COD LIVER OIL
Aceite de Higado de Bacalao, Acides Gras Oméga 3, Acides Gras N-3, Acides Gras Polyinsaturés, Cod Oil, Fish Liver Oil, Fish Oil, Halibut Liver Oil, Huile de Foie, Huile de Foie de Flétan, Huile de Foie de Morue, Huile de Foie de Poisson, Huile de Morue, Huile de Poisson, Liver Oil, N-3 Fatty Acids, Omega 3, Oméga 3, Omega 3 Fatty Acids, Omega-3, Omega-3 Fatty Acids, Polyunsaturated Fatty Acids.
Overview InformationCod liver oil can be obtained from eating fresh cod liver or by taking supplements.
Cod liver oil is used as a source of vitamin A and vitamin D. It is also used as a source of fat called omega-3 for heart health, depression, arthritis, and other conditions, but there is no good scientific evidence to any use.
How does it work?Cod liver oil contains certain "fatty acids" that prevent the blood from clotting easily. These fatty acids also reduce pain and swelling.
Uses & Effectiveness
Likely Effective for
- Lowering blood fats called triglycerides. Taking cod liver oil by mouth can reduce triglyceride levels by 20% to 50% in people with high triglyceride levels.
Possibly Effective for
- High blood pressure. Taking cod liver oil by mouth seems to lower blood pressure (both numbers) a small, but important, amount in people with mild high blood pressure.
- Kidney disease in people with type 2 diabetes. Taking cod liver oil seems to reduce protein in the urine, a marker for kidney disease severity.
Possibly Ineffective for
- Cholesterol disease that runs in families (familial hypercholesterolemia).
Insufficient Evidence for
- An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD). People who eat a lot of fish and take cod liver oil don't have a lower risk of developing this condition compared to people who just eat a lot of fish.
- Hay fever. Taking cod liver oil during pregnancy or while breast-feeding, or giving cod liver oil to the infant up to 2 years of age, does not seem to prevent hay fever.
- Irregular heartbeat (arrhythmia). Taking cod liver oil by mouth might reduce a specific type of irregular heartbeat in some people. But it's not known if this reduces the risk of heart-related death. Taking cod liver oil by mouth does not seem to reduce irregular heartbeat in men with irregular heartbeat after a heart attack.
- Asthma. Most research shows that taking cod liver oil during pregnancy or breast-feeding, or giving cod liver oil to an infant up to 2 years of age, doesn't prevent asthma. But taking cod liver oil 1-3 times weekly during pregnancy might reduce the risk of asthma in the child at 6 years of age.
- Eczema (atopic dermatitis). Most research shows that taking cod liver oil during pregnancy or breast-feeding, or giving cod liver oil to an infant up to 2 years of age, doesn't prevent eczema. But fewer infants have eczema at one year of age if they take cod liver oil at least four times weekly.
- Depression. Taking cod liver oil has been linked with a 29% lower chance of older adults having depression symptoms.
- Diabetes. Taking cod liver oil may help control blood sugar in people with diabetes during pregnancy. This might help to prevent complications at birth. It may take up to 12 weeks for benefit. Taking cod liver oil doesn't seem to help with blood sugar control in people with type 1 diabetes.
- Inherited tendency towards high cholesterol (familial hypercholesterolemia). Early research shows that taking cod liver oil doesn't seem to lower cholesterol levels in people with familial hypercholesterolemia.
- High cholesterol. Taking cod liver oil by mouth doesn't lower cholesterol levels in people with high cholesterol. But it might increase "good" high-density lipoprotein cholesterol levels in people with type 1 diabetes and high cholesterol. Also it might lower blood fats called "triglycerides" in men who have had a heart attack.
- High blood pressure. Taking cod liver oil by mouth seems to slightly lower blood pressure in healthy people and those with slightly high blood pressure. But it's not clear if this reduction is clinically meaningful for people with very high cholesterol.
- Long-term swelling (inflammation) in the digestive tract (inflammatory bowel disease or IBD). Some people with inflammatory bowel disease have joint pain. Taking cod liver oil might reduce joint pain in some people with this condition.
- Osteoarthritis. Taking cod liver oil along with an NSAID doesn't reduce swelling in people with osteoarthritis better than taking an NSAID alone.
- Ear infection (otitis media). Taking cod liver oil and a multivitamin might reduce the need to use medicine to treat ear infections in young children by about 12%.
- Infection of the airways. Giving young children cod liver oil and a multivitamin seems to reduce the number of doctor's office visits for airway infections.
- Rheumatoid arthritis (RA). Taking cod liver oil might decrease pain, morning stiffness, and swelling in some patients with rheumatoid arthritis. Also, taking cod liver oil and fish oil seems to reduce the need to use medicine to treat joint swelling in people with this condition.
