- Updated on November 1, 2020
By Dr. Artour Rakhimov, Alternative Health Educator and Author
- Medically Reviewed by Naziliya Rakhimova, MD
Content of this web page – manual
4.1 Omega 3 benefits
4.2 Side effects, risks and dangers of fish oil and other EFAs
4.3 Fish oil vs. flaxseed oil and other vegetable oils
4.4 What is the difference between DHA and EPA?
4.5 How much fish oil is recommended?
4.6 “3-day test”
4.7 What is the difference between fish oil and cod liver oil?
4.8 What is krill oil for (krill oil vs. fish oil)?
4.9 Salmon oil vs. fish oil
4.10. Sources of Fish oil, cod liver oil, salmon oil and krill oil: their EPA and DHA
4.11 Criteria and summary for choosing EFAs or omega 3 supplements
Quotes and references (dangers in fish oil and fish due to pollution)
Quotes and references about conversion rates of ALA (alpha-linolenic acid) to EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)
Quotes and references (fish oil versus flaxseed oil)
Quotes and references (krill oil medical research)
Quotes and references (long-term use causes negative effects)
(This is Part 2 of the Major Nutrients Guide for Better Breathing and Body-Oxygen Level. Part 1 has a title Macrominerals (Ca, Mg, Zn) and Fish Oil. Note that it would be difficult to understand the ideas of this Guide (3-day test or how to practically check nutritional deficiencies) without knowledge of the following topics: how to measure body oxygenation; effects of breathing patterns and body oxygenation; CO2 uses in the human body; and web pages related to the Homepage of this website.)
Modern people, as it is proven by numerous studies, consume too much omega 6 EFAs (essential fatty acids), with too little omega 3 fats. This review focuses on omega 3 EFAs supplements, including fish oil, cod liver oil, salmon oil, krill oil, algae oil, and many other sources of these supplements. Note that the main signs of EFAs deficiency are considered in Part 1. Here we are going to consider more fine details of EFAs supplementation and related challenges.
While medical research continues to discover new health benefits of fish oil, cod liver oil, and other sources of EFAs, it is clear that replenishing any missing nutrient is ultimately useful against any chronic disease since all chronic diseases have one common cause: alveolar hyperventilation, which results in cellular hypoxia. Therefore, the previous list of related health problems (Coronary heart disease, High blood pressure, Angina pectoris, Epilepsy, Cancer, Crohn’s disease, Diabetes, Rheumatoid arthritis, Depression, Sinusitis, Acne, Asthma, Bronchitis, Cystic fibrosis, and Other inflammatory disorders) from Part 1 of this Guide can be extended to include 150-200 common or chronic health disorders. In short, when someone asks, “What is fish oil for?”, “What does fish oil do for the body?”, “What are fish oil health benefits?”, “Why take fish oil?”, “Why is fish oil good for you?”, the answer is simple: to improve breathing and body oxygenation, thus curing chronic diseases. Physiologically, fish oil reduces inflammation and, hence, is used for so many seemingly unrelated health problems.
Therefore, when one is sick and starts breathing retraining, regardless of the chosen source of EFAs, when conditions are right (the process of breathing retraining is active and the CP or body oxygen level is steadily growing) and no damage is done to the body (e.g., due to allergic reaction or toxicity of the dietary supplement), then the deficient student will benefit from having this missing nutrient in the diet. Hence, for example, fish oil will help with weight loss, cholesterol, prostate cancer, depression, arteries, inflammation, and many other problems, provided that you improve your body oxygen level. Therefore, it is not a particular supplement, but one’s health state and the corresponding health zone in the Buteyko Table of Health Zones that matters most.
Dangers and side effects of fish oil and other sources of EFAs relate to various mechanisms and interactions of numerous factors. They also depend on the health state of the person.
Contamination of the environment with mercury (mostly from burning coal), lead, nickel, arsenic, cadmium, dioxins, and PBCs (polychlorinated biphenyls), and other toxins are present in oceans due to activities of humans. To avoid these poisons, use purified dietary supplements (e.g., molecular distillation) or pharmaceutical grade supplements.
