DHA supplement and fish oils health benefit, side effects, review of published studies, used with EPA fatty acid, source of omega-3 for vegetarians and vegans
April 1 2018 by Ray Sahelian, M.D.

DHA is an omega-3 fatty acid found mostly in the brain, retina, and in sperm. It plays an important role in vision. Omega-3 fatty acids are beneficial because they provide fluidity to cell membranes and improve communication between brain cells. They also reduce the clotting ability of platelets, thus potentially decreasing the incidence of heart attacks and strokes. Two very important omega-3 fatty acids are eicosapentanoic acid (EPA) and docosahexanoic acid (DHA). They are found in seafood, especially mackerel, salmon, striped bass, rainbow trout, halibut, tuna, and sardines. Supplements of fish oils that contain EPA and DHA are sold over the counter. DHA is also sold by itself, usually from an algae source.

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How it is made
EPA and DHA are made from another fatty acid called alpha-linolenic acid. ALA is found predominantly in flaxseed oil (also known as linseed) and hemp seed oil. Green leafy vegetables, soybeans, walnuts, and canola oil have small amounts of omega3 fatty acids. ALA converts - after several enzymatic steps - into EPA and then on to DHA. This fatty acid should not be confused with DHEA, a Hormone.

Benefits, which medical conditions can be helped
The main marine omega 3 fatty acids are eicosapentaenoic acid, docosapentaenoic acid and docosahexaenoic acid. It is of interest that DHA is specifically localised in the retina and the brain in humans and other mammals. The longer chain omega 3 fatty acids are rapidly incorporated into cell membrane phospholipids where it is regarded they influence the metabolism/metabolic events within the cells. The mechanisms by which these changes occur include alteration in the fluidity of membranes such that there are subtle changes in receptor function, alteration in cell signaling mechanisms, membrane-bound enzymes, regulation of the synthesis of eicosanoids, and regulation of gene expression.
   Fish and fish oils may be beneficial in reducing the risk for heart disease, heart arrhythmias, mental decline, and may also help reduce symptoms of arthritis and several autoimmune conditions. Eating fish and perhaps taking fish oil supplements may also help reduce the risk for macular degeneration.
Fish oils are found in sperm, and these oils may support healthy sexual organ function.
   Dr. Malcolm Peet of the Swallownest Court Hospital in Sheffield, England and his colleague found that depressed patients who received a daily dose of 1 gram of an omega-3 fatty acid for 12 weeks experienced a decrease in their symptoms, such as sadness, anxiety and sleeping problems.

Aggression, impulsiveness reduction
Hum Psychopharmacol. 2013. A double-blind trial of the effect of docosahexaenoic acid and vitamin and mineral supplementation on aggression, impulsivity, and stress.L Department of Psychology, University of Swansea, Swansea, Wales, In a double-blind randomized trial, four groups of young adult men without a history of aggressive or impulsive behavior received a placebo, multivitamins / minerals, DHA or both for 3 months. With the Picture-Frustration Task, DHA decreased the display of aggressive behavior. DHA also decreased impulsivity as measured using the GoStop Impulsivity Paradigm that examines the ability to inhibit already initiated behavior. Although a multivitamin and mineral supplement did not influence these measures, it did decrease perceived stress. The influence of supplementation on aggression and impulsivity can be conveniently studied in a sample without a history of antisocial behavior, using laboratory-based measures. No evidence was found of a synergistic interaction between vitamins/minerals and DHA.

Brain health, Alzheimer's disease
Prog Lipid Res. 2016. The role of omega-3 polyunsaturated fatty acids eicosapentaenoic and docosahexaenoic acids in the treatment of major depression and Alzheimer's disease: Acting separately or synergistically? Omega-3 polyunsaturated fatty acids (n-3-PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA), improve or prevent some psychiatric and neurodegenerative diseases in both experimental and clinical studies. As important membrane components, these PUFAs benefit brain health by modulating neuroimmune and apoptotic pathways, changing membrane function and/or competing with n-6 PUFAs, the precursors of inflammatory mediators.

