Summary: Antarctic Krill Oil has shown many possible benefits including helping women with painful menstruation and controlling cholesterol levels.  There may be some questions on if the current studies are biased.  If the popularity of Krill Oil takes off it could have a huge impact on not only the Krill but also the predators who feed on Krill.  Pure antarctic Krill Oil is also expensive.

Dear Curtis: I heard about a new supplement called Antarctic Pure Krill Oil that is said to benefit bad periods.  I’m particularly interested in it as I have pretty bad menstrual periods and cramping.  What do you think?

My Answer: Hey, they use Prozac for bad periods, so why not the oil of a shrimp from Antarctica?

Seriously, I have to admit I’ve been keeping a bit of an eye (albeit a skeptical one at this point) on Krill Oil. But before I get into my personal feelings let’s look at the proven benefits of Krill Oil (specifically if it’s worth trying for your periods).

Krill Oil for Premenstrual Symptoms (PMS) and Dysmenorrhea

The most referenced study to date was published in 2003.  The study was set up as a double-blind (that’s good – none of the participants knew what they were taking) comparison between Neptune Krill Oil™ (NKO) and omega-3 fish oil in the treatment of PMS and dysmenorrhea (painful menstruation).

The researchers found that both NKO and omega-3 fish oil showed a statistically significant improvement in both conditions.  They went on to also state that while they were both effective the group of women taking NKO used even fewer analgesics (pain killers) than the omega-3 group did.

Here’s how I would interpret these results.  Yes, NKO will reduce your need for over-the-counter pain medications.  So will omega-3 fish oil.  NKO will likely reduce your need for pain pills even more than fish oil.

The question is how much more and is it worth it?

At the end of the 90 day treatment period NKO users saw a decrease of ibuprofen use of 50% (from1,200mg a day to 600mg a day.  A typical over-the-counter ibuprofen tablet is 200mg).  The omega-3 group saw the same decreases as NKO at 30 days but the 90 day measurements weren’t as promising at a decrease of ibuprofen from 1,200mg a day to 800mg a day.

Users stated similar decreases if they were using Tylenol.  For example, the NKO group saw acetaminophen use decrease from 2,500mg to 1,000mg.  The omega-3 group fell from 2,500mg to 1,480mg of acetaminophen.

So yes, to answer your question Krill Oil will likely help your painful periods and PMS symptoms but it won’t make them all go away.  Neither will fish oil.  Unfortunately, there are so many hormonal things going on when women menstruate that it’s tough to imagine that any one supplement will make it all go away.  The question you should really be asking yourself is, is it worth it to you?

That I can’t answer.  I can tell you that most of the Krill Oil products I see on the market are pretty expensive.  On the other side of the coin I hate to see people taking that much ibuprofen or acetaminophen on a consistent basis.  Ibuprofen is tough on your stomach and acetaminophen will run your liver through the ringer.  In short, I think either of them are worth a try and will do you no harm.

The doses of each supplement used in the study were: 2,000mg a day of either Antarctic Pure Krill Oil NKO or omega-3 with food for the first 30 days.  During the next two months study participants took 2,000mg a day eight days prior to and two days during menstruation.  The other popular brand is Kriaxanthin Antarctic Krill Oil.

I should also note that most people claim to tolerate Krill Oil better as their is no burping or fishy aftertaste like there is with fish oils.  This appears to be from how Krill Oil is absorbed in your body.

SIDENOTE: Are you allergic to shellfish?  If you are avoid Krill Oil.  I won’t go into specifics – unless you like reading about IgE antibodies and tropomyosins – but the risk of an allergic reaction outweighs the reward in my opinion.

Cholesterol Control

In addition to helping with painful menstruation it’s important to note that Krill Oil shows even more promise in cholesterol control.  And not just lowering cholesterol (as is too often our focus) but in also raising your ‘good’ (HDL) cholesterol.  In fact, in one study Krill Oil raised HDL 43.5% and lowered bad cholesterol (LDL) by 34%.

Prescription drugs can lower LDL numbers by this much but they do not raise HDL that much at the same time.  The only other supplement I’ve seen that can raise HDL to that extent is niacin.

Downsides of Krill Oil

While both of these studies are promising I’m not ready to jump on the Krill Oil bandwagon just yet.

First of all, both of these studies – from what I could gather – were supported in part or whole by the manufacturer of Neptune Krill Oil™.  This is something a lot of mainstream folks will jump on.  You should also note though that pharmaceutical companies are also known for that practice in addition to many other things to try to influence prescribing habits.

