Is fish oil giving you Heart Disease?! 

Your videos are the best out there. As someone who has done research myself, I appreciate your bringing in multiple studies and resisting sweeping conclusions. Well done, doc!

I love your nuanced approach to these claims, rather than the kneejerk reactions we commonly see online. Nothing is black and white!

Thank you, finally someone with no hype, who I can trust. Science background here, and I take the science very seriously. Your videos are very informative, thanks for delving into the research and doing excellent summaries. Saves the rest of us a lot of time!

I use to take fish oil every day and ended up with heart palpitations and headaches so I’d say that study is spot on

as usual i'm so thankful that there's still people like you who actually inform people to scientific standards. hope you'll be able to do this for a long time.

I really hope this works out for you in the style you do these videos. This actually provides value and saves me time

Another great review Gil. You are a wonderful source to keep us balanced with the ton of studies and wild information out there. Hoping all is well with the family and hope to see your content for a very long time. All the best.

I was experiencing A Fib after taking Fish Oil tables . I stopped taking it and the A Fib went away . After a few months I tried taking Fish Oil tablets again and the A Fib came back .I was taking 1g . I now get my Omega 3 from my diet and have had no issues /no A Fib.

Gil, I am quite suspicious of the reduce-it trial because it was not a true placebo control RCT since the "placebo" was mineral oil which is known to be pro-inflammatory and is likely harmful.

Thank you for acknowledging algae supplementation. I don't know why these studies don't compare those to the fish oil. What if the algae oil doesn't have any side effects. It would be so cool if they could also compare those who consume a well-planned whole Food vegan diet with a regularly high intake of alpha linolenic acid rich foods like nuts and seeds. Feels like nothing's really changed still after some long. Great video, Nice update!

I've been worrying about this. So happy you covered this. I'm vegan and take 1 gram every day. Now I might lower it a little. Appreciate the clarification!

I'm 63 and eat a healthy diet and exercise 5 days a week. I eat salmon and tuna every week and take fish oil supplement every day. I brought my cholesterol down from 220 to 130. Works for me.

Second comment: My anecdotal experience is: I used to have AF sometimes a decade ago and it went away for the most. A few months back I started taking 1h of Omega3 a day and after a few weeks I noticed palpitations and short bursts of what I felt when I was diagnosed with AF. I stopped the pills and the palpitations went away. I had no clue about this research then, on the contrary, my placebo mindset told me "this is good for your heart". Maybe a total coincidence, but funny that it fits.

I always find that if I listen to your videos all the way through, the questions that start popping up in my head get answered. Thanks for covering algae oil.

What I think keeps getting lost in all the discussion of Omega 3s and CVD is the risks/benefits in terms of brain health. Neither my husband nor I are at high risk for CVD, but we have some family histories of dementia and mental illness to contend with, so we take algae oil. Are we off base on this? I'd love to see more on the research regarding brain health rather than CVD. As always, great content, Gil!

I was a long-term taker of fish oil supplements, and i always noticed i had slight AF, but i just dismissed it. After this study, i stopped taking them, and the AF has pretty much gone. I won't be taking it again. I just eat fish within my diet.

Very good video that was clear and well nuanced, ending with good answers to what an individual might do, given what we know and how well we know it. Thanks, Gil, for all you do. Would you consider a video specifically about your diet (and any supplements) - What do you eat/take and why? I think given your knowledge and background, a talk about your choices would be helpful!

If some is good, more is not necessarily better, and too much is almost always bad.

Nutrition never turns out to be simple, but that doesn't matter. I'm really here for accurate information.

Thank you so much for this comprehensive overview. I was hoping you would do this video when almost everybody else ran with one piece of data. 🙏🏻

The concern I have with supplements is that they aren’t regulated so there is no way to know if they have high levels of heavy metals in the supplements from the manufacturing process. So, then you have to go down this rabbit hole of who has sent for a third party lab results for contamination, then you have to do your own research into if that third party lab is reputable or can be bought off. Etc etc etc. Now you have to concern yourself with if the benefits of the supplement outweigh the risks of the contaminants in the pills and who can do that?

Hi Gil, Can you please make a video to review the evidence available regarding Omega3 (fish consumption not supplementation) and prostate cancer? Thank you so much for the great, unbiased content you provide.

What is the omega 3/fish oil actually doing to the heart that causes the problems? Also is there anything about the micro plastics found fish oils?

Well done. Thanks for adding clarity.

I've tried many brands, but whenever I take omega-3 I feel weird and sick, I reduced my supplementation to a single capsule only twice a week, to avoid any noticeable side effects.

