Costco vs. The World Round 1: Fish Oil and the Search for the Ultimate Omega!

by Stephen

In today’s post we will look at Costco’s Fish Oil selection and compare them to my two “gold standard” fish oil supplements.

This will be the ultimate cost benefit analysis and will hopefully help you make a better decision about the best fish oil supplement for your needs and budget.

Kirkland Signature™ vs. Nature’s Bounty® vs. Nature Made® vs. Nordic Naturals® vs. Carlson®

Some time ago I changed the way I recommended fish oil.  This was mostly based on anecdotal evidence from “those in the know” that certain brands were far superior, not only in taste but in quality and efficacy.

This has been backed up by scant evidence.  And the more research I do the more I have began looking again at traditional low cost brands. Especially those from Costco.

I have been sending my patients to Costco for years.  Mostly because of availability, quality and their wonderful bulk pricing.  Not everyone can afford to fork out $324 (The cost of a 1 year supply of Nordic Naturals Ultimate Omega).

This was a fun blog post to write because the results were completely surprising and I will probably change my fish oil as a result.

And the winner is? (Scroll to the bottom to see the results)

Kirkland Signature™

 

Omega-3 Fish Oil Concentrate
1000 mg

400 Softgels (not enteric coated)

IMG_0445IMG_0438
(click to enlarge)IMG_0454

 

[easyazon_link identifier=”B002VLZHLS” locale=”US” nw=”y” nf=”y” tag=”4hourlife00-20″ popups=”y”]Kirkland Signature Fish Oil Concentrate with Omega-3 Fatty Acids, 400 Softgels, 1000mg[/easyazon_link]

Price: 8.89
Cost per pill after tax: $0.02
Each fill lasts 122 days
Cost over 12 Months: 21.60
Total EPA/DHA per day: 900 mg(at dose of 1 tab three times daily)Info Sheet (Click to Enlarge)

Costco 1000 mg product details

Suggested Use:

Take one softgel three times daily with a full glass of water, preferably after a meal.

Supplement Facts:
Serving Size:Softgel

Each Softgel Contains

  • Calories 10 (Calories from Fat 10)
  • Total Fat 1 g
  • Saturated Fat 0.5 g
  • Polyunsaturated Fat 0.5 g
  • Monounsaturated Fat 0 g
  • Cholesterol 10 mg
  • Natural Fish Oil Concentrate 1000 mg

Omega 3 Fatty Acids

(EPA/DHA and other Omega 3) 300 mg

EPA: ?

DHA:?

Nature’s Bounty®

All Natural Maximum Strength Fish Oil
1400 mg, 980 mg Omega-3

130 Enteric Coated Liquid Soft gels

IMG_0442IMG_0447IMG_0446

[easyazon_link identifier=”B004BF8LOM” locale=”US” tag=”4hourlife00-20″]Nature’s Bounty Fish Oil 1400 mg 130 Softgels[/easyazon_link]

Price: 19.89
Cost per pill after tax: $0.16
Each fill lasts 130 days
Cost over 12 Months: $57.60
Total EPA/DHA per day: 980 mg Info Sheet (Click to Enlarge)

Natures Bounty Maximum Strength Fish Oil

Directions:
For Adults, take one (1) softgel daily, preferably with a meal.

Serving Size: 1 Soft gel

  • Calories 15, Calories from Fat 15
  • Total Fat 1.5 g
  • Saturated Fat 0 g
  • Polyunsaturated Fat 1 g
  • Monounsaturated Fat 0 g
  • Cholesterol < 5 mg

Fish Oil 1,400 mg (1.4 g)

  • EPA (Eicosapentaenoic Acid) 700 mg
  • DHA (Docosahexaenoic Acid) 280 mg
  • Total Omega 3 Fatty Acids 980 mg

Nature Made®

Fish Oil 1200 mg

Maximum Strength, 375 Soft gels (not enteric coated)

IMG_0450IMG_0451IMG_0452 [easyazon_link identifier=”B004GJVD2K” locale=”US” tag=”4hourlife00-20″]Nature Made Fish Oil 1200 Mg Burp-less, Value Size, 200-Count[/easyazon_link]

Price: 12.99 (sale price)
Cost per pill after tax: $0.04
Each fill lasts 94
Cost over 12 Months: $57.60
Total EPA/DHA per day (based on 2 tabs 2x per day): 960 mg Info Sheet (Click to Enlarge)

Natures Made Costco Fish Oil

Suggested Use:
Take one to two softgels two times daily with a meal

Serving Size: 2 Softgels 

Supplement Facts

  • Calories 25
  • Calories From Fat 20
  • Total Fat 2.5 g
  • Saturated Fat 1 g
  • Polyunsaturated Fat 1 g
  • Monounsaturated Fat 0.5 g
  • Cholesterol 25 mg
  • Protein < 1 g

