fatty acid (linoleic acid) is in most vegetable and cooking
oils and is the primary oil used in processed and fast foods. Some of
this fat may break down into arachidonic acid that may enhance
inflammation.
Omega-3 fatty acids and gamma linoleic acid are good fats, but we
always have too little in our diets. Gamma linoleic acid can be found
in borage seed oil and evening primrose seed oil, while omega-3
fatty acids are found in cold-water fishes, and some plants oils such
as flaxseed, olive and canola oils.
FISH OIL ACTIVE INGREDIENT
Omega-3 fatty acid is a group of fatty acids characterized by a
double bond that sits three carbons down from the n terminal of the
molecule, e.g. eicosapentaenoic acid. [1] N-3 Omega-3
polyunsaturated fatty acids have well documented anti-inflammatory
effects in vitro and have also been demonstrated to have health
benefits in a range of chronic inflammatory diseases, including
cardiovascular disease, rheumatoid arthritis and diabetes,
supporting their role in modulating inflammation in vivo. [2] Fishes
that give good fats include Mackerel, Herring, Sardines, Anchovies,
Albacore tuna and Salmon. In general, the colder the water they live
in, the more omega-3 oil in the fish.
FISH OIL SIDE EFFECTS ON HEALTHY SUBJECTS
Fish oil side effects vary depending on the brand, dosage and the
user physical conditions. Low dose fish oil extracts are found to be
beneficial to healthy, older or sick subjects, but long-term use of
high dose fish oil may lead to harmful side effects. [8] The most
common side effects of fish oil supplements include fishy odor on the
breath, stomach upset, gastrointestinal disturbances, and greasy
stools. To avoid the unpleasant fish oil taste and gastrointestinal
side effects, researchers suggested using enteric-coating to prepare
the fish-oil supplements. [9]
Fish oil side effects have been observed and reported in subjects
with varioius health conditions. Insignificant side effects were noted
with patients suffered from sporadic adenomas [10], arthritis [11-
12], asthma [13], depression [14], and systemic lupus
erythematosus [15,16]. No untoward or only mild gastrointestinal
side effects were observed in patients suffered from cancer. [17-
20], from high blood pressure [21,22], from high triglyceride or
cholesterol [23, 24] However, potential side effects such as
gastrointestinal distress, prolonged bleeding, and vitamin A toxicity
may happen to patients suffered from pruritus. [25]
In a study of healthy male subjects, supplementation of purified fish
oil to eight healthy male subjects led to reduced platelet
aggregation and whole blood viscosity. [7] This may be a good
news for people with high blood viscosity, but it may lead to
prolonged bleeding under certain conditions. [25]
Intake of fish is a major source of exposure to mercury, and a high
content of mercury probably inhibits the beneficial effects of omega-
3 fatty acids on the development of coronary artery disease. In
some studies no beneficial effects of fish intake on coronary heart
disease could be found; one Finnish study even found a positive
correlation between intake of freshwater fish and coronary heart
disease. Researchers explained this paradox due to a high content
of mercury in fish. In one study the odds ratio for myocardial
infarction in those with the highest content of mercury was 2.16.
They also observed a positive correlation between mercury in hair
and the progression of carotid atherosclerosis. [28]
HOW IT IS USED
The optimal dose of omega-3 fatty acid is not yet determined.
However, 1 g of fish oil has shown to reduce overall and
cardiovascular mortality, myocardial infarction, and sudden cardiac
death. Higher doses may be used for its potent triglyceride-lowering
effects and for patients with rheumatoid arthritis to reduce non-
steroidal anti-inflammatory use. American Heart Association Dietary
Guidelines committee to recommend to the general population the
consumption of at least two servings of fatty fish per week, in
addition to vegetable oils high in alpha-linolenic acid. [27] Omega-3
fatty acid supplementation of infant formula has shown benefit in
infant neural growth and development. [3,4]
Most commercial products of fish oil are in form of softgels. The
maximum dose is about 3 g, total of EPA/DHA per day. Be sure to
check the labels: the label may say “1 g of fish oil” but it may
contain a petite amount of EPA and DHA. Look for high potency
products, so you donÂ’t need to take so many softgels a day.
