Published in Nutrients, researchers at Warsaw University of Life Sciences, Poland, conducted a 12-week randomized study involving 56 women with endometriosis. Participants followed either a standardized healthy diet alone or the same diet supplemented with the fish-derived lipid formulation.
The study was supported by Marinex International, which supplied the intervention product Biomarine Medical Immuno & Neuro Lipids, a supplement containing fish-derived fatty acids, alkylglycerols, squalene and vitamins A and D3.
Researchers assessed participants’ inflammatory markers, gut inflammation, pain, and quality of life (QOL), with resulting data indicating a modest improvement in pain and QOL in the supplemented group.
But effects appeared to be context-dependent, suggesting “immune re-balancing rather than generalized immuno-suppression”, according to the authors.
“Collectively, these findings support a cautious interpretation that increased IL-10 may reflect regulatory adaptation even when changes in canonical pro-inflammatory cytokines are heterogeneous,” the report said.
Authors noted a lack of consistent reductions in circulating pro-inflammatory cytokines, and improvements in VAS and EHP-30 were small at the group level but heterogeneous across participants.
They concluded the results underscore the need for larger, adequately powered trials with mechanistic endpoints to clarify pathways and identify responders most likely to benefit.
Nutritional intervention
Affecting around one in ten women of reproductive age, endometriosis is a chronic inflammatory condition in which tissue similar to the uterine lining grows outside the uterus, causing pain, immune dysregulation and reduced quality of life.
Current clinical management relies primarily on pharmacologic and surgical interventions, with hormonal therapies remaining central for symptom control. But diet is increasingly discussed as an adjunct strategy that may influence relevant endocrine and inflammatory pathways.
The Biomarine Medical product studied is a complex mixture of approximately 500 bioactive lipids, including n-3, n-9, and n-11 fatty acids, alkylglycerols, squalene, plus vitamins A and D3. EPA and DHA are widely recognized for immunomodulatory actions with squalene and alkylglycerols also reported to affect inflammatory responses in experimental contexts.
Methodology
In the prospective, two-arm, parallel, controlled dietary intervention study, researchers enrolled a total of 56 women aged 22–48 years with a confirmed diagnosis of endometriosis.
Forty-six participants completed the full 12-week intervention.
Data such as age, address, education, physical activity level, medical history, dietary habits, and supplement use were collected.
Women who met the inclusion criteria and provided written informed consent were enrolled in the study and randomly assigned to the control group (CG; n = 23) or the intervention group (IG; n = 23). Randomization was stratified by BMI value.
Women in the CG followed the Polish Healthy Eating Plate diet, while the IG followed the same diet plus FDL supplementation at a dose of 0.5 mL/kg body weight/day (split into two doses across the day). Both groups received individualized dietary counselling based on the Polish Healthy Eating Plate model.
Adherence to dietary recommendations and supplementation was monitored using three-day food records. Mean daily energy and nutrient intake was calculated at baseline (T0) and after intervention (T2).
Measures included anthropometric measurements and body composition at baseline, plus biochemical assessments via blood and fecal samples (analyzed for circulating cytokines and fecal calprotectin) at T0 and T2.
The quality of life of the women was assessed using the EHP-30 questionnaire devoted to measuring QOL in endometriosis. Intensity of pain was measured using the VAS scale.
Reduction in pain
Resulting data indicated FDL supplementation was associated with a selective immunological response, mainly reflected by a significant adjusted between-group effect for serum IL-10.
Other inflammatory biomarkers, including IL-1β, IL-6, IL-8, TNF-α, and fecal CAL, did not demonstrate consistent significant between-group effects.
New endometriosis tests to speed up diagnoses
The UK's National Health Service (NHS) has this month approved two new non-invasive tests—a saliva genetic test and a gut sensor-pad test—for endometriosis, in an effort to reduce delays to diagnosis.
Dr Nagi Rostom, fertility consultant at CREATE Fertility clinic, London, welcomed the news and said many women with the condition spend close to a decade living with symptoms before receiving answers.
“During that time, many are repeatedly told their pain is normal or are treated for other conditions before endometriosis is even considered,” he said. ”The prospect of having reliable, non-invasive tests available in primary care could help shorten that journey considerably.”
He noted the update reflects a wider shift in women’s healthcare.
“The fact that NICE is now supporting innovative diagnostic technologies reflects growing recognition that women deserve faster answers and earlier intervention.”
Similarly, although within-group changes in pain-related outcomes were observed, adjusted between-group analyses did not confirm a significant effect on VAS pain intensity or EHP-30 domains.
However, a ≥1-point reduction in VAS pain intensity was noticed more frequently in the IG than in the CG. This finding may suggest a potential clinically relevant signal.
The intervention increased not only EPA/DHA but also other constituents of fish-derived lipids, including squalene and alkylglycerols.
Regarding possible MOA, the report noted experimental data suggests squalene can modulate macrophage responses and NF-κB-related pathways and may influence anti-inflammatory outputs. While alkylglycerols have been linked to ether lipid remodeling and changes in inflammatory mediator profiles.
The authors concluded the results should be interpreted with caution and confirmed in larger studies with longer intervention time, taking into account the potential mechanisms of biological response.
Source: Nutrients, 2026, 18(13), 2184; https://doi.org/10.3390/nu18132184, “Effect of Fish-Derived Lipids on Inflammation Status and Health-Related Quality of Life in Women with Endometriosis”, Authors: Bogusz, A., Szewczyk, K., et al
