Omega-3, Fish Oil

1.00 Softgel

twice per day

Take with food

Ongoing

Additional notes

"Why it is here: The guide's fit for excessive inflammatory load: an oil enriched with specialized pro-resolving mediators (SPMs). Choose one omega-3 product from this protocol, not several. How to take: With a meal that contains fat, preferably your largest meal if tolerated. Published evidence: Early and mechanistic: In a randomized, placebo-controlled study, an enriched marine oil raised blood levels of SPMs. Outcome evidence in people is still early: one small pilot trial in knee osteoarthritis reported less pain, with no change in joint function. Clinical experience (observation): In my practice this has worked well for some patients to resolve inflammation and pain when other options have not. That is an observation from my own patients, not a trial result. Caution: Two softgels supply 850 mg of EPA + DHA and 600 mcg of SPMs, below the 1,000–2,000 mg a day of EPA + DHA the guide gives for this goal. The label directs 1 softgel a day; this protocol uses 2. Ask your clinician first if you take a blood thinner or antiplatelet medication, have a fish or shellfish allergy, or have surgery ahead. Review: Track stiffness, pain, and function over 30–90 days; reassess about every 3 months."

1.00 Softgel

once per day

Take with food

Ongoing

Additional notes

"Why it is here: For general wellness when fatty fish intake is low. This is ProOmega 2000, a higher-strength version of the ProOmega the guide describes. Choose one omega-3 product from this protocol, not several. How to take: With a meal that contains fat, preferably your largest meal if tolerated. Published evidence: In the VITAL trial, 840 mg a day of EPA and DHA did not significantly reduce the primary cardiovascular endpoint. Evidence supports correcting low intake more strongly than routine supplementation in people already eating fatty fish. Clinical experience (observation): My preferred choice for routine use in most people who supplement with fish oil. That is my own practice pattern, not a trial finding. Caution: Each softgel supplies 1,000 mg of EPA + DHA, the top of the guide's 500–1,000 mg a day for general wellness. The label serving is 2 softgels (2,000 mg); this protocol uses 1. Ask your clinician first if you take a blood thinner or antiplatelet medication, have a fish, shellfish, or iodine allergy, or have surgery ahead. Review: Reassess about every 3 months: continue with a clear reason and benefit, adjust, or stop."

1.00 Softgel

once per day

Take with food

Ongoing

Additional notes

"Why it is here: The guide's higher-potency option, for goals that need more EPA + DHA per softgel. Choose one omega-3 product from this protocol, not several. How to take: With a meal that contains fat, preferably your largest meal if tolerated. Published evidence: Higher doses carry a safety signal: in a meta-analysis of cardiovascular outcome trials, the risk of new atrial fibrillation rose roughly 11% for each additional gram a day. Clinical experience (observation): I reach for this when a higher dosage goal is being pursued and a more potent product makes that simpler. That is my own practice pattern, not a trial finding. Caution: Each softgel supplies 1,000 mg of EPA + DHA. The label serving is 2 softgels (2,000 mg); this protocol uses 1. Moving into higher-dose territory is a conversation with your clinician, not a self-directed decision. Ask your clinician first if you have a history of atrial fibrillation, take a blood thinner or antiplatelet medication, have a fish, shellfish, or iodine allergy, or have surgery ahead. Review: Reassess about every 3 months: continue with a clear reason and benefit, adjust, or stop."

1 Capsule

three times per day

Take with food

Ongoing

Additional notes

"Why it is here: The krill option, for someone who prefers krill or tolerates it better. How to take: Take with a meal that contains fat, preferably your largest meals, if tolerated. Caution: Each softgel supplies 195 mg of EPA + DHA (135 mg EPA, 60 mg DHA), below the guide’s 500–1,000 mg a day for general wellness. The label allows up to 3 softgels a day; this protocol advises 3. Contains krill, a shellfish: do not take it if you are allergic to shellfish. Not vegan; the softgel is bovine gelatin. For adults only. Mild, passing stomach upset can occur. Ask your clinician first if you take a blood thinner, an NSAID, or a statin, or have surgery planned. Review: Reassess about every 3 months: continue with a clear reason and benefit, adjust, or stop."