Using fish oil, for example, is generally much safer than eating whole fish (see abstracts below). Children, pregnant and nursing women are more sensitive to mercury toxicity; avoiding contaminated fish and supplements is an especially high priority for these groups of people.
Concerns about safety and contamination of animal and fish products are legitimate. However, there is no indication in toxicological, nutritional, and environmental studies that there are dangers associated with purified fish oil or cod liver oil products. However, some studies warn of pollutants in whole fish.
Many people are sensitive to fish (because of seafood allergy) and/or related products. It is crucial to avoid allergic reactions and to change the supplement source or brand or route of administration so as not to trigger any adverse side effects, including skin rashes. Algae oils may be a suitable alternative as they provide the most important essential fatty acid, DHA. If someone has adverse effects to all forms of EFAs when taken orally, omega fats can be successfully administered rectally or cutaneously (by rubbing small amounts of fish oil into arms and taking a shower afterward).
Irritation of the stomach and other GI symptoms
Since gastritis (inflammation of the stomach lining) is almost the norm for modern people, many omega fat supplements often produce incessant burping, upset stomach, aftertaste, or even nausea, especially when taken on an empty stomach. Fish oil, cod liver oil, and other EFAs can also cause abdominal discomfort, diarrhea, heartburn, and indigestion. The suggested solution is to start with a small dose, avoid taking supplements on an empty stomach and chew your omegas mixed with food and do it very well (more will be absorbed in the mouth too). If the problem persists, try freezing the capsules and taking them on an empty stomach (so that they melt in your small intestine), consider changing the brand or buy enteric coated fish oil tablets (if your duodenum is in a normal state), or apply fish oil, cod liver oil, and other EFAs rectally or cutaneously. Rancid sources of omegas are more likely to cause these negative effects.
Polyunsaturated oils, including EFAs, are extremely susceptible to damage from oxygen, heat, and light. The unstable double bond between carbon atoms can easily attract oxygen atoms from air, forming free radicals, which can trigger chain reactions destroying many hundreds of substances and/or structures of the human body. Rancidity changes the flavor and smell of the fish oil and other EFAs. Such supplements may still produce some positive effects on health, but excessive rancidity will increase one’s breathing and decrease the CP. Hence, all oils that are high in polyunsaturated fatty acids (including fish oil, krill oil, flaxseed oil, etc.) should be stored in dark tightly closed, glass containers in the refrigerator or freezer. Obviously, EFAs, as well as other unsaturated fats, should never be used for frying or in hot dishes. To avoid rancidity, it is wise to choose those EFAs supplements that are certified and organic, and have been refrigerated in a dark glass jar. Note that the same relates to capsules of fish oil and other supplements. Gelatin capsules do not protect unsaturated oils from oxidation since over periods of weeks or months, oxygen can easily penetrate through various plastic materials, while glass provides much better protection from oxygen damage. Presence of combinations of natural tocopherols (vitamin E) significantly reduces rancidity of these unstable oils.
When the person has been practicing breathing technique exercises and has significantly improved his own CP, the temporary need for EFAs to reduce inflammation and do other useful jobs in the body can be much greater. In such conditions of deficiency, taking cod liver oil, fish oil, or krill oil supplements can produce a lasting invigorating effect (similar to barefoot walking) so that one can experience problems with sleep if the supplement is taken in the second half of the day or especially just before sleep. To avoid this, take fish oil, krill oil, and other omega supplements in the morning with your breakfast.
Increased bleeding myth
It has been previously reported that fish oil components DHA and EPA can increase the chances of bruising and bleeding (e.g., nosebleeds, GI bleeding, strokes or blood in the urine). This myth has gained some popularity on various websites, including official medical sites, while medical research did not find any significant association between intake of fish oil and bleeding. Dr. Harris (see the reference and abstract below) analyzed about 20 medical studies where patients were given between 3 and 7 g of EPA. Most studies were very large (up to several hundred patients) and there were no reports of increased bleeding while bleeding time increased moderately only in a few studies.