Also, Krill are an integral part of the aquatic environment.  I don’t know how many Krill they have to catch to make a month’s supply of the product but there is some concern right now that if the demand for Krill Oil takes off it may have a detrimental impact on not only the Krill population of those waters – but also their predators who depend on them for survival.

Summary: You can use fish oil for weight loss.  However, beware that many claims regarding fish oil pills and weight loss have been taken out of context.  The exact mechanism behind fish oil and weight loss is still debatable.  You may need to adjust your dose of fish oil upwards to achieve some of the weight loss benefits.

Q: Is fish oil really something that can help me lose weight?

A: Let me start by saying this – it does appear that taking fish oil can help you lose weight.  But, there is a lot of misinformation and reaches out there about how much fish oil can help and how it goes about helping you.

For example, there are claims that fish oil pills cause weight loss by killing adipose (fat) cells.  Technically, this has proven to be true in a study published in the Journal of Nutrition.  But, if you read the fine print this study was conducted in vitro – i.e., in glass or a test tube.  This wasn’t a study conducted in actual human beings.

I’m not saying it can’t do that in real life, but for someone to make the jump from an in vitro study to saying it ‘absolutely works’ in humans (in vivo) is a big jump.  And irresponsible.

Fish Oil Pills and Weight Loss – What You Need to Know

Aside from some of the wild claims taken out of context I’m comfortable in saying that fish oil does have weight loss benefits.  It won’t do the job all on it’s own – but, if you are eating naturally it’s certainly going to supplement your weight loss efforts.

Here are the proven basics that it’s going to be helpful for you to know:

1. As I mentioned above, in a test tube, fish oil does cause apoptosis (programmed cell death) in certain fat cells.
2. Some of the claims I read said that you had to focus on the DHA (Docosahexaenoic Acid) content of your fish oil.  While this was the case in the study above where they looked at DHA killing fat cells – the other studies linking fish oil to weight loss included both components of fish oil: EPA (Eicosapentaenoic Acid) and DHA.  A quality fish oil should contain both parts.
3. The dosages of fish oil used in the studies varied.  So there is no specific dosing recommendation.  Typical dosage recommendations that I’ve seen generally fall around 1,000mg a day of fish oil (EPA and DHA).  If I were to make an educated case I would say you’d want to talk to your doctor about upping that a bit to the 1,500mg to 2,000mg a day dose for weight loss.  At least for the first few months as this was the general dosage range that appeared to show positive results.
4. The studies that I looked at (in humans) were placebo controlled – which is good.  It means that one group was taking a ’sugar’ pill which eliminates bias in the study and is really the ‘gold standard’ of any well-designed study.
5. On the downside – the studies were also small.  So the weight loss benefit of fish oil hasn’t been proven on a massive scale yet.  But I’ve seen enough to believe that it will benefit you in that regard.
6. When I started researching this I was encouraged because I saw another claim that fish oil benefited weight loss by improving insulin sensitivity.  This would have been huge.  But, after digging a little more it was clear that this isn’t the case.  In fact, one study clearly stated that there was no improvement in insulin senitivity in their study.
7. Cholesterol markers (triglycerides, VLDL (very low density lipoproteins) were much improved after months on fish oil.

In Conclusion

All in all, I definitely think that fish oil could benefit weight loss efforts.  However, there are also some bogus claims out there about how it actually does it.  So, beware of what you believe.  You may need to take a little higher dose than what’s on your bottle and this is something you should talk to your doctor about first as their are side effects to fish oil.

Also, you need to make sure that the first thing you do is change how you eat.  Focus on eliminating processed foods (immediately improving your omega3:omega 6 ratio), eat natural foods like meats, nuts, fruits and vegetables and exercise (although, contrary to popular opinion, don’t get carried away.  Too much exercise too often will actually set you back).

Q: My husband and I are convinced that we need to be taking a fish oil.  But with so many on the market and all the claims and DHA this, EPA that it gets confusing.  Any advice on selecting the best fish oil supplement for our particular needs?

A: The main reason most folks want to start taking fish oil is because of omega 3 fatty acids.  That’s good.  And, something you are probably very aware of.  However, I mention it first just as a reminder that one of the best, and most effective ways, to increase your omega 3 to omega 6 ratio’s is to cut out the typical American fare in your diet.

