Medically reviewed by, Russell Braun RPH
The top causes of death in the United States is heart disease. One of the key reasons for so much heart disease is inflammation in the arteries. That is why finding ways to reduce this inflammation is vital to keeping heart disease at bay. The good news is that omega-3 fatty acids have been show to lower levels of inflammation and prevent death from heart disease. That is why you should know the differences in Lovaza vs fish oil.
It is estimated that over $1 billion per year is spent on various types of fish oil. These fatty acids are vital for humans to get in their diet or via a supplement because our body can’t produce them. The best sources of fish oils are fatty fish such as salmon, mackerel and sardines.
What Is In Lovaza and Fish Oil?
There are two primary fatty acids that you should look for in fish oils. They are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These key ingredients have been researched and found to have the following positive impacts.
- Substantially reduce triglyceride levels.
- Lower the risk of death from heart disease, for people who do not eat fish 2 or more times per week.
- Reduce inflammation throughout the body.
- Relieve symptoms of rheumatoid arthritis.
- Prevent non alcoholic fatty liver disease.
- Maintain healthy hair, skin and nails.
Before reviewing Lovaza to fish oil directly, it is important to understand what fatty acids do.
What Are Triglycerides?
It is estimated that 25% of adults in the U.S. have high triglyceride levels. Triglycerides are packets of three fatty acids (hence the prefix tri) that can be carried in the blood to your cells. The cells take these fatty acids and use them for energy and to build cell components or hormones.
The energy in triglycerides can only be unlocked by oxidizing them. Oxidation is the body’s way of metabolizing the triglyceride, which produces ketones that can be used by cells as energy. This occurs when you don’t have any food hanging around for your body to burn. However, when people consume too many calories these triglycerides are stored in fat cells and eventually the levels of them floating around in the blood stream become high.
There are three different kinds of fatty acids that your body turns into triglycerides to allow them to be carried around the body. These include:
- Saturated fatty acids
- Monounsatruated fatty acids
- Polyunsaturated fatty acids
What Is The Difference In Fatty Acids?
Saturated fatty acids have no bends in the long carbon chain that makes them up. Monounsaturated fatty acids have one bend in the chain. Polyunsaturated fatty acids have multiple bends in the carbon chain.
Saturated fats and trans fats have been associated with increased risk of cardiovascular disease. Trans fats are created by frying foods in oils. Therefore you should try to limit the amount of saturated fat in your diet and totally avoid trans fat as much as possible.
Monounsaturated and polyunsaturated fats are thought of as healthy fats. However, if the right ratio is not present then even these types of fats can cause problems. They can be present in a few different forms. The ones most people have heard of include:
Pay Attention To The Ratio In Lovaza and Fish Oils
Part of the reason that people need to supplement their diet with more omega-3 fatty acids is due an important ratio. This ratio specifically refers to how may omega-6 to omega-3 fatty acids are present in your diet. Prior to the advent of our modern diets people would receive a ratio of 3/1 or 4/1 omega-6 to omega-3’s. Today with the overload of processed and fast foods that ratio has gone out of control.
Typical western diets contain in excess of 15/1 omega-6 to omega-3’s. This type of ratio has been found to promote many diseases such as cardiovascular disease, cancer and inflammatory diseases including autoimmunity.
Therefore, getting your ratio of omega-6 to omega-3 closer to 3/1 is very important for your health. Ask your doctor if they can check your ratio so you can track it over time.
Natual Sources Of Omega-3 Fatty Acids
Omega-3 fatty acids are found mainly in different types of fish. Specifically fatty fish contain the highest amounts. That would include fish such as:
Certain plants contain omega-3’s as well. However, plants do not contain DHA or EPA. Instead they have a version of omega-3 called alpha-linolenic acid. The good news is the body can convert alpha-linolenic acid into DHA and EPA. The bad news is this conversion process is not very efficient. Therefore, not a lot of DHA and EPA are produced in the conversion.
Common plant sources of omega-3’s include:
- Chia seeds
- Hemp seeds
- Kidney beans
Lovaza is a prescription medication that contains a combination of omega-3 fatty acids. The main two components are EPA and DHA. Each 1 gram capsule is reported to contain 465mg of EPA and 375mg of DHA. It was approved by the Food and Drug Administration (FDA) in 2004. Since then there have been other prescription omega-3 products come to the market due to the growing use of these products as dietary supplements.
FDA Approved Use
Lovaza is approved to lower triglyceride levels in patients with high levels (> 500mg/dl).
High triglycerides are one of the biggest risk factors for hear disease. It is also known to cause non-alcoholic fatty liver disease.
Is Lovaza The Same As Fish Oil?
The main difference in Lovaza and fish oil supplements that are sold as dietary supplements is that Lovaza requires a prescription. As a result, it has been tested for safety and efficacy by the FDA. In addition prescription and over the counter (OTC) products have to follow good manufacturing processes. These things are not he case for dietary supplements. That doesn’t mean all fish oil products are bad, but an important thing to keep in mind when looking at products.
Glaxo Smith Klein, a large pharmaceutical company manufacturers Lovaza. It is available as a capsule that is quite large. The only available strength is 1 gram (1,000mg). Even though the capsules are a soft with a gelatin like feel they can’t be crushed, or cut in half.
- Doses of 2 to 4 grams per day may lower triglyceride levels by as much as 50% in patients with high triglycerides.
- Lowers inflammation that causes atherosclerosis, as well as blood pressure and heart rate variability.
- Can increase HDL, which is known as the “good” cholesterol.
- Lovaza will contain consistent amounts of EPA and DHA per dose.
- The amount of DHA and EPA is normally higher in Lovaza than most fish oil supplements.
- Are purified through a process that removed heavy metals and other impurities that are found in fish, such as mercury.