Concerns related to vitamin A toxicity
While there are many internet claims about too much vitamin A in cases of using cod liver oil, medical research does not support these claims. There are published cases of individuals taking too much cod liver oil and resultant liver problems, but these cases are confined to very large doses. The typical therapeutic dosage recommended is only between 1 teaspoon and 1 tablespoon daily. Additionally, the inability of the organism to regulate vitamin A accumulation indicates very low CP (likely less than 10 s). Therefore, people taking therapeutic doses of cod liver oil and other EFAs sources do not need to worry about this effect. There are many published studies where doctors treated surgical patients with up to 7-8 g of DHA and EPA per day. In such cases they suggest using fish oil and other sources of these EFAs, to avoid overdoses of vitamin A in cod liver oil.
Other possible negative symptoms
Medical studies have revealed that fish oil may contribute to worsening of some health problems in certain patient population, for example: aggravation of symptoms of bipolar disorder and depression; drop in blood pressure due to reduction of inflammation in medicated hypertension; worsened blood sugar control in diabetes; possible contribution to some cancers in certain groups of people; lowered immune response in HIV/AIDS; and other similar situations. Such adverse effects would be expected for those people who improved their CPs (e.g., up to 5-10 s) but continue to use the same dose of their medication. This can be dangerous since, with higher CPs, most drugs have a much stronger effect. Hence, many such cases rather relate to interactions with medical drugs rather than to the effects of fish or cod liver oil.
Interactions with medication
During breathing retraining, it is sensible to explain to your family doctor (or general practitioner) that your symptoms subsided (or disappeared) depending on your progress and previous health problems. Since most MDs and GPs have no time to follow alternative medicine developments and are bombarded with papers representing official doctrines, very few MDs know in detail about the Buteyko method. Hence, you can emphasize healthy changes in your lifestyle as the likely cause of your health improvement. [Doctors do know about the benefits of exercise, better diet, etc.] Then it will be easier to convince them to reduce your medication.
There have been many Buteyko students who could achieve up to 5-10 s higher morning CP just by taking fish oil. Such changes in breathing modify the effects of many medical drugs so that their efficiency is greatly increased. This relates to medications that control blood pressure, blood glucose level, blood clotting, blood thinning and some other physiological parameters. Thus, potentially, it is not the direct effect of fish oil, but changes in breathing, that alter the reactions to usual dosages of medical drugs. Hence, ask your MD or GP to reduce medication accordingly.
Should everyone use fish oil or other animal-derived omegas? This depends on your body oxygenation (or health state). For hundreds of generations, many human communities, groups, and tribes could thrive without eating fish, provided that they had high CPs. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are normal components of the human blood and are necessary for numerous functions. These fatty acids can be synthesized from ALA (alpha-linolenic acid), which is also an omega fat, provided that the GI tract is healthy. ALA is abundant in various nuts and seeds. For example, flax oil and milled flax seeds are a rich vegetarian omega 3 source, but flax doesn’t have DHA or EPA. The same relates to hemp seed omega-3 oil, linseed oil, olive oil and sunflower oil. Among vegetarian sources, only algae oils have a high DHA content (see the Table below).
People with low CPs (less than 20 s) and/or GI problems are often unable to utilize vegetarian sources of EFAs, as it was confirmed by many published studies, provided 2 paragraphs below. Hence, when most people try flaxseed (linseed) oil, hemp oil, sunflower oil, and other oils (usually extracted from seeds and nuts), they still experience their symptoms and deficiency in essential fatty acids. When they try cod liver oil or fish oil for 3 days, their morning CP can increase by 3, 5 sometimes up to 10 s. Hence, this supplementation can greatly assist health recovery.
If you have any, even very mild digestive problems, vegetarian sources of omegas cannot be used to build and repair the body as effectively as animal sources of EFAs. However, if you are reluctant to use animal products, try a 3-day test with flaxseed oil and later with animal omega sources and compare the results.
There are some people, even with low CPs, who do not experience any improvement after a 3-day fish oil trial and then there is no need for them to use this animal product. They can use flaxseed, linseed, hemp and other seed- or nut-based oils or just regularly consume nuts and seeds or sunflower and other food grades, better cold-pressed oils.
This question (What is better for you: fish oil or flaxseed oil?) can be also answered using 2 different scientific ways. First, we can consider studies related to conversion rates in modern humans, who, according to medical respiratory research, can be divided into sick (ordinary humans) and very sick people.
