Articles

Eicosapentaenoic Acid (EPA)

Introduction

Eicosapentaenoic acid (EPA) is a member of the omega-3 family of fatty acids. Although EPA can be consumed directly by eating certain kinds of fish, it is also produced in the body from the conversion of alpha linolenic acid (ALA). EPA is a precursor for agents in the body that provide anti-inflammatory activity, (1) enhance the immune system, thin the blood, and lower blood pressure.

The richest dietary sources of EPA are the oils from cold water fish such as salmon, mackerel, herring, sardines, and other marine animals.

Dosage Info

Dosage Range

170mg to 3.6 grams of EPA daily, or 3 to 12 grams of fish oil concentrate daily.

Most Common Dosage

1-2 grams of EPA daily.

Dosage Forms

Capsules and tablets.

Interactions and Depletions

Interactions

Reported Uses

EPA has been associated with many potential health benefits. Support of cardiovascular health is first on the list. More specifically, EPA may reduce the occurrence of angina attacks. (2) This benefit is probably related to EPA’s blood-thinning properties. EPA may also be able to help the heart maintain a steady rhythm by positively affecting its electrical activity. (3) EPA may help the body lower harmful triglyceride levels in the blood stream. (4) , (5) Triglycerides are a contributing factor to atherosclerosis and other cardiovascular diseases. EPA may also lower blood pressure in people with moderate hypertension. (6) One study measured the impact of omega-3 fatty acids on the elastic nature of the arteries. Both EPA and docosahexaenoic acid (DHA) were evaluated and compared to a group taking only a placebo (sugar pill). The measure of elasticity study is called systemic arterial compliance (SAC). When SAC is low, the arteries are less elastic, which may be a sign of cardiovascular disease. Compared to placebo, EPA increased SAC 36% and DHA increased SAC 27%. (7)

Studies suggest that increased intake of fish oils containing EPA may decrease incidences of asthma in children. (8) EPA may provide treatment for a number of skin disorders including eczema, psoriasis, and lupus. (9) , (10) , (11) It may also decrease inflammation associated with Crohn’s Disease. (12) , (13)

When used in combination with DHA, which is another omega-3 fatty acid, EPA may help support health in people with diabetes. (14) EPA deficiency has also been noted among diabetics. (15) Consumption of fish oils that contain EPA and DHA may also inhibit the inflammation associated with rheumatoid arthritis. (16) This anti-inflammatory benefit may extend to the treatment of colon inflammation, often referred to as colitis. (17) , (18)

Studies suggest that the omega-3 fatty acids contained in fish oils (EPA and DHA) exhibit mood-stabilizing properties in patients with bipolar disorder, which is also known as manic depressive illness. EPA and DHA seem to behave in a manner similar to lithium carbonate and valproate, which are medications frequently used to treat this disorder. (19) Researchers found that bipolar mood disorder patients had lower levels of EPA than control subjects and that supplementation may be beneficial to the patients. (20)

Animal studies have noted that EPA has decreased cancerous tumor size. (21) And, clinical trials indicate that eicosapentaenoic acid (EPA) provided substantial benefits for patients with schizophrenia when taken alone or with antipsychotic medications. The researchers concluded that EPA may represent a new treatment approach for schizophrenia. (22) A study found that schizophrenic patients had significantly lower levels of EPA than control subjects and that patients may benefit from supplementation of antioxidants and essential fatty acids. (23)

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

People who take supplemental EPA are advised to take additional antioxidants, especially vitamin E, to protect against free radical damage to EPA in the body. (24)

Side Effects

People who take a fish oil form of EPA may experience belching that causes a “fishy” odor

Pregnancy / Breast Feeding

To date, the medical literature has not reported any adverse effects related to fetal development during pregnancy or to infants who are breast-fed. Yet little is known about the use of this dietary supplement while pregnant or breast-feeding. Therefore, it is recommended that you inform your healthcare practitioner of any dietary supplements you are using while pregnant or breast-feeding.

Age Limitations

To date, the medical literature has not reported any adverse effects specifically related to the use of this dietary supplement in children. Since young children may have undiagnosed allergies or medical conditions, this dietary supplement should not be used in children under 10 years of age unless recommended by a physician.

