Flaxseed oil is derived from the seeds of the flax plant (Linum usitatissimum, L.). Flaxseed oil and flaxseed contain substances that promote good health. One of these substances is alpha-linolenic acid (ALA), an essential fatty acid that appears to be beneficial for heart disease, inflammatory bowel disease, arthritis, and other health conditions. Flaxseed, in addition to ALA, contains a group of chemicals called lignans that may play a role in the prevention of cancer. Please see the flaxseed monograph for further information on this herbal agent.

ALA, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), belongs to a group of substances called omega-3 fatty acids. EPA and DHA are found primarily in fish while ALA is mostly found in flaxseed oil and other vegetable oils. Although similar in structure, the benefits of ALA, EPA, and DHA are not necessarily the same.

It is important to maintain an appropriate balance of omega-3 and omega-6 (another essential fatty acid) in the diet, as these two substances work together to promote health. These essential fats are both examples of polyunsaturated fatty acids, or PUFAs. Omega-3 fatty acids help reduce inflammation and most omega-6 fatty acids tend to promote inflammation. An inappropriate balance of these essential fatty acids contributes to the development of disease while a proper balance helps maintain and even improve health. A healthy diet should consist of roughly 2 - 4 times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 14 - 25 times more omega-6 fatty acids than omega-3 fatty acids, and many researchers believe this imbalance is a significant factor in the rising rate of inflammatory disorders in the United States.

Omega-3 fatty acids have been shown to reduce inflammation and help prevent certain chronic diseases such as heart disease and arthritis. These essential fatty acids appear to be particularly important for cognitive and behavioral function as well as normal growth and development.

Clinical studies suggest that flaxseed oil and other omega-3 fatty acids may be helpful in treating a variety of conditions. The evidence is strongest for heart disease and problems that contribute to heart disease, but the range of possible uses for flaxseed oil include:

High cholesterol

People who follow a Mediterranean diet tend to have an increased high density lipoprotein (also called HDL, or "good") cholesterol level. The Mediterranean diet consists of a healthy balance between omega-3, omega-6, and omega-9 (found in olive oil) fatty acids. It emphasizes whole grains, root and green vegetables, daily intake of fruit, fish and poultry, olive and canola oils, and ALA (from flaxseed, flaxseed oil, and walnuts), along with discouragement of ingestion of red meat and not much use of butter and cream.

Flaxseed and flaxseed oil have been reported to possess cholesterol-lowering properties in laboratory studies. Human studies have used flaxseed products and measured effects on cholesterol, with mixed results. A recent human study found that dietary flaxseed significantly improved lipid (cholesterol) profile in patients with high cholesterol, and may favorably modify cardiovascular risk factors.

Heart disease

A diet rich in fruits, vegetables, whole grains, nuts or legumes, and ALA-rich foods may substantially reduces the recurrence of heart disease. One of the best ways to help prevent and treat heart disease is to eat a low-fat diet and to replace foods rich in saturated and trans-fat with those that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids from flaxseed). Evidence suggests that people who eat an ALA-rich diet are less likely to suffer a fatal heart attack. ALA may reduce heart disease risks through a variety of biologic mechanisms, including platelet function (making them less "sticky"), inflammation, blood vessel health, and arrhythmia (irregular heart beat).

Several human studies also suggest that diets rich in omega-3 fatty acids (including ALA) may lower blood pressure.

Other

Although further research is needed, preliminary evidence suggests that omega-3 fatty acids may also prove helpful in protecting against certain infections and treating a variety of conditions including autism, ulcers, migraine headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease, systemic lupus erythmatosus (lupus), irregular heart beats (arrhythmias), multiple sclerosis, and panic attacks. Omega-3 fatty acid supplementation may also help to reduce stress and the effects it has on the body.

Flaxseed oil is obtained from the seed of the flax plant. It contains 50 - 60% omega-3 fatty acids in the form of alpha-linolenic acid (ALA). This amount is roughly double that contained in fish oil. However, ALA must be converted in the body into usable forms. ALA from flaxseed may not have the same benefit as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) because it is more difficult for the body to efficiently convert ALA to a form of omega-3 fatty acids that it can readily use.

