Eicosapentaenoic acid (EPA) is one of several omega-3 fatty acids used by the body. The typical Western diet is relatively deficient in omega-3 fatty acids compared to the diets of our ancestors. Our main dietary sources of EPA are cold water fish such as wild salmon. Fish oil supplements may also raise the concentrations of EPA in the body. Increased intake of EPA has been shown to be beneficial in coronary heart disease, high blood pressure, and inflammatory disorders such as rheumatoid arthritis.

Autoimmune Diseases

The omega-3 fatty acids, including EPA, found in fish oils have been shown to modify the immune response and may be helpful in treating inflammatory autoimmune diseases such as rheumatoid arthritis.

Cardiovascular Health

Omega-3 fatty acids have also been shown to improve cardiovascular health and may prevent the accumulation of plaque (cholesterol and fat) on the walls of the arteries. Fish oil supplementation may also reduce high blood pressure in people with diabetes.

Growth and Development

The omega-3 fatty acids in proper balance are essential for normal growth and development. Nutrition experts have issued recommendations for appropriate intake of each type of omega-3 fatty acid in infant formulas and diets. According to these recommendations, intake of EPA for infants on formula diets should be less than 0.1%.

Other Conditions

Omega-3 fatty acids, including EPA, may also have positive effects on lung and kidney diseases, Type II diabetes, obesity, ulcerative colitis, Crohn's disease, anorexia nervosa, burns, osteoarthritis, osteoporosis, attention deficit/hyperactivity disorder, and early stages of colorectal cancer.

EPA can be obtained by eating cold water fish such as wild salmon (not farm raised), mackerel, sardines, and herring.

EPA is also available in fish oil supplements. Some commercial products may also contain vitamin E to maintain freshness.

Recommendations for adequate intakes put forth by the International Society for the Study of Fatty Acids and Lipids (ISSFAL) appear below.

Pediatric

• EPA is naturally found in breast milk; therefore, infants that are breastfed should receive sufficient amounts of EPA.

• ISSFAL recommends that formula for infants contain less than 0.1% EPA. 

Adult

• The adequate daily intake of EPA for adults should be at least 220 mg/day. 
• Therapeutic recommendations from diet: 2 to 3 servings of fatty fish per week, which corresponds to 1,250 mg EPA plus DHA per day.
• Fish oil supplements: 3,000 to 4,000 mg standardized fish oils per day. This amount corresponds to 2 to 3 servings of fatty fish per week.

Some commercial products may also contain vitamin E to maintain freshness. For supplements, follow the directions on product labels for both dosage information and storage requirements; some products may require refrigeration. Do not use products beyond their expiration date.

Supplements containing EPA may not be recommended for infants or small children because they upset the proper balance with DHA, another omega-3 fatty acid needed during early development. This suggests that pregnant women should also be cautious about taking fish oil supplements.

Fish oil capsules may be associated with side effects such as loose stools, abdominal discomfort, and unpleasant belching. In addition, they may prolong bleeding time slightly; therefore, people with bleeding disorders or those taking blood-thinning medications should discuss the use of fish oil capsules with their healthcare providers before taking them. Consumption of fish oil supplements may also increase antioxidant requirements in the body. Taking extra vitamin E along with these supplements may be warranted; again, please consult your healthcare provider.

In combination with aspirin, omega-3 fatty acids could be helpful in the treatment of some forms of coronary artery disease. Consult your healthcare provider about whether this combination would be appropriate for you if you have coronary artery disease.

Omega-3 fatty acids may reduce some of the side effects associated with cyclosporine therapy, which is often used to reduce the chances of rejection in transplant recipients. Consult your healthcare provider before adding any new herbs or supplements to your existing medication regimen.

In an animal study, omega-3 fatty acids protected the stomach against ulcers induced by reserpine and nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin. Consult your healthcare provider before using omega-3 fatty acids if you are currently taking these medications.

EPA has also been shown to boost the effects of a combination of low-dose etretinate and a topical corticosteroid medication used to treat severe, chronic psoriasis. Consult your doctor to determine if this combination therapy may be of benefit for you if you suffer from chronic psoriasis.

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