Fish Oil Concentrate 2400 mg

Omega-3 (EPA)  360 mg

Omega-3 (DHA) 120 mg

Other Omega-3 120 mg

Kirkland Signature™

Enteric Coated Omega-3 Fish Oil Concentrate 1200 mg

One Per Day Formulation 180 Softgels

IMG_0444IMG_0435IMG_0434 [easyazon_link identifier=”B002RL8FDO” locale=”US” tag=”4hourlife00-20″]Kirkland Signature Enteric Coated Fish Oil Omega 3 1200 MG Fish Oil, 684 MG of Omega 3 Fatty Acids, 180 softgels[/easyazon_link]

Price: 15.29
Cost per pill after tax: $0.09
Each fill lasts 180
Cost over 12 Months: $32.40
Total EPA/DHA per day (based on 2 tabs 2x per day): 684mg

If you take 2 pills per day to reach 1368 mg of EPA/DHACost over 12 Months: $64.80

Info Sheet (Click to enlarge)
Costco Enteric Coated Fish Oil

Suggested Use:

Take one softgel daily with a full glass of water

Serving Size: soft gel

Supplement Facts:  

  • Calories 10,
  • Calories from Fat 10
  • Total Fat 1 g
  • Cholesterol 10 mg

Fish Oil Concentrate 1200 mg

Omega 3 EPA 410 mg

Omega 3 DHA 274 mg

Now a Look at the “Premium Brands”

Ultimate Omega®

120 softgels

1429
(click to enlarge)
SF_CLO-flavored
[easyazon_link identifier=”B002CQU564″ locale=”US” tag=”4hourlife00-20″]Nordic Naturals Ultimate Omega Lemon 1000 mg 180 Soft Gels[/easyazon_link]

Price: 49.95
Cost per pill after tax: $0.45
Cost per dose: 0.90
Each fill lasts 60 days
Cost over 12 Months: $324.00

Suggested Use:
Two softgels daily with food, or as directed by your health care professional or pharmacist.

Supplement Info:

Total Omega 3: 1280 mg
EPA 650 mg
DHA 450 mg
Other Omega 3: 180 mg

 

ELITE OMEGA-3 GEMS

90 Soft gels

Elite Omega-3 Gems
(click to enlarge)
carlson info
[easyazon_link identifier=”B003BVIBK6″ locale=”US” tag=”4hourlife00-20″]Carlson Labs Elite Omega-3, 800 mg, Gems Fish Oil Soft Gels, Natural Lemon Flavor, 120 Count[/easyazon_link]

Price: 29.90
Cost per pill after tax: $0.36
Cost per dose: 0.36
Each fill lasts 90 days

Cost over 12 Months: $129.20
(based on 1 pill per day)

Suggested Use: 1-5 tabs per day

Supplement info: per pill

Omega 3 from fish oil: 800
EPA : 400mg
DHA: 300 mg
Other Omega 3: 100mg

 

Fish Oil Cost vs. Dose Comparison

Kirkland Brand *Natures Bounty Enteric Coated Nature Made *Kirkland Enteric Coated Nordic Naturals *Carlson Labs Elite Omega-3 Gems
12 month cost $ 21.60 57.60 57.60 32.40
(62.80)
324.00 129.20
cost per day $ 0.06 0.16 0.16 .09
(.18)
0.90 0.36
EPA/DHA Total mg. 900 980 960 684
(1360)
1280 800
Tabs Per Day 3 1 4 1
(2)
2 1

* Denotes best of class based on all criteria

Discussion

The Costco Comparison

Based on ease of use (total tabs per day), cost, EPA/DHA ratios, and palatability. Both the Natures Bounty Enteric Coated and the Kirkland Brand Enteric Coated fish oil seem like very good deals.

I have taken the enteric coated Kirkland brand tabs and found that even though they are enteric coated they taste poor and still cause the proverbial “fish burps”.  I have yet to try the Nature’s Bounty brand but I think I will give it a try.

Premium Brands

When it comes to premium brands I currently take Nordic Naturals – Ultimate Omega/Lemon Taste soft gels.  After seeing the comparison and price structure it seems as though Carlson Labs may be a better bet. You would get significantly more omega 3 with a good EPA/DHA ratio at a lower cost. I have heard they are also quite palatable and have a good track record for quality and purity.

Final Thoughts

I will probably continue to dish out the extra dough for a premium fish oil. I say this because I have found since taking the Nordic Naturals I never get a fishy aftertaste and I feel confident in the quality of the fish oil.  For the first time I actually look forward to taking my fish oil… Something I used to hate while taking the Costco brand. The end result over the last 9 months is that I have hardly missed a dose.  My serum cholesterol levels have been better than ever (not that that probably matters but it is a good metric).

