Everything you need to know about fish oil supplements


Ever since researchers discovered that Greenland Eskimos had really low rates of heart disease because of all of the fish they ate, fish oil has been a hot topic.  And once supplement manufacturers realized they could bottle and sell it, fish oil really took off. 

So let’s dish about fish – here’s everything you need to know about fish oil supplements.      

What conditions does fish oil really help?

It’s been proven that the Omega-3 fatty acids in fish oil – eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid – prevent heart disease, improve cholesterol by reducing triglyceride levels, and prevent heart attacks, stroke, and death in people who already have heart disease. 

While Dr. Google will tell you that fish oil will cure rheumatoid arthritis, high blood pressure, depression, bipolar disorder, menstrual pain, and certain kidney problems, there isn’t a lot of good evidence to back that up at this point.

Is taking a fish oil supplement the same as eating fish?

Obviously, the best way to consume fish oil is to eat oily fish.  The American Heart Association (AHA) recommends at least two servings per week for cardiovascular health.  A serving is 3 ounces (the size of a deck of cards, or ¾ of a cup).  So if you can afford, prepare and stomach salmon a couple times per week, you can skip the fish oil capsules.

How much fish oil supplement should you take?

A good target intake is between 250 and 500 mg per day of EPA + DHA.  You could get that in a daily 1 gram fish oil supplement, which contains between 200 and 800 mg of EPA + DHA, depending on the formulation and manufacturer.   

Do fish oil capsules have side effects?

The most common side effects are nausea, heartburn, a fishy aftertaste, and burping.  Taking them with food or refrigerating them helps a lot, but some brands can’t be refrigerated so be sure to check with your pharmacist.  In general, fish oil capsules have an “expiration date” of about 90 days after opening a new bottle.  Capsules with a very strong or spoiled smell should be thrown away.

Can you get mercury poisoning from taking fish oil supplements?

There’s been a lot of concern lately about mercury contamination in the world’s fish supply.  In general, this is more of a concern for pregnant women and young children, but it’s always a good idea to pay attention to what you’re eating.  Fish known to be low in mercury include shrimp, canned light tuna (not albacore), salmon, pollock, and catfish. 

Fish oil capsules are generally low in mercury and other pollutants.  But to be safe, only buy products with the “USP Verified Mark” on the label; these have been tested and found to contain acceptable levels of mercury.    

Jason Goodman, PharmD, RPh
Student Health Services
The Ohio State University

What are probiotics and what do they do?


Q: I keep hearing about probiotics.  What are they?  What do they do? 

A: According to the World Health Organization, probiotics are “live microorganisms which confer a health benefit on the host”.  Our gastrointestinal tract normally contains many different types of bacteria, yeast and viruses, collectively known as our “gut flora.”  The theory behind probiotics is that certain illnesses or medications can knock that flora out of balance – which causes all kinds of other problems – and probiotics help restore it.   

Probiotics exist naturally in such foods as yogurts, cultured milks (buttermilk, kefir) and fermented foods such as fresh sauerkraut, kimchi, tempeh, and miso.  They also can be found in certain nutritional supplements, and are added to many commercial foods including:

  • Yogurt (Activia, DanActiv Dairy Drink, YoPlus, store brands)
  • LiveActive Cottage Cheese
  • Kashi Vive Cereal
  • LiveActive Drink Mix
  • Goodbelly Juices
  • Attune Probiotic Bars

So do they work? 

Hard to say.  It’s like comparing billions of apples and oranges and trying to find an exact match.  We each have our own unique gut flora made up of countless groups of microorganisms; within a given group, there are multiple species of microorganisms; and within a given species there are multiple strains of microorganisms.  Studies have shown that some probiotics may be helpful in the following conditions:

  • Acute gastroenteritis (“stomach flu” or “traveler’s diarrhea”)
  • Diarrhea associated with antibiotics
  • Atopic eczema in infants
  • Lactose intolerance
  • Inflammatory bowel disease
  • Irritable bowel disease
  • Childhood respiratory infections
  • Dental caries (cavities)
  • Clostridium Difficile diarrhea
  • Urinary tract infections in females

But there are some very important things to remember:

  • Like other products marketed as supplements (as opposed to medications), probiotics are not regulated by the FDA, so there’s no way to know if the product in the bottle actually contains what the label says.  ConsumerLab.com is an independent laboratory that analyzes dietary supplements and their report on probiotics showed several common brands did not have the ingredients they claimed.
  • Consuming foods that naturally contain probiotics is a healthier way to get them than taking a supplement.  Eating real food is not only more enjoyable, but you get the benefit of other nutrients as well.
  • No matter how you get your probiotic, they need help to work.  It is important to choose meals and snacks that contain fruits, vegetables, and whole grains.  The healthy non-digestible substances in these foods (call prebiotics) help the bacteria to survive and flourish once they enter your gastrointestinal tract.

To learn more about probiotics, click here or make an appointment to talk with one of our nutritionists

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Greg Avellana RD, LD, CDE
Student Health Services
The Ohio State University

Can Chiropractors really help my neck and back pain? Are they safe?


BuckMD Readers – We received a couple comments on this earlier post. Take a look, and add your own comments!

 I don’t know a lot about chiropractors.  I’ve never worked with any, didn’t learn much about them in my medical training, and don’t refer a lot of patients to them since a lot of insurances don’t cover chiropractic treatment.   

But a lot of people swear by them.  And I have a few medical colleagues who recommend them for certain patients.  And our very own medical center has a Center for Integrative Medicine that provides chiropractic treatment (you can see their take on what a chiropractor does here).