Thank you for this, a great video! Question: How about older omega-3 trials, I think those should be considered into the complex EPA/DHA equation?

I have hated even the smell of fish since forever. I have been taking cod liver or fish oil for years but have it lemon flavored. It has seemed to help my triglyceride to HDL ratio immensely and it may be my imagination but I think it has also helped mental focus. I have tried to eat fish but I just can’t do it.

Thank you- I really needed this! I’m a vegetarian who takes low dose algae derived DHA/DPA supplements. When the link between atrial fibrillation and fish oil came up, I wondered if I should stop those supplements.

Thank you, Doctor! I take fish oil because I don't eat fish often and I am a higher risk for heart disease. I was diagnosed with AFib with RVR last year and I guess I will chat with my PC and cardiologist if I should even be taking this supplement. You're the best.

Hi, i like you podcasts, very enlightening. With regards to this podcast, I've been taking fish oil supplement (2500 mg) for 15 years. I started this after I had a heart attack. Last month I went for a complete heart check. Everything seems to be fine. Guess I belong to the lucky group.

I had high triglycerides (over 1600) and was prescribed Lovasa, 4 capsules a day (generic equivalent) years ago, to help in lowing them. My continual shift in diet I feel was more the cure for the problem, but the only reaction I got from taking this, was if I bumped my arm on something I'd get broken capillaries. My triglycerides were down to 88 and I asked my doctor if I could stop taking the medicinal fish oil, my concern was I could get internal bleeding. I take a lower does of fish oil now instead of the prescription and no problems anymore.

Another nuanced and informative video, thank you sir! I do wonder whether or not fish oils are still worth taking in general due to the supposed health benefits for the brain?

How about vegetable sources of Omega 3's like walnuts, flax, and chia? Especially for people who didn't want to use fishies.

Well, omega 3 thins the blood also, with all the risk that follows with that so moderation is the key. If you don't eat a lot of fish then omega 3 supplementation makes sense. I choose krill oil since it has less toxins than fish oil.

1:17 Yeah. And by that logic smoking may be good for you. After all, negative effects of smoking are primarily based on epidemiological studies. No RCT. (OFC I know it's not your opinion.) I like how you used uncolored fish slice as farmed salmon truly is. (Without colorings added to the fish forage or most likely added later...) Algae are a *MUCH better source for Omega-3 fatty acids* as they are the source. With fish derived Omega-3 capsules you only ingest additionally accumulated pollutants from toxic heavy metals to PCAs, BPAs, microplastics, and more. Additional hormones and antibiotics if farmed fish or krill is used... Wild caught had too many "bycatch" and pollutants including thousands of tons of nets. Deriving oil from poor sharks is even worse. Algae should be farmed in a much larger scale worldwide. It would be better for the environment, better for our health and vegan friendly as bonus. It would lower both production and final cost. Also true for apart as good ingredients. Cheaper nori, wakame, Kombu... Cheaper Asian food in the West...

Interesting. I was facing with some afib symphoms and suplementing 500EPA 750DHA every day. Since begining of spring cut it to one dose 250/500 and any symphtomps just stopped. It wasnt because I heard about side effects of O3 - just decided to lower my dose. Now it's second month since I dont suplement it anymore, but from time to time I consume some tasty fish. None of afib sympthoms anymore to this day.

I started taking fish oil because I read an article saying it can reduce rage. Idk if it's the pre-menopause, but I get this rage from the depths of hell!!! Hasn't been a month yet, but it seems to be helping so far. Can you speak on this please?

I've cut my dose to 1000mg twice a week, since seeing the Afib news. I've been taking FO for 30+ years. It's definitely helped my blood #s. I do have bouts of Afib and flutter. So seeing this latest news has me perplexed.

@Nutrition Made Simple!: Here's an idea for another video: Arsenic levels in rice and how relevant they are for human health or Phytic acid: Good, bad or irrelevant? Does soaking seeds and nuts actually do anything?

I take it for inflammation. Have ankylosing spondylitis

Another thing that goes back and forth. One day you must take it (up to 4,000 IU a day) and the next day it's no good for you. I take a plant based EPA/DHA because I am allergic to seafood. I live in a place that only has 3 months of summer sun, so I take 3,000 IU a day. Now, should I be lowering that to 500? Who and what are you supposed to believe anymore?

What about Krill oil?

Living is deadly.

Great info. I've been taking Algae oil for years and yes it does raise your EPA/DHA.