  • Triglycerides:36
  • HDL:56
  • LDL: 46

Some Interesting Food for thought:

Omega 3 Mania

  1. Doctor Mercola Beating up on Costco
  2. Evolutionary Psychiatry: Just Eat Fish (Also a truly awesome blog)
  3. Marks Daily Apple:
    1. Definitive Guide to Fish Oil 1
    2. Definitive Guide to Fish Oil 2

Awesome tool to calculate your med costs

  1. Medication Cost Calculator

{ 48 comments… read them below or add one }

Justin January 23, 2012 at 4:17 pm

As a frugal health nut this is a great article to see the cost of the different supplements. I have taken the kirkland brand most of last year only because I am cheap. I have been talking about getting the Green Pastures fermented cod liver oil for quite some time and am waiting on my order now.

I think it is important to note the difference between modern fish oil supplements and fermented cod liver oil. Liver and organs are where a lot of the nutrients are located, the fish oil supplements here use the cheapest parts of the fish. There are much more nutrients then just Omega-3s. Also modern fish oils are extracted with heat, which causes a lot of the nutrients to be lost, where pasteurization retains some very important nutrients (most notably vitamin A and D). Some fish oils add synthetic vitamin D back which is NOT the same as a naturally occurring vitamin D, some people believe synthetic vitamin D to be toxic (not me).

Some more info here http://www.cheeseslave.com/why-fermented-cod-liver-oil/

Reply

Stephen January 24, 2012 at 12:58 am

Justin, you are not cheap just extremely practical.

I am glad you mentioned the fermented cod liver oil here. It was in writing my last blog post about testosterone and the Green Pastures product that I too realized how in many ways it was far superior to all of the options listed hear for all the reasons you mentioned… as well as the additional K2. I should have added this in my cost comparison. In fact I may do this and add it in up there because I think it deserves to be mentioned.

I was surprised to see the big differences between EPA/DHA content among the various supplements. This has really helped me guide my patients much better as they shop for fish oil. It is a confusing world of consumer vitamins/supplements and the supplement companies offer little help.

Let me know your feelings on the Green Pastures when you start using it. Or, this would make a great next blog post from http://www.my4hbdiary.com/

Reply

Justin February 3, 2012 at 10:47 pm

Hi Stephen,

I have been doing some research on cancer and I ran into this article http://www.brianpeskin.com/BP.com/publications/Dec.2010-Explore19-6.pdf

It is something you might want to take a look at. Some studies so no benefit to fish oil and some studies even show fish oil can have negative effects.

Here are some other related article
http://chriskresser.com/when-it-comes-to-fish-oil-more-is-not-better
http://rawfoodsos.com/2011/04/29/will-omega-3s-boost-your-risk-of-prostate-cancer/
http://www.marksdailyapple.com/fish-oil-prostate-cancer/#axzz1lOOqEzqo
http://perfecthealthdiet.com/?p=3287
http://perfecthealthdiet.com/?p=3309

I am starting to think that fish oil is much like rapeseed (canola) oil. It needs to be pressed and heated for us to get oil out of it. And we know how bad canola oil is. This is why I am going to stick to real food and/or fermented cod liver oil, which I would still call real food (and so does the FDA).

I am doing as much research about it as I can so let me know if you want more info.

Reply

Stephen February 7, 2012 at 10:33 pm

Justin you are absolutely killing me man!

So I am just finishing Gary Taubes’ why we get fat, which has basically disproved everything I was taught about diet and nutrition, and then you send me articles like this. Just after I have spent the last two years optimizing my patients intake of fish oil and vitamin D3. Which of course we have been told will prevent heart disease and reduce their risk of all cause mortality. Many are even on prescription fish oil like Lovaza.

I need to print this article out and do some more research. My question is how does this compare with articles like this:

Studies in which I based my own recommendations for my patients.

Honestly right now my head hurts from the constant influx of recommendations that are constantly changing. Maybe we should just all throw in the towel and go Paleo! Or just screw it and eat, drink and be merry.. for tomorrow we die!

Reply

Justin February 7, 2012 at 10:48 pm

I know, it sucks. The thing is Paleo people recommend fish oil!
http://whole9life.com/2010/03/robb-wolf-fish-oil-calculator/

So I am confused. I sent questions submissions to Chris Kresser, Robb Wolf and Denise Minger (rawfoodsos.com great critique on the China Study you should look into).

Have you started following Chris Kresser at all? Or the ‘Paleo’ types that are actually practicing medicine?

I think this fish oil issue comes down to the process used to refine it. Like I said above it needs to be pressed AND heated. How much does it oxidize when you heat it? Is it as bad as canola (rapeseed) oil?

The article you link to is hard to take seriously because they actually recommend canola oil and other vegetable oils as a good source of omega-3, which I hope most people know it is not, and it is one of the biggest cause of our poor health epidemic.

Read whole food, and/or fermented foods are the way to go.

