Last month, Dr. Douglas Bibus stopped by our Facebook page to answer some of your questions about fish oils and omega supplements. Here are some of your questions and answers straight from our omega expert, himself!
Q: Does my child with autism need omega 3 or can he get enough is his diet?
DR. BIBUS: Omega 3 fatty acids are the special molecules that nearly every cell in our body needs to thrive. The brain is particular rich in one kind of omega 3 fatty acid called DHA. ALL children need sources of omega 3 in their diet and diets low in omega 3 have been reported to compromise cognitive function and physical health. Dietary sources of plant based omega 3’s include sources like flax and chia. Green vegetables also contain plant based omega 3 but tend to be lower in content than flax and chia. While plant based omega 3 can be converted into the long chain omega 3 like EPA and DHA, many of us will need to consume EPA and DHA directly. Fish and fish oil are two common ways to get EPA and DHA in your diet. If fish like salmon or sardines are not on your radar, seek out a high quality fish oil supplement. Emulsified fish oils, like Coromega, taste great and are easily absorbed. Your healthcare provider or nutrition store manager can help you with the many options.
Q: My son has been taking the omega-3 gummies (the ones shaped like little characters and in a “gummi bear” form). Would an actual oil or gel pill that we can squeeze into his drink work better? Or are the gummi’s just as effective?
DR. BIBUS: Gummi’s are a great tool for getting kids nutrients but may not provide enough of a omega 3 dose compared to taking a typical fish oil supplement. If you are trying to get 600mg of long chain omega 3 per day, you may have to take several gummies, while a product like Coromega would only require 1 packet.
Q: Is there a recommended ratio of EPA and DHA for a child with ADHD?
DR. BIBUS: No specific ratios have been recommended. Both omega 3 fatty acids (EPA and DHA) are very important for health. I generally tell people to consume both and let your body determine what to do with either. We have evolved eating fish that contains both EPA and DHA. Following digestion, living systems “decide” which fatty acids go where. DHA generally goes to the brain which explains why brain tissue has ~30% of its fatty acids as DHA but almost no EPA. EPA is thought to fight inflammation more effectively than DHA. Clinical trials in ADHD patients suggest that EPA may be more effective than DHA at treating symptoms but I still would recommend consuming both EPA and DHA.
Q: What do you think of Fermented Cod Liver Oil for ASD kids?
DR. BIBUS: Generally I like to only recommend high purity triglyceride based oils. I have looked into fermented cod liver oil and I am not sure or don’t honestly understand the value of allowing oil or livers to ferment and then harvesting the oil. I do know that fermented cod liver oil has a large amount of free fatty acids which often indicated an oil that has gone bad. High levels of free fatty acids also tend to promote oxidation of omega 3 oils. The fermented oil product I tried also had a bit of a fish smell to it which usually tells me when an oil has gone bad. Perhaps try a good quality cod liver oil first to see if it has a positive effect. You could then consider trying a fermented product.
Q: Can you have too much Vitamin E??
DR. BIBUS: While it has been traditionally been thought that vitamin E at high doses has little to no toxicity, recent publications have challenged this. The tolerable upper limit for children under 8 is 450IUs. If you are working with your physician you can monitor any potential adverse events. You can learn more about vitamin E at
Q: A blood test showed my daughter was allergic to fish (not shellfish) but in the past she’s eaten it with no problem, up until this test we were also giving her fish oil gummies and didnt notice any allergic reactions, but due to the test results we stopped. Do you suggest another source of omega 3 or should we keep using fish oil if no reactions were noticed. Also she is 3 and cannot swallow pills, so which supplements, fish oil or not, would be best for a kid that age to get their omega 3s?
DR. BIBUS: Fish allergies are generally associated with protein ‘parts’ of fish. Fish oils are the fat portion of fish and should be free of protein. I would check with your doctor before going back on fish oil. There are also omega 3 supplements derived from algae which should not affect her fish allergy.
Q: Is there an amount that is too high in your opinion? We are using a liquid form and give a teaspoon a day.
DR. BIBUS: The US FDA states that up to 3000mg of long chain omega 3 per day is safe. This is the equivalent to 10 regular grade 1 gram fish oil capsules. A teaspoon of oil will most likely fall below 3000mg of long chain omega 3 unless it is a super concentrate. As an adult I take 5000mg of long chain each day. The Greenland Inuits, living on a marine diets, were reported to have daily intakes of omega 3 from 9000mg to 16,000mg per day without any side effects.
Q: Sometimes I get confused in regards to things like fish oil, cod liver oil, and omega-3’s. Can I give cod liver oil, and extra omega-3’s or would the benefits be enough from simply taking CLO? They make so many options, with so many labels, sometimes it’s over whelming when choosing what bottle is best to give. (for a 5 year old. We noticed a cease in visual stims with cod liver oil, so I’m doing one thing right! I’ve just wondered if I should be adding in something more.)
DR. BIBUS: Congrats on finding something that works! Yes it can be daunting when looking at all the omega 3/fish oil options. Just remember your goal is providing a daily dose of long chain omega 3 that includes EPA and DHA. Cod liver oil will work just fine but the oil also contains vitamin A. If you taking higher amounts of cod liver oil you should be aware of how much vitamin A you are also feeding. Vitamin A is toxic at high doses. Check with your healthcare provider if you are unsure. In general I would say that if you follow label directions for supplement use you should be fine.
Q: What is a good brand of fish oil? Currently using genestra cod liver oil..how do I know where the fish is coming from..and that it is not contaminated..regarding the whole Fukushima accident…
DR. BIBUS: There are a number of good fish oil products in the market today. I like emulsified fish oils like Coromega that provide a highly absorbable and tasty way to get omega 3 which I think appeals more to children. Most fish oils are coming from Peru as anchovy oil. I know companies are monitoring any potential contamination of radio isotobes from the Fukushima accident. To date I have not heard of any contamination in fish or fish oil sold in the US.
Q: At what age should you start giving a child omega 3s?
DR. BIBUS: I started at conception (through mom) and all the way through infancy and childhood for my kids. Remember that omega 3 is incredibly important for brain development. Breast milk naturally contains DHA to support brain development. When breast feeding stops, the need for DHA omega 3 does not stop nor should supplementation with omega 3. Check with your pediatrician on dosing if you plan on giving your kids omega 3 below age 4.