Study Finds Fish Oil Supplements May Overpromise Health Benefits

Dietary supplements are big business in the US, with the industry valued at over $50 million and around 60% of adults regularly taking a supplement to support their health and well-being.

A big component of the sector revolves around fish oil supplements — with many of these products possessing claims related to heart health benefits.

But are these claims backed by science? This is a question that scientists at the University of Texas Southwestern Medical Center explored in a new analysis report published August 23 on the JAMA Cardiology website.

Their findings stated that the majority of fish oil supplement labels comprise health claims relating to the heart (and other organs) — “despite a lack of trial data showing efficacy.”

Furthermore, they revealed that levels of all-important eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can vary between products.

The researchers looked at data from on-market fish oil (and non-fish omega-3 fatty acid) supplement labels, taken from the National Institutes of Health Dietary Supplement Label Database.

They reviewed the prevalence of two types of claims concerning cardiovascular disease: qualified health claims and structure/function claims.

Qualified health claims (QHCs) are claims relating to a supplement’s potential to aid in disease treatment or prevention and are made by the US Food and Drug Administration (FDA) following an evidence review.

The study revealed there are currently two cardiovascular-related qualified health claims for fish oil, one relating to coronary heart disease and the other to blood pressure. For instance, “Supportive but not conclusive research shows that consumptions of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.”

On the other hand, the FDA states that a structure/function claim “‘describes the role of a nutrient or dietary ingredient intended to affect the structure or function in humans.’’ These claims cannot declare that the supplement prevents, treats, or cures any illness or disease.

Some structure/function examples shared in the paper include “Promotes heart health,” “Supports heart, mind, and mood,” and “Omega-3 fatty acids are important for cardiovascular, immune, and nervous system health.”

Out of 2,819 unique fish oil supplements assessed, 2,082 (73.9%) possessed at least one health claim — most of which were structure/function claims.

Only 399 supplements (19.2%) used a QHC: 394 relating to coronary heart disease, three for blood pressure, and two relating to both.

Of all health claims on fish oil supplements, a significant proportion (62%) related to heart health.

This is problematic, said the researchers, as “Multiple randomized clinical trials have shown no cardiovascular benefit to fish oil supplements.”

Further, they added, the pervasiveness of structure/function claims could lead to misinformation among consumers.

The researchers recognized several limitations to the study:

Experts unrelated to the study highlighted other potential drawbacks.

The Council for Responsible Nutrition, a trade group for dietary supplements, issued a statement criticizing the study.

“The report appears to ignore that [structure/function] claims and Qualified Health Claims (QHCs) serve different purposes – one to provide general non-disease specific health information to consumers, and the latter are permitted [by the FDA] to discuss the relationship between a nutrient and disease risk,” said the Council for Responsible Nutrition (CRN) in a statement.

The CRN continued: “While [structure/function] claims may not have the same level of scientific substantiation as qualified health claims, they still require evidence to support their validity and provide consumers with valuable health information.”

Furthermore, they added, “Existing labeling, as the authors point out, carry the appropriate legal disclaimers regarding the limitations of those claims.”

Frustratingly, there’s no definitive answer.

Why? The research evidence is somewhat mixed.

“Fish oil supplements have always been a little controversial, especially for their use in heart health,” said Miranda Galati, MHSc, RD, dietitian and founder of Real Life Nutritionist.

In the new analysis, the researchers highlighted three different randomized trials, none of which found any cardiovascular benefits from taking fish oil supplements.

They did note that several other studies found higher doses of EPA and/or DHA (over 2 g per day) can lead to heart health benefits, including reduced cardiovascular events and lower triglycerides (blood fat) levels. However, higher doses in one study were linked to an increased risk of atrial fibrillation.

But there’s also research to support the use of fish oil supplementation in reducing cardiovascular disease risk.