Docosahexaenoic acid protects from dendritic pathology in an Alzheimer's disease mouse model.
Neuron. 2004.
High DHA consumption is associated with reduced Alzheimer's disease risk.

In the study reported in The Journal of Neuroscience, mice that ate DHA-enriched chow showed less beta-amyloid build-up in the brain than mice fed regular chow. Beta-amyloid is a protein that forms the characteristic brain plaques seen in patients with Alzheimer's disease." These results suggest that dietary DHA could be protective against beta-amyloid production, accumulation, and potential downstream toxicity," according to senior author Dr. Greg M. Cole, from the University of California at Los Angeles. Dr. Greg Cole used a mouse model of Alzheimer's disease and fed the animals low- or high-DHA chow or regular chow until age 22 months, at which point brain tissue was obtained and tested for amyloid build-up. The high-DHA diet reduced total amyloid level by 70 percent compared with the other diets. Brain plaques were reduced by 40 percent.

Neuroinflammation plays an important role in the advancement of this disorder, and n3 polyunsaturated fatty acids (PUFAs) are involved in both the reduction in and resolution of inflammation. These effects may be mediated by the anti-inflammatory and proresolving effects of bioactive lipid mediators (oxylipins) derived from n3 PUFAs [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] in fish oil. Although interventions have generally used fish oil containing both EPA and DHA, several studies that used either EPA or DHA alone or specific oxylipins derived from these fatty acids indicate that they have distinct effects. Both DHA and EPA can reduce neuroinflammation and cognitive decline, but EPA positively influences mood disorders, whereas DHA maintains normal brain structure.

Cancer, anti tumor fatty acid
A.M. El-Mowafy and colleagues from Mansoura University in Egypt evaluated the role of DHA in solid tumors growing in mice and how well it interacted with the chemotherapy drug cisplatin. The results were published in the April 2009 BioMed Central's peer-reviewed Cell Division journal. "Our results suggest a new, fruitful drug regimen in the management of solid tumors based on combining cisplatin and possibly other chemotherapeutics with DHA," A. M. El-Mowafy said in a statement. "DHA elicited prominent chemo-preventative effects on its own, and appreciably augmented those of cisplatin as well." In their study, A. M. El-Mowafy found that, at the molecular level, it reduces the accumulation of white blood cells, systemic inflammation, and a harmful condition marked by decreased antioxidant levels -- all of which have been linked to tumor growth. Their experiment also showed that the fatty acid reduced toxicity and injury to kidney tissue caused by the chemotherapy drug.

Docosahexaenoic acid supplementation in atopic eczema: a randomized, double-blind, controlled trial.
Br J Dermatol. 2008.
Fifty-three patients suffering from atopic eczema aged 18-40 years were recruited into this randomized, double-blind, controlled trial and received either DHA 5.4 g daily or an isoenergetic control of saturated fatty acids for 8 weeks. DHA, but not the control treatment, resulted in a significant clinical improvement of atopic eczema. The DHA group showed an increase of plasma n-3 PUFA and a decrease in the n-6/n-3 PUFA ratio. Our data suggest that dietary DHA could be bioactive and might have a beneficial impact on the outcome of atopic eczema, but our results need to be confirmed in a larger study.

Eyesight, eye health
Invest Ophthalmol Visual Sci. 2015. Docosahexaenoic Acid Slows Visual Field Progression in X-Linked Retinitis Pigmentosa: Ancillary Outcomes of the DHAX Trial. Docosahexaenoic acid (DHA) was supplemented in a single-site, placebo-controlled, randomized clinical trial designed to slow vision loss associated with X-linked retinitis pigmentosa (XLRP); the DHAX Trial. Male participants with XLRP (range, 7-31 years) received 30 mg DHA/kg/d or placebo for 4 years. Visual outcomes were measured annually and red blood cell (RBC) DHA determined every 6 months. Oral DHA supplementation increased mean RBC-DHA levels by 4-fold over placebo. No group differences in progression were found for visual acuity, shape discrimination, or fundus appearance. Yearly rates of progression were reduced for dark-adapted thresholds and visual field sensitivity for foveal, macular, peripheral, total, and ellipsoid zone regions by DHA supplementation. Supplementation of DHA significantly elevated blood DHA levels and reduced the rate of progression in final dark-adapted thresholds and visual field sensitivity. From the relationship between RBC-DHA and the rate of field sensitivity loss, we can extrapolate that an RBC-DHA level of 17% could minimize the decline in field sensitivity.

