Omega-3 Fatty Acids
Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA)
TL;DR
EPA and DHA are the two long-chain omega-3 fatty acids that matter clinically. Roughly 1-2 g/day of combined EPA+DHA is the usual supplemental range, with the strongest evidence for lowering triglycerides and supporting cardiovascular and joint health.
Ideal For
- Eating oily fish less than twice a week
- Elevated fasting triglycerides
- Inflammatory joint pain or rheumatoid arthritis
- Pregnancy and lactation (DHA)
- Vegans and vegetarians, via algal oil
- Established cardiovascular disease, under clinician guidance
Avoid If
- Fish or shellfish allergy (use algal oil instead)
- Taking anticoagulants without medical supervision
- Scheduled for surgery within two weeks
- History of atrial fibrillation, where high doses have been associated with increased risk
Frequently Asked Questions
Overview
Omega-3 fatty acids are polyunsaturated fats defined by a double bond three carbons from the methyl end of the chain. Three matter nutritionally: alpha-linolenic acid (ALA) from plant oils such as flaxseed and canola, and the two long-chain forms, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in oily fish, fish oil, krill oil and algal oil.
ALA is an essential fatty acid — the body cannot make it. It can be converted to EPA and then DHA in the liver, but conversion is inefficient, with reported rates under 15% and typically far lower for DHA. In practice, eating fish or supplementing EPA and DHA directly is the only reliable way to raise tissue levels of the long-chain forms.
The clearest effect is on triglycerides. Prescription-strength doses of 2-4 g/day of EPA+DHA lower fasting triglycerides substantially and are an approved treatment for severe hypertriglyceridaemia. Effects on hard cardiovascular endpoints have been less consistent across large trials, with the most favourable results coming from high-dose, EPA-only preparations in high-risk populations. For rheumatoid arthritis and inflammatory joint pain, doses of roughly 2.7 g/day and above have reduced morning stiffness and tender joint counts in randomized trials. DHA is a structural component of neuronal and retinal membranes, which underpins its role in pregnancy and infant development.
Where the evidence is weaker: general cognition in healthy adults, mood, and dry eye have produced mixed or null results in the largest trials. Labels also complicate dosing — the number on the front is often total fish oil, not EPA+DHA, and the two can differ by a factor of three.
How It Works
- EPA and DHA displace arachidonic acid in cell membrane phospholipids, shifting eicosanoid production toward less inflammatory 3-series prostaglandins and 5-series leukotrienes
- Serve as substrate for resolvins, protectins and maresins — specialised pro-resolving mediators that actively terminate inflammation
- Reduce hepatic VLDL-triglyceride synthesis and secretion, the basis of the triglyceride-lowering effect
- DHA is a major structural lipid of neuronal and retinal membranes, influencing membrane fluidity and receptor signalling
- Modest antiarrhythmic and blood-pressure-lowering effects via ion channel and endothelial modulation
Quick Facts
- Essential fats that the body cannot produce naturally
- EPA and DHA are the most important omega-3s
- Critical for brain development and function
- Powerful anti-inflammatory effects throughout the body
- Most people consume insufficient omega-3s
Benefits & Outcomes
Fibrinogen Reduction
Good for the underlying inflammatory picture; unreliable as a fibrinogen-specific lever.
Endothelial Function
Solid supporting evidence, especially at higher EPA doses and low baseline omega-3 index.
Exercise-Induced Inflammation Reduction
A sensible baseline recovery support rather than a targeted acute intervention.
Amyloid Plaque Prevention
Omega-3 may modestly slow cognitive decline in people with low baseline intake, but no human trial shows amyloid clearance.
Brain Inflammation Reduction
Omega-3 reduces inflammatory signalling with plausible central effects.
Cardiovascular Risk Reduction
Prescription high-dose EPA reduced events in high-risk patients (REDUCE-IT); general fish oil supplements have not shown event reduction.
Inflammaging Reduction
Omega-3 reliably lowers inflammatory cytokines and is the best-supported supplement for age-related inflammation.
Stress & Anxiety Reduction
Omega-3s show a modest anxiety signal, mainly at higher EPA doses.
Triglyceride Reduction
High-dose omega-3 is the most effective supplement for lowering triglycerides.
Verbal Fluency
Omega-3s may slow cognitive decline in at-risk groups without improving fluency directly.
Pregnancy Support
DHA supports fetal neurodevelopment and modestly reduces preterm birth risk.
Acne Reduction
Small trials suggest omega-3s reduce inflammatory acne lesions, but study quality is variable.
BDNF Enhancement
Omega-3 supports the membrane environment BDNF signalling depends on.
Headache Relief
High-dose omega-3 (EPA+DHA) reduced headache frequency in a large NIH RCT of a high-omega-3/low-omega-6 diet approach.
LDL Particle Size Improvement
Omega-3 lowers triglycerides substantially, which shifts LDL toward larger, less atherogenic particles.
Leptin Sensitivity
Omega-3 reduces the inflammation implicated in hypothalamic leptin resistance, though appetite effects are inconsistent.
Menstrual Cramp Relief
Omega-3 supplementation reduced menstrual pain intensity and ibuprofen use in RCTs, with effects growing across 2–3 cycles.
Mood & Mental Health Support
EPA-dominant omega-3 shows meta-analytic benefit for depression, particularly as an adjunct and in patients with elevated inflammation.
Neuroplasticity Enhancement
Supports membrane and synaptic health; effects are gradual and modest.
Nitric Oxide Production
Improves endothelial function through a different route than nitrate.