- Vitamin D deficiency. Taking cod liver oil seems to increase blood levels of vitamin D in some people. But it's not clear if cod liver oil increases vitamin D to normal levels in people with low levels of vitamin D.
- Wound healing.
- Other conditions.
Side Effects & SafetyWhen taken by mouth: Cod liver oil is LIKELY SAFE for most adults when taken by mouth. It can cause side effects including belching, bad breath, heartburn, loose stools, and nausea. Taking cod liver oil with meals can often decrease these side effects. High doses of cod liver oil are POSSIBLY UNSAFE. They might keep blood from clotting and can increase the chance of bleeding. Vitamin A and vitamin D levels might also become too high with high doses of cod liver oil.
When applied to the skin: There isn't enough reliable information to know if cod liver oil is safe or what the side effects might be.
Special Precautions & Warnings:Pregnancy and breast-feeding: Cod liver oil is POSSIBLY SAFE when used in amounts that provide no more than the recommended daily intakes of vitamin A and vitamin D. Cod liver oil is POSSIBLY UNSAFE when taken in larger amounts. Women who are pregnant or breast-feeding should not take cod liver oil that provides more than about 3000 mcg of vitamin A and 100 mcg of vitamin D.
Children: Cod liver oil is LIKELY SAFE for most children when taken by mouth in amounts that provide no more than the recommended daily intakes of vitamin A and vitamin D. Cod liver oil is POSSIBLY UNSAFE when taken in larger amounts.
Diabetes: There has been some concern that cod liver oil or other fish oils might increase blood sugar in people with diabetes. But there is no strong research that supports this concern. But there is some evidence that cod liver oil may lower blood sugar levels and increase the blood sugar-lowering effects of some antidiabetes drugs. There is a concern that blood sugar could drop too low. If you have diabetes and use cod liver oil, monitor your blood sugar levels closely.
High blood pressure: Cod liver oil can lower blood pressure and might cause blood pressure to go too low if used along with medications for high blood pressure. Be careful when using cod liver oil if you are taking high blood pressure drugs.
Be cautious with this combination
Medications for high blood pressure (Antihypertensive drugs) interacts with COD LIVER OIL
Cod liver oil seems to decrease blood pressure. Taking cod liver oil along with medications for high blood pressure might cause your blood pressure to go too low.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with COD LIVER OIL
Cod liver oil might slow blood clotting. Taking cod liver oil along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
The following doses have been studied in scientific research:
- For lowering triglycerides: 20 mL of cod liver oil per day.
- For high cholesterol: 30 mL of cod liver oil per day.
- For lowering blood pressure: 20 mL of cod liver oil per day.
- Galarraga, B., Ho, M., Youssef, H. M., Hill, A., McMahon, H., Hall, C., Ogston, S., Nuki, G., and Belch, J. J. Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatology.(Oxford) 2008;47(5):665-669. View abstract.
- Ahmed AA, Holub BJ. Alteration and recovery of bleeding times, platelet aggregation and fatty acid composition of individual phospholipids in platelets of human subjects receiving a supplement of cod-liver oil. Lipids 1984;19(8):617-24. View abstract.
- al-Meshal MA, Lutfi KM, Tariq M. Cod liver oil inhibits indomethacin induced gastropathy without affecting its bioavailability and pharmacological activity. Life Sci 1991;48:1401-9.. View abstract.
- Anon. Licensed fish-oil concentrate versus cod-liver oil. Lancet 1987;2:453.
- Aviram M, Brox J, Nordoy A. Effects of postprandial plasma and chylomicrons on endothelial cells. Differences between dietary cream and cod liver oil. Acta Med Scand 1986;219:341-8.. View abstract.
- Bartolucci G, Giocaliere E, Boscaro F, et al. Vitamin D3 quantification in a cod liver oil-based supplement. J Pharm Biomed Anal 2011;55(1):64-70. View abstract.
- Brox JH, Killie JE, Gunnes S, Nordoy A. The effect of cod liver oil and corn oil on platelets and vessel wall in man. Thromb Haemost 1981;46:604-11. View abstract.
- Brox JH, Killie JE, Osterud B, et al. Effects of cod liver oil on platelets and coagulation in familial hypercholesterolemia (type IIa). Acta Med Scand 1983;213:137-44.. View abstract.
- Brunborg LA, Madland TM, Lind RA, et al. Effects of short-term oral administration of dietary marine oils in patients with inflammatory bowel disease and joint pain: a pilot study comparing seal oil and cod liver oil. Clin Nutr 2008;27:614-22. View abstract.
