COMMENTARY

Angling for Dry Eye Therapy?

Roger F. Steinert, MD

Disclosures

July 23, 2013

In This Article

Which Form of Omega-3 Fatty Acids Is Best?

This leads to the question of which omega-3 fatty acids we should take. The past several years have seen increasing active discussions about the 2 basic forms. The naturally occurring fish form is a triglyceride fatty acid. It is more expensive to produce and keep omega-3 fatty acids in that form commercially. Therefore, most of the commercially available omega-3s are in ethyl ester form. When it is ingested, the liver breaks it down and converts it into a triglyceride form, releasing some ethyl alcohol that can be proinflammatory.

Some nutritionists feel quite strongly that the natural triglyceride form is better. There are only a few sources for that commercially. One is Premium Rx National Pharmaceuticals, which I have no proprietary or financial interest in. They are available through the Web and it is, without question, more expensive to get that form rather than the ethyl ester form. However, studies have shown that the ethyl ester form is poorly absorbed, with potentially only about 20% getting absorbed. It will have a very different impact on the total body uptake of omega-3s using the ethyl ester form as opposed to triglycerides. If you eat fish that is high in omega-3 fatty acids 3 times a week, you will get the natural triglyceride form. That is one way of dealing with this. You can also get some omega-3 fatty acids from other sources, particularly flaxseed oil. I have not personally seen any solid data comparing the benefit of one vs the other. I think that is yet to come. Personally, I take the triglyceride form.

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