Pain Relief
Omega-3 at therapeutic doses reduces inflammatory joint pain and morning stiffness, and lowers NSAID requirements.
Platelet Aggregation Reduction
Omega-3 mildly reduces platelet aggregation — relevant mainly as a bleeding consideration rather than a treatment.
Scalp Health
Omega-3s may reduce scalp inflammation and scaling in seborrhoeic presentations.
Seasonal Mood Support
Omega-3s help most in diagnosed depression with high EPA formulations, less so for seasonal patterns.
Skin Hydration
Essential fatty acids are structurally required for the skin barrier that holds water in.
Sleep Apnea Symptom Relief
Omega-3s may support the cardiovascular risk profile that accompanies apnea, not the apnea itself.
Synaptic Plasticity
DHA is structurally required for synaptic membranes, making adequacy genuinely important.
Telomere Protection
Omega-3s show one of the few positive human telomere associations, though evidence is thin.
Tendon Strength
Omega-3s have anti-inflammatory rationale with weak tendon-specific evidence.
Stress Resilience
Omega-3s show modest stress and anxiety signals at higher EPA doses.
Anger Management
Randomised trials show a small but consistent reduction in aggression and hostility scores.
Arterial Flexibility
EPA/DHA consistently improves arterial compliance across trial populations.
Back Pain Relief
Omega-3s reduce inflammatory pain in joint conditions; back-pain-specific evidence is limited but mechanistically plausible.
Cytokine Balance
Omega-3 fatty acids reliably lower inflammatory cytokines and are the best-evidenced option for restoring cytokine balance.
Pleasure Response Restoration
EPA-dominant omega-3 has modest antidepressant effects, best as an adjunct rather than a standalone.
Post-Exercise Soreness Reduction
Omega-3 gives a small, fairly consistent reduction in soreness when taken regularly rather than acutely.
Processing Speed Improvement
Omega-3 supports long-term brain health but does not measurably speed up processing in healthy adults.
Serotonin Support
Omega-3s improve serotonergic signalling indirectly through membrane and inflammation effects.
Skin Elasticity
Omega-3s support the dermal environment with modest photoprotective evidence.
Heart Rate Variability
One of the few supplements with a measurable HRV signal.
Heart Health Support
Strong cardiovascular case: meaningful triglyceride and event-reduction data, especially for EPA.
HDL Cholesterol Increase
Excellent for triglycerides, marginal for HDL.
Cognitive Function
Foundational for brain health; strongest effects with low fish intake and higher EPA/DHA doses.
Mood Stabilization
A legitimate adjunct for mood, with EPA at 60%+ of the EPA+DHA mix being the key detail.
Joint Comfort
Omega-3 at 2-3 g/day reduces joint tenderness, morning stiffness and NSAID requirement in inflammatory arthritis.
Blood Pressure Regulation
EPA/DHA around 2-3 g/day lowers blood pressure by a small margin comparable to a low-dose lifestyle intervention.
Health Concerns Addressed
Non-Alcoholic Fatty Liver Disease
Omega-3s reduce liver fat and triglycerides in NAFLD trials and are the best-supported supplement for this condition — but they work as an adjunct to weight loss, which remains the only intervention proven to reverse the disease.
Bipolar Disorder
One of the few supplements with real adjunctive data in a serious mood disorder — modest benefit for bipolar depression on top of medication, zero role in mania or as monotherapy.
Coronary Artery Disease
Triglyceride lowering is real; OTC event-reduction is not proven. The 25% event win belongs to prescription EPA (icosapent ethyl) — a clinician conversation, not a supplement-shelf one.
Raynaud's Disease
Fish oil has a small positive randomised trial in primary Raynaud's showing improved cold tolerance — a plausible adjunct to the mainstays of warmth, smoking cessation, and (when needed) nifedipine.
Cardiovascular Disease
Omega-3s reliably lower triglycerides, and high-dose prescription EPA reduced cardiovascular events in one major trial — but standard fish oil supplements have not shown clear event reduction in large trials.
Skin Redness
Likely effective for ocular rosacea symptoms; no meaningful effect on facial erythema.
Post-Concussion Syndrome
Strong animal data for axonal protection after brain injury, but human trials are small and have not yet shown symptom benefit.
Ovulation Pain
Omega-3s reduce prostaglandin-driven pelvic pain in dysmenorrhoea trials, a mechanism shared with ovulation pain — making them a reasonable daily strategy for women with generally painful cycles, though mittelschmerz itself is untested.
Peripheral Artery Disease
Omega-3s support the triglyceride and endothelial side of vascular health and are a reasonable adjunct in PAD — but the interventions with hard-outcome evidence are walking exercise, statins, and smoking cessation, none of which a capsule can substitute.
Autism Spectrum Disorder
Safe and sensible where dietary fish intake is low, but families should know trials have not moved core autism symptoms — the effect sizes are small at best.
Stroke Recovery
Insufficient evidence for stroke recurrence; reasonable as part of general cardiovascular care.
Traumatic Brain Injury
Insufficient evidence. Strong preclinical rationale with no adequate human outcome trials.
Post-Traumatic Stress Disorder
Omega-3s have intriguing early evidence in PTSD — including prevention studies after disasters — but the effect sizes are small and preliminary; trauma-focused therapy can genuinely resolve PTSD, and nothing supplemental should delay it.
Scleroderma
No supplement has trial evidence for modifying scleroderma — omega-3's plausible vascular and anti-inflammatory logic is unproven here, and management belongs with rheumatology-led organ monitoring.
