WHAT DOES A COD LIVER OIL SOFT GEL CAPSULE CONTAIN?
A. CARLSON COD LIVER OIL
From the product label of regular Carlson Cod Liver Oil, 1 serving (1 soft gel) contains 1 g of total fat, 4 mg of
cholesterol, 2000 IU of vitamin A (from cod liver oil), 250 IU of vitamin D (from cod liver oil), 10 IU of vitamin E[C Natural
(d-Alpha Tocopherol), 240 mg of omega-3 fatty acids (from cod liver oil), 90 mg of eicosapentaenoic acid, 120 mg of
docosahexaenoic acid), 20 mg of ALA (alpha-linolenic acid) and 10 mg of DPA (Docosapentaenoic acid).
B. SEVEN SEAS ONE-A-DAY Standard - COD LIVER OIL
Based on the Seven Seas' Ad (September 20, 2005), the standard strength (525 mg) of pure cod liver oil contains 525
mg of pure cod liver oil, 120 mg of omega 3 nutrients, 83.2 mg of which EPA and DHA, 800 ug of Vitamin A, 2.5 ug of
Vitamin D, 0.33 mg of Vitamin E. Other ingredients include capsule shell (modified maize starch, glycerol, gelling agent:
carrageenan, acidity regulator: disodium phosphate), Vitamin A (as Palmitate prep), Vitamin D3 (as D3 prep), Vitamin E
(d Alpha Tocopheryl Acetate). They recommend to take one capsule with liquid each day.
C. NORDIC NATURALS ARCTIC COD LIVER OIL PEACH 90 SOFTGELS
(Based on the Ad, September 20 2005) The serving size for this product is two softgels. Each container has 45
servings. Each serving contains 2 g of total fat, 0.4 g of saturated fat, 5 mg of cholesterol, 350-780 IU of vitamin A,
2-16 IU of Vitamin D, 33 IU of Vitamin E, 280 mg of docosahexaenoic acid (DHA), 180 mg of ecosapentaenoic acid
(EPA) and 100 mg of other omega-3. Other ingredients include gelatin, water, glycerin and natural peach essence.
They suggest to take two softgels daily with meals.
D. ICELAND HEALTH REGULAR STRENGTH OMEGA-3 - COD LIVER OIL
Based on its label, the recommended dose for adult is 3 softgels per day. Each serving contains 5 I.U. of Vitamin E,
504 mg of omega-3 fatty acids (252 mg of Ecosapentaenoic acid (EPA), 168 mg of Eocosahexaenoic acid (DHA) and
84 mg of other omega-3 fatty acids).
E. SPECTRUM ESSENTIALS NORWEGIAN COD LIVER OIL WITH LEMON
According to its advertisement, this product is molecularly distilled. It contains on mercury PCBs or lead. This cod liver
oil product is tested by a 3rd party. The serving size is 5 ml , containing 4.5 g of total fat, 940-2350 IU of Vitamin A,
0-19 IU of Vitamin D, 0-1 IU of Vitamin E, 540 mg of docosahexaenoic acid, 340 mg of eicosapentaenoic acid, 300 mg
of other omega-3, 120 mg of omega-6, 1,100 mg of oleic acid. However, this product also contains 25 mg of
cholesterol.
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                                            Cod Liver Oil Vs Fish Oil

The manufacturing process of cod liver oil is similar to that for fish oil, while the raw material for cod liver oil is cod liver,
the raw material for fish oil is whole fish. The types of omega-3 oils are the same for both products. However, more
contaminants may be present in the cod liver oil supplements, however, it also depends on the manufacturing process.
The excessive amount of vitamin A and D may offer side effects. Do not overdose yourself with cod liver oil.
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Conclusion
1. Intake of cod liver oil provides multiple health benefits.
2. Compared to fish oil, cod liver oil provides extra benefits, due to the presence of vitamins A and D.
3. Users should not overdose themselves with cod liver oil, because vitamins A and D are fat-soluble. Intake of large
amounts of vitamins A and D may lead to toxic levels.

