By now we all know the benefits of fish oil and its omega-3s: lower risk of heart disease, stroke and cancer, less systemic inflammation, lower risk for depression, better skin, and so on. Although fish and fish oil supplements are the best sources for these omega-3 benefits, there are nonetheless scenarios that rule out these sources.

Dear Mark:

I’m sold on the benefits of a Fish Oil Supplement and I’m interested to start taking one. However, I have had serious allergic reactions to Shell Fish in the past, and an allergist has shown me to be reactive to most fish in general. As such I have avoided anything and everything that swims for a very long time. Maybe it’s possible my allergies were due to inflammation caused by my CW diet, but I’m still wary to test my theory now that I’m eating Primal. I feel like I’m missing out on a huge variety of food and supplement options. Question: I know anything can cause an allergic reaction, but is there any scientific basis for Fish Oil Supplements causing allergic reactions in people who have demonstrated allergies to fish/shellfish? And if so, what are my options for proper Omega-3 supplementation?

Thanks to DJK for this week’s question. First, let me expand on the allergy subject. Fish allergies are most commonly set off by fish proteins and less commonly by fish bones and skin (found in gelatin products). Even if you’ve shown a sensitivity to finned fish, you don’t need to rule out fish oil just yet. Although processing varies considerably between brands, true purified fish oil shouldn’t contain anything that would incite an allergic reaction. For those with a sensitivity but not full-blown allergy to fish, I’d recommend giving a high quality purified supplement a careful but fair try. A very small study showed that purified fish oil supplements were safe for those with fish sensitivities.

If, on the other hand, you’re one of the few with a serious, life-threatening allergy to fish I’d recommend a different omega-3 route. Your best bet is to come at it from multiple angles.

• Decrease omega-6 intake and inflammation inciters in your diet. Although omega-3s are essential in their own right, they’re also needed to balance out the high levels of omega-6 in our modern diets. A clean Primal Blueprint diet free of processed foods, grains and omega-6 based oils will cut go a long way to reducing the numbers needed to maintain the golden 1:1 omega ratio.
• Eat grass-finished and wild game meats (especially organ meats). Both offer a much better omega ratio (1.6:1) than factory farmed meats.
• Increase your ALA omega-3 intake. Although the body’s conversion of ALA to EPA and especially DHA is limited (for men: 8% to EPA and 0-4% to DHA; for premenopausal women: 21% to EPA and 9% to DHA), a good wallop of ALA offers its own benefit and a leg up in the EPA/DHA department. Ground chia and flax seeds are great sources, as are the green purslane and omega-3 enriched eggs.
• Finally, add a “vegetarian” DHA supplement that is fully derived from algae sources. Health food stores and co-ops are the most likely places to carry them, but plenty of well-known Internet suppliers offer them as well. As with fish oil supplements, look for a trusted brand and refrigerate them to ensure the best quality and freshness.

Thanks for reading everyone, and be sure to weigh in with your thoughts for DJK. As always, thanks for all your great questions and comments, and keep em’ coming!

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