Reply

Stephen February 7, 2012 at 11:06 pm

Right! Yet the AAFP is THE medical Journal! This is how we get our continuing medical education Justin.

Have you ever been to a Family Medicine Conference! You would probably keel over and die… Literally!

I contacted Nordic Naturals this last year and asked them if I could tour their plant and document it on my blog. They called me back once and then I have not been able to get their head of marketing to get back to me. I wonder how their fish oil’s are made? You present some great facts here! The issue here is cost, although really what the article you sent points out is that it would be better to take no fish oil than to take the fish oil that most people take. And yes, you are right, the Paleo people have not commented on this. You are actually the first person I have seen mention this fact about it being heated and pressed.

And you will even be more disgusted to know that I have been recommending Canola oil for quite some time because I was told (obviously erroneously) that this was an extremely healthy alternative.

Reply

Stephen February 7, 2012 at 11:08 pm

Oh yeah… and the part about krill oil.. . fascinating!

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Justin February 7, 2012 at 11:13 pm

Just did a search for ‘fish oil oxidation’ and dr eades blog came up first with this post.
http://www.proteinpower.com/drmike/uncategorized/oxidized-fish-oil/

That makes sense and I think it would be a good idea to add his suggestions for storage and testing on the top of your post and to your patients.

Maybe all the studies of the negative affects of fish oil are using rancid fish oil and the positive ones are not? Would be nice to be able to see full text of the studies without having to pay.

Reply

Michelle June 19, 2014 at 11:07 am

I think the two of you should write a book!

Reply

Stephen June 20, 2014 at 11:00 am

I think you are right 🙂

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Brad January 24, 2012 at 1:03 am

Thank you so much for sharing this great comparison of the various fish oils.

I have been taking the Kirkland brand for many years and have been generally happy with them. Although seeing as I could take less pills with some of the other brands and still get the same Omega 3 content. I may also switch.

Thanks again.. Great website! I am just getting started with the 4 Hour Body, your cheat sheets have been really helpful.

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Dan January 24, 2012 at 7:02 am

Nice write up – I have been taking natures bounty for the last 13 months and there have been almost no fish burp.

At the moment I’m looking into krill oil, heard about better absorption of EPA/DHA and even after dropping over 70lbs I still hear my knee’s go snap-crackle-pop when walking up stairs at night. The krill oil with the better absorption is suppose to further reduce inflammation.

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Stephen January 24, 2012 at 11:21 pm

Absolutely, I am so glad you mentioned this. In fact I almost included Costco’s krill oil offering in this blog post but I didn’t want to complicate things. Their krill oil is the lowest price I have seen anywhere, especially when compared to places like Whole Foods.

I recommend krill oil to many of my patients, especially to those who are suffering from any type of arthritis. I have had really great results with the combination of Cod Liver oil and Krill oil. I am a big fan of this combo…. and not just for the treatment of arthritis.

Congratulations on dropping 70+ pounds! What an amazing achievement.

Stephen

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Kat September 3, 2012 at 9:50 am

Intersting about the Krill oil. I am 57 and have dropped 95 lbs over the last 3 years. Gained 85 on some meds years ago. I have had rotator cuff surgery and recently learned I have pulled the muscle away from the cap on the same shoulder! Ouch. I use to be a runner, and I think from years of standing on concrete in factories, running and significant weight gain, has taken a toll on my joints. I will add Krill to my diet.
I take the fish oils because it works great on depression. I hate taking meds for my issues, I slept to much and gained weight. The fish oils really seem to help. I am eager to take anything natural over man made. Thanks for the info.

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Stephen September 8, 2012 at 7:08 am

I agree Kat that fish oils really do work wonderfully as an adjunct treatment for depression! I wish more people would be open to this idea. Usually my patients just look at me like I am crazy 🙂

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Juliette9909 November 20, 2014 at 12:59 pm

The efficacy of fish oil and brightening or elevating one’s mood cannot be discounted. Even if there were no other benefits to the brain, heart, and joints it would continue to be worth the elevation of mood. Have some coffee (another mood elevator within 30 minutes) and then take your fish oil. Then, enjoy your day 🙂

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PIXE July 7, 2012 at 1:12 pm

You failed to mention that some of the products are ethyl esters (Kirkland, Nature’s Bounty, and Carlson) whereas Nordic and the one product of Nature Made are both natural fish oil in the triacylglycerol (TAG) form. On the Kirkland label is specifically states “as ethyl ester” and the product should not be labeled “Fish Oil.” Most TAG oils have 180 mg EPA and 120 mg DHA and are referred to as “18/12” oils. This natural fat that is found in fish are digested more efficiently by pancreatic lipase and more absorbed than the ethyl esters which are not fish oil. Fish don’t make the chemical ethyl esters. These ethyl esters are made using the same process as biodiesel except that ethanol is used for omega-3 ethyl esters as compared to methanol for biodiesel. The omega-3 ethyl esters will burn whereas the TAG will not.
Also, according to United States Pharmacopeial (USP), ethyl esters of omega-3 are not “fish oil”. Several other organizations also support this definition.