REFERENCES
[A1] Rajakumar K et al Reemerging nutritional rickets: a historical perspective. Arch Pediatr Adolesc Med 2005 Apr; 159(4):335-41. [A2}
Barker ME et al, Serum retinoids and beta caroteneas predictors of hip and other fractures in elderly women. J Bone Miner Res. 2005
Jun;20(6):913-20 Epub 2005 Jan 24. [1] Effect of cod liver oil on symptoms of rheumatoid arthritis. Adv. Ther. 2002 Mar-Apr.19(2):101-7.
Study Preparation. [2] Formation of genotoxic dicarbonyl compounds in dietary oils upon oxidation, Lipids. 2004 May;39(5):481-6. [3] Curtis
CL et al Biological basis for the benefit of nutraceutical supplementation e.g. cod liver oil in arthritis. Drug Discov Today. 2004 April
1;9(7):336. [4] Effect of cod liver oil on symptoms of rheumatoid arthritis, Adv Ther. 2002 Mar-Apr; 19*2):101-7.[5] Relationship between
dietary intake of cod liver oil in early pregnancy and birthweight. BJOG.2005 April; 112(4):424-9.[6] Maternal supplementation with
very-long-chain n-3 acids during pregnancy and lactation augments children's IQ at 4 years of age. Helland et al, University of Oslo,
Norway, Pediatrics, 2003 Jan; 111(1):e39-44].[6] Differential effects of fish oil and folic acid supplementation during pregnancy in rats on
cognitive performance and serum glucose in their offspring. Joshi et al, Agharkar Research Institute, India. Nutrition. 2004
May;20(5):465-72.][7] Use of cod liver oil during pregnancy assoicated with lower risk of childhood-onset type 1 diabetes in the offspring.
Stene et al, National Institute of Public Health, Norway. Diabetologia 2000 Sep;43(9):1093-8.][8] Nutritional supplements as adjunctive
therapy for children with chronic/recurrent sinusitis: pilot research. Linday et al, Iona College, USA, Int J Pediatr Otorhinolaryngol 2004
Jun;68(6):785-93  [9] Effect of daily cod liver oil and multivitamin-mineral supplement with selenium on upper respiratory tract pediatric
visits by young, inner-city, Latino children: randomized pediatric sites. Ann Otol Rhinol Laryngol. 2004 Nov;113(11):891-901.[10] Whiting
SJ et al, Dietary recommendations for vitamin D: a critical need for functional end points to establish an estimated average requirement. J.
Nutr. 2005 Feb;135(2):304-9.[11] .Rajakumar K. et al, Reemerging nutritional rickets: a historical perspective. Arch pediatr Adolesc med.
2005 Apri., 159(4):335-41.[12] Use of cod liver oil during the first year of life is assoicated with lower risk of childhood-onset type 1
diabetes: a large, population-based, case-control study. Stene et al, Ulleval University Hospital, Norway. Am J Clin Nutr: 2004 May;
79(5):889-90; author reply 890.][13]Vitamin D has anti-cancer properties. Earthtimes.org. May 23 2005.[14] [Effect of cod liver oil on tissue
antioxidant pathways in normal and streptozotocin-diabetic rats. Hunkar et al. Cell Biochem Funct. 2002 Dec;20(4)297-302.]  [15] [Can
vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. Meyer et al, J Bone Miner Res. 2002
Apr,17(4):709-15.[16]  [Does dietary supplementation of cod liver mitigate musculoskeletal pain? Erksen et al, University of Oslo, Norway.
Eur J Clin Nutr. 1996 Oct;50(10):689-93.  [17] Long-term effect of eicosapentaenoic acid ethyl (EPA-E) on albuminuria of non-insulin
dependent diabetic patients. Shimizu et al, Gunma University, Japan. Diabetes Res Clin Pract. 1995 Apr;28(1):35-40.][18][Effect of fish oil
and sunflower oil supplementations on gentamicin-induced nephrotoxicity in rat. Abdel-Gayoum et al, Al-Arab Medical University, Libya,
Hum Exp Toxicol. 1995 Nov;14(11):884-8]. [19] Effects of dietary lipids on daunomycin-induced nephropathy in mice: comparison between
cod liver oil and soybean oil. Lipids 2002. April; 37(4):359-66.[20]  [Fish oil improves endothelium-dependent coronary vasodilation in
heart transplant recipients. Fleischhauer et al, Stanford University, California. J Am Coll Cardiol. 1993 Mar 15;21(4):992-9].[21] [Cod liver
oil alters platelet-arterial wall response to injury in pigs. Lam et al, Mayo Clinic, Minn. Circ Res. 1992 Oct,71(4):769-7 [22] J Allergy Cli Imm