Alzheimer's Disease
Omega-3s have not been shown to prevent or slow Alzheimer's disease in randomized trials, despite strong observational associations with fish intake and brain health. They remain a reasonable general-health supplement, not a dementia treatment.
Sjögren's Syndrome
Omega-3 supplements have not demonstrated meaningful improvement in the hallmark dryness symptoms of Sjögren's syndrome.
Chronic Kidney Disease
A defensible adjunct for cardiovascular risk and possibly proteinuria, not a treatment that preserves filtration rate.
Mental Sluggishness
Omega-3s support long-term brain health and have some evidence in mood and mild cognitive impairment, but they do not quickly clear brain fog — if thinking is newly sluggish, a blood panel (thyroid, iron, B12) is worth more than any fish oil.
Carpal Tunnel Syndrome
One small trial and a plausible mechanism; a fine adjunct for mild disease, but splinting and proper staging come first.
Non-Alcoholic Steatohepatitis
Omega-3 reliably lowers liver fat and triglycerides but has not been shown to resolve inflammation or improve fibrosis.
Slow Processing
Omega-3 may modestly support processing speed when intake is low, but sleep, attention, and mood are the bigger levers.
Tourette Syndrome
Omega-3s are occasionally studied in tic disorders because of their role in brain development and inflammation, but trials in Tourette syndrome are small and inconsistent. Behavioral therapy (CBIT) remains the best-supported treatment.
General Swelling
No trial evidence, and using it risks delaying diagnosis of a serious cause.
Cancer
Not a preventive or treatment agent; a possible adjunct for cachexia under supervision.
Huntington's Disease
The main randomised trial was negative; there is no evidence omega-3 slows Huntington's progression.
Ischemic Stroke
Large randomised prevention trials found no reduction in stroke, and high doses raise atrial fibrillation risk.
Chronic Muscle Soreness
Several small trials report reduced delayed-onset muscle soreness and lower creatine kinase after eccentric exercise with omega-3 supplementation over 4-8 weeks. The literature is small and effect sizes vary widely.
Dry Skin
Omega-3 supplementation improves skin hydration and barrier measures in some trials, though most positive studies used combined omega-3/omega-6 preparations rather than fish oil alone.
Brain Fog
Omega-3 supports the structural integrity of neuronal membranes and shows small cognitive benefits in older adults and people with low baseline intake. Direct trials in people reporting brain fog are essentially absent.
High Cholesterol (Dyslipidemia)
Genuinely effective for elevated triglycerides at prescription-range doses. Set expectations correctly: this is a triglyceride intervention, not an LDL intervention.
Psoriasis
Two meta-analyses found fish oil on its own does not reduce psoriasis severity. There is some signal that omega-3 alongside conventional therapy improves PASI, and it helps the cardiometabolic risks that travel with psoriasis, but it is not a standalone treatment.
Eczema (Atopic Dermatitis)
Trials of omega-3 in atopic dermatitis show mixed results, with some reporting reduced severity scores at 2-3g of EPA and DHA daily and others finding no difference. Reasonable to try as an adjunct; not a replacement for emollients or topical therapy.
Rheumatoid Arthritis
A well-supported adjunct to DMARD therapy. It reduces symptom burden and drug requirement; it does not modify disease progression.
ADHD (Attention Deficit Hyperactivity Disorder)
Meta-analyses find a small but consistent reduction in ADHD symptoms with omega-3 supplementation, particularly with higher-EPA formulas. The effect is well below that of stimulant medication but real, and the safety profile is favourable.
Endometriosis
Higher dietary omega-3 intake is associated with lower endometriosis risk in cohort data, but no randomised trial has tested supplementation as a treatment.
Blurry Vision
Omega-3s may modestly relieve dry-eye-related blur, but the large DREAM trial found no benefit over placebo.
Loss of Appetite
Consider in illness-related appetite loss with weight loss, alongside protein and energy density. Not useful for ordinary poor appetite.
Low Mood & Sadness
A reasonable adjunct at 1-2g EPA daily, especially alongside therapy or medication. Not a substitute for treatment of moderate or severe depression.
Dry Eyes
The largest trial found no benefit over placebo. Reasonable to try for three months if lid care is already optimised, but expectations should be low.
Joint Pain
Worth a 12-week trial for inflammatory joint pain, particularly rheumatoid arthritis, where the NSAID-sparing effect is the most consistent finding. Expect less if the problem is mechanical wear.
Acne & Breakouts
Small trials suggest omega-3 supplementation reduces inflammatory acne lesions over 10-12 weeks, plausibly by shifting eicosanoid balance. The evidence base is thin and omega-3 is at best an adjunct to standard dermatological treatment.
Metabolic Syndrome
Omega-3 reliably lowers triglycerides, one of the five metabolic syndrome criteria, with reductions of 20-30% at 3-4g daily. Effects on glucose, blood pressure and waist circumference are small or absent.
Chronic Inflammation
A well-supported intervention for lowering measured inflammatory markers. Whether that translates to how you feel depends heavily on what is driving the inflammation.
Vision Changes
Failed to slow macular degeneration in the AREDS2 trial. Retains a genuine but separate role in dry eye, where the evidence is also mixed.
Cognitive Decline
Biologically plausible and safe, but the randomized evidence does not support omega-3 as a way to prevent cognitive decline in people who are already declining. Best framed as long-term dietary quality rather than treatment.
Anxiety
A modest anxiolytic signal at high EPA doses above 2 g/day in clinical populations; effects in mild everyday anxiety are small and inconsistent.
Menopause
Omega-3s may modestly help menopausal mood and triglycerides, but the best-powered trial found no benefit for hot flashes.