To minimize side effects such as belching and flatulence, one should
avoid taking the entire dose at one time. Try splitting a 3 g daily
dose into three 1 g doses, and take throughout the day with meals.
Side effects depend on the brand that you use, if you have trouble
tolerating one fish oil supplement, try switching to another brand.
RESEARCH FINDINGS
ANTI-CANCER ACTIVITIES
Eicosapentaenoic acid has received increasing attention as a
therapy for the cancer anorexia/weight loss syndrome. Multiple
studies, including laboratory and preliminary clinical studies suggest
this fish oil derivative may benefit cancer patients. Recently,
however, three large comparative studies suggest that
eicosapentaenoic acid is relatively ineffective for treating this
syndrome. [1]
ANTI-ALLERGIC ACTIVITIES (AS DIET IN PREGNANCY)
Supplementation of the maternal diet in pregnancy with omega-3
polyunsaturated fatty acids may provide a non-invasive intervention
with significant potential to prevent the development of allergic and
possibly other immune-mediated diseases. [2]
CARDIOVASCULAR DISEASES
The low incidence of reported heart attacks and cardiovascular-
related deaths in Greenland Eskimos and the Japanese has
generated interest in the possible protective effect of their diet,
which is made up primarily of fish and related marine foods. [5]
Several clinical studies have documented that intake of fish may
reduce mortality from coronary heart disease, and two
epidemiological investigations have shown a 50% reduction in the
incidence of sudden death and of "primary cardiac arrest" in
subjects eating fish. [28] Other studies show that taking omega-3
fatty acid supplements can also decrease the risk and severity of
cardiovascular disease. [5, 6]
Low dose fish oil extract administration improves the function of
platelet and red blood cells and may help prevent cerebrovascular
diseases in elderly subjects without any side effects. [26]
INFLAMMATORY DISEASES
Such supplements also provide symptomatic relief for rheumatoid
arthritis patients. Recent research suggests that asthma, another
highly prevalent, chronic inflammatory disease, may also respond to
fish oil supplements. [4]
Fish Oil may benefit psoriasis.
THIS ARTICLE IS FOR YOUR REFERENCE ONLY. IF YOU HAVE QUESTIONS,
YOU SHOULD CONSULT WITH YOUR DOCTOR. ALL RIGHT RESERVED zhion
inc. 2005 DO NOT COPY OR TRANSFER THE CONTENT TO OTHER WEBSITES
NOR OTHER TYPES OF PUBLICATIONS.
REFERENCE
[1] Jatoi A Fish oil, lean tissue, and cancer: is there a role for
eicosapentaenoic acid in treating the cancer anorexia/weight loss syndrome?
Crit Rev Oncol Hematol. 2005 Jul;55(1):37-43. [2] Dunstan JA and Prescott
SL Does fish oil supplementation in pregnancy reduce the risk of allergic
disease in infants? Curr Opin Allergy Clin Immunol. 2005 Jun;5(3):215-21.
[3] Oh R Practical applications of fish oil (Omega-3 fatty acids) in primary
care. J Am Board Fam Pract. 2005 Jan-Feb;18(1):28-36. [4] Stephensen CB
Fish oil and inflammatory disease: is asthma the next target for n-3 fatty
acid supplements? Nutr Rev. 2004 Dec;62(12):486-9. [5] Zeller FP and
Spears C Fish oil: effectiveness as a dietary supplement in the prevention of
heart disease. Drug Intell Clin Pharm. 1987 Jul-Aug;21(7-8):584-9. [6]
Herold PM and Kinsella JE Fish oil consumption and decreased risk of
cardiovascular disease: a comparison of findings from animal and human
feeding trials. Am J Clin Nutr. 1986 Apr;43(4):566-98. [7] Terano T Effect of
oral administration of highly purified eicosapentaenoic acid on platelet
function, blood viscosity and red cell deformability in healthy human
subjects. Atherosclerosis. 1983 Mar;46(3):321-31.] [8] Bartoli GM Dietary
fish oil inhibits human erythrocyte Mg,NaK-ATPase. Biochem Biophys Res
Commun. 1995 Aug 24;213(3):881-7. [9] Belluzzi A Effect of an enteric-
coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med.
