21 replies to this topic

[Clarity]

I've tried using fish oil over & over again, and many different "safe" brands. Just can't tolerate it.

I get:

Joint pain
Severe stomach irritation
Increased blood sugar.

I've taken it on a full stomach too. I take Vit. E to counteract oxidation, so that's not it. Unless they are suppose to be taken at EXACTLY the same time?

Is flaxseed a good substitution? My memory is terrible lately, so I can't remember what the heck doesn't get converted enough
with flax. I have taken the plant algae form of DHA as well without a problem. Is that combo sufficient?

Thanks in advance!

[nameless]

It depends on what you are taking it for, but for general health reasons, it may be fine. If doing CR, it may even be preferred. ALA will convert to EPA to a varying degree, but believe it doesn't convert to DHA so well (or at all). So you can go the ALA + DHA (algae) route if you want to.

Just be aware that flax may not be so stomach friendly either (at least for me). I had a bigger problem with flax seed or oil than almost any fish oil I've tried. Flax oil can oxidize too, so make sure it's refrigerated, or go with the seed and ideally grind it yourself.

If you do try fish oil again one day, just make sure it's fresh (open a gel and taste it), and try some of the better brands, if you haven' already done so. I usually find the lower dose oils more stomach friendly and less fishy tasting (barleans, carlson).

[Clarity]

It depends on what you are taking it for, but for general health reasons, it may be fine. If doing CR, it may even be preferred. ALA will convert to EPA to a varying degree, but believe it doesn't convert to DHA so well (or at all). So you can go the ALA + DHA (algae) route if you want to.

Just be aware that flax may not be so stomach friendly either (at least for me). I had a bigger problem with flax seed or oil than almost any fish oil I've tried. Flax oil can oxidize too, so make sure it's refrigerated, or go with the seed and ideally grind it yourself.

If you do try fish oil again one day, just make sure it's fresh (open a gel and taste it), and try some of the better brands, if you haven' already done so. I usually find the lower dose oils more stomach friendly and less fishy tasting (barleans, carlson).

Thanks so much nameless! Ok, so it is the DHA it doesn't convert to. At one time I was extremely sensitive to all fats & oils. I eventually learned I have a gallbladder problem, but I did adjust to the healthy fats. The saturated fats are killer to me though. So I think it's the actual oil that is bothering me. I could tolerate some short-lived stomach pain, but the joint pain becomes an everyday/all day occurance and I've been there before, and it took awhile with adjustments with diet to get rid of it (it's also the gallbladder thing). Plus the inflammation going on in my body on a daily basis isn't a good thing.

I have tried Carlson & Nordic Naturals (?), and another well known brand that I can't recall right now. Brand new bottles and always refrigerated. I don't eat fish, but eat shellfish occasionally, and get some fleeting joint pain, so I think it's just seafood in general.

What's CR? I wanted to get in my omega 3's/DHA because my memory is really going downhill. I'm 45, so I shouldn't be going senile just yet. I do have some off and on depression as well. It's the only thing I'm missing in my diet, and it's been frustrating for this to be so complicated. I'll try the flax seed & DHA and if that doesn't work, then I'm going to have to come up with something to counteract the inflammation. I have tried flax in the past and had the same problem, but maybe it won't this time. I unfortunately haven't found a single supplement yet that is suppose to be anti-inflammatory that actually works for me. It all comes down to the saturated fats.

Thanks again for your help!

[nameless]

CR = caloric restriction.

I'm not sure what fats are okay or not with gall bladder problems, but other options are:

Other sources of ALA besides flax, such as hemp, chia seeds, etc. But I'm not sure if there would be a difference in how your gall bladder likes that.

There is another fatty acid, Stearidonic acid, which may work better than ALA as far as conversion. But it's somewhat hard to find in supplement form... AOR makes one, and I think there is a vegan product on iHerb that does too, but it tends to be very expensive. No idea if it's actually worth it or not.