Keeps coming back to, forget the supplements unless you have a deficiency and just eat real food.

Great info! Many thanks for sharing Dr Carvalho

Do you know if algae oil has higher levels of microplastics than eating fish of fish oil supplements?

Would be cool to know is this about DHA/EPA or fish oil itself, how does it compare to algae-based oils. And what about ALA? There is so little info about ALA, compared to DHA/EPA.

One thing you did not cover is People that take lower doses of Omega 3 like MegaRed -3 Fish & Krill Oil Advised. That’s 500mg Total. Omega- 3 Fatty Acid 339mg EPA and DHA together 314mg For 500mg that is Pacifically made for those that cannot take high doses, but can take a lower dose and get the benefit of such.

I'm on a high level of Methadone for Chronic Pain. This medication in high doses can cause Atrial Fibrillation so I have to have an ECG once a year to make sure I'm not developing this condition. I also monitor my heart doing an ECG with my Apple Watch, regularly too. I have been taking 4,000mg of Fish Oil under advice of my doctor to counteract the problems I have with my bowels due to my Spinal Cord injury and I have had 0 issues with Atrial Fibrillation doing this for a number of years now. I just thought I'd let you know because if anyone is going to develop Atrial Fibrillation it would be me due to my high risk for it.

Hey, another great video! I was wondering if there were any attempts to explain how large doses of EPA/DHA could induce an AFIB episode? If you've across any such theories could you share it with us?

Besides heart health I take DHA from algae for my brain.

Excellent analysis!

I'd be interested whether vegans who eat lots of ALA omega-3 benefit from an algae supplement. I take them currently but I don't really know how much good they're doing me.

I believe those larger studies showed aFib risk from omega 3 intake varied by vagal tone. Low vagal tone had few aFib issues, high vagal tone (low resting HR ect) saw most of the increased risk with omega 3 supplementation.

Hi Gil good vid. I wonder if krill oil might differ from fish oil ?

What about Swedish fish? I've eaten a whole school of them in my life. Any effects beyond sticky teeth?

I used to take 5 grams fishoil per day because several RU-vid/doctor influencers said optimal DHA/EPA were 1grams each, that required me to take 5 grams overall fishoil, and I started experiencing weird heart palpitations this year even tho I been doing this for several years. My hypothesis is that it was due to oil going oxidized because I opened the capsules and oil smelled really bad. I bought another brand, opened caps, oil smelled fresh and chest discomfort went away, but came back 3 weeks later so I opened the caps again and sure enough, the oil smelled fishy again, so it went in the garbage can. I don't want to waste more money on fish oil now, these caps go bad after few weeks even if they are in the refrigerator.

Many people get confused by the numbers. We should not conflate the FISH OIL number on the front of the bottle, say 1000 mg and the OMEGA -3 number (on the front or back of the bottle) say 300 mg omega-3. Only part of that number is what we're after. Only part of that Omega-3 is the vital elements called EPA and DHA which could add up to only 250 mg. So when it is suggested you take 1000 mg it is referring to that last group, EPA and DHA. So I take 4 Softgels, 250 x4 = 1000 mg EPA and DHA,. Thats 4, 1000mg of FISH oil totaling 4,000 mg FISH OIL but only 1,000 mg EPA/DHA.... Am I correct???

