Frequently Asked Questions

Fish oil exists in three forms: ethyl ester (EE), triglyceride (TG), and free fatty acid (FFA). The TG form is the natural structure found in wild fish and is absorbed via the lymphatic system; the EE form is synthetic and absorbed mainly through the liver.

The most common form of fish oil on the market is the ethyl ester (EE) alcohol based form, which is a synthetic man-made form and has an alcohol metabolite “ethyl ester” backbone. The main reason most fish oil is in the EE form is that this alcohol form is easier and cheaper to produce compared to the natural form. The natural form of fish oil is triglyceride (TG), which has a glycerin backbone to which the EPA and DHA fatty acids are attached, and is how EPA and DHA come in wild fish. If the bottle doesn’t say triglyceride (TG) or re-esterified triglyceride (rTG) then it is not likely triglyceride (TG).

Companies that invest in the expensive steps required to produce a triglyceride (TG) form will always put it on the label. The triglyceride (TG) form is the main way your body transports and uses fats to help make every cell in your body. The triglyceride (TG) form increases your body’s natural absorption of the important EPA and DHA omega 3 fatty acids through the lymphatic system, while the ethyl ester (EE) form is mostly absorbed through the liver via the portal vein, which is not the natural pathway of Omega 3 absorption. Free fatty acid (FFA) form is the less common form where the glycerin backbone has been removed leaving the EPA and DHA unattached to the natural glycerin backbone. The availability of the free fatty acid (FFA) form of fish oil is limited, but research points to its absorption being similar to triglyceride (TG). The main take away from these different forms is found in this study: Bioavailability of fish oil forms

The Omega-3 Index measures the percentage of EPA and DHA in red blood cell membranes. ALP targets an O3i of 8-12% because levels below 5% correlate with higher inflammatory disease risk.

Normally a negative effect – high glucose (sugar) levels from starches and carbohydrates cause the body to increase its natural production of insulin, which in turn converts DGLA, an omega 6 fatty acid, to arachidonic acid (AA), which is the main culprit in prolonging the pro-inflammatory cause of accelerated chronic disease.

Actually, yes – statins are important in lowering cholesterol, and you should take them as your doctor recommends, but statins have been shown to increase arachidonic acid production, a known causative factor in chronic disease.

Medical science is learning more every day about this process of inflammation, and perhaps we can simplify it. We now know that there are two types of inflammation, known as pro-inflammatory response, and anti-inflammatory response. When damage occurs in the body, our first immune response is pro-inflammatory – its function is cell destruction. It simply clears away damaged cells so that the body can rebuild. This response is then followed by the anti-inflammatory response – its function is one of cell rejuvenation. It rebuilds and replaces damaged cells, and might be best understood as “the healing process.” What we understand as wellness can be described as a proper balance between these two functions. Problem: an unbalanced diet, one high in “negative” fatty acids, strongly supports the pro-inflammatory response, which becomes harmful when it a) continues the cell destruction phase when no longer needed, and b) continues to negatively impact the cell rejuvenation phase. The result is an increase in chronic inflammatory diseases over time. Such conditions as arthritis, asthma, cancer, type II diabetes, Crohn’s disease, heart disease, and others have been linked to this uncontrolled, ongoing pro-inflammatory response.

Wouldn’t we like to know that about everything we take? Fortunately, there is a simple way to do that. The Omega Score whole blood test, which includes the AA/EPA ratio test, is the appropriate measure of the ratio of pro–versus anti-inflammatory processes underway in the body, based on diet and omega 3 (the “good” omegas) versus omega 6 (the bad omegas) consumption, and these results have been directly linked to life expectancy factors. By using this simple “finger stick” blood test, both physician and patient can literally watch the good anti-inflammatory process taking place. This test focuses not only on the amount of omega 3s and other omegas, but most importantly on the balance between omega 3s (the EPA part) and omega 6s (the AA part) as well. Here are some specific examples:

• Increasing the omega-3 whole blood score from 6.1% to 10.2% has been linked to an 80% lower risk of sudden cardiovascular death;
• An omega 3 serum equivalence equal to or greater than 7.2 has been linked to a 32% reduction in heart disease;
• An EPA/DHA serum equivalence equal to or greater than 4.6 has been linked to a 70% reduced risk of death from fatal ischemic heart disease.

By repeating the simple Omega Score “finger stick” test every two months, therapeutic progress can be validated. Patients can order the Omega Score and AA/EPA ratio test from the ALP webstore. Physicians can refer patients to the ALP webstore to order the Omega Score test, and/or physicians can register through ALP to become an Omega Score test provider and ALP will relay the physicians information to Nutrasource Diagnostics, Inc.