Or go for straight algae. Since you tolerate it well enough already, maybe look for an algae product with EPA too. Although most algae products are DHA only, they do have some nowadays that can produce small amounts of EPA, as well. Also keep in mind that DHA should (I think) convert partially to EPA in one's body. I know of a new algae product, Ovega -- http://www.ovega.com/ and V-Pure -- http://www.v-pure.co...save-the-world/ which are algae based and have both EPA and DHA. It's not as much EPA as found in some other sources, but it's better than nothing.

I imagine you've tried various digestive enzymes for your gall bladder issue already, but if not, you can maybe find something to help from these guys:
http://www.enzymedica.com/

They are great with giving out free samples too. Just email them what you are interested in, and they should send you off a box of like a dozen or so samples (or at least they used to do that).

Edited by nameless, 12 June 2011 - 12:54 AM.

[Robert C]

I don't like the concentrated fish oils myself but you might give them a try if you have not already. I think Nordic Naturals and a few others make the so called "pharmacutical grade" fish oil that has a DHA + EPA content of 60% or more. A single one gram capsule per day would get you about the same EPA + DHA as two cans of sardines per week. These concentrated oils don't have any saturated fat. You can double check that by putting a capsule in the freezer for a while and cutting the capsule open. If there is no solid oil there at freezer temp there is no saturated fat. Also, could you be allergic to iodine? If so, you might have better luck with a very low dose of concentrated fish oil.

[Clarity]

Nameless: I have tried digestive enzymes, but not since the gallbladder problem. Never even thought to use it for that! I'll give that a shot first If I didn't throw it out or give it away. Otherwise I'll try the Ovega since it has a higher amount of EPA and see how that works. Flaxseed plus DHA would have ended up being more expensive anyway. (These damn DHA algae products are so expensive).

Robert: Is this somewhat what you are talking about regarding concentrated? http://www.vitacost....Oil-Concentrate I'll give that a try next if the Ovega doesn't work out. I'm not sure if it's iodine. I've used iodine supplements & kelp before without a problem...I think. Now I'm going to have to take a couple kelp tablets and see what happens. Is fish oil extremely high in iodine?

Ok, so what was I going to do first? lol Now I've got myself confused. Who would think one little ole capsule of fish oil would wreak so much havoc on my body.

Thanks!

[Clarity]

I must have gotten rid of the digestive enzymes, but I have Wobenzym. Will that do if taken with food or are they the wrong enzymes: Pancreatin, Papain, Bromelain, Trypsin, Chymotrypsin, Rulosid. I know there's alot missing there, but figured I'd ask anyway.

Edited to Add: Nevermind - I looked at the enzyme link Nameless provided and I need Lipase the most.

Edited by Clarity, 12 June 2011 - 01:29 AM.

[Robert C]

I think some of the Nordic Natural fish oils are very concentrated but the one on that site had 600 mg DHA/EPA per TWO capsule serving. Further down the site the Natural Factors RX fish oil has 600 mg DHA/EPA per ONE capsule serving. 60%. I doubt these highly purified oils have much iodine but some people can be very sensitive to sea food products. (People commonly say "iodine allergy" but it might just be certain sea food protiens that are the culprits.) The type of fish that the oil comes from might also matter for you. For example, you could try a small dose of cod liver oil, salmon oil, krill oil, or concentrated oil from small fish (like the Nordic Naturals). You may just have to experiment a bit. My best guess is that the most tolerable oil would be a small dose a very concentrated oil. Ultimately, if these oils make you feel bad even in small doses I would just drop them and not worry about it.

Edited by Robert C, 12 June 2011 - 02:57 AM.

[Clarity]

Thanks Robert for the advice. I may try cod liver oil, but I did notice that alot of the fish oils have mixed sources, but I'll look into single sources if necessary.

