A majority of Americans have more omega 6 fatty acids circulating their bloodstream than omega 3’s, creating inflammation and health issues. A fatty acid is a chain of lipids bound to a carboxy backbone. The chain is either saturated or unsaturated because of the types of bonds in the attached triglycerides. Omega 3’s are considered to be polyunsaturated fats and contain at least two bonds. Your average American has an omega 6 to omega 3 ratio of at least 25:1.^{1 2}

Omega 6 intake is necessary for cell membrane integrity, inflammation, and pain responses, but an excess of omega 6 causes systemic inflammation. Omega 3 intake helps to curb excess inflammation in the body. The optimal ratio of omega 3 to omega 6 is debatable, but I believe a 1(omega 3):4(omega 6) ratio is fine for most people.

All About Omega 3 Fatty Acids

There are three main Omega 3 fatty acids that are promoted to improve your health, ALA, DHA, EPA.

Alpha-Linolenic Acid

ALA is a plant-based long chain omega 3 fatty acid. ALA is a carboxylic acid with an 18-carbon chain and three bonds. ALA is an essential fatty acid for the human body, and its intake must be made through the diet. ALA can be synthesized into the other omega 3 fatty acids EPA and DHA for further use by the body, but sadly, most of it is oxidized in the process. Studies have shown that the body is only able to synthesize less than 5% of total ALA into EPA and DHA. The percentage of Omega 3 fatty acids that are synthesized from ALA ingestion by males might be even lower.^{3 4} The best intake source of ALA in the diet is through the ingestion of chia seeds. ^{5 6 7}

Docosahexaenoic Acid

DHA is an animal/algae-based long chain omega 3 fatty acid. DHA is a carboxylic acid with a 22-carbon chain and two bonds. DHA is a big component of the makeup of our brain, skin, testicles, and retina. DHA is also the most abundant omega-3 fatty acid that is found in the brain. DHA supplementation is very important for improving cognitive function and brain health. The body can poorly synthesize DHA from ALA, but it is best to obtain it from the diet either by eating fish or by supplementing it. ^{8 9 10 11}

Eicosapentaenoic Acid

EPA is an animal based long chain omega 3 fatty acid. DHA is a carboxylic acid with a 20-carbon chain and two bonds. EPA has been studied for its ability greatly to lower inflammation in the body by the proper formation and use of prostaglandins. EPA also seems to have greater cardiovascular benefits associated with its supplementation than DHA. The body can also poorly synthesize DHA from ALA, but it is best to obtain it from the diet either by eating fish or by supplementing it. ^{12 13}

Supplementation of omega 3 fatty acids or proper intake in diet is important for: ^{14 15 16 17 18 19}

• Optimal brain health and function – omega 3 ingestion reduces the risk of Alzheimer’s disease and dementia, improves memory, reduces brain fog, and helps to alleviate anxiety and depression.
• Optimal heart function – omega 3 ingestion reduces the risk of heart disease, arrhythmia, or the chance of sudden cardiac death occurring.
• Proper inflammation regulation by our immune system. DHA and EPA ingestion regulates the endocannabinoid system (similar to CBD oil and marijuana), reducing inflammation in the body and calms an overactive immune system. Reduces an overactive Th1 immune system.
• Optimal vision and important for the reduction of excessive blue light damage to our vision from living modern lives.
• Optimal nervous system function.
• Contributes to proper fetal development and growth during childhood.
• Lowering the chance of developing diabetes, and helps promote proper blood glucose regulation if you are diabetic.
• Reduction in asthmatic symptoms.
• Reducing bad cholesterol formation (VLDL, LDL, and particle size and type) and triglycerides in the blood.

The average person should supplement or obtain through diet at least 500 mg of EPA and DHA daily. More can be supplemented if needed for overall improvement of health. For the optimal intake of omega 3 it all depends on your omega 6 to omega 3 ratio. If you were following a 4:1 ratio than ten grams of omega 6 accumulated in the diet throughout the day would require 2.5 grams of omega 3 daily intake. Stick to the 4:1 ratio of omega 3 to omega 3 in diet and supplementation for optimal health.

Let us look at the different omega 3 supplements and rather we recommend them to improve your health.