Comparison between the Sacha Inchi Oil and the Fish Oil I. The process of obtaining the supplies The Sacha Inchi (Plukenetia Volubilis Linneo ) is a seed obtained through the cultivation in organic earth located in the Central Forest of the Peru in medium altitudes and it implies all the corresponding agricultural works. The required extension area is related to the amount of production that is desired to obtain, 1 Ha of earth produces 1000 Kg of seed in the first year, then, the production increases gradually until the 3rd year, when it reaches its maximum productivity, the first harvest is achieved after 10 months; to obtain 1Kg of oil it is required an average of 6 Kg of seed. At the moment exists little seed offer in relation to the demand; The oil production does not yet reach important volumes due to the fact that it is a new product, and it will take its value in the market as the demand increases and the cultivation areas expand. The fish - usually fish of cold water - is the supply of the fishmeal and the remaining oil constitutes a sub-product which is directly encapsulated (softgels), or it is used as a base -deodorized - to elaborate other products, such as snacks, cookies, candies, tofees, etc”¦, which already have a wide established market since many years ago. II. Oil obtaining Process The Sacha Inchi is an organic vegetable product which content goes through an extraction process in cold, to be converted into an extravirgen oil, allowing the human being to count with a product which enables him to metabolize his own omegas (precursory acids O-6, O-3, and O-9), creating in consequence a natural order. The fish oil, having an animal origin offers the human being the O-3, metabolized by the said organism which was used as supplier source in the process of the oil production; the source precursor is the plankton. III.Comparison among their main components The Sacha Inchi has over 47% more content of linolenic acid, the O·3 precursor The fish oil has from 22% to 33% of O·3, being the anchovy the best fish for the O·3 Oil. Due to the fact, that the Sacha Inchi contains the precursor a-linolenic in superior quantity, it is able to produce more EPA and DHA (Omega 3), than any other fish and it offers an ideal combination of O·3 (in more content), besides the O.6 and O.9. The Sacha Inchi has 3.85% of Palmitic acid and 0.0% of Palmitic-oleic. & nbsp; The Anchovy has 19.9% of Palmitic acid and 10.5% of Palmitic-oleic. A less content of these components better for the human body. The Sacha Inchi has 93.69% of Unsaturated Fatty Acids. The fish oils can contain from 65% to 77% Unsaturated Fatty Acids. The higher percentage makes it more favourable to the health. The Sacha Inchi has 6.4% of Saturated Fatty Acids. The fish oils can contain from 22% to 35% of Saturated Fatty Acids. The lowest percentage of saturated fatty is the most healthy. The smell and the flavor of the Sacha Inchi is like the nature and similar to the beans. The smell and the flavor of the fish oil is well known. When a person takes softgels of fish oil may belchs the fish flavor. The complementary process to eliminate the characteristic smell and flavor of the Sacha Inchi Oil and the development of the sub-products with flavor discretion (final product), is already a reality and slowly, but in a progressive and sustained way they will occupy a higher level in the market to those products, which are elaborated on basis of fish oil, due to their superior characteristics. IV. Conclusion ALL THIS MEANS THAT SACHA INCHI OIL, IS THE PRECURSOR SOURCE OF O·3 (WITH AN IDEAL COMBINATION OF O·6 AND O·9) OF VEGETABLE AND ORGANIC ORIGIN ALLOWS THE HUMAN BEING TO METABOLIZE THEIR OWN O·3, BECOMING A VERY SUPERIOR HEALTH PRODUCT IN RELATION TO THE FISH OILS WHICH CONTAINS O·3.

I gives me heartburn thats for sure and thats with low dose.

What about Cod LIver Oil---especially the cold-pressed variety?

A cautionary note: The majority of "fatty fish" commonly available are Farm Raised and fed all kinds of cereal/antibiotics/growth hormones and other crap to increase production and profit. Buy wild caught fish but unfortunately these types of fish are hard to find in many areas and are way more expensive.. Do your research before just assuming the fish you buy at a grocery store is all that good for you because it's usually a mixed bag of good things for you wrapped in a "bad" package.

The actual incidence of Afib in the non-fish oil users was around 4.2%, while that in the fish oil users was 4.8% - this represents an absolute risk increase attributable to using fish oil of just 0.6%. Another study published in 2020 and included nearly the same group of participants as the current UK Biobank study found regular use of fish oil was associated with a 13% lower risk of all-cause mortality, a 16% lower risk of dying from cardiovascular disease, and a 7% lower risk of incident cardiovascular disease events (i.e., myocardial infarction or stroke).

Great video thank you, so clear and well explained.

What are your opinions on the risk of oxidation of omega 3 supplements? Seems to be a relatively common occurence and one that is not always super easy to detect. Could it possibly be contributing to some of these side effects?

I had been eating one can of oily fish (sardines, herring, kipper etc) a week for the last five years & sporadically before that. Until I saw a documentary about Chernobyl & realized the fallout plume squarely hit the Baltic Sea where my fish originates. I researched evidence of contamination but could find nothing. If anyone knows the answer please speak up?

That's interesting, thanks. Always thought I want at least 1g of combined, EPA and DHA per day. Would be interesting to see studies that also check for omega-3 index and whether there's a correlation.

What I haven’t seen is any evidence discussed of increased risk of atrial fibrillation in populations that have a high fish diet leading to a high percentage of Omega-3 fatty acids in their cell membranes. For example, in Japan. If this is real, is a higher rate of atrial fibrillation observed in the cohort that eats fatty fish daily. Is there any evidence like this?

Yes, fish oil supplements did give me arrythmia, or atrial tachycardia. I was on statins, which eventually poisoned me, but because they gave me joint pain and swelling I was advised to take fish oil supplements. I did this for many years, but between the statins and the fish oil I became extremely ill. Now I have given both up and after 5 months I am finally feeling normal again, and managing my cholestrol with diet, which includes oily fish one to two times a week.