Hashimoto's Thyroiditis
No trial has shown omega-3 supplementation lowers thyroid antibodies or alters hormone requirements in Hashimotos thyroiditis.
Supporting Research137 studies
Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease
Abdelhamid AS, Brown TJ, Brainard JS +8 more
Increasing alpha-linolenic acid intake probably makes little or no difference to all-cause mortality or cardiovascular events, with possible small reductions in cardiovascular mortality and arrhythmia
Phosphatidylserine containing omega-3 fatty acids may improve memory abilities in non-demented elderly with memory complaints: a double-blind placebo-controlled trial
Vakhapova V, Cohen T, Richter Y +2 more
PS-DHA improved immediate and delayed verbal recall in the subgroup with higher baseline cognitive status; overall group differences were not significant
Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association
Skulas-Ray AC, Wilson PWF, Harris WS +2 more
Prescription omega-3 at 4 g daily lowered triglycerides by roughly 20-30% in patients with hypertriglyceridaemia, effective as monotherapy or added to statins. EPA-only and EPA/DHA products lowered triglycerides comparably, though EPA/DHA products modestly raised LDL cholesterol in some patients. Over-the-counter supplements are not equivalent because of lower and variable EPA/DHA content.
Comparison of omega-3 polyunsaturated fatty acid bioavailability in fish oil and krill oil: network meta-analyses
Nguyen TT, Mafruhah OR, Nguyen HT
Krill oil produced comparable or slightly greater omega-3 incorporation per gram of EPA and DHA than fish oil, consistent with phospholipid delivery.
Omega-3 fatty acids for secondary prevention of posttraumatic stress disorder after accidental injury: an open-label pilot study
Matsuoka Y
In this open-label pilot, omega-3 supplementation started shortly after accidental injury was associated with lower PTSD symptom scores at follow-up than expected from the historical comparison, generating a hypothesis of secondary prevention.
Comparing the cardiovascular risk-reducing effects of polyunsaturated fatty acids in fish oil and krill oil: a network meta-analysis
Nguyen TT, Mafruhah OR, Huynh TTL
Krill oil lowered triglycerides and LDL cholesterol comparably to fish oil, with a possible advantage on LDL, though effect sizes were small.
Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial
Age-Related Eye Disease Study 2 Research Group, Chew EY, Clemons TE +8 more
In 4,203 participants at high risk of progression, adding lutein 10 mg + zeaxanthin 2 mg to the AREDS formulation did not significantly reduce progression to advanced AMD overall, but in secondary analyses lutein/zeaxanthin outperformed beta-carotene (HR ~0.82) and benefited participants with the lowest dietary lutein intake. Omega-3 (DHA+EPA) showed no effect. Beta-carotene raised lung cancer risk in former smokers.
Omega-3 Fatty Acids and Depression: Scientific Evidence and Biological Mechanisms
Bozzatello P, Brignolo E, De Grandi E +1 more
Omega-3s significantly reduced depressive symptoms (SMD -0.32, p<0.001) EPA more effective than DHA for depression (doses >1000mg EPA) Higher doses (≥2000mg EPA+DHA) more effective than lower doses Adjunctive omega-3 with antidepressants superior to monotherapy Effects comparable to standard antidepressants in some studies Benefits more pronounced in severe depression Onset of action within 2-4 weeks No significant adverse effects Effects independent of baseline omega-3 status
Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or Other Nutrient Supplementation on Cognitive Function: The AREDS2 Randomized Clinical Trial
Chew EY, Clemons TE, Agron E
Lutein/zeaxanthin supplementation had no significant effect on cognitive decline over five years in older adults.
Preventing food allergy in infancy and childhood: Systematic review of randomised controlled trials
Neither maternal nor infant supplementation with probiotics, prebiotics, vitamin D or fish oil consistently prevented allergic disease or wheeze.
Metabolism and functional effects of plant-derived omega-3 fatty acids in humans
Baker EJ, Miles EA, Burdge GC +2 more
Conversion of alpha-linolenic acid to EPA is limited and conversion to DHA is very low in humans
Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer (VITAL)
Manson JE, Cook NR, Lee IM +3 more
Supplementation with n-3 fatty acids did not result in a lower incidence of major cardiovascular events or cancer than placebo.
Efficacy of the omega-3 fatty acids supplementation on inflammatory biomarkers: An umbrella meta-analysis
Supplementation of n-3 PUFAs in adults can improve CRP, TNF-alpha, and IL-6 concentrations under various health conditions.
Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial
Kiecolt-Glaser JK, et al.
These data suggest that n-3 supplementation can reduce inflammation and anxiety even among healthy young adults.
Individual and additive effects of vitamin D, omega-3 and exercise on DNA methylation clocks of biological aging in older adults from the DO-HEALTH trial
Bischoff-Ferrari HA, Gangler S, Wieczorek M
Omega-3 alone slowed the DNAm clocks PhenoAge, GrimAge2 and DunedinPACE, and all three treatments had additive benefits on PhenoAge.
Fish-oil dietary supplementation in patients with Raynaud's phenomenon: a double-blind, controlled, prospective study
DiGiacomo RA
Fish oil improves tolerance to cold exposure and delays the onset of vasospasm in patients with primary Raynaud's phenomenon.
Omega 3 fatty acid for the prevention of cognitive decline and dementia
Sydenham E, et al.
The available trials showed no benefit of omega-3 PUFA supplementation on cognitive function in cognitively healthy older people.
Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial
Okereke OI, et al
These findings do not support the use of omega-3 supplements in adults to prevent depression.