1996 Jun 13;334(24):1557-60. [10] In a study, 60 patients with sporadic
adenomas received low dose fish oil for 30 days. Side effects were found to
be insignificant. Anti M Effects of different doses of fish oil on rectal cell
proliferation in patients with sporadic colonic adenomas. Gastroenterology.
1994 Dec;107(6):1709-18. [11] No significant fish oil side effects were
detected in a 12 week-study of fish oil on 8 patients with arthritis. Astorga G
Active rheumatoid arthritis: effect of dietary supplementation with omega-3
oils. A controlled double-blind trial Rev Med Chil. 1991 Mar;119(3):267-72.
[12] No serious side effects were observed when 51 patients with arthritis
supplemented with fish oil extracts for 12 weeks. Faarvang KL Fish oils and
rheumatoid arthritis. A randomized and double-blind study. Ugeskr Laeger.
1994 Jun 6;156(23):3495-8. [13] No significant fish oil side effects were
observed, after 29 children suffered from asthma were supplemented with
fish oil for 10 months. Nagakura T. Dietary supplementation with fish oil rich
in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur
Respir J. 2000 Nov;16(5):861-5. [14] Twelve patients with depressive
symptoms were treated with 1.5 to 2 g/day of fish oil for 6 months. No
patients developed hypomania or manic symptoms. No significant fish oil
side effects were reported. Osher Y Omega-3 eicosapentaenoic Acid in
bipolar depression: report of a small open-label study. J Clin Psychiatry.
2005 Jun;66(6):726-9. [15] No major side effects were noted in a study of
27 patients with active systemic lupus erythematosus supplemented with
high fish oil. Walton AJ Dietary fish oil and the severity of symptoms in
patients with systemic lupus erythematosus. Ann Rheum Dis. 1991 Jul;50(7):
463-6. [16] Oral supplementation of fish oil extracts induced prolonged
remission of SLE in 10 consecutive patients without any side-effects. Das UN
Beneficial effect of eicosapentaenoic and docosahexaenoic acids [fish oil
extracts] in the management of systemic lupus erythematosus and its
relationship to the cytokine network. Prostaglandins Leukot Essent Fatty
Acids. 1994 Sep;51(3):207-13. [17] Patients with malignancy and weight loss
> or = 2% of body weight in the preceding month took concentrated, high-
doses of fish oil that were supplied by the NIH. A majority of patients did not
gain weight and There was marked variability in the tolerability of the
capsules, and many patients had gastrointestinal side effects. [Burns CP et
al Phase II study of high-dose fish oil capsules for patients with cancer-
related cachexia. Cancer. 2004 Jul 15;101(2):370-8.] [18] Postsurgical
cancer patients receiving fish oil/medium-chain triglyceride structured lipid
experienced no untoward side effects. Kenler AS Early enteral feeding in
postsurgical cancer patients. Fish oil structured lipid-based polymeric formula
versus a standard polymeric formula. Ann Surg. 1996 Mar;223(3):316-33.
[19] EPA (95% pure, fish oil) was administered to 26 patients suffered from
pancreatic cancer for a few weeks. Fish oil supplementation was well
tolerated, with only five patients experiencing side effects possibly
attributable to the EPA. Wigmore SJ Effect of oral eicosapentaenoic acid on
weight loss in patients with pancreatic cancer. Nutr Cancer. 2000;36(2):177-
84. [20] Patients undergoing major abdominal surgery for upper
gastrointestinal malignancies receiving fish oil/medium-chain triglyceride
structured lipid experienced no untoward side effects demonstrated a general
trend toward improved hepatic, renal and immune function found in the
previous study. Swails Effect of a fish oil structured lipid-based diet on
prostaglandin release from mononuclear cells in cancer patients after
surgery. JPEN J Parenter Enteral Nutr. 1997 Sep-Oct;21(5):266-74. [21]
Common fish oil side effects are eructation and a fishy taste, in six studies
of 291 untreated hypertensives. Appel LJ. Does supplementation of diet with
'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials.
