Updated one FAQ
We updated the FAQ "Can I eat flax seeds instead of fish or fish oil for omega-3s?"
Fish oil is a source of omega-3 fatty acids. It reduces triglycerides, but does not seem to affect the rate of cardiovascular events. It seems to notably reduce the symptoms of depression and improve some painful, inflammatory conditions.
Fish Oil is most often used for
Last Updated:December 18, 2023
Fish oil is the go-to source for two long-chain omega-3 (a.k.a. n-3) polyunsaturated fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fish oil can be consumed in the diet (from foods like salmon or anchovies), and is also available as a dietary supplement and as a prescription drug. The role of fish oil in cardiovascular disease, cancer, and many other conditions is a field of considerable interest and research.[1]
According to recent analyses of NHANES, over 20% of the population in the United States takes an omega-3-containing dietary supplement.[2]
Fish oil is best known for its ability to reduce triglyceride levels in the blood, for which prescription fish oil is best studied.[3] Fish oil also seems to modestly reduce blood pressure, especially in people with hypertension.[4] Despite this, a meta-analysis of large clinical trials shows that taking fish oil for at least 1 year does not reduce the rate of cardiovascular events.[5] Most analyses suggest a modest benefit of fish oil for depression,[6][7][8][9] but this benefit may be too small to make a difference in people with major depressive disorder.[8][10] Limited evidence suggests that fish oil may have some benefit for inflammatory conditions like systemic lupus erythematosus and rheumatoid arthritis.[11]
Fish oil is usually well-tolerated and safe. Common side effects from taking fish oil supplements include stomach pain, fishy breath and burps, heartburn, nausea, and diarrhea. Also, some fish oil formulations have been linked to increased levels of low-density lipoprotein (LDL) cholesterol. Fish oil supplements are not strictly regulated, and some may contain contaminants, oxidized fatty acids, saturated fats, and other impurities that may reduce the overall benefit of the supplement. Fish oil has antiplatelet effects, although most clinical research has not found that supplementation with fish oil increased bleeding risk. A large 5-year study in Japan did find a small increase in bleeding in people taking prescription eicosapentaenoic acid (EPA), though.[3]
Fish oil reduces triglyceride levels by decreasing triglyceride-rich lipoprotein synthesis and release by the liver. It may also increase clearance of triglycerides by upregulating the lipoprotein lipase enzyme.[3] EPA and DHA from fish oil are usually initially incorporated into the phospholipid layer of cell membranes in platelets, neutrophils, and red blood cells. EPA especially seems to stabilize cell membranes and inhibit lipid oxidation, which can help regulate vascular tone, improve cell signaling, and reduce inflammation.[12]
Fish oil doses vary depending on the goal of supplementation. For general health, 250 mg of combined EPA and DHA is the minimum dose and can be obtained via fish intake. The American Heart Association recommends 1 g daily.
Since fish oil is a combination of two different fatty acids, these numbers reflect a combined total. Total eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) consumption should come from a mix of real food and supplements. The more EPA and DHA is provided by the diet, the less supplementation is required.
Fish oil can be taken throughout the day. To minimize the "fish burp" taste, take fish oil with meals.
Pregnant women should increase their intake of DHA by at least 200mg a day, as long as there is no risk of elevated mercury levels.
Updated one FAQ
We updated the FAQ "Can I eat flax seeds instead of fish or fish oil for omega-3s?"
Full page update
We updated our FAQs and database with the newest meta-analyses.
Major FAQ and database update
We updated our FAQs and database with all the meta-analyses that have been published in the last several years.
The information in this section is slated for renovation — it will soon be transformed into a more usable (and readable!) form in the coming months. As such, the text in this section may be out of date and not up to Examine’s current standards for writing style.