Efficacy of Omega-3 Intake in Managing Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Wang WX, Ko ML
Patients given omega-3 treatment demonstrated more significant improvements in dry eye symptoms (Hedges' g = -1.047; p < 0.001)
Effect of supplementation with marine omega-3 fatty acid on risk of colorectal adenomas and serrated polyps in the US general population
Song M, Lee IM, Manson JE +2 more
Marine ω-3 fatty acid, 1 g daily (which included eicosapentaenoic acid, 460 mg, and docosahexaenoic acid, 380 mg)
ω-3 Fatty Acid Supplementation Does Not Affect Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis
Horvath A, Lukasik J, Szajewska H
With 4 exceptions, there were no statistically significant differences in ASD symptoms between groups measured by validated scales.
Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis
Lee YH, Bae SC, Song GG
We undertook this study to assess the effects of omega-3 polyunsaturated fatty acids (PUFAs) (administered at ≥2.7 g/day) for a minimum duration of 3 months on clinical outcomes in patients with rheumatoid arthritis (RA).
Efficacy of fish oil and its components in the management of psoriasis: a systematic review of 18 randomized controlled trials
Chen X, Hong S, Sun X +9 more
Fish oil or ω-3 PUFAs combined with conventional treatments, however, resulted in a decreased PASI score (mean difference [MD], -3.92; 95%CI, -6.15 to -1.69; P = 0.0006) and lesion area.
Omega-3 fatty acids and platelet aggregation: a systematic review and meta-analysis of randomized trials
Gao LG, Cao J, Mao QX +3 more
Omega-3 supplementation significantly reduced platelet aggregation at higher EPA and DHA doses
Effects of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability and Heart Rate in Patients on Chronic Dialysis: A Randomized Controlled Trial
Rantanen JM, Riahi S, Johansen MB +2 more
Marine n-3 PUFA did not change the primary endpoint SDNN (SD of all RR-intervals) reflecting overall HRV
Effect of n-3 PUFA supplementation on cognitive function throughout the life span from infancy to old age: a systematic review and meta-analysis of randomized controlled trials
Jiao J, Li Q, Chu J
n-3 PUFA supplements did not promote cognitive function in terms of composite memory, executive function, and processing speed domains in children, adults, or the elderly
Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC randomized controlled trials
Feagan BG, Sandborn WJ, Mittmann U
Omega-3 free fatty acids were not effective for the prevention of relapse in Crohn disease.
Effect of a nutritional supplement on hair loss in women
Le Floc'h C, Cheniti A, Connetable S
After 6 months of treatment, photograph assessment demonstrated a superior improvement in the supplemented group (P < 0.001)
Nutritional supplements and cognition in healthy aging and mild cognitive impairment patients: a systematic review and network meta-analysis
Liu X
DHA alone was found to be beneficial in improving processing speed, whereas vitamin D3 was associated with improvements in visuospatial function.
Nutritional Supplement and Dietary Interventions as a Prophylaxis or Treatment of Sub-Concussive Repetitive Head Impact and Mild Traumatic Brain Injury: A Systematic Review
Feinberg C
Strongest evidence supports n-3FA utility for neurotrauma prevention in athletes exposed to SRHI.
Omega-3 fatty acid treatment in multiple sclerosis (OFAMS Study): a randomized, double-blind, placebo-controlled trial
Torkildsen O, et al
No beneficial effects on disease activity were detected from omega-3 fatty acids when compared with placebo as monotherapy or in combination with interferon beta-1a.
Fish oil and postoperative atrial fibrillation: the OPERA randomized trial
Mozaffarian D, Marchioli R, Macchia A
High-dose perioperative omega-3 does not prevent post-surgical atrial fibrillation.
n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease (DREAM)
Asbell PA, Maguire MG, Pistilli M
High-dose omega-3 did not relieve dry eye symptoms beyond placebo.
Anticoagulant activity of select dietary supplements
Stanger MJ, Thompson LA, Young AJ
Fish oil possesses antiplatelet activity that may potentiate the effect of anticoagulant medications.
A Randomized Controlled Trial of Omega 3 Fatty Acids in Rosacea Patients with Dry Eye Symptoms
Bhargava R
Rosacea patients with dry eye symptoms have significant improvement in symptoms, MGS, TBUT, and Schirmer score, following dietary intervention with O3FAs for 6 months.
A double-blind, placebo-controlled trial of ω-3 fatty acids in Tourette's disorder
Omega-3 fatty acids did not reduce total tic scores versus placebo in children with Tourette's disorder, though tic-related impairment improved.
Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial
Omega-3 fatty acid supplementation did not reduce progression to advanced age-related macular degeneration.
Cognitive protection and brain entropy changes from omega-3 polyunsaturated fatty acids supplement in late-life depression: a 52-week randomized controlled trial
Chang JP, et al
Omega-3 PUFAs supplement may mitigate cognitive decline in LLD through anti-inflammatory mechanisms.
Effect of omega-3 fatty acid supplementation on markers of inflammation and endothelial function in patients with chronic heart disease: A systematic review and meta-analysis
Ibrahim Mohialdeen Gubari M
Omega-3 FA supplementation significantly reduced the level of circulating IL-6.
Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis
Mohammadi MM, et al.
Omega-3 fatty acids could reduce the severity of PMS. However, we should caution in the conclusion in affirming the beneficial effects of n-3 PUFAs on PMS, since the heterogeneity is evident in the analysis.
Docosahexaenoic acid for selective prevention of posttraumatic stress disorder among severely injured patients: a randomized, placebo-controlled trial
Matsuoka Y, Nishi D, Hamazaki K
Docosahexaenoic acid supplementation was not superior to placebo for the secondary prevention of PTSD symptoms at 3 months after severe accidental injury.