Am J Kidney Dis. 1993 Jul;22(1):151-7. [22] Fish oil may help prevent
coronary artery disease. Four studies of total 203 subjects were reviewed.
Fish oil was found to be able reduce diastolic blood pressure and triglyceride
level. Gastrointestinal side effects were observed in one study.
[Sommerfield T et al, Omega-3 fatty acids for intermittent claudication.
Cochrane Database Syst Rev. 2004.] [23] In an open study of 3,958
hyperlipemic patients, 471 subjects supplemented with fish oil experienced
gastrointestinal side effects. Kunzel U[Clinical experiences with a
standardized fish oil concentrate. Field study with 3,958 hyperlipemic patients
in the practice of an established physician] Fortschr Med. 1990 Jul 30;108
(22):437-42. [24] Minor gastrointestinal side effects were reported in a study
of fish oil using 48 patients with hypertriglyceridaemia. Miller JP Triglyceride
lowering effect of MaxEPA fish lipid concentrate (oil): a multicentre placebo
controlled double blind study. Clin Chim Acta. 1988 Dec 30;178(3):251-9.
[25] Vergili-Nelsen JM Benefits of fish oil supplementation for hemodialysis
patients. J Am Diet Assoc. 2003 Sep;103(9):1174-7. [26] Terano T Changes
in fatty acid composition, platelet aggregability and RBC function in elderly
subjects with administration of low-dose fish oil concentrate and comparison
with younger subjects Nippon Ronen Igakkai Zasshi. 1994 Aug;31(8):596-
603. [27] Eilat-Adar S et al, Omega-3 fatty acids, fish, fish oil and
cardiovascular disease--a review with implications to Israeli nutritional
guidelines Harefuah. 2004 Aug;143(8):585-91, 622, 621. [28] Landmark K
and Aursnes I Mercury, fish, fish oil and the risk of cardiovascular disease
Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):198-200
omega-6 fatty acids. Saturated fats from mammal products
contribute to many chronic inflammatory and autoimmune diseases.
Omega-6 fatty acid (linoleic acid) is in most vegetable and cooking
oils and is the primary oil used in processed and fast foods. Some of
this fat may break down into arachidonic acid that may enhance
inflammation.
Omega-3 fatty acids and gamma linoleic acid are good fats, but we
always have too little in our diets. Gamma linoleic acid can be found
in borage seed oil and evening primrose seed oil, while omega-3
fatty acids are found in cold-water fishes, and some plants oils such
as flaxseed, olive and canola oils.
FISH OIL ACTIVE INGREDIENT
Omega-3 fatty acid is a group of fatty acids characterized by a
double bond that sits three carbons down from the n terminal of the
molecule, e.g. eicosapentaenoic acid. [1] N-3 Omega-3
polyunsaturated fatty acids have well documented anti-inflammatory
effects in vitro and have also been demonstrated to have health
benefits in a range of chronic inflammatory diseases, including
cardiovascular disease, rheumatoid arthritis and diabetes,
supporting their role in modulating inflammation in vivo. [2] Fishes
that give good fats include Mackerel, Herring, Sardines, Anchovies,
Albacore tuna and Salmon. In general, the colder the water they live
in, the more omega-3 oil in the fish.