Dec., 2003;112(6):1178-84. RECOMMENDED RESEARCH ARTICLES [1] Relationship between dietary intake of cod liver oil in early
pregnancy and birthweight. Olafsdottir AS et al, BJOG. 2005 Apr;112(4):424-9. [2] On call I was impressed by your July 2004 article on fish
oil, and I'm thinking of taking it. I remember that my mother gave me a spoonful of cod liver oil every day. Would it be a good thing for me to
have today? Simon HB. Harv Mens Health Watch. 2005 Jan;9(6):8. [3] Cod and the consumptive: abrief history of cod-liver oil in the
treatment of pulmonary tuberculosis. Grad R. , Pharm. Hist. 2004; 46(3):106-20. [5] Effect of daily cod liver oil and a multivitamin-mineral
supplement with selenium on upper respiratory tract pediatric visits by young, inner-city, Latino children: randomized pediatric sites.
Linday LA et al, Ann Otol Rhinol Laryngol. 2004 Nov;113(11):891-901. [6] Polychlorinated biphenyls, hexachlorobenzene,
hexachlorocyclohexane isomers, and pesticide organochlorine residues in cod-liver oil dietary supplements. Storelli MM et al, J. Food
Prot. 2004 Aug;67(8):1767-91. [7] Predictors for cod-liver oil supplement use--the Norwegian Women and Cancer Study. Brustad M. et al,
Eur J Clin Nutr. 2004 jan;58(1):128-36.[X1] Ziemlanski S et al, Effect of dietary fats on experimental hypertension. Ann Nutr Metab.
1985;29(4):223-31. [X2] Lorenz R et al, Platelet function, thromboxane formation and blood pressure control during supplementation of
the Western diet with cod liver oil. Circulation. 1983 Mar;67(3):504-11. [X3] Hermida RC et al, Administration time-dependent effects of
aspirin on blood pressure in untreated hypertensive patients. Hypertension. 2003 Jun;41(6):1259-67. Epub 2003 May 5. [X4] Hirschowitz
BI et al, Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse. J Clin Gastroenterol. 2002
May-Jun;34(5):523-8. [X5] Lanza FL  A review of gastric ulcer and gastroduodenal injury in normal volunteers receiving aspirin and other
non-steroidal anti-inflammatory drugs. Scand J Gastroenterol Suppl. 1989;163:24-31. [X7] Olafsson SO Dietary cod liver oil decreases
arachidonic acid in rat gastric mucosa and increases stress-induced gastric erosions. Lipids. 2000 Jun;35(6):601-5. [X8] Moselhy SS et
al, Modulatory effect of cod liver oil on bone mineralization in overiectomized female Sprague Dawley rats. Toxicol Ind Health. 2011 Oct 27.
[X9] Dyck MC et al, The anticancer effects of Vitamin D and omega-3 PUFAs in combination via cod-liver oil: one plus one may equal more
than two. Med Hypotheses. 2011 Sep;77(3):326-32. [X10] Kristinsdottir H, et al, Rickets in a child Laeknabladid. 2011 Sep;97(9):477-80.
[X11] Trofimiuk E,Long-term administration of cod liver oil ameliorates cognitive impairment induced by chronic stress in rats. Lipids.
2011 May;46(5):417-23 [X12] McDowell TY, et al Sun exposure, vitamin D and age at disease onset in relapsing multiple sclerosis.
Neuroepidemiology. 2011;36(1):39-45. [X13] Kumosani TA et al, Modulatory effect of cod-liver oil on Na(+)-K(+) ATPase in rats' brain. Hum
Exp Toxicol. 2011 Apr;30(4):267-74. [X14] Khare S, et al, Antiulcer activity of cod liver oil in rats. Indian J Pharmacol. 2008 Oct;40(5):209-14
[AA1] Salama MF, et al, Hepatoprotective effects of cod liver oil against sodium nitrite toxicity in rats. Pharm Biol. 2013 Jul 18. [AA2] Mai XM,
et al, Cod liver oil intake and incidence of asthma in Norwegian adults--the HUNT study. Thorax. 2013 Jan;68(1):25-30. [AA3] Moselhy SS
et al, Modulatory effect of cod liver oil on bone mineralization in overiectomized female Sprague Dawley rats Toxicol Ind Health. 2012
Jun;28(5):387-92.
BENEFITS OF COD LIVER OIL
cod liver oil side effects   cod liver oil Vs fish oil         August 15, 2013              
Zhio.com discusses the benefits and side effects of various supplements, herbs and drug products. Different people
may experience different side effects and benefits of a cod liver oil product. You are encouraged to report adverse side
effects of cod liver oil to FDA, its website is www.fda.gov., or report the adverse side effects of cod liver oil to the
manufacturer, you should be able to find the contact information on the label.

