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Invisible endometriosis
Omega-3s: How to Choose and Find Them
In episode 9, Carole Minker explains what omega-3s are, why almost all of us are deficient, and how to choose a quality supplement.
Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
In this episode, Carole Minker explains why omega-3s are essential, particularly in endometriosis, where they've been mentioned in nearly every episode. You'll understand the difference between plant and animal omega-3s, where to find them in your diet, and above all, how to recognize a quality supplement in an industry where clear benchmarks are hard to find.
- The difference between plant-based omega-3s (ALA) and animal-based ones (EPA, DHA)
- Why eating flaxseed oil isn't enough
- The 4 criteria for choosing a quality omega-3 supplement
- The TOTOX index: what it is and why it matters
- Recommended dosages based on your situation
💡 Key figures
90% of the French population has an omega-3 deficiency (EPA + DHA), a figure that rises to 96% among 18-34 year-olds.
Source: ANSES, report on fatty acid intake in the French population, September 2015.
___
The omega-6 / omega-3 ratio in the French diet averages 11 to 1, while scientific recommendations suggest a ratio close to 1:1 to 4:1 maximum. More than 95% of the population significantly exceeds this threshold.
Source: ANSES / Simopoulos A., study on the omega-6/omega-3 ratio, 2010.
What are omega-3s, anyway?
Omega-3s are a type of lipid, meaning fat. They're polyunsaturated fatty acids, which means their structure is fragile and reactive. The further along the omega-3 chain you go, the more fragile the molecule becomes. That's what makes it valuable, but also hard to preserve.
There are two main families. Plant-based omega-3s, led by ALA, found in walnut and flaxseed oils. And long-chain omega-3s, EPA and DHA, found in animal and marine products. The problem: humans are very poor at converting plant-based omega-3s into EPA and DHA. That's the job of animals. Eating flaxseed oil is good, but it's not enough on its own.
Where to find them in your diet
The best sources of EPA and DHA are small oily fish: sardines, herring, mackerel. One tin once or twice a week is ideal. Eggs and meat from the Bleu-Blanc-Cœur label also provide animal omega-3s. Algae are an interesting exception in the plant world: they can produce long-chain omega-3s, but their iodine content can be high.
How to choose a good omega-3 supplement
When diet isn't enough, supplementation makes sense. But faced with the jungle of supplements out there, here are the key criteria to know.
The natural triglyceride form
In fish, omega-3s naturally occur as triglycerides. That's the form to look for in a supplement: as close as possible to what you'd get from eating fish. Some manufacturers put their oils through extra chemical steps, producing so-called ethyl ester or re-esterified forms. These forms are less natural and less well absorbed. This should normally be stated on the box.
The TOTOX index
This measures how oxidized the oil is. Omega-3s are fragile: an oil that's poorly extracted, stored, or packaged oxidizes, making it ineffective or even harmful. A rancid oil is an oxidized oil. The ideal TOTOX index is between 3 and 12. If a manufacturer doesn't mention this index or doesn't know what it is, that's already a red flag.
IFOS certification
IFOS stands for International Fish Oil Standards. It's an independent Canadian company that certifies fish oil quality on three points: that the actual EPA and DHA doses match what's stated, that the product is pure (no heavy metals or contaminants), and that the oil is fresh (verified oxidation level).
The Friend of the Sea label
This guarantees sustainable fishing, so our omega-3 needs don't come at the expense of the oceans.
The EPAX label: to be taken with a grain of salt
Often cited, this label was created by a private brand. Its criteria are less strict than IFOS and it can tolerate semi-synthetic forms. It's not a sufficient guarantee on its own.
Recommended dosages
For general maintenance, when you don't eat enough fish: 250 to 500 mg of EPA-DHA per day. For cardiovascular and mental health: 1 to 2 grams per day. For inflammatory conditions and pain, as in endometriosis: 1.5 to 3 grams per day.
Omega-3s should always be taken with a meal containing fat, never on an empty stomach. Evening is often recommended, but consistency matters most.
The omega-6 / omega-3 ratio
Taking omega-3s isn't enough if you're also consuming too many omega-6s. These are found everywhere in processed foods, deli meats, ready meals, and fried foods. To check your actual status, there's a blood test called an erythrocyte fatty acid panel. It measures the fatty acids present in red blood cells over the past three months.
🔎 Useful definitions
Triglycerides: the natural form in which omega-3s occur in fish. It's the ideal form to look for in a dietary supplement, as it's closest to what you'd get from eating fish directly.
___
TOTOX index: a measure of an oil's oxidation level. The lower it is, the better the quality and freshness of the oil. A TOTOX index between 3 and 12 is considered satisfactory for fish oil.
🎯 Practical actions
- Increase your intake of small oily fish. Sardines, herring, mackerel: one tin once or twice a week is a good starting point.
- Choose eggs and meat from the Bleu-Blanc-Cœur label to get animal omega-3s through your diet.
- If you supplement, check three things: the natural triglyceride form, a TOTOX index below 12, and IFOS certification if possible.
- Avoid supplements that don't mention their TOTOX index or don't know what it is.
- Reduce omega-6 intake at the same time. Fewer processed foods, deli meats, ready meals, and fried foods to rebalance your omega-6/omega-3 ratio.
- If you want to go further, ask your doctor for an erythrocyte fatty acid panel to find out your actual omega-3 status.