FISH OIL SIDE EFFECTS ON HEALTHY SUBJECTS
Fish oil side effects vary depending on the brand, dosage and the
user physical conditions. Low dose fish oil extracts are found to be
beneficial to healthy, older or sick subjects, but long-term use of
high dose fish oil may lead to harmful side effects. [8] The most
common side effects of fish oil supplements include fishy odor on the
breath, stomach upset, gastrointestinal disturbances, and greasy
stools. To avoid the unpleasant fish oil taste and gastrointestinal
side effects, researchers suggested using enteric-coating to prepare
the fish-oil supplements. [9]
Fish oil side effects have been observed and reported in subjects
with varioius health conditions. Insignificant side effects were noted
with patients suffered from sporadic adenomas [10], arthritis [11-
12], asthma [13], depression [14], and systemic lupus
erythematosus [15,16]. No untoward or only mild gastrointestinal
side effects were observed in patients suffered from cancer. [17-
20], from high blood pressure [21,22], from high triglyceride or
cholesterol [23, 24] However, potential side effects such as
gastrointestinal distress, prolonged bleeding, and vitamin A toxicity
may happen to patients suffered from pruritus. [25]
In a study of healthy male subjects, supplementation of purified fish
oil to eight healthy male subjects led to reduced platelet
aggregation and whole blood viscosity. [7] This may be a good
news for people with high blood viscosity, but it may lead to
prolonged bleeding under certain conditions. [25]
Intake of fish is a major source of exposure to mercury, and a high
content of mercury probably inhibits the beneficial effects of omega-
3 fatty acids on the development of coronary artery disease. In
some studies no beneficial effects of fish intake on coronary heart
disease could be found; one Finnish study even found a positive
correlation between intake of freshwater fish and coronary heart
disease. Researchers explained this paradox due to a high content
of mercury in fish. In one study the odds ratio for myocardial
infarction in those with the highest content of mercury was 2.16.
They also observed a positive correlation between mercury in hair
and the progression of carotid atherosclerosis. [28]
HOW IT IS USED
The optimal dose of omega-3 fatty acid is not yet determined.
However, 1 g of fish oil has shown to reduce overall and
cardiovascular mortality, myocardial infarction, and sudden cardiac
death. Higher doses may be used for its potent triglyceride-lowering
effects and for patients with rheumatoid arthritis to reduce non-
steroidal anti-inflammatory use. American Heart Association Dietary
Guidelines committee to recommend to the general population the
consumption of at least two servings of fatty fish per week, in
addition to vegetable oils high in alpha-linolenic acid. [27] Omega-3
fatty acid supplementation of infant formula has shown benefit in
infant neural growth and development. [3,4]
Most commercial products of fish oil are in form of softgels. The
maximum dose is about 3 g, total of EPA/DHA per day. Be sure to
check the labels: the label may say “1 g of fish oil” but it may
contain a petite amount of EPA and DHA. Look for high potency
products, so you donÂ’t need to take so many softgels a day.
To minimize side effects such as belching and flatulence, one should
avoid taking the entire dose at one time. Try splitting a 3 g daily
dose into three 1 g doses, and take throughout the day with meals.
Side effects depend on the brand that you use, if you have trouble
tolerating one fish oil supplement, try switching to another brand.
RESEARCH FINDINGS
ANTI-CANCER ACTIVITIES
Eicosapentaenoic acid has received increasing attention as a
therapy for the cancer anorexia/weight loss syndrome. Multiple
studies, including laboratory and preliminary clinical studies suggest
this fish oil derivative may benefit cancer patients. Recently,
however, three large comparative studies suggest that
eicosapentaenoic acid is relatively ineffective for treating this
syndrome. [1]
ANTI-ALLERGIC ACTIVITIES (AS DIET IN PREGNANCY)
Supplementation of the maternal diet in pregnancy with omega-3
polyunsaturated fatty acids may provide a non-invasive intervention
with significant potential to prevent the development of allergic and
possibly other immune-mediated diseases. [2]
CARDIOVASCULAR DISEASES
The low incidence of reported heart attacks and cardiovascular-
related deaths in Greenland Eskimos and the Japanese has
generated interest in the possible protective effect of their diet,
which is made up primarily of fish and related marine foods. [5]
Several clinical studies have documented that intake of fish may
reduce mortality from coronary heart disease, and two
epidemiological investigations have shown a 50% reduction in the
incidence of sudden death and of "primary cardiac arrest" in
subjects eating fish. [28] Other studies show that taking omega-3
fatty acid supplements can also decrease the risk and severity of
cardiovascular disease. [5, 6]
Low dose fish oil extract administration improves the function of
platelet and red blood cells and may help prevent cerebrovascular
diseases in elderly subjects without any side effects. [26]
INFLAMMATORY DISEASES
Such supplements also provide symptomatic relief for rheumatoid
arthritis patients. Recent research suggests that asthma, another
highly prevalent, chronic inflammatory disease, may also respond to
fish oil supplements. [4]
Fish Oil may benefit psoriasis.