Quotes and references about conversion rates of ALA (alpha-linolenic acid) to EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)
Why some people cannot convert EFAs or omega fats in their bodies
The situation with the synthesis of EFA and DHA in the human body is similar to the synthesis of vitamin B12 (cobalamin) in the human gut. Theoretically, as modern researchers claim, it can take place, but practical evidence suggests that most people are not able to synthesize B12 in the body due to the absence of the intrinsic factor.
This is how Dr. K. Buteyko described some of the effects of chronic hyperventilation:
“2. DEEP BREATHING, ACCORDING TO THE LAWS, REMOVES CARBON DIOXIDE AND DIMINISHES ITS CONTENT IN THE LUNGS, BLOOD, AND IN TISSUES. THIS LEADS TO:
c) Change in the activity of enzymes and vitamins: some of them increase their activity, while others decrease. And this inevitably leads to:
d) Abnormalities of the metabolism, which is the foundation of life, i.e. enzymes (there are about 700 of them which have already been discovered) and vitamins (there are more than 20). All these control units of the metabolism start to work abnormally. The metabolism is abnormal; the foundation of life is abnormal. If carbon dioxide decreases below the limiting norm, then there is a termination of the [normal] chemical processes, death of the cells and organism…”
Note that conversion of ALA into DHA and EPA depends on the activity of enzymes.
Now we can also consider studies that compared supplementation with fish oil versus flaxseed oil and other vegetarian oils. Here are quotes from some recent research studies, most of which focus on fish oil vs. flaxseed oil effects and all claim higher efficacy of fish oil dietary supplementation.
Conclusion. Most people, due to low CP and tissue hypoxia, with the body’s inability to synthesize various vital substances (DHA and EPA included), do require supplementation with EPA omega 3 and DHA omega 3, which generally come from animal sources.
Researchers agree that DHA is the most beneficial fatty acid for the human body. DHA is also the largest molecule among all considered EFAs. It has 22 carbon chain bonds and six double bonds. Furthermore, DHA is essential for infants. Quickly growing brains of babies constantly require large amounts of DHA. Apart from cardiovascular health, it is also crucial for cognitive and neurological function, learning ability, memory, focus, kidney function, etc..
EPA is another essential fatty acid, although it is not near as important as DHA. EPA has 20 carbon chain bonds and 5 double bonds. EPA is more involved in the work of the cardiovascular, hormonal and immune systems.
Another difference is that it is relatively easy for the human body to convert the larger DHA molecule (22 carbon chain bonds) into EPA (20 carbon chain bonds), but not the other way around. Moreover, low CPs make the inverse conversion (from EPA to DHA) more difficult or even impossible. [All these concerns are not important for those whose CP is about 40 s or preferably no less than the Buteyko norm (60 s).]
Hence, it is sensible for many people to use supplements with higher DHA absolute and relative content.
The officially recommended dosage for fish oil does not exist since fats are macronutrients, and, hence, they are not assigned recommended daily allowances.
Macronutrients have AI (Acceptable Intake) and AMDR (Acceptable Macronutrient Distribution Range) instead of RDAs. The AI for omega-3 is 1.6 g/day for men and 1.1 g/day for women. The AMDR is from 0.6% to 1.2% of total energy intake. As for nutritionists and experts, their fish oil supplements dosage can range from about 300 to 2,000 mg of DHA and EPA per day depending on the health state and many other parameters of the person. Medical doctors often use up to 5-8 g of DHA and EPA daily for their patients during and after surgery.
The experience of my students indicates that personal requirements depend on many factors. First of all, not all people require animal sources of omega 3 EFAs. While most people cannot convert vegetarian sources of EFAs, some of those people who have very good digestion and use, for example, flaxseed oil would not benefit from switching to the cod liver or fish oil for a 3-day trial.
How much fish oil should I use?
In order to have a good understanding of your particular requirements, consider the main benefits of taking fish oil, cod liver oil, and other EFAs sources. What is fish oil good for? The main effect is to reduce inflammation. However, inflammation is naturally reduced when one has higher CP (the adrenal gland starts to recover and produce more cortisol when the CP is more than 20 s). Physical exercise with strictly nasal breathing and breathing exercises improve body oxygenation index and are the most powerful and common tools to fight inflammation. [Note that a small number of breathing students cannot improve their CPs at all without cortisol supplementation and this effect is considered elsewhere.] Hence, aspiring breathing students can easily compensate for their seemingly large requirements in EPAs and DHAs by smart changes in their lifestyle.