Different Ways of Increasing Omega 3 Ingestion for Proper Health

Seafood Ingestion

You can get healthy amounts of omega 3 from eating seafood every other day. Examples of low radiation and less mercury, healthy seafood include:

• Wild Icelandic cod
• Wild Atlantic flounder
• Wild Atlantic salmon
• Atlantic non-Gulf shrimp
• Wild Atlantic oysters (also good source of zinc)
• Wild Atlantic albacore tuna (make sure it is certified low mercury)
• Wild Atlantic scallops
• Wild Atlantic crab
• Wild Atlantic clams
• Wild Atlantic anchovies
• Wild Atlantic lobster
• Wild Atlantic calamari
• Bar Harbor wild Atlantic herring
• Wild Atlantic mackerel
• Wild Atlantic sardines(Season is a good brand, certified parasite free)

It is always best to get Omega 3’s from food sources over supplementation due to the possibility of the oxidation of the fatty acids in supplements. Seafood from the Mediterranean Sea (instead of the Atlantic Ocean) might also be a good source as well. Bake seafood in the oven below 350 F to prevent oxidation of Omega 3 fatty acids. Steaming and low heat smoking might be fine as well to give flavor to your seafood. I do not recommend consuming raw seafood unless you deep freeze it for a week and prepare it yourself due to increased risk of parasite consumption in improperly prepared raw seafood. Finally, raw seafood like oysters might be contaminated with the Hepatitis virus, so I do not recommend consuming them raw if possible.^{20 21 22 23}

Omega 3 fatty acid supplements should be refrigerated to preserve the oil when possible.

Fish Oil

Fish Oil is high in omega 3 fatty acids which most Americans are deficient. Fish oil is a good source of the omega 3 fatty acids EPA and DHA. Some oils are higher that others in either EPA or DHA, depending on the fish used to produce the supplement and the concentration of the oil.

One of the most important things one can do for their health is to take a high-quality fish oil supplement if you are not able to ingest seafood regularly. You do not want to take a cheap or poor-quality fish oil supplement because the oil might be rancid (oxidized) and cause an increase in inflammation and health issues. In addition, poor-quality fish oil may contain toxins, radiation, and mercury which can also make you ill.

Here are some ways you can determine if your fish oil supplement will benefit your health:²⁴

• The omega 3 content of the supplement is at least 80% or greater of the total oil. Out of 2,000 mg of fish oil, at least 1,600 mg of it should be omega 3’s.
• The omega 3 oil is certified free of toxins.
• The omega 3 oil is pharmaceutical grade.
• The omega 3 oil is CO2 supercritical extracted instead of using harsh solvents like hexane for extraction.
• The omega 3 oil comes from a reputable supplement company.
• The omega 3 oil uses triglyceride-bonded oils instead of lesser quality ethyl ester.
• The omega 3 oil is processed with as little heat and light as possible to prevent unnecessary oxidation.
• The omega 3 supplement is preserved with either natural vitamin E or rosemary oil to prevent unnecessary oxidation.
• The omega 3 oil is certified to be low mercury and contain minute amounts to no radiation.

Here are some recommended fish oil supplements that are Fix Your Gut approved:

Cod liver oil – I recommend the use of a virgin cod liver oil like Nutrapro virgin cod liver oil, Sonne’s, or Rosita. Cod liver oil is a great source of vitamin A and D and Omega 3 fatty acids. I do recommend to get your vitamin A blood levels monitored during supplementation, hypervitaminosis can occur with large doses of vitamin A rich cod liver oil over time. Rosita is my recommendation for the best cod liver oil. If you are concerned about radiation in the Pacific Ocean from the Fukushima Daiichi nuclear disaster contaminating your fish oil, then to my knowledge the only fish oil I can recommend to you is Norwegian cod liver oil. I suggest that you inform yourself into the nuclear disaster and how it is affecting the Pacific Ocean and the West Coast of the United States.²⁵

Fish oil – If you want your fish oil in an easy to take soft gel I recommend OmegaVia. Other fish oil supplements that I recommend are Carlson’s liquid fish oil, UnoCardio, and Nordic Naturals Ultimate Omega 2x.