Secondly, naturally add in more omega 3’s to improve the ratio even further.  Of course, one of the questions that immediately comes up is which foods?  Surprise, surprise … fish is one of the biggest ones.  But, some people aren’t big fish eaters or, for a hundred other reasons, have a hard time getting their omega 3’s through diet.  Then it’s on to manufactured fish oils.

Tip-Offs to the Best Fish Oils

If you’ve done that and are still looking to navigate through the claims of best fish oil supplements then here is my basic advice.

1. Be wary of labeling claims. I’ve written before about terms that manufacturers will use to ‘pump up’ their marketing like “pharmaceutical grade“.  I have yet had a manufacturer give me evidence that shows this is nothing more than a made-up term used to sell more supplements.
2. It’s helpful if your fish oil supplement lists the type of fish used to make the oil. Smaller fish like anchovies and sardines are some of the best sources of omega 3’s.
3. Make sure that the fish oil you select lists the amounts of both EPA and DHA on the label. If they don’t separate them out in the nutrition facts labeling don’t buy that product because you really don’t know what you are getting.
   While this isn’t as easily done as said … try to find a fish oil supplement that not only lists the species of fish used but one that also screens their catches to make sure they are disease free and lists the waters that they are caught from.
4. There’s a lot of concern about purity in fish oils. I understand that but sometimes focus on the words “100% pure” can lead to the same sort of labeling claims that I talked about above.  Nearly every manufacturer will claim 100% pure.  It’s non-specific but sounds impressive.  Also, a lot of manufacturers will claim that this means their particular fish oil has no mercury or other heavy metals in it.  I’ve written before about consumers thinking that this is a serious side effect of fish oil, but it really shouldn’t be.  By all means though, if you have limited your choices down to two and one claims to have 100% purity and it makes you feel better – go for it.  Just realize that, in my opinion, this sort of labeling can be misleading.
5. Third Party Tested. I’ve seen fish oils that use third parties to verify freshness and purity (heavy metals, dioxins and PCB’s).  I generally think this is a good idea.  However, don’t place too much emphasis on this as they don’t say WHO this third party is.  Is it a subsidiary of their own company or a truly independent third party?
6. Taste. A lot of people find they can’t tolerate taking even the best fish oil supplements because of the fishy taste and burps they sometimes get.  It is possible to minimize some of the bothersome side effects of fish oils.  Also, my wife Jodi was really sensitive to the fishy taste.  One brand she had good luck with was Nordic Naturals Ultimate Omega.  But, sometimes patients still can’t tolerate it and decide to go to a plant-based omega 3 supplement.  From the evidence I’ve seen thus far you’ll be wasting your time and money.  If you want to improve your omega 3 profiles the most effective way is through a fish-based product.  Plant based product do provide you with ALA (Alpha Linoleic Acid) which is a precursor to EPA and DHA.
   Two problems though: ALA is converted very inefficiently to EPA and DHA (studies show less than 1%).  Also, the ALA in those products comes from flax seed.  I’ve become critical of flax seed and the claims surrounding it in recent years.  Especially for men.

While this gives you a lot to think about in regards to selecting the best fish oils here are some warnings for YOU before you decide to take any fish oils:

• Make sure you don’t have an allergy to iodine.
• You should NOT be using blood thinners while taking fish oils (i.e., warfarin (Coumadin), Plavix, aspirin, etc.)
• Notify your doctor if you are scheduled for any sort of surgery that you are taking a fish oil supplement.
• Other ingredients.  While it’s important to know the amounts of EPA and DHA (as well as other omega 3 fatty acids) on the label.  You may find other ingredients listed.  Here are some more common ones and what they mean (and if you should avoid them):

1. d-Alpha Tocopherol: this is one of eight forms that make up Vitamin E.  This is fine.  One problem I do have is that many of the fish oils use vitamin E derived from soybean oil.  Soybeans are one of the most over-hyped ‘health foods’ of all time.  But, because it’s such a small amount, don’t worry about it.
2. Rosemary extract: this is fine.
3. Avoid products that contain gluten, milk derivatives, artificial colors or flavors.
4. Lemon flavor: to minimize fish taste.  This is fine.

Summary: Cod liver oil benefits are numerous.  Best of all, there is ample evidence supporting cod liver oil’s use – especially in northern areas where direct exposure to sunlight during the winter months may be limited and lead to vitamin D deficiencies.

Q: What are the cod liver oil benefits – as you see them?  I always see it touted online but it seems like a sales pitch for their particular product.  I’d like a little perspective.