For instance, a meta-analysis of 13 trials revealed that supplementation of marine omega-3 “lowers risk for myocardial infarction [heart attack], [coronary heart disease] death, total [coronary heart disease,] [cardiovascular disease] death, and total [cardiovascular disease.]” Most trials reviewed involved a daily dose of around 850 mg.

Another meta-analysis found certain marine fatty acids aided in lowering heart rate, while a double-blind, randomized crossover study found fish oil supplements reduced triglyceride levels by around 14%.

Unfortunately, “Nutrition studies are notoriously difficult to conduct in the right way,” said Megan Lyons, certified clinical nutritionist, board-certified holistic nutritionist, and founder of The Lyons’ Share Wellness.

“Humans have so many variables at play: different health conditions, diverse dietary intake, varying movement patterns, and distinct sleep and stress patterns — all contributing to their overall health,” she told Healthline.

Lyons explained that to isolate the very specific benefit or detriment of one nutrient or supplement, study participants would have to be rigorously restricted and controlled for years at a time — which is not possible.

“Therefore, many of these studies…often come down to what researchers are able to control and isolate,” she added.

EPA and DHA are both omega-3 fatty acids. “The most significant difference is their chemical structure because they contain different amounts of carbon atoms and double bonds,” said Allie Echeverria, a registered dietitian and founder of Eaton Broshar.

The research team found “substantial variability” in the amount of daily dose EPA, DHA, and combined EPA and DHA, across 255 different fish oil supplements from leading brands and manufacturers.

They stated that the “significant heterogeneity” in daily dose EPA and DHA can lead “to potential variability in safety and efficacy between supplements.”

The median amount of EPA in the analyzed supplements was 340 mg/d, DHA was 270 mg/d, and EPA and DHA was 600 mg/d.

However, there’s no official recommended daily amount for EPA or DHA, just as “There’s no established upper limit for omega-3 fats,” said Galati.

Typically, “You’ll want to look for a 250 mg dose of combined EPA and DHA per day,” Galati shared with Healthline. “Doses up to 1 g may be recommended for those with heart health concerns.”

Going overboard “can cause gastrointestinal distress, such as gas, belching, and diarrhea,” explained Echeverria. “Fish oil can [also] interact with blood pressure, anticoagulant, and contraceptive medications.”

The amount of fish oil a person requires can vary according to factors such as dietary habits and underlying medical issues. If you’re unsure, speak to a doctor or healthcare professional, such as a dietitian.

EPA and DHA are both believed to contribute to different aspects of health. “EPA is thought to help more with reducing inflammation and pain,” she continued, while “DHA is known to support brain health.”

Essentially, neither is “better” or more important. “Our bodies require a balance of both EPA and DHA,” said Lyons. “Without [this], their body cannot function at its highest level.”

In the U.S., dietary supplements are not regulated by the FDA in the same way drugs are — but this doesn’t mean they aren’t regulated at all.

The Dietary Supplement Health and Education Act of 1994 outlines various standards supplement manufacturers must meet regarding factors such as manufacturing processes, labeling, and ingredients.

If these are not adhered to, the FDA states it “has the authority to take action against any adulterated or misbranded dietary supplement product after it reaches the market.”

Despite this, issues can still arise with supplements, said Lyons. For example, they might contain less of the active ingredient than promoted or “incorporate other additives, fillers, or harmful agents that may be binders, or similar substances not listed on the label.”

Fortunately, consumers can take steps to help them stay safe when buying and consuming supplements.

“I always recommend looking for supplements that have been third-party tested,” stated Galati. “This means a company has taken the extra step to have their formulas tested for accuracy and safety by an unbiased third party.”

A product’s label or website usually states if the supplement has been third-party tested.

You could also consider doing some of your own research, suggested Lyons — such as by “consulting a practitioner who can offer personalized guidance on suitable supplements.”

A new analysis of fish oil supplements states that many on-label claims relating to heart health lack support from clinical trial data.

