Dear Pharmacist: I just heard about the new study that says fish oil supplements don’t prevent heart attacks, and may not help us. Should I keep taking fish oils? --S.S., Chicago

Answer: Yes, if they’re high-quality. The “study” wasn’t a study at all, it was a meta-analysis, which means researchers examine results from a bunch of trials and draw their own conclusions based on the collective data. The meta-analysis you refer to appeared in the September 2012 issue of JAMA and included 68,000 participants in 20 different studies that covered a time frame of 24 years. I have some problems with their opinion that fish oils are fairly worthless. The research I know of suggests strong benefits to the heart and arteries when you take high-quality fish oils. These are my problems with the JAMA article:

1. The researchers only reviewed 20 studies, but there are thousands that suggest cardiovascular protection by fish oils, particularly the EPA and DHA components. You’re not going to get the full picture from 20 studies.
2. How much fish oil was used? Most people were taking 1,000mg per day, but you need about 2,000 mg per day (total daily dose of EPA and DHA) to truly impact coronary heart disease. We come up therapeutically short! What about the ratio of EPA to DHA; ideally, I’d like it to be 3:2; for example, 600mg of EPA to 400mg DHA is a 3:2 ratio.
3. They looked at chronically ill people who had serious conditions, for example, they had already suffered a heart attack and stroke, not folks taking it for prevention. Fish oils are not intended to prevent heart attack or stroke but rather reduce the risk of them by reducing a risk factor such as high triglycerides, for example. Plus, it’s super hard to prevent more health catastrophes, once you’ve had one. Feeling skewed?
4. What about the medications these folks were taking? The participants were taking all sorts of blood pressure pills and diuretics, most of which just so happen to be drug muggers of magnesium! Do you realize that serious uncorrected magnesium deficiency can cause a heart attack, no matter how much fish oil you take! To me, this is a huge gap in their premature conclusion.
5. What about gamma linolenic acid or “GLA” status? When you take fish oils, an omega- 3 fatty acid, you have to also supplement with GLA (an omega-6 fatty acid) because high doses of fish oils will cause drug mugging of GLA. For example, if you take 1,000 mg of fish oil (EPA and DHA totaled together), you need 500mg GLA at the same time. Evening primrose oil supplements can provide this GLA. This is important because GLA deficiency can increase your tendency to form clots (bad). GLA is known to protect the heart; without adequate amounts, you could suffer cardiac consequences, and this was not even addressed.

Even the American Heart Association approves of fish oils for heart health. Think smart and don’t be fooled by a single study intended to sway you away from decades of positive research.

A licensed pharmacist for over 22 years, Suzy Cohen shares the pros and cons of medication use as well as natural substitutions for most any of your health concerns. Visit Suzy’s website at www.dearpharmacist.com.

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