Benefits
- Convenient once daily dosing in a highly bioavailable softgel
- Pharmaceutical grade omega-3 blend, USP verified for quality and consistency
- Optimal 2:1 ratio EPA to DHA, provides convenient one-per-day dosing
- Free from lipid peroxides and environmental pollutants including heavy metals, pesticides, dioxins, PCBs and other harmful compounds
- Sourced from wild anchovies, sardines, and/or mackerel, some of the best natural sources of EPA and DHA
- Harvested through sustainable fishing practices
Feature Summary
Vitamin D and omega-3 fatty acids from fish oil are among the most powerful nutrients for improving overall health, and they are also among the most commonly deficient.3,4 EPA and DHA improve a number of cardiovascular risk factors including lowering of atherosclerotic burden, reducing triglyceride levels and blood pressure, and improving platelet and vascular function.5-8 Not only do these fatty acids modulate risk factors, but controlled clinical trials have shown them to be effective in preventing cardiovascular events, and coronary events, particularly in persons at high risk.9,10
EPA and DHA also support cognitive function through multiple mechanisms, as they are indispensable to neuronal membranes, with lower levels found to be not only a marker for neurological disease but also a risk factor for cognitive impairment.11,12 EPA and DHA are essential to the resolution of inflammatory processes, providing the substrates for anti-inflammatory prostaglandins, resolvins and protectins.13-15
Vitamin D modifies cardiovascular risk and reduces the risk of autoimmune disease, and osteoporotic fractures.16-20 It has also been shown to have anti-inflammatory effects, with supplementation particularly important for those with signs of inflammation.21,22 Insufficient intake of vitamin D and EPA/DHA has been implicated in brain dysfunction, including impaired serotonin activation, cognitive decline, ADHD, and mood disorders.23-28 EPA and DHA combined with vitamin D have synergistic benefits for improving overall wellness.29-31
Medicinal Ingredients
Each Enteripure® Softgel Contains: | |
Fish Oil Concentrate (Molecularly Distilled, Ultra Purified) (Anchovy, Sardine and/or Mackerel) | 1425 mg |
Omega-3 Fatty Acids | 900 mg |
Eicosapentaenoic Acid (EPA) † | 600 mg |
Docosahexaenoic Acid (DHA) † | 300 mg |
Vitamin D3 (Cholecalciferol) | 1000 IU (25 mcg) |
† Ethyl ester form |
Non-Medicinal Ingredients
Enteripure® softgel (gelatin, glycerin, purified water, pectin), natural vitamin E.
Allergens:
Contains no artificial colours, preservatives, or sweeteners; no dairy, sugar, wheat, gluten, yeast, soy, egg, shellfish, salt, tree nuts, or GMOs. Sealed for your protection. Do not use if seal is broken. For freshness, store in a cool, dry place.
Recommended Use:
Recommended Adult Dose: 1 softgel per day or as directed by a health care practitioner. Dry Eye Relief: Use for a minimum of 1 month to see beneficial effects.
Contraindications
Individuals with an allergy to fish or seafood should use caution, though fish oil is rarely allergenic. Both benefit and risk have been documented for those at risk of or being treated for cardiac arrhythmias, with close supervision indicated.32 Pregnant and nursing women are often advised to consume a minimum of 300 mg DHA per day, and although DHA is recognized as essential to neurological development, no dosage recommendations have been made for children or infants. Supplemental vitamin D should be used with caution in those with sarcoidosis, lymphoma, tuberculosis, hypercalcemia or renal impairment.33
Drug Interactions
The antihypertensive effect of fish oil and/or vitamin D may potentially reduce the need or dosage for blood pressure medications, and patients should be closely monitored. Because fish oil has an antithrombotic effect, caution is advised for those on anticlotting, antiplatelet or anticoagulant medications, or those at high risk of bleeding. However, a multinational randomized and controlled trial found that fish oil did not increase perioperative bleeding, and it reduced the number of transfusions needed, and appeared to be associated with a lower risk of bleeding when given pre- and postoperatively.34,35 At doses greater than 3 g per day, hyperglycemia has been observed in diabetics and those with hypertriglyceridemia and close monitoring of patients on antidiabetic medication is recommended. Vitamin D may increase the risk for hypercalcemia when taken with a thiazide medication (diuretic).36 Benefit has been shown when fish oil is taken with statins, SSRIs, anticonvulsant and cytotoxic medications.37,38
- Tripkovic, L., Wilson, L.R., Hart, K., et al. (2017). Daily supplementation with 15 µg vitamin D2 compared with vitamin D3 to increase wintertime 25-hydroxyvitamin D status in healthy South Asian and white European women: a 12-wk randomized, placebo-controlled food-fortification trial. Am J Clin Nutr, 106(2), 481-490.
