If You Are Going to take Fish Oil — here’s how to take the right amount

The amount of fish oil one has to take each day depends upon why one is taking it. Here are some diseases and the amount of the effective daily doses of total fish oil or EPA and DHA (the most active components of fish oil) needed for each disorder (according to the experts at the Natural Medicines Comprehensive Database):

  • Hypertriglyceridemia (elevated triglycerides): Studies have used 1-4 grams/day of fish oils. The only FDA-approved fish oil product for elevated triglycerides (Lovaza), 4 grams/day given in two divided doses provides 1860 mg per day of EPA and 1500 mg per day of DHA (or 3360 mg TOTAL EPA/DHA per day).
  • Combined hypertriglyceridemia and hypercholesterolemia: 1800-2160 mg of EPA and 1200-1440 mg of DHA (3000 to 3600c mg TOTAL EPA/DHA per day, ombined with garlic powder 900-1200 mg/day) has been used to lower total cholesterol, LDL, triglycerides, and the ratios of total cholesterol to HDL, and LDL to HDL.
  • Hypertension (high blood pressure): Studies have used either 4 grams of fish oil or 2040 mg of EPA and 1400 mg of DHA (3440 mg TOTAL EPA/DHA per day).
  • Heart Failure: Studies have used 850-882 mg of EPA and DHA in a ratio of 1 to 1.2.
  • Reducing Death Rate: Reducing overall mortality and sudden death in patients with coronary heart disease: 300 to 600 mg of EPA and 600 to 3700 mg of DHA has been used (900 to 4200 mg TOTAL EPA/DHA per day).
  • Atherosclerosis: For preventing and reversing the progression of atherosclerosis in the coronary arteries, 6 grams/day of fish oil for the first three months, followed by 3 grams/day thereafter, has been used.
  • Rheumatoid arthritis: 3800 mg of EPA and 2000 mg of DHA have been used (5800 mg TOTAL EPA/DHA per day).
  • Preventing muscle soreness after physical exercise: fish oil 1.8 grams/day has been used.

For most of my patients asking about fish oil, they are seeking improvements in their abnormal lipid profiles and/or their cardiovascular health. Therefore, the first two points above are the most important. So, I like my patients to find products that are rated NOT just for the amount of “fish oil,” or “total omega-3 fatty acids,” but rather products whose labels show the EPA and DHA level of each capsule.

And, based upon the data above, I tell patients to take at least 3200 to 3500 mg of EPA and DHA COMBINED per day.

So, you could consider any of the following:

  • Prescription doses of four Lovaza capsules per day (two capsules twice a day). Lovaza contains about 465 mg per capsule of EPA and about 375 mg per capsule of DHA. Taking four a day would result in 1860 mg per day of EPA and 1500 mg per day of DHA. But, this prescription is VERY expensive ($180 to $200 per month). So, here are some over-the-counter options:
  • Nordic Natural capsules recently passed independent quality lab testing at ConsumerLab.com. However, to get the right amount of EPA and DHA, you’d have to take 6-7 capsules per day (I’d recommend 7 per day). I’ve found them online for as low as $35.66 for 180 capsules — or a 30 day supply at 6 per day. Taking 7 per day would cost about $41.60 per month.
  • I personally use the Walmart brand “Once-a-Day Omega 3” (Spring Valley One-Per-Day Omega 3 Fish Oil Dietary Supplement — which is also ConsumerLab.com approved). It costs $10.00 for 90 capsules. One softgel contains 410mg EPA and 274mg DHA (684mg of total EPA and DHA per softgel) — so you’d only have to take 5 per day, which costs about $17.00 per month.
  • I’ve been told that Carlson’s Super Omega-3 is made by the same manufacturer who makes Lovaza (it’s like getting the prescription medication at a fraction of the cost). However, the brand is neither ConsumerLab.com or USP approved. I’ve seen it on-line at the Vitamin Shoppe for $10.20 for 130 soft gels, which are said to contain 500 mg of EPA and DHA per capsule. So, you’d have to take 7 per day, which would cost about $20.00 per month.
  • For those of you who have a Costco nearby, there’s the Kirkland Signature Enteric Coated Fish Oil Omega 3. You can find it on-line at $15.39 for 180 capsules. At 684 mg of EPA and DHA per softgel, you’d have to take 5 per day at a cost of about $13.00 per month.