Heart disease, reduce the risk of sudden death with omega-3s
An editorial in Circulation: Journal of the American Heart Association suggests that increasing dietary omega-3 fatty acids, which come from fatty fish or flaxseed oil, and decreasing omega-6 fatty acids, found in plant seed oils such as corn, safflower, and sunflower, is a way to reduce the risk of sudden death from irregular heart rhythms or heart attacks.
   One cause of sudden death is ventricular fibrillation, in which the heart contracts in a fast and chaotic rhythm that makes it unable to pump blood to the rest of the body. A number of factors including cigarette use, fasting, diabetes, hyperthyroidism or heart attack can trigger the release of fatty acids from adipose tissue.
   Fats that we eat are stored in adipose (fat) tissue. When these fats are released from their storage sites, they become free fatty acids. But not all fatty acids are equal in their propensity to cause arrhythmias. High levels of omega-6 fatty acids may encourage arrhythmias if their levels aren’t balanced by omega-3 fatty acids.
  Comments: a year ago the American Heart Association revised its dietary recommendations to include advice to eat two meals of fatty fish – such as salmon or halibut – per week. I recommend those who don’t eat fish to take 3 to 5 fish oil capsules or a teaspoon of flaxseed oil per day and to try reducing their intake of omega-6 oils.

Omega-3 fatty acids from fish oils and cardiovascular disease.
Mol Cell Biochem. 2004.
Epidemiological studies have shown an inverse relation between the dietary consumption of fish containing EPA / DHA and mortality from coronary heart disease. These relationships have been substantiated from blood measures of omega-3 fatty acids including DHA as a physiological biomarker for omega-3 fatty acid status. Controlled intervention trials with fish oil supplements enriched in EPA / DHA have shown their potential to reduce mortality in post-myocardial infarction patients with a substantial reduction in the risk of sudden cardiac death. The cardioprotective effects of EPA / DHA are widespread, appear to act independently of blood cholesterol reduction, and are mediated by diverse mechanisms. Their overall effects include anti-arrhythmic, blood triglyceride-lowering, anti-thrombotic, anti-inflammatory, endothelial relaxation, plus others. Current dietary intakes of EPA / DHA from fish oils in North America and elsewhere are well below those recommended by the American Heart Association for the management of patients with coronary heart disease.

Infants, children and vision
Front Hum Neurosci. 2013. Does docosahexaenoic acid supplementation in term infants enhance neurocognitive functioning in infancy? The proposal that dietary docosahexaenoic acid (DHA) enhances neurocognitive functioning in term infants is controversial. Theoretical evidence, laboratory research and human epidemiological studies have convincingly demonstrated that DHA deficiency can negatively impact neurocognitive development. However, the results from randomized controlled trials (RCTs) of DHA supplementation in human term-born infants have been inconsistent.

Improvement in visual acuity in infants
The DIAMOND (DHA Intake And Measurement Of Neural Development) Study: a double-masked, randomized controlled clinical trial of the maturation of infant visual acuity as a function of the dietary level of docosahexaenoic acid.
American Journal of Clinical Nutrition, 2010.
Three hundred forty-three healthy, term, formula-fed infants were enrolled at 19 d of age and were randomly assigned to be fed 1 of the following 4 infant formulas containing equivalent nutrient amounts, except for long-chain polyunsaturated fatty acids: control (0% DHA), 0.32% DHA, 0.64% DHA, or 0.96% DHA; DHA-supplemented formulas also provided 0.64% arachidonic acid. Infants fed control formula had significantly poorer visual evoked potential visual acuity at 12 mo of age than did infants who received any of the DHA-supplemented formulas. There were no significant differences in visual evoked potential visual acuity between the 3 amounts of DHA supplementation for either site at any age tested. DHA supplementation of infant formula at 0.32% of total fatty acids improves visual acuity. Higher amounts of DHA supplementation were not associated with additional improvement of visual acuit.