The objective here is to increase the presence of EPA/DHA in the body, and likewise minimize the presence of AA — put this way, the answer becomes easy:

• 98% of all fats absorbed, stored, and transported in the human body are in natural triglyceride form– the supplement you take should say “natural triglyceride form” on the label – accept no substitutes;
• Enteric coating substantially increases the absorption rate of natural triglyceride fish oil preparations;
• ALP High 3 is formulated from the highest quality pharmaceutical grade fish oil — five star rated by the international Fish Oil Standards (IFOS) Organization for purity and content — look for the IFOS logo on the label;
• Because of absorption in the intestines, not the stomach, ALP High 3 achieves a significantly better absorption/penetration of omega 3 fatty acids into phospholipids (determined by red blood cell analysis), thereby boosting EPA/DHA levels, and effectively displacing arachidonic acid (AA) almost completely. Enteric coating has also been shown to reduce occasional burping, fishy aftertaste or G.I. upset.
• New enteric-coated natural triglyceride ALP High 3 provides concentrations/plasma levels/measurable efficacy at the site of inflammation.

Good question, and you are right – ocean contaminants are a consideration. What’s in the water is in the fish. Some fish, especially shark, king mackerel, and farm-raised salmon, can be contaminated with mercury, PCBs, and other industrial and environmental chemicals/pollutants. ALP High 3 fish oils are derived from mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovies, sardines, herring, trout, and menhaden. ALP High 3 fish oil is carefully purified to reduce heavy metals, dioxins, and PCBs, in addition to being tested for oxidation levels. ALP High 3 exceeds strict international standards for guaranteed pure and potent fish oil, will always exceed the stated amounts of EPA and DHA, and is manufactured in a cGMP facility. Always insist on the IFOS five-star rating — your guarantee of quality and purity when selecting fish oil supplements.

The only contraindication to their use is known hypersensitivity to omega 3 fish oils (such as anaphylaxis), EPA, DHA or any of its components. Care should be exercised during pregnancy or lactation, in patients facing surgery, those with bleeding problems or in patients undergoing any other treatment (either drug therapies or nutritional supplements) which may affect the ability of the blood to clot. Routine liver function tests should be performed, specifically when higher doses are being utilized. There are no known interactions with foods. Using fish oil supplements concomitantly with drugs that lower blood pressure (i.e., captopril, and enalapril, losartan, diltiazem, amlodipine, hydrochlorothiazide, furosemide, and others) may increase the effect of these drugs and may excessively lower blood pressure in some patients. The most commonly reported adverse reactions to fish oil therapy include “burping”, dyspepsia, and taste perversion.

No, but it’s a good question! Our bodies can naturally manufacture the good things that fish oil provides as replacements from the fats we consume – the problem is that today’s diet is high in different kinds of fats — processed, polyunsaturated fatty acids, partially hydrogenated vegetable oil, and other types of fats — these don’t contain enough of the proper “raw materials”, and in some cases produce compounds that actually work against the production of the proper omega-3 fatty acids (the beneficial ones). ALP High 3 provides high concentrations of EPA and DHA, beneficial omega-3 fatty acids, in the natural form which our bodies can easily absorb and use.

The research-recommended Omega-3 Index range is 8–12%. Many people sit below 5%, which is considered the danger zone. If you are young, healthy, and not overweight, the low end (8–9%) can be acceptable. As you age or face inflammatory-related health conditions, ALP’s strategy is to target the high end of the range — 11–12%, which ALP calls the “Summit.”

Plan A uses ALP High-3 TAG (fish oil in triglyceride form) only — and it is a good plan. Plan A+ adds ALP High 3–PL krill oil in phospholipid form — it is the highly recommended plan because krill oil phospholipids carry choline and target efficient remodeling of lipid membranes in the blood, brain, tissue, and organs.

Fish oil (TAG) does the heavy lifting — it delivers higher concentrations of EPA and DHA per serving. Krill oil (PL) adds the “lipid-membrane magic” — its phospholipid form carries choline and targets cell membrane integration more efficiently. Together, they give you two biologically active delivery systems working in concert to raise and maintain your Omega-3 Index.

For the “Summit” target (11–12% O3i), the typical person needs approximately 3,000 mg (3 g) of EPA+DHA per day from all sources. Lower targets (Base Camp at 8–9%, Ascent at 9–11%) use proportionally less. You should always confirm with testing, since your metabolism, diet, genetics, and exercise habits affect your personal O3i.

ALP recommends the Omega-3 Index test by OmegaQuant.com, which uses red blood cells (RBC) and is a simple finger-prick test you can do at home. The O3i RBC test is increasingly used in peer-reviewed omega-3 research, so your results let you follow the emerging science. Other testing options are also available — discuss with your healthcare provider.

ALP krill oil contains omega-3s in a phospholipid form with choline bound to the phospholipid. Up to 90% of Americans fall short of the necessary daily intake of choline, and over 60% carry a genetic mutation that predisposes them to choline deficiency. The ALP Protocol is designed to address both omega-3 and choline deficiency together — emerging research shows these deficiencies often coincide and have compounding inflammatory consequences.