I'm going to try the digestive enzymes first, as I seem to have located my missing bottle at my brother's house! : p

[hbar]

I'm not sure if current research has shown otherwise, but some quick googling turned up a couple of studies that showed the ALA -> EPA conversion rate to be in the realm of 15-30% (DHA rate significantly lower than that). So if you're taking a large enough dose of ALA which takes into account the conversion rate, I'd think it would be fine to substitute, though you really can't be sure exactly how much EPA/DHA your body is actually converting.

Most high-quality fish oils have very little saturated fat in them, so I doubt that's what's causing the problem. And any good fish oil will already have some Vitamin E mixed into it to prevent rancidity, so you shouldn't really need to take extra Vitamin E (and some brands, like Nordic Naturals, already give you 100% of the daily value of alpha tocopherol, so you probably don't want to be supplementing with too much Vit E on top of that anyway).

One thing you may try is to use a fish oil which has enteric coated capsules. That should prevent the fish oil from bothering your stomach, but I'm not sure if that would help with gallbladder issues since the pill will still dissolve in your intestine.

Personally I wouldn't bother with Nordic Naturals - their fish oils aren't that highly-concentrated and they're very expensive. I use Jarrow's EPA/DHA Balance (400mg EPA/200mg DHA per pill) and it costs like $25 for 240 pills...NN is something like $50 for 180 pills and a slightly lower EPA/DHA amount.

Another option might be krill oil. It supposedly has a significantly higher bioavailability than fish oil - personally I'm not sold on it because the increase in bioavailability is more than counteracted by the much higher price of krill oil. However, the upside is that krill oil pills come in much lower doses than fish oil, so that may be an option as well if a large mass of EPA/DHA is bothering you.

Finally, I'd be careful about using cod liver oil. They aren't (IIRC) as concentrated in EPA/DHA as some of the fish oils are, meaning you have to take more pills (and ingest more total fat) to get the same amount of omega-3s. The other problem with cod liver oil is that it has pre-formed Vitamin A in it, which is the kind of Vitamin A that you generally want to avoid. Nordic Naturals' cod liver oil doesn't have a ton, but some brands can have several thousand I.U. per serving, which is definitely not a good idea.

[Clarity]

I'm not sure if current research has shown otherwise, but some quick googling turned up a couple of studies that showed the ALA -> EPA conversion rate to be in the realm of 15-30% (DHA rate significantly lower than that). So if you're taking a large enough dose of ALA which takes into account the conversion rate, I'd think it would be fine to substitute, though you really can't be sure exactly how much EPA/DHA your body is actually converting.

Most high-quality fish oils have very little saturated fat in them, so I doubt that's what's causing the problem. And any good fish oil will already have some Vitamin E mixed into it to prevent rancidity, so you shouldn't really need to take extra Vitamin E (and some brands, like Nordic Naturals, already give you 100% of the daily value of alpha tocopherol, so you probably don't want to be supplementing with too much Vit E on top of that anyway).

One thing you may try is to use a fish oil which has enteric coated capsules. That should prevent the fish oil from bothering your stomach, but I'm not sure if that would help with gallbladder issues since the pill will still dissolve in your intestine.

Personally I wouldn't bother with Nordic Naturals - their fish oils aren't that highly-concentrated and they're very expensive. I use Jarrow's EPA/DHA Balance (400mg EPA/200mg DHA per pill) and it costs like $25 for 240 pills...NN is something like $50 for 180 pills and a slightly lower EPA/DHA amount.

Another option might be krill oil. It supposedly has a significantly higher bioavailability than fish oil - personally I'm not sold on it because the increase in bioavailability is more than counteracted by the much higher price of krill oil. However, the upside is that krill oil pills come in much lower doses than fish oil, so that may be an option as well if a large mass of EPA/DHA is bothering you.