However, while the analysis highlighted studies finding no benefits to taking fish oil, other research indicates fish oil can aid in supporting various aspects of heart health. More investigations are required before firm conclusions can be drawn.

If you’re considering taking fish oil supplements, Galati said it’s vital to note they “aren’t necessarily harmless for everyone — so always check with your doctor and pharmacist before adding it into your routine.”

Ambulance 'response times' miss the big picture: health outcomes

The best hair growth products of 2023, according to experts

Hair loss can wreak havoc on their self-esteem, physical comfort, and overall well-being. To add insult to injury, hair loss and thinning can be caused by a wide variety of factors - many being out of your control. Genetics, vitamin deficiencies, hormonal concerns, and hair growth disorders are just a few things that can lead to hair loss. Additionally, hair loss is a rising concern amongst those who struggle with hair growth after contracting COVID-19. “The phenomenon is believed to be associated with physical and emotional stress related to the illness, as well as potential disruptors to the hair growth cycle,” explains Dr. Michelle Henry, board-certified dermatologist. So, if you’ve had Covid and experienced hair shedding or thinning two to three months later, it’s likely Covid is the culprit.

Quick Overview

With so many people enduring distressed tresses, they tasked their research team with finding the best hair experts and hair growth products to help us get some much-needed answers and remedies to their hair woes. Their team researched 23 companies treating hair loss and interviewed nine medical experts to come up with their top picks for the best products that target hair loss. When making their selections, they paid special attention to cost, product type, and ease of use. Read on to find the best hair growth product to fit your specific needs.

If you're tired of watching your hair thin and shed but overwhelmed by all the available options, we're here to help. We’ve broken down some key factors to consider when finding the best hair growth product for your unique needs.

To find the correct product, you’ll want to get familiar with the type of hair loss you’re up against. Genetics, stress, hormones, diet and Covid are all common causes of hair loss. If you’re not quite sure what type of loss you’re working with, you may want to consult a dermatologist for further clarity.

When considering the type of product you’d like to use, look at your daily routines. Are you someone who only shampoos your hair a few times a week? Then perhaps a supplement would work better than a shampoo for you. Do you have thicker hair that can easily absorb oil without looking greasy? Then be sure to check out the oil and serum treatments we’ve included in their top picks. Do you struggle to remember to take medication? If so, an oral supplement may not be the best for you.

Money is a major factor in considering treatment. Figure out how much you’re comfortable spending monthly on a hair loss formula before making a decision. Plenty of their picks are budget-friendly, so they are confident you’ll be able to find a formula that fits your needs.

You’ll notice they will use gendered language throughout this article due to certain products crafted with a gender-specific solution: for women, you will see 2% to 5% topical Minoxidil solutions, but only 5% for men. When it comes to prescription-only hair loss medications such as Finasteride, Dr. Henry tells AOL, "Finasteride and dutasteride are 5-alpha-reductase inhibitors that are often used in the treatment of male hair loss. Both inhibit the conversion of testosterone to DHT, decreasing 5-alpha-reductase and decreasing the effects DHT has on the hair follicles." She also notes that, "treatment with Finstraride in women should be avoided in those who are pregnant or may become pregnant, because the drug is teratogenic, which means it could affect a male fetus. They use both of these medications in practice." As always, they recommend discussing any new treatments with your healthcare provider before starting.

Rogaine

Product type: Foam

Key ingredient: 5% Minoxidil

Best for: Hair Regrowth

If you want to be very aggressive about restoring your hair to a thick, full, happy head of hair, look no further than the Rogaine 5% Minoxidil Unscented Foam. This hair regrowth treatment is designed to stimulate hair follicles, which is essential to hair regrowth. "Minoxidil is thought to prolong the anagen (growth) phase, decrease the telogen (resting) phase of hair follicles and increase the size of follicles that have already been miniaturized, enabling hairs to become thicker and grow longer," explains Dr. Henry. They were especially thrilled with its promising clinical trials – according to Rogaine, 80% of women saw hair growth begin within 12 weeks and substantial growth after 24 weeks of daily use. This product is available in two different formulations; this one is formulated for women, but you can also get a product formulation specific to men. 