There are always new information. Please, send me an email (zhion@zhion.com) to correct my mistake(s). Reasonable
care has been taken in preparing this document and the information provided herein is believed to be accurate. The
information is not intended to be a substitute for professional medical advice. It is important to seek the advice of a
physician about any medical condition or symptom or the benefits and side effects of a cod liver oil supplement or
product. Finally, please, do not transfer the article to other website(s). Thank you. ALL RIGHTS RESERVED.
COD LIVER OIL REVIEWS
Cod liver oil is an oil extracted from cod livers. It was once a popular nutrititonal supplement for children, as it the cooked livers to extract the oil,
while, fish oils are extracted from the cooked whole body tissues of fatty fish. Though cod liver oil and fish oils are similar, cod liver oil contains
much more vitamins A and D per unit weight than regular fish oil. Thus, cod liver oil can provide extra health benefits to the users, such as
prevention of rickets in infants. On the other hand, users should not overdose themselves with cod liver oil, as high levels of vitamins A and D are
toxic. A high quality cod liver oil is pale-yellow, thin, oily liquid with fishy taste.

Cod liver oil is a drug as well as food since it is recognized in the United States Pharmacopeia (USP). According to USP XXII, cod liver oil is the
partially destearinated fixed oil obtained from fresh livers of Gadus morrhua Linne and other species of Fam. Gadidae. Cod liver oil cotains, in each
g, not less than 255 ug of vitamin A and not less than 2.125 ug of vitamin D. Cod liver oil may be flavored by the addition of less than 1% of a
suitable flavor or a mixture of flavors.
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COD LIVER OIL HEALTH BENEFITS AND SIDE EFFECTS

HEALTH BENEFITS OF COD LIVER OIL

Arthritis
Cod liver oil has been demonstrated in several studies that mimic cartilage destruction in arthritic disease. [3] Forty three patients with rheumatoid
arthritis took 1g of cod liver oil daily for 3 months. They found Improvement in morning stiffness, painful and swollen joints. Ratings of "good" or
"very good" were awarded by 68% of the patients for cod liver oil efficacy and by 95% for cod liver oil tolerability. Eleven patients reported non
severe adverse side effects during the course of taking cod liver oil.[4] Thus, it is believed that cod liver oil supplementation benefit people suffered
from arthritis.

Cancer
Vitamin D was reported to help ward off many types of cancer, such as lymphoma, prostate, lung and skin cancers. [13] Supplementation of Vitamin
D and omega-3 PUFA via cod-liver oil may have additive and possibly synergistic anticancer effects. [X9]

Cholesterol and Cardiovascular Events
Researchers successfully decreased serum cholesterol, low density lipoprotein cholesterol and triglycerides in18 normolipemic pigs with cod liver
oil. Endothelium-dependent Coronary Vasodilation In a study of a group known to have coronary artery disease and endothelial dysfunction, dietary
fish oil supplementation enhanced endothelium-mediated vasodilator responses in human heart transplant recipients. [20] Well, cod liver oil
supplement may benefit people suffered from high cholesterol and possibly at risk of cardiovascular events. But, more studies are needed to
support this health benefit claim.