Finally, I'd be careful about using cod liver oil. They aren't (IIRC) as concentrated in EPA/DHA as some of the fish oils are, meaning you have to take more pills (and ingest more total fat) to get the same amount of omega-3s. The other problem with cod liver oil is that it has pre-formed Vitamin A in it, which is the kind of Vitamin A that you generally want to avoid. Nordic Naturals' cod liver oil doesn't have a ton, but some brands can have several thousand I.U. per serving, which is definitely not a good idea.

Thanks hbar. I think with the enteric coated I still wouldn't be able to overcome the joint pain. I also have the same problem with Wobemzym taken on an empty stomach. And I also get joint pain from Glucosamine & Resveratrol (which makes me feel outright ill). I think you are right, it's probably not the fat. My theory is I've got some toxic muck going around in my body, and anything I introduce that either thins my blood or breaks down fibrin sets me up for that reaction. I have a mild clotting disorder that wasn't discovered until a few years ago, and maybe that contributed to it. But I don't know much about these things to understand it all.

I did end up having a joint pain flare with the Kelp. Whether that's the iodine or some component of it's growth environment I don't know. But I do get enough iodized salt that I think it's more likely that it's not that. I've also had iodine contrast with no problems except a very prolonged metallic taste.

And I had some crazy blood sugar levels on the digestive enzymes (no other problems except that). My fasting blood sugar was still ok, but 8 hrs after eating my glucose levels would just not drop off. Maybe it has to do with what I read about increased cell permeability and some toxin release...I'll keep up with it though. I do recall now that is why I didn't continue taking them last time.

I ended up ordering the Ovega (EPA/DNA algae source) and hopefully I'll have no problems with that. I just had a feeling that no type of fish oil is going to work out.

[nameless]

The joint pain thing I find weird. I'm not sure why fish would cause it, while other sources of Omega 3s wouldn't. Or why it should occur at all, unless it's some fat + gallbladder thing.

Do you have allergies to any types of fish?
The amount of iodine in fish oil is pretty minuscule, so I really doubt that can be an issue.

Hbar is correct about the flax conversion. Intake of Omega 6s and other forms of Omega 3s will also impact the conversion rate.

What type of clotting disorder do you have? Just wondering if your blood becomes too thin, or you are prone to clots. In the latter case, fish oil could be of theoretical benefit due to blood thinning (although I think you'd need an awful lot of it to thin your blood).

I just started looking at algae sourced DHA in more detail very recently. I'm not sure it's an issue or more an issue raised by competitors for marketing reasons, but I think Martek (Life's DHA) uses hexane as part of its extraction method. If you continue with the Ovega, past the bottle you already have, you may wish to contact them and see if they still use this same process. Hexane extraction can be used in other supplement extracts too, such as with some krill oils, so it may not be a big issue if all of the hexane is removed from the final product. I just wanted you to be aware of it, as I didn't even read about it until yesterday, and don't know if it's an actual health issue or not.

[niner]

Thanks hbar. I think with the enteric coated I still wouldn't be able to overcome the joint pain. I also have the same problem with Wobemzym taken on an empty stomach. And I also get joint pain from Glucosamine & Resveratrol (which makes me feel outright ill). I think you are right, it's probably not the fat. My theory is I've got some toxic muck going around in my body, and anything I introduce that either thins my blood or breaks down fibrin sets me up for that reaction. I have a mild clotting disorder that wasn't discovered until a few years ago, and maybe that contributed to it. But I don't know much about these things to understand it all.

I did end up having a joint pain flare with the Kelp. Whether that's the iodine or some component of it's growth environment I don't know. But I do get enough iodized salt that I think it's more likely that it's not that. I've also had iodine contrast with no problems except a very prolonged metallic taste.

And I had some crazy blood sugar levels on the digestive enzymes (no other problems except that). My fasting blood sugar was still ok, but 8 hrs after eating my glucose levels would just not drop off. Maybe it has to do with what I read about increased cell permeability and some toxin release...I'll keep up with it though. I do recall now that is why I didn't continue taking them last time.