Flaxseed oil is available in liquid and softgel capsule forms. Like any oil, flaxseed oil may turn rancid if it is not refrigerated. Flaxseed oil requires special packaging because it is easily destroyed by heat, light, and oxygen. The highest quality flaxseed products are manufactured using fresh pressed seeds, bottled in dark or opaque containers, and processed at low temperatures in the absence of light, extreme heat, or oxygen.

Be sure to buy flaxseed oil supplements made by reputable companies who certify that their products are free of heavy metals such as lead and mercury.

The dosage to prevent and treat disease will vary depending on the amount of fatty acids in the diet and the type of disorder being treated.

Pediatric

Flaxseed oil may be added to a child's diet to help balance fatty acids. If an infant is breastfed, the mother may ingest oil or fresh ground seed to increase fat content in breast milk. See adult dosage below. Only use flaxseed oil supplements in children under 18 years of age under the supervision of a health care provider.

Adult

Flaxseed oil: Take 1 - 2 tablespoonfuls daily, or 1 - 2 capsules daily. Flaxseed oil is often used in a liquid form, which contains approximately 7 grams of ALA per 15 mL (1 tbsp), and contains approximately 130 calories.

As a substitute for fish oil, a dose of 7.2 grams of flaxseed oil is approximately equivalent to 1 gram of fish oil.

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Flaxseed may slow down the absorption of oral medications or other nutrients if taken at the same time. Try to avoid taking flaxseed at the same time as medications and other supplements.

People with either diabetes or schizophrenia may lack the ability to convert ALA to EPA and DHA, the forms more readily used in the body. Therefore, those with either condition should obtain their omega-3 fatty acids from dietary sources rich in EPA and DHA.

Although studies have found that regular consumption of fish (which includes the omega-3 fatty acids EPA and DHA) may reduce the risk of macular degeneration, a recent study including two large groups of men and women found that diets rich in ALA may substantially increase the risk of this disease. More research is needed in this area. Until this information becomes available, it is best for people with macular degeneration to obtain omega-3 fatty acids from sources of EPA and DHA, rather than ALA.

Similar to macular degeneration, fish and fish oil may protect against prostate cancer, but ALA may be associated with increased risk of prostate cancer in men. More research in this area is needed.

If you are currently being treated with any of the following medications, you should not use flaxseed oil (alpha-linolenic acid or ALA) or other omega-3 fatty acids without first talking to your health care provider.

Blood-thinning medications -- Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as in heart disease), they should only be taken together under the guidance and supervision of a health care provider.

Blood sugar lowering medications -- Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking blood sugar lowering medications, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin, as omega-3 fatty acid supplements may increase your need for the medication(s).

Cyclosporine -- Taking omega-3 fatty acids during cyclosporine (Sandimmune) therapy may reduce toxic side effects, such as high blood pressure and kidney damage, associated with this medication in transplant patients.

Etretinate and topical steroids -- The addition of omega-3 fatty acids (specifically EPA) to the drug therapy etretinate (Tegison) and topical corticosteroids may improve symptoms of psoriasis.

Cholesterol-lowering medications -- Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as "statins," including atorvastatin (Liptor), lovastatin (Mevacor), and simvastatin (Zocor) to work more effectively.

Nonsteroidal anti-inflammatory drugs (NSAIDs) -- In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Motrin or Advil) and naproxen (Alleve or Naprosyn). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.

Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S. Hypertension prophylaxis with omega-3 fatty acids in heart transplant recipients. J Am Coll Cardiol. 1997;29:1324-1331.

Angerer P, von Schacky C. n-3 polyunsaturated fatty acids and the cardiovascular system. Curr Opin Lipidol. 2000;11(1):57-63.

Arnold LE, Kleykamp D, Votolato N, Gibson RA, Horrocks L. Potential link between dietary intake of fatty acid and behavior: pilot exploration of serum lipids in attention-deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 1994;4(3):171-182.

Balk EM, Lichtenstein AH, Chung M et al. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis. 2006 Nov;189(1):19-30.

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin of North Am. 1999;46(5):977-992.

Bays HE. Safety considerations with omega-3 Fatty Acid therapy. Am J Cardiol. 2007;99(6A):S35-43.

