The Fish Oil Conundrum

It’s hard enough to know what to eat to lower your risk of heart disease, but it’s even more complicated to know what, if any, supplements to take. If I had a nickel for every claim I’ve seen on the Internet about herbs, essential oils, vitamins, and other supplements that help your heart, well, I’d have a shit ton of nickels. I’m a skeptic by nature, but beyond that I prefer to act based on fact versus hyperbole.

But one thing we know for sure is that fish oil is good for your heart. Right? Well, the real answer is — it depends on what you mean by “good for your heart.” Despite all the studies done over the last few years, there is no proof that taking omega-3 fatty acids (fish oil) will decrease your risk of having a heart attack. OK, well, fish oil lowers cholesterol at least, right?

“If you’re taking supplements like fish oil or a multi-vitamin in the hopes of improving your cholesterol counts, save your money.” — Cleveland Clinic

It turns out that fish oil has been proven to lower your triglycerides, which is a significant risk factor for heart disease. But it does not lower your cholesterol. Which I think would be a surprise to most people. It certainly was to me.

I had very high triglycerides, which I believe was one of the main factors that led to my heart attack at age 45. So in the years following my heart attack I started taking fish oil supplements and that, along with significantly decreasing my consumption of bread and other processed carbs, lowered my triglycerides dramatically. How dramatically? Prior to my heart attack and before drug therapy to lower it, once or twice my trigs were measured well north of 500. The medical consensus on triglycerides suggest they should be below 150. These days my trigs have been consistently around 100.

But then about a year ago a blood test showed they had crept back up to around 175. I had been slacking on my diet, eating a bit more carbs and sugar than I should have been, so I redoubled my efforts to stay away from processed carbs and sugar and doubled down on my fish oil, going from 2,000 mg a day to 4,000 mg a day. My trigs immediately nosedived back down under 100.

All’s well, yes? As college football commentator Lee Corso says — not so fast my friend. In the months following my increased fish oil consumption, my LDL cholesterol started creeping up. From 35, to 42, to 48 to my most recent results in which my LDLs came in at 59. Still lower than the recommendations, but over about a one year period that’s a 70 percent increase!

Was I doing something else differently that could cause my LDL levels to skyrocket? I hadn’t changed any of my medications. I was eating more unsaturated fat, but that is good fat (avocado, olive oil, nuts, etc.). Could it be the fish oil? Can fish oil actually raise LDL levels? If so, how come I didn’t know this before upping my daily dose by 2,000 mg a day?

Off to the Internet I went and sure as shit, there is evidence that high doses of fish oil can increase LDL levels.

“Despite their excellent ability to reduce triglycerides naturally, EPA and DHA actually increase LDL cholesterol, concerning some doctors and medical researchers.” — University Health News

Sometimes no matter what you do you can’t win! Something I was doing successfully to lower my triglycerides may be raising my bad cholesterol. While I’m not 100 percent sure fish oil is the culprit of my increased LDLs, there’s one way to find out — take less fish oil and retest my blood. I have an appointment with my doctor this week to discuss just that and I’ll report back on his take on the matter. In the meantime, if you are one of the nearly 20 million Americans taking fish oil be sure to keep an eye on your LDL levels.

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