- Conus N, Burgher-Kennedy N, van den Berg F, Kaur Datta G. A randomized trial comparing omega-3 fatty acid plasma levels after ingestion of emulsified and non-emulsified cod liver oil formulations. Curr Med Res Opin. 2019;35(4):587-593. View abstract.
- Dawson JK, Abernethy VE, Graham DR, Lynch MP. A woman who took cod-liver oil and smoked. Lancet 1996;347:1804.
- Detopoulou P, Papamikos V. Gastrointestinal bleeding after high intake of omega-3 fatty acids, cortisone and antibiotic therapy: a case study. Int J Sport Nutr Exerc Metab 2014;24(3):253-7. View abstract.
- Eysteinsdottir T, Halldorsson TI, Thorsdottir I, et al. Cod liver oil consumption at different periods of life and bone mineral density in old age. Br J Nutr 2015;114(2):248-56. View abstract.
- Farmer A, Montori V, Dinneen S, Clar C. Fish oil in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2001;3:CD003205. View abstract.
- FDA. Center for Food Safety and Applied Nutrition. Letter regarding dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Available at: https://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-Rpt0272-38-Appendix-D-Reference-F-FDA-vol205.pdf. (Accessed February 7, 2017).
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
- Foti C, Bonamonte D, Conserva A, Pepe ML, Angelini G. Allergic contact dermatitis to cod liver oil contained in a topical ointment. Contact Dermatitis 2007;57(4):281-2. View abstract.
- Gibson RA. Long-chain polyunsaturated fatty acids and infant development (editorial). Lancet 1999;354:1919.
- Gruenwald J, Graubaum HJ, Harde A. Effect of cod liver oil on symptoms of rheumatoid arthritis. Adv Ther 2002;19(2):101-7. View abstract.
- Hansen JB, Olsen JO, Wilsgard L, Osterud B. Effects of dietary supplementation with cod liver oil on monocyte thromboplastin synthesis, coagulation and fibrinolysis. J Intern Med Suppl 1989;225:133-9.. View abstract.
- Hardarson T, Kristinsson A, Skúladóttir G, Asvaldsdóttir H, Snorrason SP. Cod liver oil does not reduce ventricular extrasystoles after myocardial infarction. J Intern Med 1989;226(1):33-7. View abstract.
- Helland IB, Saarem K, Saugstad OD, Drevon CA. Fatty acid composition in maternal milk and plasma during supplementation with cod liver oil. Eur J Clin Nutr 1998;52(11):839-45. View abstract.
- Helland IB, Saugstad OD, Saarem K, et al. Supplementation of n-3 fatty acids during pregnancy and lactation reduces maternal plasma lipid levels and provides DHA to the infants. J Matern Fetal Neonatal Med 2006;19(7):397-406. View abstract.
- Henderson MJ, Jones RG. Cod liver oil or bust. Lancet 1987;2:274-5.
- Jensen T, Stender S, Goldstein K, et al. Partial normalization by dietary cod-liver oil of increased microvascular albumin leakage in patients with insulin-dependent diabetes and albuminuria. N Engl J Med 1989;321:1572-7. View abstract.
- Jonasson F, Fisher DE, Eiriksdottir G, et al. Five-year incidence, progression, and risk factors for age-related macular degeneration: the age, gene/environment susceptibility study. Ophthalmology 2014;121(9):1766-72. View abstract.
- Landymore RW, Kinley CE, Cooper JH, et al. Cod-liver oil in the prevention of intimal hyperplasia in autogenous vein grafts used for arterial bypass. J Thorac Cardiovasc Surg 1985;89:351-7. View abstract.
- Landymore RW, MacAulay M, Sheridan B, Cameron C. Comparison of cod-liver oil and aspirin-dipyridamole for the prevention of intimal hyperplasia in autologous vein grafts. Ann Thorac Surg 1986;41:54-7. View abstract.
- Landymore RW, MacAulay MA, Cooper JH, Sheridan BL. Effects of cod-liver oil on intimal hyperplasia in vein grafts used for arterial bypass. Can J Surg 1986;29:129-31.. View abstract.
- Linday LA, Dolitsky JN, Shindledecker RD, Pippenger CE. Lemon-flavored cod liver oil and multivitamin-mineral supplement for the secondary prevention of otitis media in young children: pilot research. Ann Otol Rhinol Laryngol 2002:111:642-52.. View abstract.
- Linday LA, Shindledecker RD, Tapia-Mendoza J, Dolitsky JN. Effect of daily cod liver oil and a multivitamin-multimineral supplement with selenium on upper respiratory tract pediatric visits by young, inner-city, Latino children: randomized pediatric sites. Ann Otol Rhinol Laryngol 2004;113:891-901. View abstract.
- Linday LA. Cod liver oil, young children, and upper respiratory tract infections. J Am Coll Nutr 2010;29(6):559-62. View abstract.