References

  1. View Abstract: Read JA, Clarke SJ, Volker D. Nutritional and anti-inflammatory strategies in the treatment of advanced colorectal cancer - a pilot study. Asia Pac J Clin Nutr. 2004;13(Suppl):S93.
  2. View Abstract: Saynor R, et al. The long-term effect of dietary supplementation with fish lipid concentrate on serum lipids, bleeding time, platelets and angina. Atherosclerosis. Jan1984;50(1):3-10.
  3. View Abstract: Kang JX, Leaf A. Prevention of fatal cardiac arrhythmias by polyunsaturated fatty acids. Am J Clin Nutr. Jan2000;71(1 Suppl):202S-7S.
  4. View Abstract: Rambjor GS, et al. Eicosapentaenoic acid is primarily responsible for hypotriglyceridemic effect of fish oil in humans. Lipids. Mar1996;31 Suppl:S45-9.
  5. View Abstract: Lovegrove JA, Lovegrove SS, Lesauvage SV, et al. Moderate fish-oil supplementation reverses low-platelet, long-chain n-3 polyunsaturated fatty acid status and reduces plasma triacylglycerol concentrations in British Indo-Asians. Am J Clin Nutr. Jun2004;79(6):974-82.
  6. View Abstract: Prisco D, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res. Aug1998;91(3):105-12.
  7. View Abstract: Nestel P, Shige H, Pomeroy S, Cehun M, Abbey M, Raederstorff D. The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. American Journal of Clinical Nutrition. Aug2002;76(2):326-330.
  8. View Abstract: Hodge L, et al. Consumption of Oily Fish and Childhood Asthma Risk. MJA. Feb1996;164:137-140.
  9. View Abstract: Bjorneboe A, et al. Effect of dietary supplementation with eicosapentaenoic acid in the treatment of atopic dermatitis. Br J Dermatol. 1987;117(4):463-69.
  10. View Abstract: Collier PM, et al. Effect of regular consumption of oily fish compared with white fish on chronic plaque psoriasis. Eur J Clin Nutr. Apr1993;47(4):251-4.
  11. View Abstract: Das UN. Beneficial effect of eicosapentaenoic and docosahexaenoic acids in the management of systemic lupus erythematosus and its relationship to the cytokine network. Prostaglandins Leukot Essent Fatty Acids. Sep1994;51(3):207-13.
  12. View Abstract: Ikehata A, et al. Effect of intravenously infused eicosapentaenoic acid on the leukotriene generation in patients with active Crohn's disease. Am J Clin Nutr. Nov1992;56(5):938-42.
  13. View Abstract: Belluzzi A, et al. Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Dig Dis Sci. Dec1994;39(12):2589-94.
  14. View Abstract: Popp-Snijders C, et al. Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res. Mar1987;4(3):141-7.
  15. View Abstract: Horrobin D. Essential Fatty Acids in the Management of Impaired Nerve Function in Diabetes. Diabetes. 1997;46(Suppl. 2):S90-S93.
  16. View Abstract: James MJ, et al. Dietary polyunsaturated fatty acids and inflammatory mediator production. Am J Clin Nutr. Jan2000;71(1 Suppl):343S-8S.
  17. View Abstract: Almallah YZ, et al. Distal proctocolitis and n-3 polyunsaturated fatty acids (n-3 PUFAs): the mucosal effect in situ. J Clin Immunol. Jan2000;20(1):68-76.
  18. View Abstract: Grimminger F, et al. Influence of intravenous n-3 lipid supplementation on fatty acid profiles and lipid mediator generation in a patient with severe ulcerative colitis. Eur J Clin Invest. Nov1993;23(11):706-15.
  19. View Abstract: Stoll AL, et al. Omega 3 fatty acids in bipolar disorder; A preliminary double-blind, placebo-controlled trial. Archives of General Psychiatry. May1999;66:407-412.
  20. View Abstract: Ranjekar PK, Hinge A, Hegde MV, et al. Decreased antioxidant enzymes and membrane essential polyunsaturated fatty acids in schizophrenic and bipolar mood disorder patients. Psychiatry Res. Dec2003;121(2):109-22.
  21. View Abstract: Colquhoun A, Ramos KL, Schumacher RI. Eicosapentaenoic acid and docosahexaenoic acid effects on tumour mitochondrial metabolism, acyl CoA metabolism and cell proliferation. Cell Biochem Funct. Jun2001;19(2):97-105.
  22. View Abstract: Peet M, Laugharne JD, Mellor J, Ramchand CN. Essential fatty acid deficiency in erythrocyte membranes from chronic schizophrenic patients, and the clinical effects of dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. Aug1996;55(1-2):71-5.
  23. View Abstract: Ranjekar PK, Hinge A, Hegde MV, et al. Decreased antioxidant enzymes and membrane essential polyunsaturated fatty acids in schizophrenic and bipolar mood disorder patients. Psychiatry Res. Dec2003;121(2):109-22.
  24. View Abstract: Moison RM, et al. Dietary eicosapentaenoic acid prevents systemic immunosuppression in mice induced by UVB radiation. Radiat Res. Jul2001;156(1):36-44.