The short answer, without question is fish oil. We have found better results by eliminating the flax seed oil and greatly increasing the EPA and DHA (we like 2000 mg to 3000 mg of EPA and DHA combined). Flax seed oil is very unstable and thus has a short shelf life at room temperature. Flax seed oil also does not contain omega 3 fatty acids, instead our bodies must convert the ALA (alpha linolenic acid) contained within the flax seed into the omega 3 fatty acids that can then be used by our bodies. Another disadvantage to flax seed oil is that our body’s conversion of flax seed oil to EPA or DHA is very inefficient. The conversion ALA to EPA/DHA rate has been reported to be between 4% and 15% (worse for DHA than EPA and lower for men than women). A person’s conversion rate can vary based on many factors. Therefore, fish is a much better and efficient source of omega 3 fatty acids.
This article is the third in the four part series on using omega 3 fatty acids in treating dry eye syndrome