- It requires you to get a prescription from your doctor. Therefore, if you take this on an ongoing basis you will have to get renewals of that prescription.
- Lovaza costs more than over the counter fish oil supplements.
- Some people may have increased LDL, which is known as the “bad” cholesterol.
- The drug may not lower risk of heart problems if your overall diet is not changed, especially one high in processed foods and sugar.
- Potential side effects include: upset stomach, burping and unpleasant fish like taste.
- Could increase risk of bleeding. Ask your doctor before use if you take blood thinning medications.
- Lovaza is used in doses of 2-4 grams per day. Given that fact, you need to purchase 60-120 capsules for a 30 day supply.
- The cost for 120 Lovaza 1 gram capsules is $300**, using the pharmacy discount app GoodRx.
- There is a generic now available called omega-3-acid ethyl esters. The cost for 120 of these 1 gram capsules is $22.96.**
Similarly with most medications the generic option is much more cost effective.
**Prices subject to change.
Fish oil products are non prescription and sold as dietary supplements. They also contain omega-3 fatty acids and the primary components are EPA and DHA. Some may also contain alpha-linolinec acid. Subsequently, you should look for products that have the highest amount of EPA and DHA that you can find.
Take A Comparable Dose
Keep in mind that prescription Lovaza contains 465mg of EPA and 375mg of DHA when comparing products. Also make sure to see how much is contained in each dose or capsule. Sometimes the labeled dose is 2 or even 3 capsules. As a result that affects how many you need to take and ultimately the cost.
Example fish oil supplement label
One of the major problems with studies that have been done on fish oils is that they did not use comparable doses to Lovaza studies. In order to see similar results you need to take similar amounts of the components EPA and DHA.
Fish Oil Products
First of all, remember dietary supplements do not have to undergo the same FDA requirements as prescription and over the counter drugs do. Specifically, testing for safety, efficacy and the procedures used in the manufacturing process.
Therefore, the best practice is to only buy dietary supplements from reputable manufacturers. Those can be found by looking at organizations that verify supplements for purity and quality. The United State Pharmacopeia (USP) is an organization that does just that. Above all, you should look for supplements that have the USP seal on them.
Fish oil products that have been USP approved are included in the table below.
|Product||Name||EPA Per Serving||DHA Per Serving|
|Nature Made w/|
For people who don’t enjoy capsules, Lovaza and fish oil might be an issue. They both come in very large sized capsules. However, fish oil is available in liquid products as well. At this time none of those liquid are USP verified.
Fish Oil Pros:
- The key ingredients EPA and DHA are the same that are found in Lovaza.
- Studies with higher doses of EPA and DHA are used have also found cardiovascular benefits of fish oil. Especially, in people who do not eat fish on a regular basis.
- Fish oil products may have less heavy metal contaminates than eating fish.
- There is also a low risk of side effects as is seen with Lovaza.
Fish Oil Cons:
- Some fish oil products will not specifically list the amount of EPA and DHA.
- The FDA does not test dietary supplements for safety, efficacy or how they are manufactured. Therefore, they may contain heavy metals found in fish such as mercury.
- Most fish oil supplements have not undergone clinical trials to prove they work. Meanwhile, Lovaza did have to undergo this process to be approved as a prescription medication.
Fish Oil Cost:
- One bottle of Nature Made fish oil with 360mg of EPA and 240mg of DHA contains 230 capsules and costs $17.46.**
- If you take four capsules per day (to get an EPA and DHA dose similar to Lovaza 2 grams per day) that is a 58 day supply or roughly 2 months. That brings the monthly cost would be ~$9**.
All in all this is a relatively affordable supplement given the potential upside.
**Prices subject to change.
Lovaza Vs. Fish Oil FAQ
The name of the generic prescription substitute for Lovaza is omega-3-acid ethyl esters. That means if your doctor writes you a prescription and does not also include the words dispense as written (DAW) your pharmacist will fill the script with the generic.
The most current studies have looked at the amount of liver fat that a person has. When high amounts are found this is referred to as non-alcoholic fatty liver disease. This is a key indicator for the health of the liver as we age. Some studies have shown that omega-3’s found in fish oil can lower the amount of liver fat. However, other studies have shown no overall benefits for fish oil to lower liver fat. That means that in normal doses fish oil will not harm your liver over the long term.
When looking for fish oil supplements you want to focus in on the amount of EPA and DHA. These two components provide the most benefits. Also, these two fatty acids are the omega-3’s that are required to help increase the ratio of omega-6 to omega-3. Trying to limit omega-6’s in your diet will also help improve the ratio.
Diet and exercise are always the best options to achieve optimal health. Improving these two areas could eliminate the need for prescription medications and supplements. Subsequently the risks of side effects could be eliminated. However, when you are on your path back to optimal health fish oil can be a good option. The American Heart Association recommends the following:
Adults consume 2 servings per week of fish to reduce the risk of death from cardiovascular disease.
Adults with previous cardiovascular problems supplement with omega-3 fatty acids.
That means that unless you consume 2 servings per week of fish you should talk to your doctor about a fish oil supplement.
There are hundreds of different brands of fish oil sold today. To ensure you are getting a brand that has been tested for quality and purity follow the United States Pharmacopeia recommendations. These USP verified supplements will be safer options than other brands.
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Kris-Etherton PM, Harris WS, Appel LJ. American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002; 106: 2747–2757.
Wang C, Chung M, Balk E, Kupelnick B, Jordan H, Harris W, Lichtenstein A, Lau J. N-3 fatty acids from fish or fish-oil supplements, but not α-linolenic acid, benefit cardiovascular disease outcomes in primary and secondary-prevention studies: a systematic review. Am J Clin Nutr. 2006; 83: 5–17.