Therefore, price is not the only concern but the chemical form at which the omega-3s are in are also important.
PIXE

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Stephen July 7, 2012 at 9:40 pm

That was so informative, I cannot even tell you how much I appreciate that!

If you don’t mind I am going to create a link to your comment here at the beginning of the blog post with an annotation.

I personally only take Nordic Naturals Fish Oil only because I have heard through the grapevine that it is a better product. Although many of the leading Nutrition “gurus” online have recommended Carlson’s in the past. Your comment really narrowed this down for me personally.

And you are right price is not the only concern, many of my patients are on an extremely fixed budget and don’t have access to high quality fish oil. I often wonder if taking Costco Fish Oil is worse than nothing at all!

Thanks again for your thoughtful and through comment! It will affect many people down the line as I “prescribe” fish oil on a daily basis. Would you say then that the Natures Made would be a good alternative for people who don’t have access to, or would not fork over the extra cash for a product such as Nordic Naturals?

Stephen

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Mike July 18, 2012 at 2:50 pm

Since my Dr. told me to take at least 1000mg of Omega-3 or as much as I can, I have been struggling to make sense of it all. After reading the blog here, I have a much better understanding. I was wondering if you can take too much Omega-3? Money not being my major concern considering my Heart, which Brand would you recommend.

Thank You

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Stephen July 19, 2012 at 8:29 am

No Mike, you really cannot take “too much” fish oil.

Lovaza which is a prescription dose of Omega 3 is 4000 mg per day. Depending on the fish oil you buy you will get different ratios of EPA to DHA. My favorite (and the one I personally take) is Nordic Naturals. I take their PRO OMEGA capsules and take 2 per day.

If you are using this for it’s cardioprotective features or to lower cholesterol I would consider up to 4 capsules per day. That would be completely safe and like I mentioned that would be equivalent to prescription strength… I use this often in my practice.

Nordic Naturals also makes a liquid cod liver oil that is worth considering but it is a bit hard to stomach. Has higher levels of vitamin A and some Vitamin D as well. I have recommended this for certain types of inflammatory conditions and been amazed by the clinical improvement. I have been using it a lot more in my practice lately as well.

Here is Nordic Naturals web site http://www.nordicnaturals.com/consumers.php
I have no affiliation with them, I just love their product.
This is their Pro Omega product which I was talking about above. It’s often cheaper online then in the store. But shop around!
http://amzn.to/OJuU6n

Best of luck!

Stephen

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Justin July 19, 2012 at 2:40 pm

Stephen have you read this article by Chris Kresser? http://chriskresser.com/when-it-comes-to-fish-oil-more-is-not-better

There are quite a few studies and plausible mechanisms as to why too much fish oil can actually be bad.

Fermented Cod Liver Oil being a whole food is the only fish oil I take now.

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Borrow Money Bad Credit 4000 October 31, 2012 at 4:35 pm

Hello! I know this is kinda off topic but I was wondering if you knew where I could
find a captcha plugin for my comment form? I’m using the same blog platform as yours and I’m having difficulty finding one?
Thanks a lot!

Reply

Stephen November 1, 2012 at 12:03 am

I have to tell you I am not a fan of captcha forms, they are a huge deterrent to user interaction and I find with akismet installed I get very little spam. I would recommend just a search among the WordPress plugins from within the dashboard and trying a couple out if you decide to use one.

Contact form 7 and fast secure contact forms are probably the best comment form plugins, the former being a bit more versatile. I have had no problems with spam using either of them.

Stephen

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Josh January 23, 2013 at 4:36 pm

Stephen, thanks for the informative article. The note from PIXE was exceptionally helpful. I found a couple of articles discussing the absorption of the EE vs TG forms:

http://www.ascentahealth.com/health-science/science-articles/fish-oil-triglycerides-vs-ethyl-esters-as-nature-intended

http://www.mainoptical.com/pdf/TG_vs_EE.pdf

Any ideas for an easy way to determine the source of a specific supplement, be it EE or TG? Aside from the one Kirkland you have pictured that states it is derived from EE’s, the other labels fail to specify.