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
_____
⭐ La série Invisible endométriose est possible grâce à la participation de Norsan. L'épisode Bonus leur est dédié, et vous en apprendrez plus sur les Oméga 3 dans l'épisode 9. Norsan, entreprise spécialiste en production d'Oméga 3 depuis 2013 sont le plus grand distributeurs d'Oméga 3 en pharmacie car leur Oméga 3 naturels et de haute qualité font partie aujourd'hui des meilleurs Oméga 3 disponibles sur le marché.
What you will learn in this episode
In this episode, Carole Minker explains why omega-3s are essential, particularly in endometriosis, where they've been mentioned in nearly every episode. You'll understand the difference between plant and animal omega-3s, where to find them in your diet, and above all, how to recognize a quality supplement in an industry where clear benchmarks are hard to find.
- The difference between plant-based omega-3s (ALA) and animal-based ones (EPA, DHA)
- Why eating flaxseed oil isn't enough
- The 4 criteria for choosing a quality omega-3 supplement
- The TOTOX index: what it is and why it matters
- Recommended dosages based on your situation
💡 Key figures
90% of the French population has an omega-3 deficiency (EPA + DHA), a figure that rises to 96% among 18-34 year-olds.
Source: ANSES, report on fatty acid intake in the French population, September 2015.
___
The omega-6 / omega-3 ratio in the French diet averages 11 to 1, while scientific recommendations suggest a ratio close to 1:1 to 4:1 maximum. More than 95% of the population significantly exceeds this threshold.
Source: ANSES / Simopoulos A., study on the omega-6/omega-3 ratio, 2010.
What are omega-3s, anyway?
Omega-3s are a type of lipid, meaning fat. They're polyunsaturated fatty acids, which means their structure is fragile and reactive. The further along the omega-3 chain you go, the more fragile the molecule becomes. That's what makes it valuable, but also hard to preserve.
There are two main families. Plant-based omega-3s, led by ALA, found in walnut and flaxseed oils. And long-chain omega-3s, EPA and DHA, found in animal and marine products. The problem: humans are very poor at converting plant-based omega-3s into EPA and DHA. That's the job of animals. Eating flaxseed oil is good, but it's not enough on its own.
Where to find them in your diet
The best sources of EPA and DHA are small oily fish: sardines, herring, mackerel. One tin once or twice a week is ideal. Eggs and meat from the Bleu-Blanc-Cœur label also provide animal omega-3s. Algae are an interesting exception in the plant world: they can produce long-chain omega-3s, but their iodine content can be high.
How to choose a good omega-3 supplement
When diet isn't enough, supplementation makes sense. But faced with the jungle of supplements out there, here are the key criteria to know.
The natural triglyceride form
In fish, omega-3s naturally occur as triglycerides. That's the form to look for in a supplement: as close as possible to what you'd get from eating fish. Some manufacturers put their oils through extra chemical steps, producing so-called ethyl ester or re-esterified forms. These forms are less natural and less well absorbed. This should normally be stated on the box.
The TOTOX index
This measures how oxidized the oil is. Omega-3s are fragile: an oil that's poorly extracted, stored, or packaged oxidizes, making it ineffective or even harmful. A rancid oil is an oxidized oil. The ideal TOTOX index is between 3 and 12. If a manufacturer doesn't mention this index or doesn't know what it is, that's already a red flag.
IFOS certification
IFOS stands for International Fish Oil Standards. It's an independent Canadian company that certifies fish oil quality on three points: that the actual EPA and DHA doses match what's stated, that the product is pure (no heavy metals or contaminants), and that the oil is fresh (verified oxidation level).
The Friend of the Sea label
This guarantees sustainable fishing, so our omega-3 needs don't come at the expense of the oceans.
The EPAX label: to be taken with a grain of salt
Often cited, this label was created by a private brand. Its criteria are less strict than IFOS and it can tolerate semi-synthetic forms. It's not a sufficient guarantee on its own.
Recommended dosages
For general maintenance, when you don't eat enough fish: 250 to 500 mg of EPA-DHA per day. For cardiovascular and mental health: 1 to 2 grams per day. For inflammatory conditions and pain, as in endometriosis: 1.5 to 3 grams per day.
Omega-3s should always be taken with a meal containing fat, never on an empty stomach. Evening is often recommended, but consistency matters most.
The omega-6 / omega-3 ratio
Taking omega-3s isn't enough if you're also consuming too many omega-6s. These are found everywhere in processed foods, deli meats, ready meals, and fried foods. To check your actual status, there's a blood test called an erythrocyte fatty acid panel. It measures the fatty acids present in red blood cells over the past three months.
🎯 Concrete actions
- Increase your intake of small oily fish. Sardines, herring, mackerel: one tin once or twice a week is a good starting point.
- Choose eggs and meat from the Bleu-Blanc-Cœur label to get animal omega-3s through your diet.
- If you supplement, check three things: the natural triglyceride form, a TOTOX index below 12, and IFOS certification if possible.
- Avoid supplements that don't mention their TOTOX index or don't know what it is.
- Reduce omega-6 intake at the same time. Fewer processed foods, deli meats, ready meals, and fried foods to rebalance your omega-6/omega-3 ratio.
- If you want to go further, ask your doctor for an erythrocyte fatty acid panel to find out your actual omega-3 status.
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