Salmon oil – I do not recommend most salmon oil because it is low in DHA and EPA and most salmon oil supplements are produced from salmon that come from the northern Pacific Ocean.

Krill Oil

In the future, krill oil omega 3 supplements might be considered the best for optimal health. There are not enough published studies currently to recommend it over fish oil for omega 3 supplementation.

Fatty acids in krill oil are bonded to phospholipids instead of triglycerides or ethyl esters like fish oil. The cell membranes in our body are made from phospholipids so in theory krill oil is better assimilated into the cells than fish oil. Triglycerides are not easily assimilated into cellular membranes and have to be broken down first and run through the kinase pathway. There is also proposed better absorption of DHA and delivery to the brain with krill supplementation. Krill oil also naturally contains the potent antioxidant, astaxanthin, which may prevent oxidation of omega 3 oils in the supplement and provide additional health benefits as well. All of these reasons are why it is believed that krill oil supplementation is superior to fish oil.²⁶

I do recommend that if you have arthritis, you supplement with krill oil, based on its superiority in improving arthritic conditions by being phospholipid bound and the extra astaxanthin in the oil which can further reduce inflammation.^{27 28}

Do not supplement krill oil if you are allergic to shellfish; it may cause an allergic reaction. If you are allergic to krill oil, Jarrow offers a fish oil supplement made from a sand eel that is bonded to phospholipids called PhosphOmega.

I recommend that any krill oil that you use is Neptune Brand Krill Oil; it seems to be the best. NKO is extracted from Antarctic krill and is tested free of heavy metals and contaminants. It is produced in a GMP certified plant in Canada. See if your favorite brand out of the recommended brands in chapter one uses NKO in their krill oil supplements.

Algal Oil

Algal DHA-rich oil is produced from certain types of algae. Algal oil was developed by NASA-sponsored research in the 80’s to find a plant-based food source that can be grown and used in space. It was later discovered that oil extracted from the algae was rich in DHA. DHA or docosahexaenoic acid is a significant component of the makeup of our brain, skin, testicles, and retinas.²⁹

In addition, DHA is the most abundant omega-3 fatty acid in our brain. DHA supplementation is essential for improving cognitive function and brain health.

It appears that the quality of DHA found in algal oil is comparable to the quality of the DHA found in fish oil.

Algal oil is a good way for people allergic to seafood, vegetarians, and vegans to get in proper amounts of DHA. Algal oil is also more sustainable to the environment than fish and seafood based omega 3 oils. Finally, the DHA amount of algal oil is comparable to most mid-grade fish oil supplements.

Algal oil is equivalent in most cases to DHA concentrated fish oil but is extremely expensive in comparison.

The main problem with algae-based DHA (including some DHA fish-based supplements) is the use of hexane and other chemicals to extract the DHA, which leads to a poorer quality DHA supplement. Some algal oil supplements on the market use CO2 extraction instead of hexane that lead to a better quality supplement.³⁰

Very few algal oil supplements contain algae-based EPA. EPA or eicosapentaenoic acid has been studied for its ability greatly to lower inflammation in the body by the proper formation and use of prostaglandins. EPA also seems to have greater cardiovascular benefits associated with its supplementation than DHA. One good brand of algal oil that contains a good amount of EPA is Nordic Naturals Algae Omega.

If you are concerned about radiation in the Pacific Ocean from the Fukushima Daiichi nuclear disaster contaminating your algal oil, then to my knowledge I cannot recommend any algal oil at this time. I suggest you look further into the disaster and how it is affecting the Pacific Ocean and the West Coast of the United States.

Ultimately, I can only recommend the use of algal oil based omega 3 supplements if you are allergic to seafood or are vegetarian/vegan. For everyone else, I recommend you get your omega 3 supplementation from seafood consumption or fish/krill oil supplementation.

If you choose to supplement with algal oil, I recommend you use Minami VeganDHA or Nordic Naturals Algae Omega.

Calamari Oil

I cannot recommend the use of calamari oil yet for omega 3 supplementation, but some general info about the oil does make it look promising. There are no studies currently on calamari oil, but it might be a rich source of DHA. If you want to read more about the oil, you can read about from its manufacturer Calamarine. I would take any information a manufacturer gives you with a grain of salt; also, the manufacturing of the oil comes from squid by-products, and it is unknown if they use hexane. Finally, calamari oil supplements appear to be in an ethyl ester instead of triglyceride bonded, which makes them poorer quality.