Maturation of visual acuity is accelerated in breast-fed term infants fed baby food containing DHA-enriched egg yolk.
J Nutr. 2004.
Between 6 and 12 mo of age, blood levels of the (n-3) long-chain PUFA, docosahexaenoic acid, in breast-fed infants typically decrease due to diminished maternal DHA stores and the introduction of DHA-poor solid foods displacing human milk as the primary source of nutrition. We evaluated the effect of supplemental DHA in solid foods on visual development of breast-fed infants with the primary outcome, sweep visual-evoked potential (VEP) acuity, as an index for maturation of the retina and visual cortex. At 6 mo of age, breast-fed infants were randomly assigned to receive 1 jar (113 g)/d of baby food containing egg yolk enriched with DHA (115 mg DHA/100 g food) or control baby food . Gravimetric measures were used to estimate the supplemental DHA intake which was 83 mg DHA/d in the supplemented group and 0 mg/d in controls. Although many infants in both groups continued to breast-feed for a mean of 9 mo, RBC DHA levels decreased significantly between 6 and 12 mo (from 3.8 to 3.0 g/100 g total fatty acids) in control infants, whereas RBC DHA levels increased by 34% from 4 to 5.5 g/100 g by 12 mo in supplemented infants. VEP acuity at 6 mo was 0.49 logMAR (minimum angle of resolution) and improved to 0.29 logMAR by 12 mo in controls. In DHA-supplemented infants, VEP acuity matured to 0.14 logMAR at 12 months (1.5 lines on the eye chart better than controls). RBC DHA levels and VEP acuity at 12 mo were correlated, supporting the need of an adequate dietary supply of DHA throughout 1 year of life for neural development.

Children who are breastfed are about fifty percent less likely to be nearsighted. Docosahexaenoic acid or DHA, a substance found in breast milk, could be the main element that improves early visual development in babies, resulting in more ordered eyeball growth which then reduces the development or severity of nearsightedness. Nearsightedness is the most common eye problem. It affects as much as 40 percent of the population in the United States and Europe but between 70 and 90 percent of some Asian populations such as Singapore, Japan and Hong Kong. DHA is important for the development of photoreceptor cells in the retina, which play a major role in whether children become develop nearsightedness. Researchers studied 797 children aged between 10 to 12 years in Singapore as part of the survey. They were given medical tests and also had to answer a series of questions including the number of books they read per week. The study, led by the Singapore Eye Research Institute, found that the risk of nearsightedness in a child who was breastfed is 0.6 times that of child that was not, even after taking other factors into account. While genetic variation was seen to be the culprit of nearsightedness among children, soaring rates of the condition have led more researchers to believe it is the rise in watching television, playing computers games and reading that is to blame.

Macular degeneration
The incidence of age related macular degeneration (ARMD) is reduced in those who consume fish.

Memory, attention, reaction time
DHA supplementation improved both memory and reaction time in healthy young adults in those whose diets were low in this fatty acid. Am J Clin Nutr 2013.

Vision, seeing is believing
The rods and cones of the retina in the eyes are very rich in DHA. Hence, a deficiency in dietary fish oils will reduce the photoreceptor activity of retinal cells, and may reduce visual acuity. On the other hand, supplementation with fish oils (or flaxseed oil) could lead to visual improvement with enhanced color perception.
   Since levels of DHA in the brain decline with age, it is likely that the levels of DHA also decline in the retina. Is it possible that daily intake of fish oils can improve vision in older individuals? Hopefully future research can give us some answers.

A supplement of 600 mg DHA per day in the last half of gestation resulted in overall greater gestation duration and infant size.  2013 American Journal of Clinical Nutrition, DHA supplementation and pregnancy outcomes.

