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Are there any possible problems or complications?


Not enough is known about omega-3 fatty acids to determine if they are safe in large quantities or in the presence of other drugs. Omega-3s may increase total blood cholesterol and inhibit blood clotting. People who take anticoagulant drugs or aspirin should not consume additional amounts of omega-3 because of the risk of excessive bleeding.

The source of some omega-3 fatty acids may be a health concern. Many larger predatory fish contain toxins absorbed from pollution. Swordfish, shark, and tilefish (golden bass or golden snapper), for instance, which are high in omega-3 fatty acids, may also contain high levels of mercury. King mackerel, a lesser source of omega-3s, may also have high mercury levels. Grouper, red snapper, and fresh or frozen tuna may have more moderate amounts of mercury. Other larger fish, such as tuna and salmon, may contain other compounds such as dioxin and polychlorinated biphenyls or PCBs, although fresh or frozen salmon usually has low mercury levels and large amounts of omega-3 fatty acids. Some studies have shown that farm-raised fish may carry more toxins than fish caught in the wild. Unfortunately, there is no way for a consumer to know what might be present in any particular fish, although some fish are inclined to have higher levels of contamination than others.

The precise risks and benefits of eating these fish is not known at this time. Experts recommend that adults vary the type of fish eaten as part of a healthy, balanced diet to reduce the chances of getting too many contaminants. Mercury poses the greatest risk to young children and unborn babies. Women who are pregnant, trying to get pregnant, or are nursing should not eat the highly contaminated fish, nor should young children. They should also limit their intake of the moderately contaminated fish.

For middle-aged and older adults (women after menopause), the benefits of eating fish may outweigh the risks of mercury or other contaminants. Even so, experts suggest limiting intake of the most-contaminated fish to one serving per week. Most refined fish oil supplements have little or none of these contaminants.

Prolonged use of fish oil supplements may cause vitamin E deficiency, which is why vitamin E is added to many supplements. Fish liver oils (such as cod liver oil) may cause toxic levels of vitamins A and D if overused. Supplements may cause fishy breath odor, belching, or abdominal bloating. They may also increase a tendency toward anemia in menstruating women. Women who are pregnant or breast-feeding should consult their physician before adding extra omega-3 to their diets.

People who are allergic to fish may have serious reactions to fish oil or supplements derived from fish and should avoid them. People who are allergic to nuts should avoid supplements that are made of the type of nuts to which they react.

Relying on this type of treatment alone, and avoiding or delaying conventional medical care, may have serious health consequences.



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