Dietary marine fatty acids (fish oil) for asthma in adults and children
Thien FC, De Luca S, Woods RK
There is little consistent evidence that fish oil improves asthma symptoms, lung function or medication use.
Low-dose omega-3 fatty acids reduce seizures in uncontrolled epilepsy: a randomized placebo-controlled study
DeGiorgio CM, Miller PR, Harper R +4 more
Low-dose omega-3 reduced seizure frequency by 33.6 percent compared with placebo, whereas high-dose did not.
Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials
Grosso G, Pajak A, Marventano S
The use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.
Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose
Hill CL, et al
In people with symptomatic knee OA, there was no additional benefit of a high-dose fish oil compared with low-dose fish oil.
Safety and Effectiveness of Oral Nutraceuticals for Treating Acne: A Systematic Review
Shields A, Ly S, Wafae B +7 more
This systematic review suggests a possible role for nutraceutical supplements in the treatment of acne.
Omega-3 fatty acid supplementation and fecundability
Stanhiser J, Jukic AMZ, McConnaughey DR +1 more
Prospectively recorded omega-3 supplement use was associated with an increased probability of conceiving.
N-3 Polyunsaturated Fatty Acids in Elderly with Mild Cognitive Impairment: A Systemic Review and Meta-Analysis
Omega-3 supplementation showed modest cognitive benefit in mild cognitive impairment but not in established dementia.
A randomised controlled trial of long-chain omega-3 polyunsaturated fatty acids in the management of rotator cuff related shoulder pain
Sandford FM
Omega-3 PUFA supplementation may have a modest effect on disability and pain outcomes in RCRSP.
Omega-3 Index and Obstructive Sleep Apnea: A Cross-Sectional Study
Tittus J
In contrast to our hypothesis, an Omega-3 Index of 5.7% was not associated with OSA severity.
Nutritional Interventions to Improve Cachexia Outcomes in Cancer - A Systematic Review
Omega-3 enriched nutritional supplements produced modest and inconsistent effects on weight and lean mass in cancer cachexia.
Effect of omega-3 fatty acids supplementation on muscle mass, fat mass, and visceral fat of hemodialysis patients; A randomized clinical trial
Abbas Torki S, Roumi Z, Tahavorgar A +1 more
No significant difference was found in the mean of BMI, FAT, muscle, and visceral fat in the intervention group compared to the control group after the intervention.
Fish-oil dietary supplementation in patients with Raynaud phenomenon: a double-blind, controlled, prospective study
DiGiacomo RA, Kremer JM, Shah DM
Fish oil increased the time to onset of cold-induced vasospasm and improved tolerance in primary Raynaud only.
Phosphatidylserine containing omega-3 fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints
Vakhapova V
A significant improvement in sustained attention and memory recognition was observed in the PS-DHA naive group.
The adjuvant treatment role of ω-3 fatty acids by regulating gut microbiota positively in the acne vulgaris
Omega-3 supplementation as adjuvant therapy reduced inflammatory acne lesions and modulated gut microbiota.
Randomized Multicenter Placebo-Controlled Trial of Omega-3 Fatty Acids for the Control of Aromatase Inhibitor-Induced Musculoskeletal Pain: SWOG S0927
Hershman DL
We found a substantial improvement in AI arthralgia for both O3-FAs and placebo but found no meaningful difference between the groups.
Prenatal Fish Oil Supplementation, Maternal COX1 Genotype, and Childhood Atopic Dermatitis: A Secondary Analysis of a Randomized Clinical Trial
Chen L
The association of prenatal n-3 LCPUFA supplementation with risk of childhood AD varied by maternal COX1 genotype.
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia (REDUCE-IT)
Bhatt DL, Steg PG, Miller M +3 more
Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic events was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo.
Effect of omega-3 fatty acids supplementation on indirect blood markers of exercise-induced muscle damage: Systematic review and meta-analysis of randomized controlled trials
Xin G, Eshaghi H
The outcomes showed a significant effect of omega 3 supplementation on reducing creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin (Mb) concentrations.
The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Salas-Huetos A, Rosique-Esteban N, Becerra-Tomás N +1 more
Sperm counts were increased by omega-3 fatty acids (18.70 x 10^6 spz/mL; 16.89, 20.51 spz/mL)
Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease
Downie LE, Ng SM, Lindsley KB +1 more
There is uncertainty as to whether omega-3 supplements improve dry eye signs and symptoms.
Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation for prevention and treatment of perinatal depression: a systematic review and meta-analysis of randomized-controlled trials
Suradom C, Suttajit S, Oon-Arom A +1 more
Although n-3 PUFA supplementation may improve maternal and infant outcomes, our meta-analysis found insufficient evidence to determine its benefit for perinatal depression.
Omega-3 fatty acid addition during pregnancy
Middleton P, Gomersall JC, Gould JF +3 more
Omega-3 supplementation reduced preterm birth before 37 weeks and early preterm birth
Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline
Yurko-Mauro K, et al
Twenty-four week supplementation with 900 mg/d DHA improved learning and memory function in ARCD and is a beneficial supplement that supports cognitive health with aging.
Effects of fish oil supplement on psoriasis: a meta-analysis of randomized controlled trials
Yang SJ, Chi CC
The current evidence does not support the use of fish oil supplement in treating psoriasis.
The effect of omega-3 fatty acids on aggression: A meta-analysis
Omega-3 supplementation produced a small but significant reduction in aggression across randomized trials.