A: OK, I admit it.  There are a lot of supplements out there that have a lot of hype and baseless claims.  As a matter of fact, that’s part of my job here at this website is to steer people in the right direction and give them the straight scoop and raise a bright red flag when I see a scam or an over-hyped supplement.

But, in my humble opinion, cod liver oil is the real deal.  Not only is it relatively low cost but it offers a lot of benefits.

Cod liver oil, unless you are eating superbly and have more than adequate exposure to natural sunlight, is something almost everyone should supplement with in different quantities at different times of year.  And honestly, I eat healthy.  Better than most.  But even I supplement with cod liver oil.

I won’t get into a long discussion of what exactly is in cod liver oil because this question focuses more on the benefits.  But suffice it say, that cod liver oil is one of the riches sources of vitamin A, vitamin D and omega 3 fatty acids.  It’s natural.  Its inexpensive and the benefits are great.

And, speaking of benefits I’m going to try to keep this answer relatively short.  I don’t want it to read like a PhD dissertation.  It will cover the main, proven benefits of cod liver oil.  If you want to go into more detail Google offers you plenty.

Cod Liver Oil Benefits

(1)  Rickets (Vitamin D deficiency)

While almost never seen in industrialized countries nowadays – rickets was pretty common 150 years ago.  It was particularly a problem in northern hemisphere’s where exposure to sunlight was limited and the food source was primarily grain-based.

This is exactly what you had in 19th century England.  Little sun and a very grain-based diet.  Actually, one of the early researchers into rickets, Dr. E. Mellanby was researching rickets in dogs (don’t laugh – physiologically we are pretty close to dogs – particularly our digestive tracts) and discovered in addition to cereal grains promoting rickets it also had the added effect of blocking mineral absorption due to the high phytic acid content in grains and legumes.

This is why phytic acid is considered by many to be an ‘anti nutrient’ and is why I personally try to avoid grains in my own eating style.

(2)  Arthritis

Arthritis researchers in Great Britain have shown that the elongated omega 3 fatty acids in cod liver oil can reduce the pain and inflammation from arthritis.

(3)  Babies Growth and Development

Remember Dr. E. Mellanby above?  Well his wife actually did research in babies and discovered that tooth enamel will not form properly unless the baby is exposed to adequate vitamin D.  This is especially true the more cereal-based foods a baby is fed (i.e., the more cereal you give a baby the more vitamin D they will require).

(4)  Secondary Dentintion

As you and I go through life our body is able to ‘patch’ our teeth.  We know that the more vitamin D a person has the better able they are to ‘patch’ the spots on their teeth as you have up to three times more calcium in your saliva to go to work on your damaged teeth.

(5)  Pregnancy

Women who supplemented with cod liver oil during pregnancy had infants who were at lower risk for Type 1 diabetes.  Incidentally, this same effect has not been seen with women who supplemented with simple multi-vitamins.

Additionally, brain development in the newborn is dependent upon the fatty acid profile of the mothers breast milk.  This is probably one of the reasons why babies born to strict vegetarian mothers may be at risk for stunted brain development.

Also, cod liver oil is high in vitamin A which has a clear role in preventing infections.

SIDENOTE: talk to anyone who is 80 years or older and they’ll likely remember their parents giving them cod liver oil.  Despite our advances the old time doctors knew more about nutrition than we do today.

Incidentally, the practice of giving kids cod liver oil was shunned by none other than Dr. Spock who instead relied heavily on vaccines.

It’s important to note that while cod liver oil has high amounts of vitamin D it doesn’t appear to increase the vitamin D content in breast milk.

Risks During Pregnancy

Over the years women have been advised to avoid any vitamin A containing supplements for risk of the fetus developing deformities.  First of all, the deformities were associated with synthetic vitamin A – or retinoic acid.

Almost all the studies that have been done looking at vitamin A and birth defects have shown that you have to get pretty high amounts of vitamin A – in one famous study over 5,000 IU’s a day with synthetic vitamin A.  Other researchers have concluded that you would likely have to go over 10,000 IU’s per day based on the data.  Other researchers have concluded that you can safely go up to 30,000 IU’s of vitamin A a day.

In short, most dosing regimens of cod liver oil would likely give a pregnant woman somewhere in the neighborhood of 1,000 IU’s to 2000 IU’s per day.  Well within the limits of safety established by researchers.

But, the decision to take cod liver oil while pregnant and how much you should take is up to you and your doctor.  I simply mention it here because I think that there is not a strong link between natural vitamin A and teratogenicity.