Reply

PIXE February 1, 2013 at 11:29 am

Josh:
One giveaway to EE forms are the concentrations. Typically you will see concentrations greater than 180 mg EPA and 120 DHA (“18/12”) to be EE forms except there are those from Nordic Naturals that are re-esterified TAGs in which the concentrations are higher than 18/12. These will most likely not be even numbers. Many EE fish oils have concentrations of 300 EPA 200 DHA (“30/20”) and 400 EPA and 200 DHA (“40/20”). Also, look closely at the labels and a few companies will say that it is EE form. For example, some of the products from Nature Made say as ethyl esters. Others such as Simply Right Fish Oil (Ethyl esters, not real fish oil!) 1200 mg from Sams Club list the source of ethyl esters of omega-3 coming from MEG-3 (Ocean Nutrition Canada now DSM). Go to there web site and they use to list the composition of EPA and DHA in their MEG-3 EE. From these formulations, you can determine if the source is MEG-3. Companies that use MEG-3 will put this on the label of their fish oil. Be aware that you paid for fish oil but did not get fish oil. Instead, you bought ethyl esters of omega-3 and the metabolite is ethanol. Look at the labels and you will see that the omega-3s are typically 50% for the EE (“30/20”) and did you wonder what the other 50% is? Well, they are mainly saturated fatty acid ethyl esters that are co-products in the transeterification process. Seems that “molecular distilled” did not remove these lower boiling point ethyl esters that you are consuming that are hazardous to your health.
PIXE

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Josh February 11, 2013 at 3:03 pm

PIXE: Thank you for the detailed reply! It is very helpful and I am working to find my ideal omega 3 source now.

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Tracey April 2, 2013 at 10:35 am

Hey Stephen,
I just came across this post today and was about to explain the functional differences between EE and TG fish oil but see that Pixe is on the ball here and has already explained this. If you are unsure whether your fish oil is EE or TG, break open 4 capsules of fish oil and pour this into a styrofoam cup, after 10 minutes, EE oil will start to melt the cup. TG fish oil is also more stable and less likely to oxidize. Krill oil and algae supplements are also rich in EPA + DHA. Cod liver oil can have high amounts of Vit A and D which can be problematic for some people so be sure not to exceed the recommended dose. Fish oil does not contain Vit A and is free from contaminants unlike Cod liver oil. Regarding an optimum dose, most professionals recommend 2.4 grams of Omega 3’s, which is the total EPA + DHA, not the total fish oil.

Reply

Craig May 23, 2013 at 8:38 am

Stephen,
As an ophthalmologist, I routinely rec’d fish oil to my patients for blepharitis/dry eyes and have discovered that not all fish oils are created equally. I agree with PIXE that TAG fish oil is the purest form. There is another company http://www.prnomegahealth.com that also seels TAG fish oil like nordic naturals.

Another question I have is about reverse engineered omega 3 from plants. Would love to hear everybody’s thoughts on that.

Thanks!

Reply

Tanner May 28, 2013 at 2:35 pm

Came across your site while searching for some specific fish oil info. Mostly, to compare other brands to the brand I recommend and sell. Over the past two years, I have been completely sold on the company, its founder, and most importantly its product. The transparency of the company is amazing and they cite everything. They are also accredited by third party laboratories such as the Nutrisearch Comparative Guide to Nutritional Supplements and ComsumerLab.com (of which I subscribe to). In fact you should check out https://www.consumerlab.com/reviews/Omega-3_Fatty_Acids_EPA_and_DHA_from_Fish_Marine_Oils/omega3/#whatitis. Or https://www.consumerlab.com/results/print.asp?reviewid=omega3. You will find that Nordic Naturals in the past has had some labeling issues. Feel free to email me your thoughts. In health and happiness, Tanner

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James Anthony Biehl April 4, 2014 at 9:25 pm

And what company is that?

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Dianne March 3, 2014 at 6:46 pm

Have you heard of Nutra Sea? Canadian made…EPA /DHA is 1500 mg/500 mg? Any thoughts on this brand?

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Stephen March 7, 2014 at 8:37 am

Sorry Dianne I am not familiar with this particular brand although most Canadian made natural products are quite good because in Canada even supplements must clear testing through the Canadian version of the FDA. Unlike here in the US where anything goes.

Stephen

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Lex713 May 6, 2014 at 2:24 pm

That’s a little funny. I take the Nature’s Bounty Fish oil supplement and I’m looking at the bottle now. The Funny thing is that it doesn’t not actually state how much EPA and DHA there is. It just says … after it while including it in the total 900 mg of Omega-3 fatty acids. Just thought that was interesting.

Reply

Stephen May 8, 2014 at 10:28 am

I know Lex it is interesting, the truth is they probably don’t even know. There is so much debate in the medical literature right now about the benefits of fish oil I am not even sure if I should still recommend it to my patients. I still lean towards Nordic Naturals or Carlson’s brand fish oil though. Mostly because of their production methods and their strong quality testing. If I were you, I would do the same. I am not sold on the quality of Natures Bounty, and the wrong fish oil does have the potential to do more harm than good.