- Lombardo YB, Chicco A, D'Alessandro ME, et al. Dietary fish oil normalize dyslipidemia and glucose intolerance with unchanged insulin levels in rats fed a high sucrose diet. Biochim Biophys Acta 1996;1299:175-82. View abstract.
- Lorenz R, Spengler U, Fischer S, Duhm J, Weber PC. Platelet function, thromboxane formation and blood pressure control during supplementation of the Western diet with cod liver oil. Circulation 1983;67(3):504-11. View abstract.
- Lucas A, Stafford M, Morley R, et al. Efficacy and safety of long-chain polyunsaturated fatty acid supplementation of infant-formula milk: a randomized trial. Lancet 1999;354:1948-54. View abstract.
- Mai XM, Langhammer A, Chen Y, Camargo CA. Cod liver oil intake and incidence of asthma in Norwegian adults - the HUNT study. Thorax 2013;68(1):25-30. View abstract.
- Mavroeidi A, Aucott L, Black AJ, et al. Seasonal variation in 25(OH)D at Aberdeen (57°N) and bone health indicators--could holidays in the sun and cod liver oil supplements alleviate deficiency? PLoS One 2013;8(1):e53381. View abstract.
- Øien T, Schjelvaag A, Storrø O, Johnsen R, Simpson MR. Fish consumption at one year of age reduces the risk of eczema, asthma and wheeze at six years of age. Nutrients. 2019;11(9). pii: E1969. View abstract.
- Olafsdottir AS, Thorsdottir I, Wagner KH, Elmadfa I. Polyunsaturated fatty acids in the diet and breast milk of lactating Icelandic women with traditional fish and cod liver oil consumption. Ann Nutr Metab 2006;50(3):270-6. View abstract.
- Porojnicu AC, Bruland OS, Aksnes L, Brant WB, Moan J. Sun beds and cod liver oil as vitamin D sources. J Photochem Photobiol B Biol 2008;91:125-31. View abstract.
- Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998;1:105-12. View abstract.
- Raeder MB, Steen VM, Vollset SE, Bjelland I. Associations between cod liver oil use and symptoms of depression: The Hordaland Health Study. J Affect Disord 2007;101:245-9. View abstract.
- Rajakumar K. Vitamin D, cod liver oil, sunlight, and rickets: a historical perspective. Pediatrics 2003;112(2):e132-5. View abstract.
- Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds). Dietary reference intakes for calcium and vitamin D. Institute of Medicine, 2011. Available at: www.nap.edu/catalog/13050/dietary-reference-intakes-for-calcium-and-vitamin-d (accessed April 17, 2016).
- Sanders TA, Vickers M, Haines AP. Effect on blood lipids and haemostasis of a supplement of cod-liver oil, rich in eicosapentainoic and docosahexaenoic acids, in healthy young men. Clin Sci (Colch) 1981;61:317-24. View abstract.
- Sellmayer A, Witzgall H, Lorenz RL, Weber PC. Effects of dietary fish oil on ventricular premature complexes. Am J Cardiol 1995;76:974-7. View abstract.
- Shimizu H, Ohtani K, Tanaka Y, et al. Long-term effect of eicosapentaenoic acid ethyl (EPA-E) on albuminuria of non-insulin dependent diabetic patients. Diabetes Res Clin Pract 1995;28:35-40. View abstract.
- Skúladóttir GV, Gudmundsdóttir E, Olafsdóttir E, et al. Influence of dietary cod liver oil on fatty acid composition of plasma lipids in human male subjects after myocardial infarction. J Intern Med 1990;228(6):563-8. View abstract.
- Stammers T, Sibbald B, Freeling P. Efficacy of cod liver oil as an adjunct to non-steroidal anti-inflammatory drug treatment in the management of osteoarthritis in general practice. Ann Rheum Dis 1992;51:128-9. View abstract.
- Terkelsen LH, Eskild-Jensen A, Kjeldsen H, et al. Topical application of cod liver oil ointment accelerates wound healing: an experimental study in wounds in the ears of hairless mice. Scand J Plast Reconstr Surg Hand Surg 2000;34:15-20. View abstract.
- Toft I, Bonaa KH, Ingebretsen OC, et al. Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial. Ann Intern Med 1995;123:911-8. View abstract.
- Veierod MB, Thelle DS, Laake P. Diet and risk of cutaneous malignant melanoma: a prospective study of 50,757 Norwegian men and women. Int J Cancer 1997;71:600-4. View abstract.
- Yang S, Lin R, Si L, et al. Cod-liver oil improves metabolic indices and hs-CRP levels in gestational diabetes mellitus patients: A double-blind randomized controlled trial. J Diabetes Res. 2019;2019:7074042. View abstract.
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