The Effect of Omega-3 Fatty Acids, EPA, and/or DHA on Male Infertility: A Systematic Review and Meta-analysis
Hosseini B, et al
This meta-analysis indicates that supplementing infertile men with omega-3 fatty acids resulted in a significant improvement in sperm motility and concentration of DHA in seminal plasma.
Effect of Omega-3 Polyunsaturated Fatty Acid Supplements on Cognitive Performance in Patients with Mild Cognitive Impairment or Alzheimer's Disease: A Systematic Review and Meta-Analysis
Khatun M, et al.
Our findings have provided evidence of the effectiveness of an n-3 PUFA treatment in improving Full-Scale IQ (FSIQ)... information processing... and digit span/working memory/attention aspects of cognitive functioning.
Fish and fatty acid consumption and the risk of hearing loss in women
Curhan SG, Eavey RD, Wang M +2 more
In comparison with women in the lowest quintile of intake of long-chain omega-3 PUFAs, the multivariable-adjusted RR for hearing loss among women in the highest quintile was 0.85 (95% CI: 0.80, 0.91).
Omega-3 fatty acids in bipolar patients with a low omega-3 index and reduced heart rate variability: the BIPO-3 trial
Berger M, Seemuller F, Voggt A +6 more
119 patients with bipolar disorder according to DSM-IV were screened, with 55 euthymic bipolar patients ... being enrolled in a randomized, double-blind, 12-week parallel study design with omega-3 fatty acids
Supplementation with vitamin D or omega-3 fatty acids in adolescent girls and young women with endometriosis (SAGE): a double-blind, randomized, placebo-controlled trial
Nodler JL, DiVasta AD, Vitonis AF +3 more
Participants were randomly assigned to receive 2000 IU vitamin D3, 1000 mg fish oil, or placebo daily for 6 mo
Effects of omega-3 polyunsaturated fatty acids on plasma indices of thrombogenesis and inflammation in patients post-myocardial infarction
Omega-3 supplementation after myocardial infarction did not significantly reduce plasma fibrinogen versus usual care.
Omega-3 fatty acids supplements for dry eye - Are they effective or ineffective?
Evidence for omega-3 supplements in dry eye is conflicting, with the largest randomized trial showing no benefit.
Omega-3 fatty acid supplementation for distal symmetrical peripheral neuropathy in adults with diabetes mellitus
Evidence was insufficient to determine whether omega-3 supplementation improves diabetic peripheral neuropathy.
Lutein/zeaxanthin for the treatment of age-related cataract: AREDS2 randomized trial report no. 4
Chew EY, SanGiovanni JP, Ferris FL +2 more
Participants were randomly assigned to daily placebo; lutein/zeaxanthin, 10mg/2mg; omega-3 long-chain polyunsaturated fatty acids, 1 g; or a combination.
Effects of omega-3 polyunsaturated fatty acids on psychophysiological symptoms of post-traumatic stress disorder in accident survivors
Matsumura K, Noguchi H, Nishi D
These findings suggest that post-trauma supplementation of omega-3 PUFAs might be effective for the secondary prevention of psychophysiological symptoms of PTSD.
Effects of Vitamin D3 and Marine Omega-3 Fatty Acids Supplementation on Biomarkers of Systemic Inflammation: 4-Year Findings from the VITAL Randomized Trial
Dong Y, Zhu H, Chen L
Marine n-3 fatty acids showed no significant effects on the inflammatory biomarkers assessed.
Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial
Hahn J, Cook NR, Alexander EK
Omega-3 showed a non-significant 15% reduction in incident autoimmune disease.
Oral omega-3 fatty acids treatment in computer vision syndrome related dry eye
Bhargava R, Kumar P, Phogat H +2 more
220 patients received two capsules of omega-3 fatty acids each containing 180mg eicosapentaenoic acid (EPA) and 120mg docosahexaenoic acid (DHA) daily
Omega-3 Polyunsaturated Fatty Acid Supplementation for Reducing Muscle Soreness after Eccentric Exercise: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Lv ZT, et al
The effect size of less muscle soreness with n-3 PUFA supplements did not appear to be clinically relevant.
The effects of fish oil and isoflavones on delayed onset muscle soreness
Lenn J, et al
These data indicate FO or ISO, at the doses supplemented, were not effective in ameliorating DOMS with the above-cited protocol.
Effect of Omega-3 Polyunsaturated Fatty Acid Supplementation on Clinical Outcome of Atopic Dermatitis in Children
Niseteo T, et al.
Omega-3 fatty acids in combination with GLA and vitamin D may decrease symptoms and were associated with an improvement clinical picture of AD in children.
Omega-3 Intake Improves Clinical Pregnancy Rate in Polycystic Ovary Syndrome Patients: A Double-Blind, Randomized Study
Trop-Steinberg S, Heifetz EM, Azar Y +3 more
There were clinical pregnancies in 8/30 (26.7%) treatment cycles for women receiving omega-3 supplements versus 4/30 (13.3%) cycles with placebo.
Safety considerations with omega-3 fatty acid therapy
Bays HE
Omega-3 prolongs bleeding time modestly but clinically significant bleeding was not increased.
Tart cherry supplementation and recovery from strenuous exercise: a systematic review and meta-analysis
Hill JA, Keane KM, Quinlan R
Tart cherry polyphenols accelerated strength recovery and reduced soreness after strenuous exercise.
Omega-3 fatty acids for cardiovascular disease prevention
Abdelhamid, A.S., Brown, T.J., Brainard, J.S.
Increasing EPA and DHA has little or no effect on all-cause mortality and cardiovascular events.