THIS ARTICLE IS FOR YOUR REFERENCE ONLY. IF YOU HAVE QUESTIONS,
YOU SHOULD CONSULT WITH YOUR DOCTOR. ALL RIGHT RESERVED zhion
inc. 2005 DO NOT COPY OR TRANSFER THE CONTENT TO OTHER WEBSITES
NOR OTHER TYPES OF PUBLICATIONS.
REFERENCE
[1] Jatoi A Fish oil, lean tissue, and cancer: is there a role for
eicosapentaenoic acid in treating the cancer anorexia/weight loss syndrome?
Crit Rev Oncol Hematol. 2005 Jul;55(1):37-43. [2] Dunstan JA and Prescott
SL Does fish oil supplementation in pregnancy reduce the risk of allergic
disease in infants? Curr Opin Allergy Clin Immunol. 2005 Jun;5(3):215-21.
[3] Oh R Practical applications of fish oil (Omega-3 fatty acids) in primary
care. J Am Board Fam Pract. 2005 Jan-Feb;18(1):28-36. [4] Stephensen CB
Fish oil and inflammatory disease: is asthma the next target for n-3 fatty
acid supplements? Nutr Rev. 2004 Dec;62(12):486-9. [5] Zeller FP and
Spears C Fish oil: effectiveness as a dietary supplement in the prevention of
heart disease. Drug Intell Clin Pharm. 1987 Jul-Aug;21(7-8):584-9. [6]
Herold PM and Kinsella JE Fish oil consumption and decreased risk of
cardiovascular disease: a comparison of findings from animal and human
feeding trials. Am J Clin Nutr. 1986 Apr;43(4):566-98. [7] Terano T Effect of
oral administration of highly purified eicosapentaenoic acid on platelet
function, blood viscosity and red cell deformability in healthy human
subjects. Atherosclerosis. 1983 Mar;46(3):321-31.] [8] Bartoli GM Dietary
fish oil inhibits human erythrocyte Mg,NaK-ATPase. Biochem Biophys Res
Commun. 1995 Aug 24;213(3):881-7. [9] Belluzzi A Effect of an enteric-
coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med.
1996 Jun 13;334(24):1557-60. [10] In a study, 60 patients with sporadic
adenomas received low dose fish oil for 30 days. Side effects were found to
be insignificant. Anti M Effects of different doses of fish oil on rectal cell
proliferation in patients with sporadic colonic adenomas. Gastroenterology.
1994 Dec;107(6):1709-18. [11] No significant fish oil side effects were
detected in a 12 week-study of fish oil on 8 patients with arthritis. Astorga G
Active rheumatoid arthritis: effect of dietary supplementation with omega-3
oils. A controlled double-blind trial Rev Med Chil. 1991 Mar;119(3):267-72.
[12] No serious side effects were observed when 51 patients with arthritis
supplemented with fish oil extracts for 12 weeks. Faarvang KL Fish oils and
rheumatoid arthritis. A randomized and double-blind study. Ugeskr Laeger.
1994 Jun 6;156(23):3495-8. [13] No significant fish oil side effects were
observed, after 29 children suffered from asthma were supplemented with
fish oil for 10 months. Nagakura T. Dietary supplementation with fish oil rich
in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur
Respir J. 2000 Nov;16(5):861-5. [14] Twelve patients with depressive
symptoms were treated with 1.5 to 2 g/day of fish oil for 6 months. No
patients developed hypomania or manic symptoms. No significant fish oil
side effects were reported. Osher Y Omega-3 eicosapentaenoic Acid in
bipolar depression: report of a small open-label study. J Clin Psychiatry.