Stephen

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Jerry December 13, 2014 at 8:01 pm

Stephen or Justin, I have a question. I am 43 and just went in for a complete check up. The first one in prob 5 years or so. I had it because my wife recently tested positive for TB and I needed to get tested. They did xrays and they came back cloudy so I had to go in for a CT. CT showed a 5mm mass in my lung and another spot on some hormone gland in my abdomen near my spine. I go to see an Endo on Monday. I am obviously very worried about my health. I thought I have been doing things right. Since about the end of August I haven’t doing as well about my eating habits, but they are not horrible. Prior to that I was in Germany eating some organic fruits and vegetables as they come into season. I also grew a garden in the summer and juiced from my organic garden. Anyways, my blood work came back and the only thing bad was: Chol: 174, Triglcyc: 196, HDL:39, and LDL 95. I recall that these numbers were similar about 10 years ago or so. Being my tri’s were a little high and my HDL being a little low. I think they are lower now than they were back then. In Germany I ate tilapia about once a week. I also ate canned tuna, salmon, mackerel, or sardines prob at least 3 to 4 days a week. I usually ate a big can of pink pacific salmon or mackerel during the week. I would eat the can in about 3 days or so. Then I would eat a can of tuna one day and then maybe a tin of sardines, and then start back on salmon. Anyways, I would really like to get my HDL up some more. I know recently I have not been exercising as I was when I was in Germany because I pulled a hamstring over there and it has my back out of whack and I haven’t gotten it fixed yet. I have degenerative disc disease and my sciatic nerve is getting pinched too much right now. Can you tell me what you would do to get those numbers back in to check if it were you? Thanks. Sorry for writing the short story.

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Stephen December 15, 2014 at 3:24 am

Hi Jerry, you are asking the million dollar question. First of all, I wouldn’t worry too much about the CT scan findings. The majority of the time these are what we call in the medical community “incidentalomas” which may have been there your entire life and are only now of concern because the medical community is obligated to explore this further. In 10 years of practice I have seen dozens of these, none which have ever been of concern, but they still warrant a workup.

Secondly, I am not a big fan of these basic cholesterol panels because they do not give us the most important part of the picture and that is particle size. Only 50% of heart attack and stroke victims have “abnormal” cholesterol profiles which means as a screening test for heart disease and stroke risk it really isn’t great. If you can get a NMDR cholesterol profile done, one that breaks your results into particle size it will be much better.

It sounds like you were doing well dietarily through August, before you do any more cholesterol studies I would suggest you get back on the healthy eating routine. Exercise makes a big difference as well, for me personally, when I started running, I went from an HDL of 38 to about 60 in 1 year, which really amazed me. As you may have heard red wine can be beneficial as well (of course in moderation). The amount of fish you were eating should suffice and I see no reason for supplementation with more Omega 3’s unless you want to.

I wish you the best of luck on your upcoming visit with the endocrinologist. Keep me posted.

– Stephen

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adrienne December 24, 2014 at 3:28 pm

Hi Stephen,
I’m a high level athlete suffering from acute patellar tendinosis. I had ACL reconstructive surgery just over a year ago, using the patellar tendon as the graft for a new ACL. Recently I was recommended to start taking Cod Liver oil in hopes that it may help my tendon problems.
I have purchased the Kirkland brand Cod Liver oil from Costco, after reading your article as well as comments from others, from what I understand this is not a recommended brand? Which brand do you primarily suggest? How much should I be taking? Do you believe it could help with my tendon problems?

Thanks

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Stephen December 25, 2014 at 1:03 pm

Hi Adrienne,

I am a big fan of Cod Liver Oil for the treatment of inflamatory tendinitis, because I have seen great results in my patients and in my own family. My favorite brand is Nordic Natuarals Cod Liver Oil, not the capsule form, but the liquid. I would take 1-2 tablespoons (not teaspoons) per day and give it at least 2 months. It takes this much time for your body to decrease its natural prostaglandin synthesis and overcome the chronic inflammation. I think with the correct physical rehab, ice and cod liver oil you should be able to see significant improvement if not complete resolution. Make sure you are NOT taking NSAIDS as well, this is very important!

Hope this helps and best of luck on your recovery,

Stephen

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Mari January 21, 2015 at 8:11 am

What do you know about the levels of mercury in these Omega-3 products?

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Stephen January 23, 2015 at 3:27 pm

Hi Mari,

The better companies will supposidly test for Mercury levels in their fish oil products. I know when I spoke to the Nordic Naturals rep she specifically commented on this. Nordic Naturals markets to clinics and because their products are often recommended for pregnant mothers and children the company claims to take it rather seriously. The products sold at Costco are also commonly “USP certified” http://www.usp.org/dietary-supplements/overview (which is one reason I often recommend them) so they theoretically should have safe mercury levels. But this is all theoretical and because the vitamin and supplement market remains unregulated in the US we really don’t know for certain. That being said, I would feel pretty safe taking any of the above products, although if you can stomach it, I still feel liquid cod liver oil is the gold standard.