- Logan, V.F., Gray, A.R., Peddie, M.C., et al. (2013). Long-term vitamin D3 supplementation is more effective than vitamin D2 in maintaining serum 25-hydroxyvitamin D status over the winter months. Br J Nutr, 109(6), 1082-8.
- Liu, X., Baylin, A., Levy, P.D. (2018). Vitamin D deficiency and insufficiency among US adults: prevalence, predictors and clinical implications. Br J Nutr, 119(8), 928-936.
- Papanikolaou, Y., Brooks, J., Reider, C., et al. (2014). U.S. adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results of an analysis using observational data from NHANES 2003-2008. Nutr J, 13, 31.
- Pischon, T., Hankinson, S.E., Hotamisligil, G.S., et al. (2003). Habitual dietary intake of omega-3 and omega-6 fatty acids in relation to inflammatory markers among US men and women. Circulation, 108(2), 155-60.
- Swanson, D., Block, R., Mousa, S.A. (2012). Omega-3 fatty acids EPA and DHA: health benefits throughout life. Adv Nutr, 3, 1-7.
- Wang, C., Harris, W.S., Chung, M., et al. (2006). n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr, 84(1), 5-17.
- Saito, Y., Yokoyama, M., Origasa, H., et al. (2008). Effects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors: sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS). Atherosclerosis, 200(1), 135-40.
- Delgado-Lista, J., Perez-Martinez, P., Lopez-Miranda, J., et al. (2012). Long chain omega-3 fatty acids and cardiovascular disease: a systematic review. Br J Nutr, 107(S2) S201-13.
- Chareonrungrueangchai, K., Wongkawinwoot, K., Anothaisintawee, T., et al. (2020). Dietary factors and risks of cardiovascular diseases: An Umbrella Review. Nutrient, 12(4), 1088.
- Lin, P.Y., Chiu, C.C., Huang, S.Y., et al. (2012). A meta-analytic review of polyunsaturated fatty acid compositions in dementia. J Clin Psychiatry, 73(9), 1245-54.
- Dyall, S.C. (2015). Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front Aging Neurosci, 7, 52.
- Yedgar, S., Krimsky, M., Cohen, Y., et al. (2007). Treatment of inflammatory diseases by selective eicosanoid inhibition: a double-edged sword? Trends Pharmacol Sci, 28(9):459-64.
- Schmitz, G., &Ecker, J. (2008). The opposing effects of omega-3 and omega-6 fatty acids. Prog Lipid Res, 47(2), 147-55.
- Molfino, A., Amabile, M.I., Monti, M., et al. (2017). Omega-3 Polyunsaturated Fatty Acids in Critical Illness: Anti-inflammatory, proresolving, or both?. Oxid Med Cell Longev, 2017, 5987082.
- Muscogiuri, G., Sorice, G.P., Ajjan, R., et al. (2012). Can vitamin D deficiency cause diabetes and cardiovascular diseases? Present evidence and future perspectives. Nutr Metab Cardiovasc Dis, 22(2), 81-7.
- Fletcher, J.M., Basdeo, S.A., Allen, A.C., et al. (2012). Therapeutic use of vitamin D and its analogues in autoimmunity. Recent Pat Inflamm Allergy Drug Discov, 6(1), 22-34.
- Baz-Hecht, M., &Goldfine, A.B. (2010). The impact of vitamin D deficiency on diabetes and cardiovascular risk. Curr Opin Endocrinol Diabetes Obes, 17(2), 113-9.