Something to consider: The company recommends starting with a four-month supply since it will take at least three months to see results. 

BosleyMD

Key ingredients: Pumpkin seed extract; biotin; niacin; zinc

Best for: Reducing shedding

One of the most common forms of hair loss is female patterned hair loss (FPHL), marked by a slow decrease of hair density on the scalp. According to board-certified dermatologist Dr. Jodi LoGerfo, about 50% of women will experience this at some point. “This slow and steady loss of hair is caused by the action of the hormone dihydrotestosterone (DHT),” she explained. As such, a popular form of hair supplement treatment is one that includes ingredients that block DHT. Bosley MD Healthy Hair Growth Supplements does just that.

Pumpkin seed extract is the star of the show, known for its natural ability to block DHT. Biotin, niacin, and zinc are other key players in this paraben-free, cruelty-free, gluten-free, sulfate-free formula. The supplement may even boost the appearance of your skin and nails. Men need not worry – Bosley offers a hair growth supplement for you too.

Nioxin

Product type: Foam, shampoo, conditioner

Key ingredients: 2% or 5% minoxidil

Best for: Thinning hair

Why They Love It

Nioxin's System Kits offer a unique approach to shedding and thinning hair with minoxidil-infused products in the form of shampoo, conditioner and foam to ensure you're getting the best overall treatment in one easy-to-use kit. The company offers six different system kits, each tailored for specialized needs, including products to help with natural hair, bleached hair and color-treated hair. The Nioxin System 2 regimen reduces hair fall due to breakage, strengthens the hair and delivers a healthy shine to natural hair while refreshing the scalp, with options for color-treated hair. There are also trial sizes if you want to test the system before making a large investment. 

Follow the product's suggested use for best results:

Step 1: Massage Cleanser Shampoo into hair and scalp. Rinse thoroughly.

Step 2: Work Nioxin Scalp Therapy Revitalizing Conditioner through the hair, from scalp to ends. Rinse thoroughly to make sure all product is removed.

Step 3: Shake the Scalp & Hair Treatment to activate it, then apply to scalp and work through hair from roots to ends. Do not rinse.

For best results, use the Nioxin System Kit daily on scalp and hair.

Act + Acre

Key ingredient: Swiss Apple Stem Cells

Best for: Hair thinning and slow regrowth

Act + Acre is a newer contender on the hair loss scene, featuring plant-based products that are sustainable and effective. The woman-owned company was founded by celebrity hair stylist Helen Reavey, Act + Acre takes an innovative science-forward approach to modern hair care. Its hair system features a derma roller paired with a cold-processed stem cell serum. The serum features apple stem cells, aloe vera, bamboo extract, and pea extract, which all come together to stimulate hair growth, extend the hair growth phase, hydrate the scalp, and reduce free radical production. According to the company’s study, one-third of users saw significantly less shedding after just one month of use. Visible regrowth can occur after 12 weeks. Use it daily and see your hair thrive.

BaumanMD

Key ingredient: Procapil

Best for: Thinning hair

BaumanMD is a line of hair care treatments formulated by board-certified hair restoration physician and hair transplant surgeon Dr. Alan Bauman. The fact that the line is founded by a physician with specialized expertise in hair loss deepens their trust in the brand. Dr. Bauman notes that the best treatments for hair loss are the ones that optimize scalp health and enhance hair follicle function. The BOOST Olfactory DHT-Control Densifying Shampoo does just that.

Procapil, which is a blend of oleanolic acid, apigenin, and biotinyl-GHK, is the star of the show for this product. This powerhouse ingredient increases blood flow and nourishes your hair follicles, which only builds hair strength and thickness. Another key ingredient is Sandalore, which is a molecular compound that extends the hair growth phase of the follicle. At $49, it is a pricier option, but the fact it is formulated with a physician’s expertise leaves us confident it is worth the pretty penny. There's also a hair growth conditioner you can pair with the shampoo.

