Q: A doctor advised me to take fish oil supplements to improve my cholesterol level. But the source of fish oil in many preparations includes sardines, trout and herring – fish that are high in purines and on the list of foods I should avoid because I have gout. How much purine is in fish oil supplements? Should I take them or not? 

A: Purines are found in the meat of the fish but not in highly purified, molecularly distilled fish oil, so it should not affect your gout. I recommend everyone consume at least 2,000 milligrams (mg) per day of EPA and DHA (two fatty acids in fish oil crucial to human health). Those with autoimmune disorders and arthritis should consume 3,000 to 6,000 mg in divided doses with meals. 

Buy only pharmaceutical-grade, molecularly distilled fish oil supplements. And go to the supplement company’s Web site and make sure you research what you’re getting. Also, know that using fish oil supplements to bring down your cholesterol level may thin your blood. If you have any bleeding disorders or already are taking medications to thin your blood, such as clopidogrel (Plavix) or warfarin (Coumadin), please talk to your doctor.

James McKoy, MD, Rheumatologist