There’s obviously something to it, so I have scoured the medical literature to provide you with the most objective information I can find.  Here goes…

Do people suffering from chronic neck or back pain benefit from chiropractic treatment?

Spinal manipulation has been shown to be mildly beneficial in the treatment of uncomplicated low back pain.  Uncomplicated means that there is nothing more serious going on, like severe arthritis, pinched nerves or slipped discs.     

There’s just not enough good information about whether or not spinal manipulation is beneficial in the treatment of neck pain.  Some studies showed it might be; others showed it was only helpful if used in conjunction with exercise, and others showed no benefit. 

There is no evidence that spinal manipulation is beneficial in the treatment of headaches.

Is the cure temporary or permanent?

That’s hard to say.  Most problems that cause back or neck pain are chronic and recurrent so the treatments don’t “cure” the condition but rather relieve the symptoms of an acute flare-up.  If the symptoms come back, it’s not necessarily that the treatment didn’t do what it was supposed to.

Are there any adverse effects of chiropractic treatment?

Minor complaints are fairly common after spinal manipulation, occurring in a third to a little over half of patients.  They include headache, fatigue, and pain at the site of manipulation.  Some people report dizziness and nausea, but these are less common.

Serious adverse effects from spinal manipulation (slipped disc, stroke or torn blood vessels in the spinal column) are pretty rare.  Since the cervical spine (i.e. neck) is so much more mobile than the lumbar spine, it may be at higher risk for these problems.  Because of this – and because spinal manipulation doesn’t have any proven benefit in treating neck pain – you should probably avoid seeing chiropractors for neck pain. 

If you’re having back or neck pain, come in and see us at Student Health.  We have a full-service Physical Therapy and Sports Medicine Department right here in the building and we will be happy to discuss all of your treatment options with you after we figure out what the problem is.

John A. Vaughn, MD (OSU SHS)

The Androgen Sisters Ride Again!


THE ANDROGEN SISTERS, an education and support group for women diagnosed with Polycystic Ovarian Syndrome (PCOS) or Insulin Resistance (IR) will be resuming their meetings this quarter!

WHEN: Wednesdays from 4-6pm – January 20th and 27th, and February 3rd, 10th, 17th and 24th

WHERE: The Wilce Student Health Center (1875 Millikin Road) in room 360 – right across from the elevator on the 3rd floor.  


  • Medical Review of PCOS/IR
  • Nutritional Lifestyle Changes
  • Approaches to exercise
  • Social Support
  • Strategies for change
  • Positive Thinking Patterns

If you are interested in joining the group, please RSVP by email to Beth Askue at Student Health Services.

The Androgen Sisters is supported by Student Health Services, Counseling and Consultation Service and the Department of Sport and Exercise Science


The “Magic Pill” and the Common Cold

photo: ehow.com

Lest you think I’m against alternative medicine (see previous post) I’m not. I am wholeheartedly for any effective, safe treatment. Evidence about alternative therapies can be hard to find, sadly. Nevertheless, I made a list of stuff I’ve been asked about for treating colds over the last two weeks. I thought I’d lay out the fact and fiction about these popular treatments.

First, some standard, boring doctor disclaimers:

  1. Alternative products are food to the Food and Drug Administration and aren’t tested like drugs.
  2. As food, there is no standardized product. Is a burger from White Castle the same as McDonald’s? Wendy’s? No. When you test Echinacea, are all products the same? Purpurea or Pallida? In what dose? Is Nature Made’s product the same as Kroger’s? Nobody knows.
  3. Over 200 viruses cause the common cold. What works against rhinovirus might not against adenoviruses. This makes testing (pharmacologic or otherwise) very tricky.

Vitamin C:

Prevention: Not helpful, even in high doses.

Cure: Mixed. In high doses some studies (not all) suggest that the length of the cold might be shortened by a day or so. 


Prevention: Not helpful.

Cure: Don’t use the nasal spray. It might destroy your sense of smell forever. If you can stand the metallic, astringent taste of zinc lozenges, you’ll need to start using them within 24-48 hours of your symptoms and use one every 2-3 hours to possibly decrease a little the severity and duration of your already short, self-limited illness.


Prevention: CONSISTENTLY proven to be useless.

Cure: Perhaps a 10-30% decrease in severity of symptoms.  However, there are plenty of studies which show no benefit whatsoever. Furthermore, Echinacea is related to ragweed. If you suffer from hay fever in the fall you should avoid Echinacea altogether.


Prevention: One very small study demonstrated one less cold a season.

Cure: No evidence.

Ginseng, American and Asian

Prevention: Mixed. There are a couple of trials demonstrating a decrease in the number of respiratory infections in a season, but not enough good evidence yet to recommend it. Ginseng interacts with a lot of commonly used drugs for diabetes, pain, mental health and blood clots, making safety potentially an issue.

Cure: No evidence.


Prevention: In little kids, there are small studies demonstrating a moderate decrease in the number of respiratory infections. No good data on adults.

Cure: No data.

Things that DON’T work:

Airborne, Vitamin E, Oscillococcinum, goldenseal, bee propolis, boneset, wild indigo, peppermint, chamomile, meadowsweet, or linden flowers.

Lest you cry in your deadly nightshade, there is some hopeful news on the horizon. Andrographis, “Indian Echinacea” shows some promise in prevention and treatment. There’s not enough data yet on safety to recommend it. Given how much I hate being snotty, though, I will follow this closely. Maybe I’ll find a clinical trial and can offer my nose up to science. In the meantime I’m going to wash my hands, a proven way of preventing infection.

Victoria Rentel, MD (Ohio State University Student Health Services)

Prescribers Letter Vol 9 #29: Natural Medicines and the Clinical Management of Colds and Flu