Plant-Based ALA

I do not recommend supplementation of plant-based ALA from the diet or in supplemental form. ALA conversion to DHA and EPA is very poor; it is not worth the trouble. If you are male, forget about getting proper ALA conversion from ingesting plant-based ALA, men have an abysmal conversion rate. I recommend algal oil for vegans and vegetarians over plant-based ALA.^{31 32 33 34 35}

If you choose only to intake plant-based ALA chia seeds are a superior source. Soak your chia seeds for at least ten minutes in water to let them gel before eating them to help with assimilation. Try to get organic chia seeds if possible. Flax is a decent source but not as good as chia. Flax can cause issues because of its phytoestrogenic properties and can be hard on digestion for people with gut and probiotic microbiome issues. Perilla seeds also might be a better source of ALA than flax. Hemp is a good source of ALA but contains a lot of omega 6.³⁶

Potential Problems with Increasing Omega 3 Fatty Acid Ingestion

There are some issues that can occur in some people that try to ingest Omega 3 sources to improve their health. The amount of fish oil supplemented might need to be limited in people taking blood thinners and people with chronic heart failure. Large intake of omega 3’s may change the viscosity of blood and interfere with blood thinners. People with chronic heart failure need reasonable amounts of omega 3, but too much can cause some issues with proper heart rate and output homeostasis. If you are suffering from these problems ask your medical professional about the dosage of fish oil you can safely take to improve health.^{37 38}

People with histamine intolerance or mast cell activation disorder may have issues when ingesting seafood and seafood based omega 3 fatty acid supplements. In addition, some people have severe allergies to seafood and seafood based oils which can make it difficult for them to obtain proper amounts of Omega 3’s in their diet. Rarely, someone with an iodine allergy might have a reaction to seafood or seafood based oil ingestion as well. Fish, for example, contain bacteria (Morganella morganii) in their flesh that can produce histamine from the amino acid histidine in their flesh. Even in healthy people, spoiled fish (mainly mackerel, tuna, bonito, mahi-mahi, and amberjack) can cause a type of food poisoning known as scombroid poisoning if ingested from too much histamine being produced. Symptoms of scombroid poisoning are similar to people who have histamine intolerance that swallow non-fresh fish, heart palpitations, itching, hives, facial flushing, headache, intestinal cramps, diarrhea, tongue swelling, and in severe cases, respiratory distress, coma, and death. If you are suffering from histamine intolerance and mast cell you may want to ingest fish that you know is properly caught, stored and incredibly fresh, or frozen fish that you either do not defrost to cook or cook within a day of defrosting. I would recommend avoiding most canned fish which is extremely high in histamine. Fish oil supplements can be very hit and miss; I would suggest avoiding any fish oil supplement that contains citrus which can cause issues and refrigerate your fish oil for preservation.^{39 40}

Finally, a rare type of food poisoning from ingesting reef fish(tuna, barracuda, amberjack) known as ciguatera can occur. Reef fish that ingest toxins produced by dinoflagellates(Gambierdiscus toxicus) can pass their toxic loads to fish that are higher up the food chain. Humans then consume these larger tasty fish, and in doing so, we ingest a higher concentration of the ciguatoxin(biomagnification). Ciguatoxin is odorless and tasteless and cannot be inactivated during cooking. Symptoms of this horrible poisoning include intestinal upset, nausea, vomiting, neuropathy, headaches, muscle aches, numbness, vertigo, and hallucinations. Severe cases can cause a burning sensation when one becomes cold or cold items make contact with the skin (cold allodynia). Symptoms of the poisoning can last from weeks to months to even years and can be triggered by alcohol, seafood, poultry, eggs, and chemical sensitivities. The ciguatera toxin can also be spread by sexual contact and through breast milk. Leaves containing rosmarinic acid is used as a folk remedy to help treat the condition and may help remove the toxins from the body, calm the immune system, and reduce inflammation caused by the toxins.^{41 42}