Fish oil: Friend or foe?

Dear Dr. Roach: I have heard that fish oil can clog the arteries and cause problems, but I’ve also heard it’s good to take. I don’t know if it is good or bad! Can you help me out with this? — G.G.

Answer: There remains controversy about fish oil, but recent studies prompted the U.S. Food and Drug Administration advisory committee to recommend wider use of a prescription fish oil. These new studies showed that icosapent ethyl (Vascepa), a highly purified fish oil ester, reduced the risk of cardiovascular events by 5%, and lowered the risk of cardiovascular death by 0.9% in people with high triglycerides, known coronary artery disease, diabetes and at least one other risk factor despite the use of statin drugs. However, there are several important cautions.

The first is that this is a high-risk group, and the results of this study cannot be applied to people who do not have these risk factors. The second is that two potential side effects (bleeding and abnormal heart rhythms, especially atrial fibrillation) were seen at higher rates in those who took the fish oil drug. The third is that this drug does not take the place of statins, which have been far better studied and in different populations. Finally, this drug is highly purified and subject to intense regulation. There are very good reasons to think that the prescription version of this drug has different effects on the body than omega-3 supplements you can buy at the pharmacy or health food store.