175
The Natural Standard adds that: “Caution may be warranted, however, [in people with
low blood pressure], in [people with diabetes or] at risk of bleeding, or in those with
high levels of ...LDL." NCCAM concurs. However, Berkeley Wellness, Fugh-Berman and
Gerbarg dissent, as set forth above.
The Natural Standard cautions that vitamins A and D are added to many commercial fish
oil products. As a result, regular use may lead to elevated levels of these fat soluble
vitamins. Since fat soluble vitamins can build up in the body and cause toxicity,
consumers should be aware of any vitamins added to fish oil products in order to assure
appropriate total vitamin dosages.
Hypervitaminosis A is generally only seen when cod or other fish liver oil is used in very
high dosages. Hypervitaminosis A occurs when the maximum limit for liver stores
of retinoids is exceeded. The excess vitamin A enters the circulation causing systemic
toxicity.
According to Brown et al., the most common side effects of omega-3s are
gastrointestinal nausea, heartburn, stomach pain, belching, bloating, or diarrhea. These
side effects are most apparent in large doses. Brown et al. indicate that the possibility
of triggering manic episodes is "probably low," but should be kept in mind.
Finally, the Natural Standard documents “mild” elevations in liver function tests, "rare"
skin rashes, and “rare" reports of mania or restlessness.
According to the Natural Standard, it is unknown whether use of omega 3s by pregnant
and breastfeeding mothers is beneficial to infants; nor are there any safety data,
particularly in large doses. Although it is used in infant formulas, there are no data
supporting that use either. Given the side effects and the likely benefits, the use of
omega-3s by pregnant and breastfeeding mothers as well as young children seem
reasonable. But large doses should be monitored by a physician.
- FISH CONTAMINATION/NO TESTING:
Fish may contain mercury and PCBs and dioxins which could be especially dangerous to
young children and pregnant or breastfeeding women. Contaminants are much more