When a person applies various breathing retraining techniques and has a CP that is growing, it is relatively easy to define if a person requires fish oil or not. It can be done using the 3-day test. The exact instructions for this test are provided below as your bonus content.
Take the full or even double dose of fish oil (20 ml or 2 tbs) or equivalent of EPA and DHA for 3 days while monitoring your CP, especially the morning CP, dryness of your skin, and heart rate. Then do not use the supplement for 5 days and again record your parameters in your daily log. If there is a definite improvement at the end of the 3-day trial (less dry skin and higher morning CPs), while your parameters worsen later (when you stop taking the supplement), then you need this supplement. If you are uncertain and there are other healthy lifestyle changes that could also influence the results, you can repeat this test 2, 3 or even many more times. If there are no changes in your parameters (especially the morning CP), do not waste your time and money for this supplement (fish oil).
How much fish oil should you take a day after this trial or in a long run? The dosage during this trial can be much larger than your optimum requirements and your next step is to define the optimum dose, which produces the maximum effect. For example, if your morning CP is less than 20 s, your 3-day dose can be up to 2 tablespoons of fish oil or cod liver oil (or about 2-3 g of DHA and EPA daily). However, you may need only 1 tablespoon or even 1 teaspoon for a long-term use later. If your morning CP is over 60 s, you may require only 1 teaspoon of cod liver or fish oil per day or you can even try to switch to nuts and seeds for 2-3 weeks, the most natural sources of omegas for healthy people. (The long-term strategy is described at the end.)
Cod liver oil is traditionally produced from livers of codfish, while fish oil is produced from tissues of fatty fish. Cod liver oil has a fishy taste. Many companies now add peppermint, lemon or citrus flavors to make the taste more pleasant. Cod liver oil has a higher ratio of DHA to EPA (which is good for low CPs), while fish oils have a higher ratio of EPA to DHA (which is ok for high CP). If we take the same amount of both oils, fish oils have an almost twice greater amount of total EPA plus DHA than cod liver oil. Cod liver oil, on the other hand, has additional vitamins A and D. Note that concerns about health problems due to excessive vitamin A consumption is reasonable for low CP people (especially for those with less than 10 s CP) and low CP pregnant women.
If we compare krill oil vs. fish oil, krill oil also contains EPA and DHA, but in a different form. In krill oil, the EFAs are linked in phospholipid form. It is the same structure as the fat cells in the human body. Hence, it is much easier for the human organism to absorb and use krill oil EPA and DHA for building human tissues. However, the most valuable components of krill oil are antioxidants, such as phospholipids, vitamins E, A and D, and astaxanthin, which is a very potent one.
Studies found benefits of krill oil in reducing inflammation and pain associated with rheumatoid arthritis, as well as other inflammatory conditions. It was used to treat the symptoms associated with PMS and dysmenorrhea and to suppress autoimmune murine lupus. When the CP is over 30 s, the students generally require only one 500 mg capsule per day, while low CP students (with less than 20 s of oxygen in the body), usually require 2 capsules daily in order to prevent or reduce, for example, joint pain due to arthritis.
Krill oil benefits and advantages also include a better absorption rate of its nutrients, less pollution (krills are at the bottom of the food pyramid and hence accumulate fewer toxins), excellent antioxidant supply, stability against rancidity due to the naturally present antioxidant, and fewer side effects.
Conclusion (fish oil versus krill oil). Due to high antioxidant power, but the low content of DHA and EPA, krill oil can rather be used as an additional source of antioxidants, while fish oil or cod liver oil can be used as sources of omega 3 fats.
Which one is better? First of all, the supplement can have only salmon oil inside, while the main label and the name of the product can include “Fish Oil” words without any referral to salmon. Second, the choice depends on many factors that have been described above. Generally, salmon oil is better due to higher DHA content and higher DHA to EPA ratio, but this does not mean that any salmon oil supplement is better than any fish oil supplement. There are fish oil brands and varieties that can be much better than salmon oil. For more details on how to choose omega oils, see the summary of factors provided below.
