For ASTHMA, studies show that a fish oil concentrate can make airways less reactive to allergens and improve air flow. Higher omega-3 levels in cell membranes lead to less of the highly inflammatory type of leukotrienes that trigger asthma being made. A concentrate is essential for full health benefits: it gives better blood levels with fewer pills and without a fishy aftertaste, versus whole fish oil which is poorly absorbed. Concentrated doses of EPA and DHA formulated for high absorption provide ample omega-3 oils for calming the asthma response so that tissues are less reactive to pollen, dander, mold, irritant foods, or other triggers. A fish oil concentrate helps other allergic conditions, including allergic rhinitis, seasonal nasal allergies, and possibly chronic sinusitis. For asthma and these conditions, changing the balance of fats and oils in the body to prevent or defuse allergic reactions is a fundamental treatment. The benefits build up over months, as new cells gradually replace old ones.

The key fact is that our bodies cannot make omega-3 fatty acids: they are essential fats that we must consume to reap wide-ranging benefits for lung and respiratory health, as well as optimal mood, brain and eye function, muscle and joint health, and immune support. Because we cannot produce omega-3s ourselves, we need to ingest them in the richest form possible.

For our patients taking a fish oil concentrate, we may test blood levels after 2 to 3 months to ensure that each patient is absorbing sufficient omega-3 fats. The standard omega-3 panel includes the main types of omega-3 fats, EPA, DHA, and DPA, as well as omega-6 levels and the ratio between the 3s and 6s to make sure that helpful omega-3s predominate. We like the Omega Check panel.

The important role of omega-3 fatty acids in our bodies

The crucial omega-3 fatty acids are an integral part of every cell membrane throughout the body, including the lungs and airways, and they are required for membrane cell receptors to function. All cells are wrapped in a membrane that acts as a selective barrier to regulate the passage of nutrients and waste in and out of the cell. The membrane is made of fatty acid phospholipids and cholesterol, which serve a very important function. High levels of omega-3 fats are naturally found in the human brain and eye, reproductive organs, spermatozoa, and omega-3s are important in bronchial lining cells.

Each new cell will try to form its membrane with generous and optimal amounts of omega-3 fats. If these are lacking, the membrane will include saturated or other fats. But cell membranes lacking omega-3 lipids are impaired: they are less fluid, and less able to function as a vital barrier. They fail at keeping electrolytes, water, and vital nutrients within the cell; and they cannot efficiently communicate with other cells or fully receive regulating hormones such as insulin or thyroxine from the thyroid gland. Homeostasis, which should maintain stable conditions within tissues, is then compromised.

Equally important, omega-3 fatty acids are building blocks for prostaglandins, body mediators with widespread functions. Various types of prostaglandins help control inflammation, allergic reactions including reactive asthma, immunity, and cardiovascular functions such as blood pressure, platelet stickiness and clot risk, contraction and relaxation of artery walls, and more.

Omega-3 oils promote the pathway that forms the beneficial prostaglandin 2 series and the inflammation-calming leukotrienes. Type 2 prostaglandins tend to reduce asthma reactions. Omega-3s also bind to cell receptors that regulate genetic function. It is through the helpful influence on membranes and prostaglandin balance that omega-3 fats have their widespread beneficial actions. Disturbance of membrane quality and prostaglandin balance underlie most disorders related to omega-3 deficiency.

The term ‘omega-3’ refers to the chemical structure of these fatty acids, and the location of their double bonds. Omega-3s are a specific type of long-chain unsaturated fats.

Only small amounts of omega-3 fats are found in foods. The main dietary sources in the animal kingdom include oily fish such as salmon, mackerel, trout, and sardines; and organic cold-pressed flaxseed oil in the vegetable kingdom. The main omega-3s in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), while the omega-3 in plant sources is mainly alpha-linolenic acid (ALA) which in the body is converted down a similar pathway as fish oil into an active omega-3 form.