Vegetarian diet
Docosahexaenoic acid supplementation in vegetarians effectively increases omega-3 index: a randomized trial.
Lipids. 2005. Division of Metabolic Diseases and Nutrition, Dr. von Hauner Children's Hospital, Ludwig Maximilians University of Munich, Munich, Germany.
Low red blood cell (RBC) membrane content of EPA + DHA (hereafter called omega-3 index) has recently been described as an indicator for increased risk of death from coronary heart disease. The relationship between plasma and RBC fatty acids, focusing on omega-3 index, and the response to DHA supplementation were investigated in a double-blind, randomized, placebo-controlled, intervention study. Healthy vegetarians consumed daily a microalgae oil from Ulkenia sp. (0.94 g DHA  per day) or olive oil (placebo) for 8 wk. DHA supplementation significantly increased DHA in RBC total lipids and in plasma phospholipids whereas EPA levels rose to a much lesser extent. Microalgae oil supplementation increased the omega-3 index. After intervention, 69% of DHA-supplemented subjects (but no subject of the placebo group) reached an omega-3 index above the desirable value of 8 wt%. We conclude that an 8-wk supplementation with 0.94 g DHA/d from microalgae oil achieves a beneficial omega-3 index of > or =8% in most vegetarian diet subjects with low basal EPA + DHA status.

Effects of docosahexaenoic acid supplementation on blood lipids, estrogen metabolism, and in vivo oxidative stress in postmenopausal vegetarian women.
Eur J Clin Nutr. 2005.
Vegetarians are generally deficient in long-chain n-3 fatty acids. Long-chain n-3 fatty acids have a beneficial effect on plasma lipid levels, and some studies showed that they had breast cancer suppression effect. To investigate the effect of docosahexaenoic acid (DHA, 22:6n-3) supplementation on blood lipids, estrogen metabolism and oxidative stress in vegetarians. Design: Single-blind, randomized, placebo-controlled trial. Twenty-seven postmenopausal vegetarian women were recruited. After a 2-week run-in period with 6 g placebo corn oil, the subjects were subsequently randomized to receive either 6 g corn oil or 6 g DHA-rich algae oil (2.14 g of DHA /day) for 6 weeks. Two subjects in corn oil group withdrew before completion. Conclusion: DHA supplementation at a dose of 2.1 g/day for 42 days decreases plasma cholesterol but neither does it show beneficial effects on estrogen metabolism, nor does it induce deleterious effects on the observed in vivo antioxidant or oxidative stress marker in postmenopausal vegetarian women.

Retinitis pigmentosa
Invest Ophthalmol Vis Sci. 2015. Docosahexaenoic Acid Slows Visual Field Progression in X-Linked Retinitis Pigmentosa: Ancillary Outcomes of the DHAX Trial. DHA was supplemented in a single-site, placebo-controlled, randomized clinical trial designed to slow vision loss associated with X-linked retinitis pigmentosa. Supplementation of DHA significantly elevated blood DHA levels and reduced the rate of progression in final dark-adapted thresholds and visual field sensitivity.

Side effects, safety, risk
No major side effects have been reported in medical journals with the use of DHA supplements.

DHA Research studies
Effect of fish and fish oil-derived omega-3 fatty acids on lipid oxidation.
Redox Rep. 2004.
There is evidence that omega-3 fatty acids derived from fish and fish oils reduce the risk of cardiovascular disease via mechanisms underlying atherosclerosis, thrombosis and inflammation. Despite these benefits, there has been concern that these fatty acids may increase lipid peroxidation. However, the in vivo data to date are inconclusive, due in part to limitations in the methodologies. In this regard, our findings using the measurement of F(2)-isoprostanes, a reliable measure of in vivo lipid peroxidation and oxidant stress, do not support adverse effects of omega3 fatty acids on lipid peroxidation.

