Cod liver oil: benefits, dosage, contraindications

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For centuries, cod liver oil has held a significant place among the "health" foods in Nordic cultures. Recognized for its high content of vitamins A, D, and E, as well as omega-3 fatty acids, cod liver oil has endured through ages, evolving from a folk remedy to a scientifically acknowledged dietary supplement. The tradition of using cod liver oil traces back to antiquity in northern regions. During that time, fish viscera, including livers, were fermented in barrels of seawater, which allowed the oil to be released and rise to the surface. People consumed this oil for both its nutritional and medicinal benefits, particularly for relieving muscle and joint pain. In the 19th century, cod liver oil production became industrialized, especially in European fishing communities. This period saw significant improvements in oil quality, although production methods remained artisanal. It was in the mid-19th century that cod liver oil began gaining attention from the medical community. It was identified as an effective treatment for rickets, a disease caused by a vitamin D deficiency, marking the start of its use as a supplement. Cod liver oil is particularly rich in vitamins A and D, along with omega-3 fatty acids (EPA and DHA). These nutrients provide numerous benefits for the immune system, vision, cellular and bone growth, muscle function, and heart health. Cod liver oil is a prime food choice to support children's growth and development.

Other name(s) 

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Fatty Acids

Active ingredients:

Docosahexaenoic acid (DHA)

Eicosapentaenoic acid (EPA)

Vitamin A

Vitamin D


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Eye Health
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The components of cod liver oil (EPA, DHA, vitamin A) are recognized for their effectiveness in developing vision in infants and children.

Posologie

posologieOral administration

posologie10 - 20 mL


Pregnancy
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Results of a study suggest that maternal intake of cod liver oil during pregnancy is associated with a reduced risk of type 1 diabetes in the child. This association might be attributed to the effects of vitamin D or omega-3 fatty acids (EPA and DHA) present in cod liver oil, or to a combination of both. Clinical research shows that taking cod liver oil at a dose of 500 mg per day for 12 weeks, starting from the 24th-28th week of gestation, reduces HbA1c by 8.4%, fasting blood glucose by 41%, and insulin resistance by 43% from baseline values, in women with gestational diabetes. A reduction in perinatal complications and postpartum infections was also noted. Moreover, cod liver oil supplementation is beneficial for pregnant women as it provides vitamin D and omega-3 fatty acids essential for fetal development, particularly for bone growth and brain development.

Posologie

posologieOral administration

posologie20 - 40 mL


Vitamin D Deficiency
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Epidemiological research has highlighted that increased daily intake of cod liver oil is associated with higher serum vitamin D levels. This suggests that its consumption could be an effective means of enhancing vitamin D intake, particularly during periods of low sun exposure. Additionally, a study involving postmenopausal women in northern Scotland demonstrated that those who consumed a daily cod liver oil supplement were less likely to suffer from vitamin D deficiency during winter and spring compared to those not taking a supplement.

Posologie

posologieOral administration

posologie10 mL


Depression
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Results of a large-scale epidemiological study among Norwegian adults aged 40 to 49 and 70 to 74 show that daily oral intake of cod liver oil is associated with a 29% decrease in the risk of depressive symptoms compared to no cod liver oil intake. Rich in omega-3 fatty acids (EPA and DHA), as well as vitamins A and D, cod liver oil may play a role in protecting against oxidative brain damage and inflammation associated with depression and promote neurogenesis in the hippocampus.

Posologie

posologieOral administration

posologie15 mL


Hypercholesterolemia
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Preliminary clinical research indicates that the daily consumption of 20 mL of cod liver oil for 8 weeks seems to increase levels of good HDL cholesterol (high-density lipoproteins) by 5 mg/dL from baseline. On the other hand, another clinical study conducted among men who had a myocardial infarction shows that a daily intake of 20 mL of Icelandic cod liver oil for 6 weeks reduces triglycerides by 18 mg/dL, without improvement in LDL levels. A larger clinical study on hypercholesterolemic patients shows that taking cod liver oil in combination with rosuvastatin (a drug belonging to the statin class) further reduces total and LDL cholesterol compared to rosuvastatin monotherapy.

Posologie

posologieOral administration

posologie20 mL

duration6 - weeks


Rheumatoid arthritis
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Clinical research has shown the benefit of consuming 1 to 10 g of cod liver oil over a period ranging from 3 months to 9 months, in reducing pain and lowering the consumption of non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis. However, studies remain preliminary or of limited quality.

Posologie

posologieOral administration

posologie1 - 10 g

duration36 - weeks


Properties


Platelet Aggregation Inhibitors/Anticoagulant

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Early studies suggest that consuming cod liver oil can have significant effects on blood clotting. These studies, conducted primarily on healthy volunteers, indicate a prolongation of bleeding time by up to 81%, a reduction in platelet aggregation induced by thrombin, ADP, or collagen, and a decrease in the production of thromboxane B2 by platelets in response to thrombin. The consumption of cod liver oil is also associated with a reduction in the synthesis of thromboplastin, a key enzyme in the coagulation cascade. The clinical impact of these changes on platelet aggregation and bleeding times, however, remains uncertain.


Anti-inflammatory

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Rich in omega-3 fatty acid EPA, cod liver oil plays a notable role in modulating inflammatory responses. This oil inhibits the conversion of arachidonic acid into inflammatory prostaglandins and leukotrienes, and serves as a precursor to series 3 prostaglandins and series 5 leukotrienes, which are less inflammatory. These anti-inflammatory properties of cod liver oil are garnering increased interest, particularly in sports contexts to reduce exercise-induced inflammation. An observational study among amateur athletes revealed that regular cod liver oil consumption is associated with lower levels of C-reactive protein, an inflammation marker, both before and after a 91-kilometer cycling race, compared to no or occasional consumption.

Usages associés

Rheumatoid arthritis

Cardiovascular

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Cod liver oil consumption effectively reduces blood glucose levels, improves lipid profiles, and lowers high-sensitivity C-reactive protein (hs-CRP) levels, an inflammation marker according to a study. The study also highlights a reduction in insulin resistance, measured by HOMA-IR, in patients taking cod liver oil. These results suggest potential benefits of cod liver oil in managing metabolic and inflammatory complications related to gestational diabetes.

Usages associés

Hypercholesterolemia


Safety dosage

Adult from 18 years: 10 mL - 20 mL (oil)

Cod liver oil is most often used at a rate of 10 to 20 ml per day for a period of up to 4 months.

Pregnant woman: 10 mL (oil)

In the context of clinical research, cod liver oil, at a rate of 10 ml per day orally (providing 1,170 mcg of vitamin A and 10 mcg of vitamin D per day), has been used safely from week 17 of pregnancy until delivery, and for 3 months during the breastfeeding period.

Breastfeeding woman: 10 mL (oil)

Cod liver oil, at a rate of 10 ml per day, can be consumed safely during breastfeeding.

Infant from 6 to 12 months: 2.5 mL (oil)

In clinical studies, children aged 6 months to 1 year received 2.5 ml of cod liver oil per day safely for 5 months.

Child from 1 to 5 years: 5 mL (oil)

Children aged 1 year to 5 years received 5 ml daily safely for 5 months.


Interactions

Médicaments

Antiplatelet agents/Anticoagulant: low interaction

High doses of cod liver oil (20-40 ml) are associated with an increase in bleeding time and a reduction in blood clotting.

Antihypertensive: low interaction

Cod liver oil has a hypotensive effect, its combination with antihypertensive drugs could intensify the effects.