- Zittermann, A., &Prokop, S. (2014). The role of vitamin D for cardiovascular disease and overall mortality. Adv Exp Med Biol, 810, 106-19.
- Chowdhury, R., Kunutsor, S., Vitezova, A., et al. (2014). Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ, 348, g1903.
- Zanetti, M., Harris, S.S., Dawson-Hughes, B. (2014). Ability of vitamin D to reduce inflammation in adults without acute illness. Nutr Rev, 72(2), 95-8.
- Li, Q., Dai, Z., Cao, Y, et al. (2019). Association of C-reactive protein and vitamin D deficiency with cardiovascular disease: A nationwide cross-sectional study from National Health and Nutrition Examination Survey 2007 to 2008. Clin Cardiol, 42(7), 663-669.
- Patrick, R.P., Ames, B.N. (2015). Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J, 29(6), 2207-2222.
- Chang, J.P., Su, K.P., Mondelli, V., et al. (2018). Omega-3 Polyunsaturated fatty acids in youths with attention deficit hyperactivity disorder: a systematic review and meta-analysis of clinical trials and biological studies. Neuropsychopharmacology, 43(3), 534-545.
- Zhang, X.W., Hou, W.S., Li, M., et al. (2016). Omega-3 fatty acids and risk of cognitive decline in the elderly: a meta-analysis of randomized controlled trials. Aging Clin Exp Res, 28(1), 165-166.
- Bae, J.H., &Kim, G. (2018). Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression. Nutr Res, 50, 1-9.
- Jayedi, A., Rashidy-Pour, A., &Shab-Bidar, S. (2019). Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response †. Nutr Neurosci, 22(11), 750-759.
- Jung, U.J., Torrejon, C., Tighe, A.P., et al. (2008). n-3 Fatty acids and cardiovascular disease: mechanisms underlying beneficial effects. Am J Clin Nutr, 87(6), 2003S-9S.
- Jamilian, M., Samimi, M., Ebrahimi, F.A., et al. (2017). The effects of vitamin D and omega-3 fatty acid co-supplementation on glycemic control and lipid concentrations in patients with gestational diabetes. J Clin Lipidol, 11(2), 459-468.
- Rajabi-Naeeni, M., Dolatian, M., Qorbani, M., et al. (2020). The effect of omega-3 and vitamin D co-supplementation on glycemic control and lipid profiles in reproductive-aged women with pre-diabetes and hypovitaminosis D: a randomized controlled trial. Diabetol Metab Syndr, 12, 41.
- Talari, H.R., Najafi, V., Raygan, F., et al. (2019). Long-term vitamin D and high-dose n-3 fatty acids’ supplementation improve markers of cardiometabolic risk in type 2 diabetic patients with CHD. Br J Nutr, 122(4), 423-430.
- Kromhout, D., &de Goede, J. (2014). Update on cardiometabolic health effects of n-3 fatty acids. Curr Opin Lipidol, 25(1), 85-90.
- Sage, R.J., Rao, D.S., Burke, R.R., et al. (2011). Preventing vitamin D toxicity in patients with sarcoidosis. J Am Acad Dermatol, 64(4), 795-6.
- Harris, W.S. (2007). Expert opinion: omega-3 fatty acids and bleeding-cause for concern? Am J Cardiol, 99(6A), 44C-46C.
- Akintoye, E., Sethi, P., Harris, W.S., et al. (2018). Fish Oil and Perioperative Bleeding. Circ Cardiovasc Qual Outcomes, 11(11), e004584.
- Boulard, J.C., Hanslik, T., Alterescu, R., et al. (1994). Symptomatic hypercalcemia after vitamin D-thiazide diuretics combination. Two cases in elderly women. Presse Med, 23(2), 96.
- Toyama, K., Nishioka, T., Isshiki, A., et al. (2014). Eicosapentaenoic acid combined with optimal statin therapy improves endothelial dysfunction in patients with coronary artery disease. Cardiovasc Drugs Ther. 28(1), 53-9.
- Mischoulon, D., &Freeman, M.P. (2013). Omega-3 fatty acids in psychiatry. Psychiatr Clin North Am, 36(1), 15-23.