Belluzzi A, Boschi S, Brignola C, Munarini A, Cariani C, Miglio F. Polyunsaturated fatty acids and inflammatory bowel disease. Am J Clin Nutr. 2000;71(suppl):339S-342S.

Boelsma E, Hendriks HF. Roza L. Nutritional skin care: health effects of micronutrients and fatty acids. Am J Clin Nutr. 2001;73(5):853-864.

Bradbury J, Myers SP, Oliver C et al. An adaptogenic role for omega-3 fatty acids in stress; a randomised placebo controlled double blind intervention study (pilot)ISRCTN22569553. Nutr J. 2004 Nov 28;3:20.

Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder. Am J Clin Nutr. 2000; 71(suppl):327S-330S.

Caron MF, White CM. Evaluation of the antihyperlipidemic properties of dietary supplements. Pharmacotherapy. 2001;21(4):481-487.

Cellini M, Caramazzu N, Mangiafico P, Possati GL, Caramazza R. Fatty acid use in glaucomatous optic neuropathy treatment. Acta Ophthalmol Scand Suppl. 1998;227:41-42.

Cho E, Hung S, Willet WC, Spiegelman D, Rimm EB, Seddon JM, et al. Prospective study of dietary fat and the risk of age-related macular degeneration. Am J Clin Nutr. 2001;73(2):209-218.

de Logeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779-785.

Deutch B. Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake. Eur J Clin Nutr. 1995;49(7):508-516.

Dewailly E, Blanchet C, Lemieux S, et al. n-3 fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik. Am J Clin Nutr. 2001;74(4):464-473.

Dichi I, Frenhane P, Dichi JB, Correa CR, Angeleli AY, Bicudo MH, et al. Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis. Nutrition. 2000;16:87-90.

Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998;48(2-3):149-155.

Fatty fish consumption and ischemic heart disease mortality in older adults: The cardiovascular heart study. Presented at the American Heart Association's 41st annual conference on cardiovascular disease epidemiology and prevention. AHA. 2001.

Fenton WS, Dicerson F, Boronow J, et al. A placebo controlled trial of omega-3 fatty acid (ethyl eicosapentaenoic acid) supplementation for residual symptoms and cognitive impairment in schizophrenia. Am J Psychiatry. 2001;158(12):2071-2074.

Frangou S, Lewis M, McCrone P et al. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Br J Psychiatry. 2006;188:46-50

Freeman VL, Meydani M, Yong S, Pyle J, Flanigan RC, Waters WB, Wojcik EM. Prostatic levels of fatty acids and the histopathology of localized prostate cancer. J Urol. 2000;164(6):2168-2172.

Freund-Levi YF, Eriksdotter-Jonhagen M, Cederholm T, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD Study. Arch Neurol. 2006;63:1402-8.

Geerling BJ, Badart-Smook A, van Deursen C, et al. Nutritional supplementation with N-3 fatty acids and antioxidants in patients with Crohn's disease in remission: effects on antioxidant status and fatty acid profile. Inflamm Bowel Dis. 2000;6(2):77-84.

Geerling BJ, Houwelingen AC, Badart-Smook A, Stockbrügger RW, Brummer R-JM. Fat intake and fatty acid profile in plasma phospholipids and adipose tissue in patients with Crohn's disease, compared with controls. Am J Gastroenterol. 1999;94(2):410-417.

Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 Feb 28; [Epub ahead of print].

Hall MN, Campos H, Li H, Sesso HD, Stampfer MJ, Willett WC, Ma J. Blood levels of long-chain polyunsaturated fatty acids, aspirin, and the risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2007;16(2):314-21.

Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(5):1645S (10).

Holman RT, Adams CE, Nelson RA, et al. Patients with anorexia nervosa demonstrate deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids. J Nutr. 1995;125:901-907.

Hooper L, Thompson R, Harrison R et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004;CD003177.

Horrobin DF, Bennett CN. Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Prostaglandins Leukot Essent Fatty Acids. 1999;60(4):217-234.

Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid. Pharmacol Res. 1999;40(3):211-225.

Hu FB, Stampfer MJ, Manson JE et al. Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr. 1999;69:890-897.

Itomura M, Hamazaki K, Sawazaki S et al. The effect of fish oil on physical aggression in schoolchildren - a randomized, double-blind, placebo-controlled trial. J Nutr Biochem. 2005;16:163-71.