The fatty acids found in fish may slightly lower a man's risk of prostate cancer, but another type of fatty acid found in a range of foods may raise the risk, a large study suggests. Researchers found that among nearly 48,000 U.S. men followed for 14 years, those with the highest intakes of two fatty acids found in oily fish were 26 percent less likely than men with the lowest intakes to develop advanced prostate cancer. The opposite was true, however, when it came to alpha-linolenic acid, or ALA. Like the two fish-oil fats, ALA is an omega-3 unsaturated fatty acid that is thought to promote heart health; it is found in vegetable sources such as soybeans, canola oil, walnuts and flaxseed, and to a lesser extent in meat and dairy products. In this study, men with the highest intake of ALA were about twice as likely as those with the lowest intakes to develop advanced prostate cancer. And the risk was increased regardless of whether the ALA came from vegetable or animal sources, according to findings published in the American Journal of Clinical Nutrition.

The July/August 2004 edition of the journal Child Development reports a study found that infants whose mothers' had higher blood levels of docosahexaenoic acid (DHA) at birth showed more mature forms of attention during their first two years of development. Reported studies have consistently shown that women's diets in the U.S. have one of the lowest levels of DHA in the world.

Smart Eating for a Smarter Baby
The brain is largely made of fat, and the types of fat we consume can have an influence on how well our brain functions. Most studies show that fish oils (DHA and EPA) are essential to optimal brain function. But does maternal diet influence brain development of the child? There is a growth spurt in the human brain during the last trimester of pregnancy and the first postnatal months, with a large increase in the cerebral content of DHA. The fetus and the newborn infant depend on maternal supply of DHA. Sometimes maternal intake of DHA during pregnancy and lactation is marginal. Researchers at the University of Oslo in Norway examined the effect of supplementing pregnant and lactating women with cod liver oil on mental development of the children, compared with maternal supplementation with corn oil. The study was randomized and double-blinded. A total of 590 pregnant women were recruited in week 18 of pregnancy to take daily 10 mL of cod liver oil or corn oil until 3 months after delivery. The cod liver oil contains DHA and EPA. The corn oil contains linoleic acid and alpha-linolenic acid. All infants of these women were scheduled for assessment of cognitive function at 6 and 9 months of age. As part of the protocol, 135 subjects from this population were invited for intelligence testing with the Kaufman Assessment Battery for Children (K-ABC) at 4 years of age. The K-ABC is a measure of intelligence and achievement designed for children aged 2.5 years through 12.5 years. Children who were born to mothers who had taken cod liver oil during pregnancy and lactation scored higher on the Mental Processing Composite of the K-ABC at 4 years of age as compared with children whose mothers had taken corn oil. Dr. Sahelian says: Women who are pregnant may consider eating more fish, taking cod liver oil or fish oil supplements in consultation with their obstetrician.

Fish oil supplements contain no mercury
ConsumerLab, an independent evaluator of dietary supplements and nutrition products, released results of its product review of Omega-3 Fatty Acids from fish oils.  EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are fatty acids that have been shown to help reduce cardiovascular disease, reduce the pain associated with rheumatoid arthritis, as well as showing promise in the treatment of a number of other conditions. A concern with fish oil products has been potential contamination with mercury. ConsumerLab purchased 20 dietary supplements containing EPA and/or DHA and tested them for their claimed levels of these ingredients as stated on the label, as well as for mercury contamination and evidence of decomposition. Although six of the products had lower levels of EPA/DHA as stated on the label, none of the twenty products showed evidence of decomposition and none were found to contain detectable levels of mercury.

Q. I've been taking fish oil supplements with DHA for a few weeks now and I notice visual clarity and more pronounced colors like you said in your Mind Boosters book.

Do I need to take more vitamin E if I'm supplementing with DHA?
    Most likely yes, but only small amounts are needed. Since DHA is highly unsaturated, it would seem cautious to supplement with at least 5 to 10 units of vitamin E a day if you're taking a gram or more of an epa / dha combination.

Q. I am 24 years old and have just recently started wearing glasses because I can't see far. You mention [in the Mind Boosters book] that fish oil supplements can improve focus, color perception and clarity of vision. Is DHA or fish oil use recommended to individuals 50 years and older or do you think I would benefit by adding fish oil supplements to my diet?
  A. If your diet lacks adequate amounts of omega-3 oils, and you don't eat enough fish, it is possible that DHA or fish oil capsules could  help with your vision, although do not expect dramatic results at your age. The best way to find out if it works for you is to try the fish oils for a period of a month and observe any improvements. Eating more cold water fish is recommended.