VEGAMOUR

Key ingredients: Curcumin stem cell extract; red clover; mung bean

Best for: Hair thinning and shedding

Vegamour’s GRO Hair Serum is a game-changer for thinning hair. Its plant-based formula prioritizes natural ingredients for major results. Curcumin stem cell extract, also known as turmeric and red clover come together to block DHT production. Mung bean is another important ingredient on the roster because it contains copper. Copper strengthens the hair follicle, which in turn decreases shedding.

According to the company’s study, 52% of clinical trial participants saw more density and 76% saw less shedding. You can count on seeing results within three months and can expect to see maximum results after four months. One bottle costs $64 and lasts about a month. If you’re hoping to cut costs, you can subscribe and receive the product once a month for a 23% discount.

Mielle Organics

Key ingredients: Rosemary; mint; biotin

Best for: Hair breakage

Have you ever had a few stubborn hairs that stick straight up from breakage or regrowth? Us too, and they know how frustrating it is! Mielle Organics’ Rosemary Mint Scalp and Hair Strengthening Oil is a fantastic solution to those tiny hair woes. This cult favorite hair oil instantly smoothes out split ends and boosts length retention. It is also fantastic for conditioning a dry scalp and nourishing hair follicles, which boosts circulation and hair growth. They love that this formula is so versatile – it can even be used in protective styles like braids and weaves. In addition to rosemary, mint, and biotin, the formula also includes a nourishing blend of oils (coconut, jojoba and sweet almond to name a few). At $9.99 a bottle, you can’t beat the value of this treatment.

The Mane Choice

Product type: Oil

Key ingredients: Biotin; vitamins C & D

Best for: Scalp Health

The Mane Choice’s Multi-Vitamin Scalp Nourishing Oil is a gentle and lightweight formula that boosts scalp health. By releasing clogged pores and build-up on the scalp, this reduces breakage and creates a healthy foundation for hair to grow.

While it is effective, it is also gentle enough to use daily. Apply it to your scalp once daily and massage gently before styling as usual. They also appreciate that the Mane Choice was founded by registered nurse Courtney Adeleye who used a science-based approach to develop multicultural hair solutions that prioritize scalp and hair health. It won’t break the bank, either – it is just $12.99 per bottle.

Do hair growth products really work?

Yes, but the results depend on the condition causing the hair loss and the type of product used. “You have to remember, thinning hair may need medical treatment,” explains Dr. LoGerfo. She continues by emphasizing that you want to tend to your scalp health first to set the best foundation for hair growth.

Another one of their experts, clinical dermatologist and trichologist Dr. Andy Goren echoes the importance of scalp health. Dr. Goren also spoke to AOL about the importance of early detection of hair loss. He explained that most patients only notice hair loss when about 50% of hair has already been lost on a particular area of the scalp. Even with a genetic predisposition, early diagnosis can lead to treating hair loss successfully before it is visible. So, if you notice you’re shedding just a bit more than usual, get checked out by your doctor ASAP. From there, you’re more likely to succeed with your chosen hair growth products.

How long does it take to see results from hair growth products?

This varies based on the product; however, many products they included in their picks offer visible results within two to three months.

Are hair growth products safe for everyone to use?

It is important to remember that some hair growth products have limitations on who can use them. For example, many of the formulas they included on their list are gender-specific. You also don’t want to assume that all products are pregnancy-safe. Be sure to do your due diligence in choosing a product and don’t forget to run it past your doctor to make sure it's safe for you.

While researching 23 different hair loss companies, their team looked for innovative products that were science-backed, affordable, and effective. They paid special attention to products developed by hair care doctors or experts. They rated each product based on effectiveness, affordability, and ease of use. To make sure they were making selections that were medically-sound, they consulted with nine different hair loss experts.