Clarity, this is making me wonder if you don't have a sensitivity to something that these things have in common, like gelatin, magnesium stearate, or some other excipient. It might be best for you to try to get everything you need from a well-crafted diet, and avoid whatever supplementation you can.

[Clarity]

The joint pain thing I find weird. I'm not sure why fish would cause it, while other sources of Omega 3s wouldn't. Or why it should occur at all, unless it's some fat + gallbladder thing.

Do you have allergies to any types of fish?
The amount of iodine in fish oil is pretty minuscule, so I really doubt that can be an issue.

Hbar is correct about the flax conversion. Intake of Omega 6s and other forms of Omega 3s will also impact the conversion rate.

What type of clotting disorder do you have? Just wondering if your blood becomes too thin, or you are prone to clots. In the latter case, fish oil could be of theoretical benefit due to blood thinning (although I think you'd need an awful lot of it to thin your blood).

I just started looking at algae sourced DHA in more detail very recently. I'm not sure it's an issue or more an issue raised by competitors for marketing reasons, but I think Martek (Life's DHA) uses hexane as part of its extraction method. If you continue with the Ovega, past the bottle you already have, you may wish to contact them and see if they still use this same process. Hexane extraction can be used in other supplement extracts too, such as with some krill oils, so it may not be a big issue if all of the hexane is removed from the final product. I just wanted you to be aware of it, as I didn't even read about it until yesterday, and don't know if it's an actual health issue or not.

I'm going to make this oh so much more complicated, but the sensitivity to fats started when I was on Atkins years ago - after eating low fat all my life. It started with joint pain and severe muscle pain. Exacerbated by taking a bovine colostrum supplement which made me very sick for 6 mos., and made me sensitive to healthy fats for awhile as well as certain dairy products. Then throw in some toxic exposures - black mold, and fertility drugs from 4 IVFs...which brought on adrenal problems after being on steroids for that. I do know from changing my diet that the joint pain goes away as long as I keep the saturated fat low, and the healthy fats moderate but at small intakes at one time. I eat a whole food diet most of the time and am able to keep the gallbladder/joint symptoms at bay. It's more a cumulative effect for me. I can eat high fat for a week, but after that the symptoms crop up. I had the joint/muscle pain for 5 years until I cut back on the fat.

The clotting disorder is the Factor II Prothrombin Mutation (G20210A) - there's another Factor II clotting disorder that I believe is a slow clotting time. Mine is faster clotting/thicker blood. I also have high fibrinogen which is why my thoughts lead to the whole fibrin disguising pathogens, and then being released when a blood thinner is introduced. Only thing wrong with that theory is that I don't get those symptoms when I have taken nattokinase.

I've used castor oil (which uses but removes hexane) for castor oil packs and haven't had a problem with that, so hopefully that should not be an issue with the algae products.

Niner: I take other capsules with those ingredients without problems. But it's certainly been frustrating in the past trying to figure it out! I did go to a naturopath and did some kind of allergy testing - I did show moderate sensitivity to clams & shrimp - which are the only 2 seafood items I eat. But really maybe a few times a year. I do get mild joint pain eating them.

[Robert C]

More food for thought. There is a prescription fish oil called Lovaza that is I think 85% DHA/EPA. It is very expensive compaired to the normal stuff but it might possibly be worth trying if all else fails. You could get a doc to prescribe say 10 pills to try. Maybe your insurance would even cover it. One pill every-other-day would get you at the 0.4 to 0.5 mg of DHA plus EPA that is in two small portions of oily fish per week that the American Heart Association recommends for everyone. The advantage here might be purity of the oil and the small amount you would need to take to get your DHA and EPA.

Edited by Robert C, 13 June 2011 - 06:24 PM.

