Omega 3 Fatty Acids: Important Precautions & Dangers

Index of Diseases / Health Conditions

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Precautions:

• "Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications because excessive amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal condition in which an artery in the brain leaks or ruptures. Fish oil can cause flatulence and diarrhea. Time-release preparations may reduce these side effects, however." Source: http://www.umm.edu

• People with allergies to seafood shouldn't use krill or cod liver oil - as they are derived from fish. Please refer to this webpage for alternative sources of omega 3 fatty acids.


• Krill oil should also be used with caution by people taking herbs and supplements that are thought to increase the risk of bleeding, such as ginkgo biloba and garlic.

Dangers:

Many brands of cod liver oil are processed to remove all the vitamins A and D and then have synthetic vitamins A and D added back in. These products should be completely avoided as the synthetic versions of A and D are toxic. If in doubt, it's best to contact the manufacturer and inquire whether the A and D in their cod liver oil is naturally occurring or synthetic.

One concern about taking cod liver oil is the presence of contaminants—heavy metals (such as mercury, cadmium and lead), PCBs and so forth. Fortunately, consumers need not worry when it comes to cod liver oil. All cod liver oils in the US must be tested according to protocols of the Association of Analytical Communities (AOAC) and approved free of detectable levels of 32 contaminants before they can be imported into this country. Furthermore, mercury is water soluble. It may be present in the flesh of fish, but it is not present in the oil.

Another concern is rancidity. Cod liver oil can become rancid if improperly handled. In a 1988 study, peroxide values (indicating rancidity) ranged from a low of 2 to a high of 44.7. Nevertheless, properly handled cod liver oil is relatively stable. It contains 21 percent saturated fatty acids and 57 percent monounsaturated fatty acids, which provide stability. The fishy smell of cod liver oil is due to the presence of small amounts of fish protein and is not a sign of rancidity. To ensure that your cod liver oil is fresh, avoid buying the large economy size or the end-of-season sale item. Buy cod liver oil in small dark bottles and keep them in a cool dark place. Cod liver oil needs not be refrigerated after opening if it is used up quickly—within two months.

There is some research surrounding the possible toxicity of Cod Liver Oil. Over-elevated serum levels of vitamin D are a possibility if you combine summer or southern sun and cod liver oil. So if you are spending a lot of time out in the sun during the summer months, it's probably best to cut back on the dose. If you are unsure, you should test your blood levels of vitamin D. Cod liver oil use is safe in most of the US and all of Canada in winter but it should not be combined with other sources of vitamin D without careful testing and monitoring.

Cod liver oil is no longer recommended in Great Britain and in the US pregnant women are advised to avoid most vitamin A and vitamin A-containing foods, including cod liver oil. Both countries have adopted this policy because of the recognized teratogenicity (may cause birth defects) of retinoic acid, a synthetic form of vitamin A. But low vitamin A also causes birth defects. In the developing countries, such as Brazil, Pakistan and India, vitamin A deficiency is widespread, afflicting millions. A 1992 survey of the US population determined that 50 percent of Americans consume 19 percent or less of the Recommended Daily Allowance (RDA) or 400 IU.

• The original study showing birth defects associated with intake of mostly synthetic vitamin A exceeding 5,000 IU daily was published November 23, 1995 in the New England Journal of Medicine.46 Other studies showing an association of birth defects with vitamin A concerned topical creams containing vitamin A derivatives such as Accutane, or extremely high doses of A used in animal studies.47-52

• A later study, from the National Institute of Child Health and Human Development (NICHD), found no association with birth defects in women who took up to 10,000 IU of vitamin A during pregnancy. Because few women took more than 10,000 IU, researchers could not determine whether higher doses were a problem. Later Mills and others continued their research and determined that after serum testing and determining safe serum levels, women taking 30,000 IU of preformed vitamin A from animal foods (not beta-carotene) daily had the same blood levels of A as healthy pregnant women in the first trimester who had healthy babies. The conclusion is that a dosage over 30,000 IU vitamin A daily may be teratogenic for a certain few, but anything up to that amount is safe.53-54

• Thus if you are or may become pregnant, limit cod liver oil intake to not more than a total vitamin A value of 30,000 IU. If using my favorite brand, Carlson Labs cod liver oil, that would equal the amount of vitamin A found in 12 teaspoons or 4 tablespoons, more than anyone would ever take. If using high-vitamin cod liver oil, the limit would be 2 tablespoons. Two tablespoons of regular cod liver oil provide 15,000 IU vitamin A, 2600 IU vitamin D and 6 grams of mixed omega-3 fatty acids, safe for pregnancy and good for mom and baby.

• The most likely culprits for production of birth defects in humans are topical and oral vitamin A analogs, not cod liver oil. Researchers have criticized the original 1995 study, from which governmental policy has been derived, for overstating the negative effect. Only 1.4 percent took supplements exceeding 10,000 IU a day, not a large enough sample from which to draw conclusions. However, it is important to never combine cod liver oil or vitamin A from supplements with oral or topical medications for acne or other skin disorders treated with retinoic acid derivatives.

High levels of vitamin A are not recommended for certain types of liver disease in which there is altered vitamin A metabolism. This is frequently the case with alcoholism. Alcoholics should not take high doses (not more than 1-1.5 tablespoons of regular cod liver oil) and what they do take should be accompanied by zinc supplements. The enzymes needed for vitamin A metabolism in the liver are zinc dependent.

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