How much omega 3 do you need? For most people, the dose can range from about 500 to 2,000 mg depending on 3-day test results and factors described above. Hence, it is important to know what the DHA and EPA content in your supplements are and what the best sources of these omega 3 fats are. Here are some average or typical results.
|Type of omega 3 supplement||DHA, mg||EPA, mg||Additional substances|
and other parameters
|Typical fish oil capsule (1000 mg)||120||180|
|Ethyl ester* fish oil capsule (1000 mg)||350||490|
|LOVAZA omega-3 fish oil||375||465||Is the only FDA-approved medicine made from fish oil|
|Carlson Cod Liver Oil capsule (1000 mg)||120||90||80 to 100 mg ALA; 1600 IU v. A; 800 IU v. D; 20 IU v. E (natural d-alpha tocopherol and mixed tocopherols)|
|Carlson Cod Liver Oil capsule (10 ml)||1090||860|
|Cod liver oil, Atlantic (10 ml)||1200||800||Vitamins A and D|
|Cod liver oil, Baltic (10 ml)||2000||900||Vitamins A and D|
|Extra-Virgin Salmon Oil capsule (1100 mg)||240||240||50 mg of mixed omega 3s; 40 mcg astaxanthin complex; antioxidant blend (natural lemon oil, rosemary extract, ascorbyl palmitate – fat-soluble vitamin C, natural tocopherols – vitamin E)|
|GNLD NeoLife Omega III Salmon Oil Plus capsule (1000 mg)||240||230||50 mg DPA and 40 mg of mixed omega 3s, including SDA, ETA(3), ETA, HPA and ALA|
|Salmon Oil Plus capsule (1000 mg)||160||90||17 mg DPA and 27 mg of mixed omega 3s, including SDA, ETA(3), ETA, HPA and ALA|
|Alaska Deep Fish Oil (Salmon Oil) capsule (1000 mg)||180||80|
|Salmon Oil Concentrate capsule (1000 mg)||120||80|
|DHA-Rich Omega-3 Algae Oil capsule (800 mg)||300||10||Vegetarian|
|Krill oil, 2 capsules (1000 mg in total)||90||150||420 mg phospholipids, omega-3 rich|
(90% a phosphatidylcholine & lysophosphatidylcholine
10% as other phospholipids); 1.5 mg astaxanthin; lemon oil
* Ester forms of fish oil have better bioavailability and are more readily used by the body due to their optimum molecular geometrical configuration.
Other available products that you can buy include:
1. Enteric coated EPA and DHA capsules or tablets (for those whose stomachs are sensitive to fish oils). They are more concentrated in EPA and DHA.
2. Emulsions of fish oils (e.g., for salad dressings)
3. Functional foods with fish oil (e.g., snack bars)
4. Infant formulas with DHA.
* Your current personal needs (consider your health conditions or CP and symptoms)
* Purity of the product (choose those with special molecular distillation processes or pharmaceutical grades)
* DHA content (the more the better)
* EPA content (the more the better)
* Presence of protective antioxidants (good fish oil products must contain antioxidants such as tocopherol to protect against their oxidation during storage and at other times)
* Date of production (go for newer products)
* Storage conditions (go for those stored in the fridge)
* Packaging (go for dark glass containers, since capsules provide poorer protection from oxygen).
As you can see that choosing a right supplement can be a headache especially when one’s CP is low. Better get over 60 s for your body oxygen level and make a transition to nuts and seeds without all these cautions, warning, concerns, and rules. With maximum possible CPs (about 3 min), as hatha yoga ancient books claim, one can eat only meat and remain healthy (with high CP). For modern people, eating only meat can be a disaster since the sick ones will die probably in some weeks, while more healthy individuals may last only for some months.
PS. There are very recent 2010 studies that found that long-term use (or lifetime) use of fish oil could cause more oxidative stress and cause other negative effects (see references below). The results could be generally true since it is not physiologically normal for humans to consume fish products on daily basis. After each 1 month course, you can take 1-2 week breaks and monitor your morning body-oxygenation index and other parameters during this break and when you resume supplementation. This is another reason to raise the CP so that there are fewer complications with diet and supplements.