Krill Oil
Krill Oil
Generic Name
Krill Oil
Mechanism
- Phospholipid‑bound EPA/DHA → enhanced absorption via chylomicron formation, leading to higher circulating DHA/EPA than triglyceride‑based oils.
- EPA competes with arachidonic acid for cyclooxygenase and lipoxygenase enzymes → ↓ prostaglandin E₂ & leukotriene B₄, reducing inflammation.
- DHA incorporated into neuronal membranes → improves fluidity, supporting cognitive function and heart rate variability.
- Astaxanthin scavenges reactive oxygen species, protecting LDL and cellular lipids from oxidative stress.
Pharmacokinetics
| Parameter | Details |
| Absorption | 4–8 hours, maximal after a high‑fat meal; phospholipid form yields ~30–40 % higher bioavailability than triglyceride fish oils. |
| Distribution | Lipoprotein‑linked; high affinity for HDL, reducing VLDL‑associated secretion. |
| Metabolism | ω‑3 fatty acids → β‑oxidation in mitochondria; astaxanthin → hepatic conjugation (glucuronidation). |
| Elimination | Primarily via oxidation products; half‑life ≈ 5–7 days for EPA, 6–10 days for DHA. |
| Drug Interactions | Minimal; may augment anticoagulant effects of warfarin or antiplatelet agents when taken at high doses. |
Indications
- Hypertriglyceridemia – 0.5–1 g/day of krill oil reduces serum TG by ~30 %.
- CVD risk reduction – lowers LDL oxidation, improves endothelial function, and modestly reduces systolic/diastolic BP in statin‑treated patients.
- Arthritis/Inflammatory disorders – 0.5–1 g/day decreases inflammatory pain scores in knee OA and rheumatoid arthritis.
- Neurocognitive support – adjunctive therapy for mild cognitive impairment; DHA portion associates with reduced decline rates.
- Obesity & Metabolic syndrome – 1 g/day improves lipid profile and insulin sensitivity in overweight subjects.
Contraindications
- Allergy to krill or shellfish – avoid due to potential allergenicity.
- Bleeding disorders – may potentiate anticoagulant/antiplatelet therapy.
- Choledocholithiasis or biliary obstruction – high phospholipid load can precipitate biliary sludge.
- Pregnancy/Breastfeeding – data are limited; use only if benefits outweigh theoretical risks.
Warnings
• Gastrointestinal upset – oily texture can cause belching, diarrhea, or fishy aftertaste.
• Hemorrhagic risk – monitor PT/INR when combined with warfarin/APT.
• Quality control – ensure product is from reputable sources; batch testing for heavy metals & endotoxins is essential.
Dosing
| Condition | Dose (Daily) | Form | Notes |
| Hypertriglyceridemia | 1 g (0.5–1 g) | Softgel | Start low, titrate up; split dose with meals. |
| CVD prevention | 0.5 g | Softgel | Adjunct to statins; monitor lipids every 3 mo. |
| Inflammatory arthritis | 1 g | Softgel | Combine with NSAIDs cautiously. |
| Cognitive support | 0.5–0.75 g | Softgel | Long‑term use; assess cognition quarterly. |
• Administration – take with a high‑fat meal to maximize absorption.
• Compliance – use standardized capsule count; avoid extra doses above label.
Adverse Effects
Common (≤ 10 %)
• Fishy aftertaste
• Bloating / belching
• Diarrhea
• Mild headache
Serious (> 1 %)
• Bleeding/bruising (esp. in anticoagulant users) – high INR levels, epistaxis, GI hemorrhage.
• Severe hypersensitivity reactions (anaphylaxis, urticaria) in shellfish‑allergic patients.
• Hepatic enzyme elevation – rare; monitor LFTs if symptoms arise.
Monitoring
| Parameter | Frequency | Target |
| Serum triglycerides | Every 3 months | ≥ 25 % reduction or TG ≤ 150 mg/dL |
| Lipid panel (LDL, HDL, total) | Every 6 months | LDL ↓, HDL ↑ |
| INR/PT | Every 4 weeks (if on warfarin) | Within therapeutic range (2.0–3.0) |
| Liver enzymes | Every 6 months | < 2× ULN |
| Clinical assessment | Quarterly | GI tolerance, bleeding signs |
Clinical Pearls
1. Phospholipid Advantage – Krill oil’s EPA/DHA attached to phosphatidylcholine is a “pre‑activated” form that bypasses hepatic fatty‑acid synthase, driving faster serum enrichment vs triglyceride fish oil.
2. Astaxanthin Synergy – The natural antioxidant not only combats LDL oxidation but also boosts DHA incorporation into neuronal membranes, offering dual cardioprotective and neurocognitive benefits.
3. Dose Splitting – Splitting a 1 g dose into two 0.5 g capsules taken with breakfast and dinner improves GI tolerability and steady‑state plasma levels.
4. Combined Therapy – Use a modest krill oil dose (0.5–0.75 g) as an adjunct to statins; clinical studies show additive LDL‑lowering without augmenting statin‑induced myopathy.
5. Allergy Screening – Prior to initiation, screen for shellfish allergy; “krill” is a copepod but cross‑reactivity with shrimp, lobster, or clams has been reported.
6. Purity Matters – Look for certificates of analysis (COAs) confirming < 5 ppm heavy metals and 1 g/day) lack robust safety data; consult OB‑GYN for individualized risk assessment.
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• *This drug card is intended for educational use and should not replace individualized clinical judgement. For dosing adjustments or interactions with specific medications, consult up‑to‑date pharmacopeia resources.*