Differentiating Fish Oils: Part 1, The Form of the Oil

This series will succinctly describe various aspects of the omega-3 fish oils that cause doctors and their patients a great deal of confusion and consternation. We will begin with the form of the oil.

Fish oils come in four forms: Ethyl Ester (EE), Triglyceride (TG), Phospholipid (PL), and Free Fatty Acid (FFA). Most fish oils (including the prescription, Lovaza) come in the EE form.  In fact, the largest and most profound scientific studies to date have used EE omega-3s.  In nature, omega-3s are found in the TG and PL forms.  The problem is that in order for manufacturers to develop pills with highly concentrated important omega-3s, EPA and DHA (also known as the active ingredients in fish), they must first convert the omega-3s to the EE form.  Then these health-promoting omega-3s can be highly concentrated, and depending upon one’s preference, either EPA or DHA can be emphasized (to be discussed in a future blog). Some manufacturers chose to convert the oils back to the TG form (a process that requires the oils to be subjected to high temperatures for long periods of time – not good for the oils in some experts’ opinions).  Others convert the oils into the FFA form to try to enhance absorption.  The Krill oil producers leave the oil in its original PL form with the drawback being that only very small amounts of the key ingredients EPA and DHA can be delivered in each pill.  The Krill and TG contention is that these forms of omega-3s are more “natural” and thus better.  The reality is, however, that all the oils must be changed in our gut to FFA in order to be absorbed.  Thus, they are no longer PL, TG, or EE when they’re absorbed by our bodies.  They are all FFAs. Studies to date have shown this conversion to be an efficient process and up to 95% absorption can be expected when any of the forms are taken with food. In fact, the lion’s share of the current literature indicates that the form of the oil is probably not nearly as important as companies would like you to believe. The most important issue is how much EPA and DHA you are receiving when you swallow a pill or eat a fish.  That is what you need to look for (also the subject of another blog).

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  1. myp2p.eu footballstreaming.info December 4, 2011 at 3:40 am #

    great post, very informative. I wonder why the other specialists of this sector don’t notice this. You should continue your writing. I am sure, you have a huge readers’ base already!

    • Seth J. Baum, MD December 4, 2011 at 9:48 am #

      Thank you for your feedback. I will continue posting and exploring areas of medicine that are too often misunderstood.

  2. Evan Kreines February 10, 2012 at 3:42 am #

    Great post!

  3. Dr Ron Grassi April 14, 2013 at 2:55 am #

    Doc: Thank’s for deciphering this Omega 3 info. Very well crafted. Ron.

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