So, how to choose among these options?

  • If you want the LEAST EXPENSIVE option, it’s 5 softgels a day of the Kirkland product.
  • If you want the FEWEST CAPSULES PER DAY, it’s 4 a day of the Spring Valley product.
  • If you want the SMALLEST CAPSULE, it’s the Nordic Naturals product.

By the way, products “approved” by ConsumerLab.com do NOT have unhealthy levels of mercury, PCBs, or dioxins. And, you can purchase a 30-day access to the ConsumerLab review of all fish oils for $12.

5 thoughts on “If You Are Going to take Fish Oil — here’s how to take the right amount

  1. Dr. Walt

    Two folks wrote to my FaceBook page to ask about “Mega Red Krill Oil.” Since I had never heard of it, I did some research.

    According to what I consider the most reliable information available on natural medicines (herbs, vitamins, and supplements), http://www.NaturalDatabase.com:

    There is “INSUFFICIENT RELIABLE EVIDENCE to RATE” krill oil for any indication. There appears to be one product, Neptune Krill Oil (Neptune Technologies & Bioresources, Inc) that has some data; however, according to the NMCD, “the validity of these findings are limited due to the study methodology.” Nevertheless, here are the data to date:

    For Hyperlipidemia. Preliminary clinical research shows that taking this specific krill oil product, 1-1.5 grams daily reduces total cholesterol and low-density lipoprotein (LDL) cholesterol, and increases high-density lipoprotein (HDL) cholesterol in patients with hyperlipidemia. Higher doses of 2-3 grams daily also appear to significantly reduce triglyceride levels.

    For Osteoarthritis. Preliminary clinical research shows that patients who take this specific krill oil product 300 mg daily for 30 days have reduced pain and stiffness, and improved functionality compared to baseline.

    For Premenstrual syndrome (PMS). Preliminary clinical research shows that taking this specific krill oil product 2 grams daily might reduce self-reported symptoms of PMS.

    For Rheumatoid arthritis. Preliminary clinical research shows that patients who take this specific krill oil product 300 mg daily for 30 days have reduced pain and stiffness, and improved functionality compared to baseline (15760).

    The NMCD says, “More evidence is needed to rate krill oil for these (or any other) uses.”

  2. Judy Pearson

    Thanks for the info, Walt. My husband and I both the Omega 3’s, though he is more faithful in taking them than I am. I’ll share this info with him.

  3. betsy

    Do you consider ConsumerLab to be the gold standard for quality? It is so frustrating to know who or what to believe.

    I’ve never figured out why, but most readily available commercial supplements make me sick — VERY sick — particularly multi-vitimins or anything containing iron. At times I’ve taken prescription supplements. They worked great but were cost prohibitive to take regularly. A few of the multi-level marketing supplements seem to be OK for me, but it’s Russian Roulette finding out (not fun) and they are expensive too.

  4. Dr. Walt

    Betsy, I like ConsumerLab and USP. Both are terrific independent quality testing labs. I recommend ConsumerLab simply because they have tested far more products. But, both are fabulous. And, you’re right, without these labs, it’s like Russian roulette with natural medicines.

  5. Carrie

    Quite some time ago I remember hearing you on the radio and you recommended some websites to check for interactions between meds and vitamins which I didn’t catch at the time. Also, the doctors I’ve seen over the last several years don’t seem to know much regarding natural preventative care and I can’t find either a Christian physician nor a natural preventative physician anywhere near my small town. I’m so tired and so sick from the meds I’m on that I can’t even work. I’ve researched some alternatives for beta-blockers, ace inhibitors, diabetes meds etc., etc., but have no idea if they would interact with the meds I’m on and my doctors either won’t tell me or don’t know. It would be such a blessing to at least know some safe alternatives to try. Thank you for being a blessing to so many.

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