Over the counter vs prescription fish oil

Over the Counter vs. Prescription Fish Oil

A decade or so ago, a visit to the doctor was about an ailment you had such as a broken bone, the flu, or other symptoms that you could not remedy at home.  We were at the height of the fast food crave and generally speaking as a society we were becoming unhealthier by the generation.  

Now we see more doctors and the emergence for Dietitians and Nutritionists focused on preventative medicine starting with what you eat and consume. 

For the last 10 years I go to my doctor and get a complete annual physical which includes drawing blood and testing it for signs of more serious problems.  Blood work can identify how healthy your vital organs are such as the heart, kidneys, liver, and thyroid. 

It can even identify diseases and conditions such as HIV and diabetes, and heart disease.  If you don’t have any of these conditions, the blood results can tell you if at risk or heading in a bad direction. 

If you are heading in a bad direction such as I was, then often the advice is watch what you eat.  My blood sugar and cholesterol were rising ever year.  It was like a broken record, too much red meat, not enough vegetables.  One of the foods my doctor was adamant about me adding to my diet was fish that are rich in Omega-3 such as Salmon and Tuna. 

After finally giving in a few years ago, I headed to my local pharmacy and the pharmacist assistant pointed me to a shelf full of different brands of Fish Oil  loaded with Omega-3.  There were big 500 mg bottles, little 250 mg bottles, some labeled “purified to remove Mercury” and some did not.  Some said “burb-less” and some did not.  Some said “soft gels” some did not.  A couple of different brands said “#1 pharmacist recommended”. 

How could they both say that?  I thought this would be simple!

So, I settled on a brand that was burp less, purified to remove Mercury, supports a health heart, and 500mg of Omega-3.  How could I go wrong? 

I took a soft gel tablet every night for 365 straight days and headed back to my doctor excited about taking my blood test and seeing if my triglycerides or bad cholesterol was lower.  It went down 2 points which a step in the right direction, but my doctor was still not happy with the results. 

This time she wrote me a prescription for Fish Oil (Vascepa®) and explained to me what the difference is.

Prescribed fish oil capsules contain a higher dose of the fatty acid Omega-3 and is monitored by the Federal Drug Administration (FDA) for quality and safety.   The prescription capsule contains ethyl esters of the Omega-3 fatty acid and eicosapentaenoic acid (EPA) obtained from the oil of the fish.  The active ingredient in the capsule is icosapent ethyl which is clinically proven to reduce cholesterol.  The makers of FDA approved Vascepa performed clinical tests and the study concluded that icosapent ethyl tablets lowered LG by 27% and LDL-C by 5%.    

Over the counter fish oil products at your local store are not approved by the FDA and the purity of the Omega-3 is not monitored.  The labels on all the over the counter (nonprescription) packaging I reviewed at a popular Pharmacy stated, “this statement has not been evaluated by the Food and Drug Administration”.   

Most of the OTC labels offer guarantees that their own product meets their own company standard for purity and potency.  While the OTC Fish Oil product I used lowered my cholesterol, not all products on the market will meet that objective.  I highly recommend simple cholesterol blood tests from an allied health professional to see if your OTC fish oil works for you.

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