Jeschke MG, Herndon DN, Ebener C, Barrow RE, Jauch KW. Nutritional intervention high in vitamins, protein, amino acids, and omega-3 fatty acids improves protein metabolism during the hypermetabolic state after thermal injury. Arch Surg. 2001;136:1301-1306.

Klurfeld DM, Bull AW. Fatty acids and colon cancer in experimental models. Am J Clin Nut. 1997;66(6 Suppl):1530S-1538S.

Krauss RM, Eckel RH, Howard B, et al. AHA Scientific Statement: AHA Dietary guidelines Revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation. 2000;102(18):2284-2299.

Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr. 2000;(suppl 1):349S-351S.

Kris-Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzare TL. AHA Science Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I Dietary Pattern on Cardiovascular Disease. Circulation. 2001;103:1823.

Kruger MC, Horrobin DF. Calcium metabolism, osteoporosis and essential fatty acids: a review. Prog Lipid Res. 1997;36:131-151.

Laugharne JD, Mellor JE, Peet M. Fatty acids and schizophrenia. Lipids. 1996;31(Suppl):S-163-165.

Mayser P, Mrowietz U, Arenberger P, Bartak P, Buchvald J, Christophers E, et al. Omega-3 fatty acid-based lipid infusion in patients with chronic plaque psoriasis: results of a double-blind, randomized, placebo controlled, multicenter trial. J Am Acad Dermatol. 1998;38(4):539-547.

Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr (Phila). 1987;26:406-411.

Nestel PJ, Pomeroy SE, Sasahara T, et al. Arterial compliance in obese subjects is improved with dietary plant n-3 fatty acid from flaxseed oil despite increased LDL oxidizability. Arterioscler Thromb Vasc Biol. July 1997;17(6):1163-1170.

Newcomer LM, King IB, Wicklund KG, Stanford JL. The association of fatty acids with prostate cancer risk. Prostate. 2001;47(4):262-268.

Okamoto M, Misunobu F, Ashida K, et al. Effects of dietary supplementation with n-3 fatty acids compared with n-6 fatty acids on bronchial asthma. Int Med. 2000;39(2):107-111.

Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study. BMJ. 2002;324(7335): 447-451.

Richardson AJ, Puri BK. The potential role of fatty acids in attention-deficit/hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids. 2000;63(1/2):79-87.

Romano C, Cucchiara S, Barabino A et al. Usefulness of omega-3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: A double-blind, randomized, placebo-controlled study. World J Gastroenterol. 2006;11:7118-21.

Seddon JM, Rosner B, Sperduto RD, Yannuzzi L, Haller JA, Blair NP, Willett W. Dietary fat and risk for advanced age-related macular degeneration. Arch Opthalmol. 2001;119(8):1191-1199.

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(30 Suppl):560S-569S.

Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Ruistad L, et al. Effect of dietary supplementation with very-long chain n-3 fatty acids in patients with psoriasis. N Engl J Med. 1993;328(25):1812-1816.

Stark KD, Park EJ, Maines VA, et al. Effect of fish-oil concentrate on serum lipids in postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-controlled, double blind trial. Am J Clin Nutr. 2000;72:389-394.

Stevens LJ, Zentall SS, Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids in boys with behavior, learning and health problems. Physiol Behav. 1996;59(4/5):915-920.

Stoll AL, Severus WE, Freeman MP, et al. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind placebo-controlled trial. Arch Gen Psychiatry. 1999:56(5):407-412.

Sundstrom B, Stalnacke K, Hagfors L et al. Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis. Scand J Rheumatol. 2006;35:359-62.

von Schacky C, Angere P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999;130:554-562.

Weinstock-Guttman B, Baier M, Park Y et al. Low fat dietary intervention with omega-3 fatty acid supplementation in multiple sclerosis patients. Prostaglandins Leukot Essent Fatty Acids. 2005;73:397-404.

Yosefy C, Viskoper JR, Laszt A, Priluk R, Guita E, Varon D, et al. The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids. 1999;61(2):83-87.

Yuen AW, Sander JW, Fluegel D et al. Omega-3 fatty acid supplementation in patients with chronic epilepsy: A randomized trial. Epilepsy Behav. 2005;7(2):253-8.