2005 Jun;66(6):726-9. [15] No major side effects were noted in a study of
27 patients with active systemic lupus erythematosus supplemented with
high fish oil. Walton AJ Dietary fish oil and the severity of symptoms in
patients with systemic lupus erythematosus. Ann Rheum Dis. 1991 Jul;50(7):
463-6. [16] Oral supplementation of fish oil extracts induced prolonged
remission of SLE in 10 consecutive patients without any side-effects. Das UN
Beneficial effect of eicosapentaenoic and docosahexaenoic acids [fish oil
extracts] in the management of systemic lupus erythematosus and its
relationship to the cytokine network. Prostaglandins Leukot Essent Fatty
Acids. 1994 Sep;51(3):207-13. [17] Patients with malignancy and weight loss
> or = 2% of body weight in the preceding month took concentrated, high-
doses of fish oil that were supplied by the NIH. A majority of patients did not
gain weight and There was marked variability in the tolerability of the
capsules, and many patients had gastrointestinal side effects. [Burns CP et
al Phase II study of high-dose fish oil capsules for patients with cancer-
related cachexia. Cancer. 2004 Jul 15;101(2):370-8.] [18] Postsurgical
cancer patients receiving fish oil/medium-chain triglyceride structured lipid
experienced no untoward side effects. Kenler AS Early enteral feeding in
postsurgical cancer patients. Fish oil structured lipid-based polymeric formula
versus a standard polymeric formula. Ann Surg. 1996 Mar;223(3):316-33.
[19] EPA (95% pure, fish oil) was administered to 26 patients suffered from
pancreatic cancer for a few weeks. Fish oil supplementation was well
tolerated, with only five patients experiencing side effects possibly
attributable to the EPA. Wigmore SJ Effect of oral eicosapentaenoic acid on
weight loss in patients with pancreatic cancer. Nutr Cancer. 2000;36(2):177-
84. [20] Patients undergoing major abdominal surgery for upper
gastrointestinal malignancies receiving fish oil/medium-chain triglyceride
structured lipid experienced no untoward side effects demonstrated a general
trend toward improved hepatic, renal and immune function found in the
previous study. Swails Effect of a fish oil structured lipid-based diet on
prostaglandin release from mononuclear cells in cancer patients after
surgery. JPEN J Parenter Enteral Nutr. 1997 Sep-Oct;21(5):266-74. [21]
Common fish oil side effects are eructation and a fishy taste, in six studies
of 291 untreated hypertensives. Appel LJ. Does supplementation of diet with
'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials.
Am J Kidney Dis. 1993 Jul;22(1):151-7. [22] Fish oil may help prevent
coronary artery disease. Four studies of total 203 subjects were reviewed.
Fish oil was found to be able reduce diastolic blood pressure and triglyceride
level. Gastrointestinal side effects were observed in one study.
[Sommerfield T et al, Omega-3 fatty acids for intermittent claudication.
Cochrane Database Syst Rev. 2004.] [23] In an open study of 3,958
hyperlipemic patients, 471 subjects supplemented with fish oil experienced
gastrointestinal side effects. Kunzel U[Clinical experiences with a
standardized fish oil concentrate. Field study with 3,958 hyperlipemic patients
in the practice of an established physician] Fortschr Med. 1990 Jul 30;108
(22):437-42. [24] Minor gastrointestinal side effects were reported in a study
of fish oil using 48 patients with hypertriglyceridaemia. Miller JP Triglyceride
lowering effect of MaxEPA fish lipid concentrate (oil): a multicentre placebo
controlled double blind study. Clin Chim Acta. 1988 Dec 30;178(3):251-9.
[25] Vergili-Nelsen JM Benefits of fish oil supplementation for hemodialysis
patients. J Am Diet Assoc. 2003 Sep;103(9):1174-7. [26] Terano T Changes
in fatty acid composition, platelet aggregability and RBC function in elderly
subjects with administration of low-dose fish oil concentrate and comparison
with younger subjects Nippon Ronen Igakkai Zasshi. 1994 Aug;31(8):596-
603. [27] Eilat-Adar S et al, Omega-3 fatty acids, fish, fish oil and
cardiovascular disease--a review with implications to Israeli nutritional
guidelines Harefuah. 2004 Aug;143(8):585-91, 622, 621. [28] Landmark K
and Aursnes I Mercury, fish, fish oil and the risk of cardiovascular disease
Tidsskr Nor Laegeforen. 2004 Jan 22;124(2):198-200