(6)  Heart Disease

From what we know, it appears cod liver is not only helpful to prevent a heart attack, it can be beneficial after a heart attack.

That’s because cod liver oil alters the linings of the arteries.  In fact, every ingredient in cod liver oil from omega-3 fatty acids to vitamin A, D and K all are involved in mineral absorption, improving muscle function and elasticity in blood vessels.

Another important component involved in heart disease is inflammation.  Well, there are inflammation reducing components that are made from the EPA in cod liver oil to control the inflammation in arteries.

Work in rats has clearly shown that atheromas (artery blockers) have become smaller and the actual diameter of arteries has increased after treatment with cod liver oil.

Of course, I always caution this isn’t human studies.  But it is promising.  And, for all purposes the evidence that we have to this point for cod liver oil in heart disease is very promising.

As you can see cod liver oils has more than ample amounts of omega-3 fatty acids and important vitamins like A and D which most Americans don’t get near enough of.  Also, this isn’t an exhaustive article by any means.  There’s much more to be said about cod liver oil and the benefits it offers.  But it provides a good overview of a supplement that is inexpensive, readily available, very beneficial and with few side effects.  That’s a good combination any day.

Q: I’ve been considering taking a fish oil to help with my intake of omega 3 fatty acids.  My question is are there any side effects I should keep an eye out for?

A: As with any supplement or medication there are always possible side effects.  Keep in mind, when you say ‘fish oil’ I’m assuming you really mean regular fish oil and not cod liver oil – as there are differences in ingredients, actions and side effects with both.

Also, I don’t know anything else about your medical history or if you are taking any prescription drugs – so those are additional things you’ll want to keep in mind and discuss with your doctor/pharmacist.

Most Common Fish Oil Side Effects

Bleeding Risk

One of the biggest benefits of taking fish oil is to boost your intake of omega 3 fatty acids as most people who eat the typical American fare have a much higher concentration of omega 6 fatty acids.

But, omega 3 fatty acids have been linked to increased risk of bleeding.  So, if you have had a stroke you’d want to exercise caution.  Also, what about other medications like warfarin (Coumadin) or a regular aspirin.

Keep an eye on cuts and/or bruises, nosebleeds and in extremem cases – blood in the urine.

Heavy Metal Poisoning*

Actually, I put this one in the list because it is asked about so often and it really shouldn’t be much of a concern (and has proven not to be).

Of course, you are probably aware that fish nowadays – even in ‘pristine’ waters – can have higher than average levels of mercury, lead, dioxin and so forth.  So, because fish oil obviously comes from fish consumers are concerned about heavy metal contamination.

But, a little chemistry lesson is in order: these metal ions are not fat soluble.  Instead, metal ions bind to protein.  Of course, in fish the protein is the actual meat/flesh.  So, eating the fish itself can put you at risk for heavy metal poising – but not the fish oil itself.

However, if fish oil is to contain impurities it would likely be fat soluble organics like DDT (dichlorodiphenyltrichloroethane) and PCBs (Polychlorinated biphenyls).  But, I wouldn’t trouble your head about these too much either.

Fish Aftertaste/Burps

In my experience the most common side effect is more of a nuicansce.  That is a ‘fishy’ aftertaste or burping after consuming the fish oil.

While I haven’t every discovered a full-proof way to avoid this they may be some things you can do to limit the annoyance of these side effects.

First of all, try to take your fish oil with a meal and eat slowly.  The more air you swallow during a meal the more burping you’ll have.  Secondly, if you use a fish oil liquid you may want to try and switch to a fish oil capsule.  It’s  broken down and gets into your system slower and may limit the burping/aftertaste.

one method I DON’T recommend is freezing your fish oil capsules or liquid.  Freezing – for certain nutrients – can denature them.  Essentially making them worthless.  Fish oil – in my opinion – is too delicate to freeze and should be avoided.

Gastrointestinal Side Effects

The last side effect is gastrointestinal side effects like stomach aches and diarrhea.

Frankly, I don’t experience this but if there is this type of indigestion or heartburn it can generally be avoided by taking the fish oil with a meal.

Well Tolerated

In short, fish oil is generally well tolerated.  If you are going to get side effects they are generally mild and will be stomach related like nausea or burping.  You do want to be cautious if you have any bleeding disorders, take prescription medications for bleeding disorders (warfarin, aspirin, Plavix) or will be undergoing surgery soon.