– Stephen

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Natalie February 20, 2015 at 12:53 am

Hi
I have been taking Nordic Naturals Ultimate Omega Fish Oil Capsules for over a year now but I still suffer from tendonitis in both legs. Would like to switch to trying the cod liver oil as you suggested. However, why is taking the capsule form not as effective as the liquid form?
Thanks
Natalie

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Stephen February 23, 2015 at 2:04 am

Hi Natalie,

I am not sure I have an answer as to “why taking capsule form is not as effective as liquid form” in fact this is purely observational on my end. It could very well be that my patients who are willing to swallow liquid cod liver oil every day are simply more motivated. But in my experience liquid cod liver oil has resulted in better, short and long-term sustained benefits in my fairly small sample size of patients.

You could try capsules and see if you notice a difference if after 2 weeks you see no improvement, switch to a liquid based product. If after 60 days you see absolutely no improvement there may be no need to continue this as a “treatment”. It takes a while for Cod liver oil to work, especially if you have been taking NSAIDS, this has to do with prostaglandin synthesis and your bodies natural response to up or down regulation.

– Stephen

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Tavis Piattoly February 23, 2015 at 10:11 am

I’d be cautious about trusting the advice of an Acupuncturist when it comes to nutrition (i.e. Chris Kresser).

Numerous studies showing significantly more benefit than harm. http://www.omega-research.com.

Problem with the majority of the studies is they use an Ethyl Ester based Fish Oil which has lower bioavailability and less absorption in the blood stream than a Triglyceride based. As Stephen mentioned, Nordic Naturals is the superior brand and uses a TG based Fish Oil. I personally take 1-2 tsp of their Pro Omega liquid each day.

I’ve given my daughter their liquid DHA since she was 3 mos (now 3) and it has been extremely beneficial from a development standpoint.

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Stephen February 24, 2015 at 6:22 am

Good advice Tavis,

I did not know this about the Ethyl Ester based Fish Oil and the Triglyceride based. Thanks for the great tip!

Stephen

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MamaCassi June 9, 2015 at 9:53 am

This was amazing and the comments were wonderful.

I was on fermented cod liver oil for years. I love it. But I was bad at taking it when I wasn’t pregnant, and it is very very expensive. I buy it for my 6 children, and they take it regularly. Sadly, as a mother, I often do the right thing by my children and not by myself. In pregnancy I would prioritize my fermented cod liver oil, but not enough when nursing.

I started taking Nordic Naturals ProOmega after my dr sent me to a nutritionist for chronic angioedema/hives (I had been to allergists, rheumatologists, dermatologists, endocrinologists, without any resolution). Amazingly, regular doses, along with doubled doses of ProOmega during certain parts of my cycle have actually helped eliminate these horrible hives. My nutritionist theorized that due to pregnancy and breastfeeding for 9 1/2 years straight, my body needed heavy doses of good omega 3’s to replenish my stores. I had been doing some fermented cod liver oil, but it wasn’t the D or A that was key for my body, but actually the higher doses of EPA/DHA that seemed to make the breakthrough.

I am curious if cod liver oil would have the same effects. The nutritionist was worried about ‘extra calories’ (which I am not) vs the efficacy of the concentrated omega-3’s of Nordic Naturals. Thanks for this review! I only take supplements that actually make me feel better, and I have noticed the Nordic Naturals, though extremely expensive, have really had a great effect on my health in the last 6 months since I started taking them.

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Stephen June 12, 2015 at 4:07 pm

Hi MamamaCassi, I sure wish I could get my kids to take cod liver oil, but I may have to sedate them first 🙂 I think it is spectacular that this combination eliminated your hives and is a testament to the anti-inflammatory benefits of taking these supplements daily. And I agree 100% that one should only take supplements that make a difference in health and well-being. Too many people take MVI’s without much proof of benefit, well besides for the makers of the MVI’s who are doing pretty well for themselves. Best of luck with everything and cheers to a happy healthy family… 6 kids I commend you!!

– Stephen

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Kat September 9, 2015 at 1:34 pm

Great blog! I’m literally going out of my mind, trying to find ahi go quality fish oil, at a reasonable price. Then I find this site….and more verklempt than ever:

https://labdoor.com/rankings/fish-oil

You can view everything you want to know about fish oil…and if they’re what they claim to be. My family was on Norduc Naturals, but the price is ridonkulous. Now we’re on Carlson’s. Very reasonable….but….it’s not what it claims. Neither is Nordics (which a dr., who specializes in mental health, told me take …..specifically Nordic Cod Liver and a sublingual vitamin D3).

So now, I’m thinking just eat the dayum fish…but how do we know what’s in the fish?

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Devi October 26, 2015 at 11:57 pm

I stumbled to your blog when I typed comparison of fish oil. Indeed Nordic Omega 3 has higher price than other. Especially in Asia.. 🙁 unbelievable. Anyway. Thanks for your blog.

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