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Cod Liver Oil

What is it?

Cod 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 effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for COD LIVER OIL are as follows:

Insufficient evidence to rate effectiveness 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.
  • A group of eye disorders that can lead to vision loss (glaucoma).
  • Allergic skin reactions.
  • Burns.
  • Diaper rash.
  • Heart disease.
  • Hemorrhoids.
  • High levels of fats called triglycerides in the blood (hypertriglyceridemia).
  • Kidney damage in people with diabetes (diabetic nephropathy). .
  • Wound healing.
  • Other conditions.
More evidence is needed to rate cod liver oil for these uses.

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.

Are there safety concerns?

When 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.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Medications for diabetes (Antidiabetes drugs)
Cod liver oil might lower blood sugar levels. Diabetes medications are used to lower blood sugar. Taking cod liver oil along with diabetes medications might cause your blood sugar to become too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications for high blood pressure (Antihypertensive drugs)
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)
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), dipyridamole (Persantine), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Are there interactions with herbs and supplements?

Herbs and supplements that might lower blood pressure
Cod liver oil might lower blood pressure. It has the potential to add to blood pressure lowering effects of other herbs and supplements that also lower blood pressure. Other herbs and supplements that can lower blood pressure include andrographis, casein peptides, cat's claw, coenzyme Q10, L-arginine, lycium, stinging nettle, theanine, and others.
Herbs and supplements that might lower blood sugar
Cod liver oil might lower blood sugar. If it is taken along with other herbs and supplements that might lower blood sugar, blood sugar might become too low in some people. Some herbs and supplements that might lower blood sugar include alpha-lipoic acid, bitter melon, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
Herbs and supplements that might slow blood clotting
Cod liver oil might slow blood clotting. Using cod liver oil with herbs and supplements that also slow blood clotting might increase the chance of bruising and bleeding in some people. These herbs include angelica, borage seed oil, clove, danshen, garlic, ginger, ginkgo, red clover, turmeric, willow, and others.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The appropriate dose of cod liver oil depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for cod liver oil. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Other names

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.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

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Last reviewed - 02/12/2021