⚠️ Dr Ray said this 40 years ago and got ridiculed. Many of his followers luckily avoided fish oil.

Thanks for the update. I'm wondering if there have been any studies comparing Omega-3 precursors to DHA/EPA supplementation, or even just looking at these precursors without comparing them to another intervention, in terms of cardiovascular outcomes. Speaking of course about ALA (either in supplement form, or in foods like flax meal, hemp seed meal, or chia seeds). I was diagnosed with heart disease over 10 years ago and went plant-based about 7 years ago, and at that time I went on the strict Esselstyn diet, which I later moderated off of, but still continue to eat plant-based, and take in about 2 tbsp of flaxmeal per day. I've tried algae oil on occasion but never sustained it possibly because I detected feeling a bit "off" when taking it, although it could have been psychological, or unrelated, who knows. I take a statin and am in generally good health with no known cardiovascular events for over 5 years now, low LDL for that time period as well. I haven't heard of such studies with ALA supplements or foods and I really wish there was something that might definitely say whether this was of a benefit at all or completely useless (at least in terms of prevention of secondary events).

Is there any evidence that eating fish will increase the risk of atrial fibrillation?

Thanks, i reacted instantly to this news by taking smaller sips of strong fish oil. I started taking it earlier together with the protein meal when it is supposedly more effective. Taking it away from bedtime may have improved my sws also

Can you make a video on Berberin for lowering cholesterol. Is it effective!

Gil, is it possible that spreading a dose of fish oil throughout the day could reduce the risk? (I was reminded of researchers who speculated that it was due to the large single dose that high intake of supplemental calcium was associated with strokes.) Also, is the AFib caused by fish oil reversed when intake is stopped?

Where does all this fish oil come from? I find it hard to believe there is enough fish for the vast amounts of fish oil pills produced.

Too bad they don’t break out vegan omega 3 vs fish based. A lot of fish oil is contaminated, though the best companies filter it.

My omega fish oil is 700mg DHA and 300 EPA and appears to have greater anti inflammatory effect due to Tuna and NZ Hoki fish blend. Any Risk? Thanks

Very clear and very important. Thx

2 questions: -Were the omega 3 supplements tested or could they have been some bootleg engine oil capsules? -Were the omega 3 supplements stored correctly, or were they exposed to heat and/or sunlight?

I wonder if the consumption of ALA is a factor too.

Great Video!

Only unanswered question- will atrial fibrillation resolve if one stops taking omegas?

Why not simply increase dietary sources?

Oh wow! I've had Atrial Fibrillation. I'm not taking fish oil again.

Hello! Why not mentioning the importance of checking the omega 3 index?

I have low risk of heart problems both in tests & family history, but my eye doctor told me to take 2-3g of fish oil for my chronic dry eyes syndrome & it has helped tremendously. 40 yrs old & working out 4-5 days a week since i was 18. You think its not worth the risk to take 2 potent fish oils per day? I don’t eat fish in general & my diet is high protein high fiber

I have been taking fish oil for a long time and I was also diagnosed with arthrial fibrillation. I had an ablation and I got my normal sinus curve back. So there might be some truth in that. I took 20 ml cod oil per day for 1,5 to 2 years. I stop that rutine now and what I get now comes from food.

Wondering if you’re going to a video on the new cardiovascular calculator.

Thanks for this, I had no idea.

How often is the fish oil supplement already rancid? This would also be one thing to consider.

Dr would you consider the quality of the fish oil a factor in risk? Rancid fish oil might be common in over the counter products. Is there a fib risk in eating whole fish instead?

Hey Doc, you mentioned that you take an omega 3 supplement sometimes. Are you comfortable sharing what that translates to?

I thought EPA reduced inflammation and DHA was good for the heart and brain. Good video.

Can fish oil effect INR? Thanks.

I’m in the 4th bucket. Am I at risk of atrial fibrillation for just being a pescatarian? 🤔

What about the benefits of fish oil for mental health and joint health? Seems like there are a lot more benefits of higher dose fish oil than there are risks

I wonder if the whole foods omega 3 comes in, has something in it, you need to eat when consuming omega 3😊

Gil, what about flaxseed oil as a source of omega 3s? Since developing consistent PVCs over the winter, I cleaned up my diet and started taking 1-2 tablespoons of flaxseed oil daily. Any studies done on that? Keep up the excellent content!