Cognitive Impairment
The active constituents of cod liver oil alleviate the negative impact of prolonged restraint stress on cognitive functions of male Wistar rats.In a
study, administration statistically significantly prevented the deleterious effects of chronic restraint stress on recall and the spatial memory. [X11]
Thus, cod liver oil may benefit people at risk of memory issues.

Diabetes Mellitus
It is generally believed that cod liver oil benefits people suffered from diabetes in various aspects. Lipid disorders and increased oxidative stress
may exacerbate some complications of diabetes mellitus. Some ingredients in cod liver oil such as antioxidants, PUFAs, EPA and DHA may help
protect the cells from the destructive effect of increased lipids and lipid peroxidation products.

Diabetic rats were divided randomly into two groups as untreated or treated with cod liver oil for 12 weeks. Plasma glucose, triacylglycerol and
cholesterol levels were significantly elevated in the untreated rats. Cod liver oil treatment provided a better control on lipid and glucose metabolism.
Cod liver oil also provided better weight gain in diabetic rats. [14]

Fracture
Cod liver oil may benefit older people at risk of fracture. Combination of vitamin D and calcium may prevent fragility fracture in elderly. [15]
Multivitamin or cod liver oil supplementation was found to be associated with a significantly lower risk of any fracture in a study of older women. [A2]

Liver Issues
Exposure to high levels of nitrites for a prolonged time have adverse health effects on the liver due to oxidative properties. In a study, 32 rats were
daily treated with sodium nitrite in presence or absence of cod liver oil. Liver damage is characterized with a change in cell appearance and
elevated of enzymes. Researchers found a significant reduction of elevated liver enzymes and normal appearance of hepatocytes in presence of
cod liver oil. [AA1] Thus, cod liver oil may benefit people at risk of certain liver issues.

Musculoskeletal Pain
Study of 4490 cases from the Norwegian Health Survey demonstrated that people with mucoloskeletal pain experienced less pain if they took cod
liver oil. [16] Actually, the scientific support for this health benefit claim is insufficient, but, some people take cod liver oil just for their muscle pain.
Multiple Sclerosis (MS)
In a study, among veterans with relapsing multiple sclerosis who resided in low-to-medium solar radiation areas, low sun
exposure in the fall/winter during the ages of 6-15 years was significantly associated with earlier symptom onset by 2.1
years. Intake of cod liver oil during the same age period was associated with later onset of MS symptoms by 4 years
[X12] Not sure how cod liver oil benefits older people with MS.

Nephrotoxicity
Cod liver oil showed benefits for animals on drug treatment by amelorating the drug-induced nephrotoxicity. In a study,
cod-liver oil helped improvement on microvascular albumin leakage in diabetic patients with albuminuria.[17]. Oral
supplementation with fish oil prior to and during gentamicin exposure could markedly ameliorate the drug induced
nephrotoxicity. [18] Cod liver oil was also shown to protect the mice from daunomycin-induced nephropathy by inhibiting
oxidative damage. Dietary cod liver oil significantly reduced urinary albumin excretion and ameliorated the histological
changes induced by daunomycin. Compared to soybean oil(SO)-fed mice, the increase of tissue lipid peroxide levels
was suppressed in cod liver oil-fed mice. Cod liver oil-fed mice showed higher GSH levels than SO-fed mice throughout
the experiment. [19]

Osteoporosis
The risk of osteoporosis increased in postmenopausal women due to decline in estrogen levels. Replicable hormone
therapy is associated with undesirable side effects. In a study, the effect of cod liver oil was tested in the prevention of
bone loss in the ovariectomized (OVX) female rats. One group of OVX rats received an estrogen implantation at the time
of operation and the second group was supplemented orally with cod liver oil (dosage 200 μl/kg body weight) daily for 8
weeks. It was found that estrogen implantation as well as cod liver oil supplementation in OVX rats increased the calcium
level in femur. Thus, cod liver oil may benefits postmenopausal women at risk of osteoporosis. [AA3]