Too many people lack these crucial healthy fats. Omega-3s are often lacking in our meals because omega-3 oils are not in many foods. Also, in the standard Western diet, omega-6 oils and saturated fats predominate, replacing food sources of omega-3s. The human body’s genetic patterns are established on a diet rich in omega-3 fatty acids. Omega-6 and omega-9 fats are not essential: they can be made in the human body, and they are found in many foods including olive and other vegetable oils, nuts, seeds, eggs, and legumes. However, omega-3 fatty acids are essential, and those we cannot produce ourselves; we need to ingest them in the richest forms possible. The standard present-day diet with a distorted ratio high in saturated and trans-fats and omega-6s may aggravate asthma and contribute to numerous other diseases.

Omega-3 fatty acids are linked to better lung health

Robust scientific evidence has emerged from many human trials that omega-3 fatty acids from fish oil supplements (EPA + DHA) are important to produce specialized mediators that calm airway reactivity. When cells and their membranes have higher omega-3 levels they make less of the highly inflammatory 4-series type of leukotrienes and instead favor the lower-inflammatory 5-series type. Clinical studies show that concentrated doses of EPA and DHA for asthma can improve peak flow, reduce medication use and coughing, and make airways less reactive to allergens.

Researchers studying chronic lung diseases, including asthma and pulmonary fibrosis, found that patients with higher levels of omega-3 fatty acids in their blood had a slower decline in lung function and longer survival. Notably, these findings persisted even after they accounted for other factors such as age and co-occurring diseases. This study sheds light on the protective benefits of omega-3 which regulate the activity of inflammatory cells and slow the buildup of lung scar tissue.¹

A large, multi-faceted study in healthy adults funded by the National Heart, Lung, and Blood Institute was undertaken to study the role of diet in chronic lung disease. This 2-part study began with an observational study following 15,063 Americans comprised of a racially diverse group of adults, with an average age of 56 years, for an average of 7 years and up to 20 years. Research data shows that higher levels of omega-3 fatty acids in a person’s blood were associated with a reduced rate of lung function decline. The second part of the study analyzed genetic data from over 500,000 European patients. They studied certain genetic markers in the blood for dietary omega-3 fatty acid levels and noted again that higher levels of omega-3 fatty acids — including DHA — were associated with better lung function.²

A recent cross-sectional study confirmed omega-3 fats’ anti-inflammatory effects, with potential as an asthma therapy. This Australian study involved almost 400 adult patients, 255 who had a diagnosis of asthma. Subjects with a higher omega-3 index had well-controlled or partially controlled asthma with a lower maintenance dose of inhaled corticosteroids, demonstrating the role of omega-3 fats in asthma management.³ This study also referenced that a Mediterranean dietary pattern, which is nutrient-dense and high in fish, fruit, and vegetables, could be protective, reducing the incidence and the severity of asthma symptoms.⁴

Our patients’ experience with fish oil concentrate

In our clinic, we prefer a pure concentrate of fish oil because it is formulated for much higher absorption of omega-3 oils than standard fish oil pills or liquid. The concentrate has no fishy after-taste, requires far fewer pills, and is therefore more economical. Because of its ultra-high absorption, more of the essential omega-3 fats enter the body than with regular whole fish oil, and so far fewer capsules are needed to attain good tissue levels of omega-3 fats. Our patients find that 2 or 3 fish oil concentrate capsules daily are ample and are the equivalent of 2 tablespoons of whole fish oil, which would translate to about 8 to 10 regular fish oil pills!

Patients taking a daily concentrate of fish oil observe that they have better lung function with fewer asthma episodes, less coughing or sputum, and better aerobic capacity. They also report less joint pain or muscle stiffness, cheerier moods, stronger hair and healthier skin, and over time they experience stable eye and macular exams. We see improved ‘good’ HDL cholesterol, lower blood pressure, and reduced inflammatory blood markers such as C-reactive protein.

We want to ensure that our patients have sufficient serum levels of crucial omega-3 fats, so we test omega-3 levels with the Omega Check test, which gives the percentage of omega-3 fats, including EPA, DHA, and DPA, out of total plasma fatty acids: A value of over 5.5% omega-3s supports lung health.

Recommendation: A verified concentrate of omega-3 fish oil 1,000 to 2,000 mg daily, with any meals, or as directed by your healthcare provider. It may take 6 to 12 months for full improvement to take effect, as old cells are gradually replaced with new cells containing richer omega-3 levels.

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