Q. Let me compliment you very highly on Mind Boosters. It has been wonderful to read & implement your research. I realized after reading it that I didn't eat any fish. After taking 3 fish oil capsules per day (1000mg) for two weeks I have found my blood pressure is reduced from 140/90 to 125/80. I take this myself and have very structured measurements, due to having worked with many different blood pressure meds (and unwanted side effects) over the years. Have you seen this effect elsewhere? If this is long term I am VERY happy. Live long & prosper.
  A. I am surprised that a small dose of fish oils within two weeks could have made such a difference in your blood pressure. I usually don't see such a dramatic response in my patients.

Q. I have been looking into using EPA and DHA, but am looking for a purely vegetarian source. I have found vegetarian DHA supplements are much more available than EPA supplements. I see in fact that there is a vegetarian DHA supplement ( DHA Neuromins ), but not a EPA supplement. Is the DHA supplement sufficient, without another supplemental or major dietary source of EPA?
  A. We feel using both EPA and DHA is preferable than just using DHA by itself, although there may be people who do just fine using DHA by itself.

For mood stabilization, I have been told by my daughter's psychiatrist the Omega 3 oils must contain approximately a 7:1 ratio of EPA to DHA. Other ratios may just help joints and heart health. What are your findings on this?
   I am not aware of extensive research that specifies what the exact ratios should be for mood stabilization or depression treatment. Rather than focusing on exact EPA DHA ratios, one should just increase their overall intake of fish and fish oils and reduce sugar and junk food consumption.

Are you familiar with Dr. Andrew Stoll's research work at Harvard concerning Bipolar disorder? We have read that Dr. Andrew Stoll has developed a higher grade of Omega-3 Fish oil with 7:1 ratio of EPA over DHA. Are there any fish oils currently on the market that support this ratio in EPA / DHA levels?
    I am not aware of any supplements on the market that have a 7 to 1 ratio of EPA over DHA.

Regarding your response to the question above. OmegaBrite is amazing...it is really helping my son who has Asperger's, ADHD, learning disabilities and seizures (hyponatremia triggered - can't convert B6 to PLP/P5P). It also helped lower my sister's CRP within 3 months (stage 3 lyme). Both my son and my sister take 3 capsules per day with a meal that has some fat in it. OmegaBrite also contains a "tad" of vitamin E, to prevent oxidation of the others (EPA and DHA).

Products sold over the counter
iWi Omega-3 EPA powered by Algae, Highest-Absorption, 1000 Mg of Pure Almega PL, 120 mg of Polar Lipids, 250 mg of EPA, 100% Vegetarian, Non-GMO, Gluten-Free, Sustainable US Farming, 30 Softgel

Source Naturals, Neuromins DHA, 200 mg, 120 Veggie Softgels
purchase DHA Neuromins, 100 mg per pill
DHA Neuromins is derived from algae, not fish, hence it is a vegetarian source. Docosahexaenoic acid is an omega-3 fatty acid which plays a significant role in cerebral development, especially during the crucial period of fetal development and infancy. Pregnant mothers transfer DHA directly to the fetus to support rapid brain and retina development. DHA is supplied to the newborn via mother's breast milk. Some people have lower concentrations due to low-fat or vegetarian diets. Supplementation can help assure adequate amounts to support normal development of the brain and retina.

Supplement Facts
Serving Size: 3 Softgels
Serving Per Container: 40
  Amount Per Serving %DV
Calories 15  
Calories from Fat 15  
Total Fat 1.5 g 2% *
Saturated Fat 0 g <1%*
Tran Fat 0 g
Docosahexaenoic Acid (DHA) (from algal oil) (life's DHA) 600 mg
* Percent Daily Values (%DV) are based on a 2,000 calorie diet.

Suggested use, dosage: 1 to 3 DHA softgels daily. Some conditions may require more.
Supplement facts: DHA 200 mg each pill, Docosahexaenoic acid (from algal oil)
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