Psychiatric Disorders
Omega-3 fatty acids were used in the treatment of psychiatric diseases such as bipolar disorder. Na(+), K(+)-ATPase is
also a well-known target for these fatty acids. Cod liver oil, DHA or EPA supplementation had a beneficial effect that
associated with a normalization of fatty acids incorporation into phospholipid membranes and a partial restoration of Na
(+), K(+)-ATPase activity, suggesting that cod liver oil supplementation may improve fatty acid composition and
moderately enhance Na(+), K(+)-ATPase activity. [X13]

Rickets
Vitamin D is necessary for normal bone growth. Deficiency of vitamin D can lead to rickets in children and osteomalacia
in adults. It is difficult to reach the recommended daily dose of vitamin D in children without cod liver oil or other vitamin
D supplementation. [X10] Definitely, intake of cod liver oil has the benefits of preventing rickets to a certain extent.

Ulcer
Cod liver oil increases healing of gastric ulcers and prevents the development of experimentally induced gastric and
duodenal ulcers in rats. Thus, intake of cod liver oil may offer benefit of GI protection from ulcer. [X14]
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Maternal intake of cod liver oil benefits on newborns.
Maternal intake of cod liver oil early in pregnancy was associated with a higher birthweight. Higher birthweight always indicates a lower risk of
diseases later in life. [5] In addition, a study has shown that taking fish oil supplements during pregnancy may help prevent allergies in babies born
to women with a history of hay fever or asthma. In this study, the women took four capsules a day from the 20th week of pregnancy until delivery.
The researchers found that babies' immune cells has less reaction to allergic substances. [22]

A study shows that maternal intake of very-long-chain n-3 polyunsaturated fatty acids (cod liver oil) during pregnancy and lactation may be
favorable for later mental development of children. [6] A study of rats has demonstrated that fish oil supplementation during pregnancy improved
cognitive performance and maintained glucose levels into adulthood. [6] Cod liver oil taken during pregnancy was found to associate with reduced
risk of Type I diabetes [ a survey (85 diabetic subjects and 1,071 controls]. [7]

Cod liver oil benefits on young children.
The amount of vitamin D activity in a teaspoon of cod liver oil was sufficient to prevent rickets in infants. [10] In a study, cod liver oil prevented the
development of rickets in 34 (92%) of 37 infants treated for 6 months. [11] In another study of 65 infants, daily cod liver oil prevented the
development of rickets in 34 of 37 infants treated for 6 months. [A1]

In a study, cod liver oil together with multivitamin-mineral and selenium was effective in chronic/recurrent sinusitis (children). [1] In this study, the
cod liver oil was well-acceptable to the children. [8] Children received 1 teaspoon of cod liver oil per day and one half-tablet of multivitamin-mineral
had a statistically significant decrease in the mean number of clinical visits (for upper respiratory tract} over time, while the control group had no
change in this parameter. The cod liver oil was well tolerated, per parental report, 70%of children completed the 5-6 month course of cod liver oil.
[9] A study of 545 childhood-onset type 1 diabetes and 1668 population control subjects in Norway shows the use of cod liver oil in the first year of
life associated with a significantly lower risk of type 1 diabetes. [12]
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COD LIVER OIL SIDE EFFECTS
A study shows that high doses of cod liver oil may increase blood pressure! This can be a serious cod liver oil side effect. Side effects of cod liver
oil can be serious, especially compared with NSAIDs. Cod liver oil has been demonstrated to have blood pressure lowering activities in animal
studies. Another serious side effect can be related to gastric erosion. [Cod Liver Oil Side Effects]

A recent study shows a positive association of cod liver oil intake with incident asthma. This study involves a total of 25 616 Norwegian adults aged
19-55 years were followed up from 1995-1997 to 2006-2008. Thus, asthma could be a cod liver oil side effect for certain people. [AA2] The authors
explain that cod liver oil formula in Norway contained a high concentration of vitamin A, and High vitamin A status is associated with increased risks
of several chronic diseases, including asthma. Thus, readers should check the vitamin A content on the product label before taking a cod liver oil
supplement.
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