Flax Seed & Fish Oil Supplements

I've heard that flax seed oil and fish oil (omega-3 fatty acids) are good for IC symptoms. Is there one better than the other? Do you have any particular brand that you recommend? Also, is there any difference between the liquid and capsule?

Before we jump to the conclusion that taking supplemental omega-3s can “cure” interstitial cystitis and other diseases, it is important to know what we are talking about. Omega-3 fatty acids are a healthy fats found in foods in three main forms: DHA, EPA, and ALA.

DHA and EPA, or the “fish oils,” are found in salmon, trout, and other fish. These omega-3 sources have been shown by some studies to reduce a person’s risk for heart disease, eye disease, and possibly cancer. DHA has been studied in Alzheimer’s disease (AD) patients and may act as a partial mediator, possibly lowering the risk of AD in some genetic forms of the condition.

ALA is found in flaxseed and in small quantities in canola and soy. ALA has not been show to have any significant effects in humans and must be converted to DHA in order to be used, hardly an efficient process. In addition, some studies have discovered that men who eat an average of 1,500 mg a day of ALA in the form of flax seed oil actually have two times the risk of advanced prostate cancer than those who consumed half that amount. Consumption of flax seeds has not been shown to be a problem for men, and ALA in general does not seem to be a problem for women.

So why all the hype? Although there isn't any direct evidence that omega-3 fatty acid consumption is related to interstitial cystitis, there is emerging research suggesting that low levels of omega-3s may correlate with inflammatory conditions. In addition, omega-3 fatty acids are, in general, important for cellular health. They are a key component of cell membranes, and thus important for healthy cell replication. This is especially true of epithelial (skin) cells. Many people may not know that the urothelial cells of the bladder wall are very similar to the epithelial cells of the skin. It wouldn’t be too much of a stretch then to believe that omega-3 fatty acids could be important for a healthy bladder.

Omega-3s, like other nutrients, don’t stand alone, so the best way to get these essential nutrients is directly from food. Consuming three to four servings of fatty fish a week provides most people with the amount of omega-3 fatty acids needed to maintain good health. Some fish may be contaminated with heavy metals or other toxins, so it is important to vary the type of fish consumed and not consume these fish if you are pregnant, nursing, or if your physician has cautioned you against eating fish. The ALA in flax seeds is best digested when the seeds are ground just prior to eating. Flax seeds are also a great source of fiber and lignans, nutrients being investigated for use in the prevention and even treatment of a variety of conditions.

If you are interested in taking omega-3 fatty acids in supplement form there are a few common sense guidelines:

  • Look for a supplement with more EPA than DHA. A ratio of 3:2, EPA to DHA, is common.
  • Avoid supplements made from algae oil, which contain only DHA.
  • Avoid cod liver oil. It is high in vitamin A, which can be toxic in large doses.
  • Look for brands that meet certification standards, such as the International Fish Oils Standard (IFOS) or the United States Pharmacopeia Convention (USP).
  • Omega-3 supplements from capsules, liquid, or gels are equally effective. Some brands claim to be odorless, however these are usually more expensive. Most people find that taking the supplements with a meal works best.

Julie Beyer, MA, RD



Revised Wednesday, December 16, 2009