Home
Scan
Ask
Protocols
Profile
All Ingredients
STRONG EVIDENCE

Omega-3 (Fish Oil)

Essential fatty acids with strong evidence for cardiovascular health and inflammation reduction. EPA and DHA are the bioactive forms, with distinct benefits for heart health and brain function respectively.

Heart HealthInflammationCognitionSkinLongevity

Evidence-Backed Benefits

Reduces triglycerides

STRONG

Decreases hepatic VLDL synthesis and increases fatty acid beta-oxidation

Reduces systemic inflammation

STRONG

EPA and DHA are precursors to anti-inflammatory resolvins and protectins

Supports brain health and cognition

MODERATE

DHA is a structural component of neuronal membranes; maintains membrane fluidity

May reduce depressive symptoms

MODERATE

EPA modulates neuroinflammation and serotonin signaling

Dosage

COMMON: 1000-2000 mg EPA+DHA

TIMING: With a meal containing fat for absorption

Combined EPA+DHA dose, not total fish oil. For depression, higher EPA:DHA ratios (>60% EPA) show better results. Triglyceride form is better absorbed than ethyl ester.

Side Effects

  • Fishy aftertaste or burps
  • GI upset (nausea, diarrhea)
  • Potential increased bleeding risk at very high doses
  • Possible LDL increase in some individuals

Drug Interactions

  • Anticoagulants/antiplatelet drugs (warfarin, aspirin: additive bleeding risk)
  • Blood pressure medications (additive hypotensive effect)
  • Orlistat (reduces fat-soluble nutrient absorption)
  • Cyclosporine (may increase drug levels)

Special Populations

  • Safe and recommended during pregnancy (DHA critical for fetal brain development)
  • Choose low-mercury sources during pregnancy
  • Safe for children at age-appropriate doses
  • Caution with fish allergy (algal oil is an alternative)

Key Studies

  • REDUCE-IT trial: 4g/day icosapent ethyl (EPA) reduced cardiovascular events by 25% (n=8,179, NEJM, 2019)
  • Meta-analysis of 13 RCTs: omega-3 supplementation reduced depressive symptoms, particularly with EPA-predominant formulations (Transl Psychiatry, 2019)
  • Cochrane review: omega-3 fats reduce triglycerides by 15-30% in a dose-dependent manner (2020)
  • VITAL trial: 1g/day omega-3 did not significantly reduce major cardiovascular events in general population (n=25,871, NEJM, 2019)
Examine.com reference

Safety

Fish Oil / Omega-3: Drug Interactions

Do not combine

Dangerous interactions. Talk to your prescriber before using this supplement if you take any of these.

  • Warfarin (Coumadin)

    Omega-3 inhibits platelet aggregation, producing an additive anticoagulant effect on top of warfarin.

    RiskIncreased bleeding risk and elevated INR.
    ActionMonitor INR closely. Reduce dose if INR rises.

    Source: PMID: 25062404

  • Clopidogrel (Plavix)

    Dual antiplatelet effect.

    RiskIncreased bleeding risk.
    ActionMonitor for unusual bruising or bleeding.

    Source: FDA label

  • High-dose Aspirin

    Additive antiplatelet effect.

    RiskIncreased bleeding.
    ActionUse caution at omega-3 doses above 3g per day.

    Source: Clinical consensus

Use with caution

Moderate interactions. Monitoring, timing separation, or dose adjustment may be required.

  • Blood pressure medications

    Omega-3 may lower BP modestly.

    RiskHypotension when combined.
    ActionMonitor BP when starting omega-3.

    Source: Clinical consensus

  • Orlistat (Alli)

    Reduces fat absorption, including omega-3.

    RiskReduced omega-3 efficacy.
    ActionSeparate by 2 or more hours.

    Source: FDA label

Stop 2 weeks before surgery

Bleeding risk from antiplatelet effect.

Educational information only. This is not medical advice. These statements have not been evaluated by the FDA. Talk to your prescriber before starting, stopping, or combining any supplement with prescription medication.

Discover More

Helps With
Heart CholesterolMemory CognitionInflammation
Related Ingredients
Fish OilVitamin DCoQ10
Explore
Browse All 538 IngredientsBrowse All 20 Conditions