[Clarity]

More food for thought. There is a prescription fish oil called Lovaza that is I think 85% DHA/EPA. It is very expensive compaired to the normal stuff but it might possibly be worth trying if all else fails. You could get a doc to prescribe say 10 pills to try. Maybe your insurance would even cover it. One pill every-other-day would get you at the 0.4 to 0.5 mg of DHA plus EPA that is in two small portions of oily fish per week that the American Heart Association recommends for everyone. The advantage here might be purity of the oil and the small amount you would need to take to get your DHA and EPA.

I thought I saw a commercial on that. I'm just wondering, since natural products can't be patented, did they switch something around and turn it into a synthetic? Although I know they have rx Vit. D...so confused about that.

[Robert C]

Good question, I'm not sure if it's patented. It is probably an ethyl ester oil, and as those are controvercial, I usually stay away from them. However, the oil must be well absorbed because at the normal higher doses this med is proven to knock down trigliceride levels. I don't think there would be any negative issues if taken in very small doses (unless he just plain cannot tolerate any fish oil at all).

[caruga]

I'd go with the plain seed, I bought a kilo for less than £2. Just chew it a lot or grind it in a coffee grinder.

[hbar]

If concentrated fish oil is a problem, Lovaza won't be any better, because that's all it is. Yeah, it's a bit more concentrated than some of the pharmaceutical-grade fish oils you can get, but the increase in concentration isn't worth the massive increase in price. Your insurance may cover it, but Lovaza is a classic example of how our health care system is messed up and why everything is so damn expensive.

Also, there really isn't any "controversy" per se over ethyl ester fish oils - they're perfectly safe and effective (and probably most concentrated fish oils are ethyl esters). The only debate is whether the ethyl ester or re-esterified triglyceride form of fish oil is more bioavailable. There was a study done showing the triglyceride form has higher bioavailability (it's on Nordic Naturals' website, of course), but I believe another study was done that showed after a certain amount of time, ethyl ester bioavailability is nearly as good. Certainly in the case of NN, the increased bioavailability is completely offset by the huge price hike - there may be other brands that sell cheaper triglyceride-form fish oil, but I haven't cared enough to look.

Personally, if you really do have some kind of sensitivity or allergy to EPA/DHA, then I'm not sure that any solution is really going to work for you. No matter how you take it, and no matter the source (salmon, krill, etc), ultimately the point is that you want EPA and DHA. Even taking ALA I'm not sure would make a difference, because your body is still going to convert the ALA into EPA/DHA, which will then still bother you.

Obviously I have no idea about your medical history, but considering the severity of the reaction you have to fish oil I'd see a doctor about it if you really want to keep taking it.

[Robert C]

Hbar your points are well founded. I agree that the Lovaza is probably overpriced but I have to assume that if it makes it through the FDA process it is probably the gold standard for purity. Also since it is the most concentrated, for a given dose of DHA/EPA, it would probably contain the least other ingredients which might be causing the problems. If he got a few of these pills and took one every-other-day and felt ill it might rule out experimenting with other fish oils. IMHO, if low dose Lovaza will not work, probably none will.

[Clarity]

Thankfully I don't have to worry about Lovaza or flaxseed & conversion. I received the Ovega (thanks to 2 day shipping from Amazon), took it, and no stomach irritation, and so far no joint pain. So ecstatic about that.

Thanks for all the help, and Nameless - thanks for steering me to Ovega. Here's hoping my IQ goes up a few points, it quells the depression & generally improves my health.

Odd though that fish oil and kelp (which has no oils) trigger the joint pain, yet the algae DHA/EPA doesn't. I'll probably never know the answer. Oh, and I know there's usually alot of guys posting on here, but for the record I'm a female : )

Thanks again!

Wendy

[Hepoberman]

I switched to 1 tablespoon a day of Flax seed oil from daily fish oil supplementation about six months ago. Recently, I had a NutrEval by Genova which includes a fatty acid panel.

 

My ALA, LA, and EPA were each at top of range while my Arachidonic acid was at the bottom of range. This is exactly what I had hoped for. No more fish oil for me! [What IS fish oil anyway?]