Effect of Dietary and Supplemental Omega-3 Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares
Zhang Y, McCormick N, Rai SK +1 more
To determine the relationship between omega-3 polyunsaturated fatty acid (n-3 PUFA) consumption (dietary or supplemental) and risk of gout flares.
The effects of Omega-3 supplementation on stress, anxiety, depression, sleep quality, and everyday memory
Omega-3 supplementation improved stress, anxiety, depression and sleep quality in individuals with psychological distress.
Randomized controlled trial of ethyl-eicosapentaenoic acid in Huntington disease: the TREND-HD study
Huntington Study Group TREND-HD Investigators
Ethyl-EPA was not beneficial in patients with Huntington disease during 6 months of placebo-controlled evaluation.
Effect of omega-3 fatty acids on systemic lupus erythematosus disease activity: A systematic review and meta-analysis
Duarte-Garcia A, et al
This meta-analysis suggests that omega-3 fatty acids could provide therapeutic benefit in addition to immunosuppressive regimens used for SLE.
The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials
Mohammadi MM, Mirjalili R, Faraji A
The results of the meta-analysis showed that n-3 PUFAs reduce the severity of primary dysmenorrhea in women (SMD = -1.075, 95% CI: -1.871 to -0.279)
Effects of nutritional interventions on the severity of depressive and anxiety symptoms of women in the menopausal transition and menopause: a systematic review, meta-analysis, and meta-regression
Grigolon RB, Ceolin G, Deng Y +1 more
The pooled effect size favored the intervention group over placebo for both DS and AS (DS: standardized mean difference, -0.35 [95% confidence interval, -0.68 to -0.03; P = 0.0351])
The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis
Enns JE, Yeganeh A, Zarychanski R +1 more
We conducted a systematic review and meta-analysis to determine whether omega-3 PUFA supplementation reduces the incidence of cardiovascular events and complications in adults with peripheral arterial disease.
Effect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial
Bischoff-Ferrari HA, Vellas B, Rizzoli R
vitamin D3, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in ... physical performance
Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis
Hu Y, Hu FB, Manson JE
Marine omega-3 supplementation was associated with lowered risk of myocardial infarction and coronary heart disease death.
The Effect of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability in Renal Transplant Recipients: A Randomized Controlled Trial
Lilleberg HS, Cichosz SL, Svensson M +4 more
Marine n-3 polyunsaturated fatty acid (PUFA) supplementation may decrease rHR, increase HRV, and reduce the risk of SCD.
Influence of oral vitamin and mineral supplementation on male infertility: a meta-analysis and systematic review
Buhling K, Schumacher A, Eulenburg CZ +1 more
the polyunsaturated fatty acids eicosapentaenoic acid (EPA; 1.12 g/day) and docosahexaenoic acid (DHA; 0.72 g/day)
Omega-3 supplementation and cognitive performance in healthy older adults: a randomized controlled trial
van de Rest O, Geleijnse JM, Kok FJ +3 more
Omega-3 supplementation produced no significant improvement in attention, processing speed or memory versus placebo
Intake of omega-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: a systematic review and meta-analysis
Gioxari A, Kaliora AC, Marantidou F
Omega-3 modestly reduced tender joint count and NSAID use in rheumatoid arthritis.
Pharmacological Treatments for Cancer-Related Anorexia-Cachexia Syndrome: An Umbrella Review of Systematic Reviews and Meta-Analyses
Zamanian N, Mohajerani A, Barkhordar M +1 more
Omega-3 fatty acids provided limited benefits, with small improvements in health-related quality of life but inconsistent effects on body weight, lean body mass, or inflammation.
Significant differential effects of omega-3 fatty acids and fenofibrate in patients with hypertriglyceridemia
Omega-3 fatty acids therapy decreased triglycerides by 21% in patients with hypertriglyceridemia.
Energy-restricted, n-3 polyunsaturated fatty acids-rich diet improves the clinical response to immuno-modulating drugs in obese patients with plaque-type psoriasis: a randomized control clinical trial
Guida B, Napoleone A, Trio R +4 more
Specifically Psoriasis Area Score Index (7.7 ± 3.7, 5.3 ± 4.3 and 2.6 ± 3.0, respectively; p < 0.05), itch scores and Dermatological Life Quality Index all decreased respect to baseline.
Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk (STRENGTH)
Nicholls SJ, Lincoff AM, Garcia M +3 more
Among statin-treated patients at high cardiovascular risk, the addition of omega-3 CA, compared with corn oil, resulted in no significant difference in a composite outcome of major adverse cardiovascular events.
Effect of omega-three supplementation on serum urate and gout flares in people with gout; a pilot randomized trial
Stamp LK, Grainger R, Frampton C +1 more
Omega-3 supplementation did not significantly change serum urate levels but was associated with a trend toward fewer gout flares.
Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression
Sarris J, Mischoulon D, Schweitzer I
Adjunctive omega-3 benefited bipolar depressive symptoms (Hedges g 0.34) but not mania.
Effect of Long-Term Marine Omega-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
Gencer B, et al.
In RCTs examining cardiovascular outcomes, marine omega-3 supplementation was associated with an increased risk of AF. The risk appeared to be greater in trials testing >1 g/d.
Effects of omega-3 fatty acids on LDL particle size and lipoprotein subclasses: a systematic review
Bays HE, Tighe AP, Sadovsky R +1 more
Omega-3 supplementation shifted LDL toward larger, more buoyant particles while lowering triglycerides
Omega-3 fatty acids for depression: a systematic review and meta-analysis of randomised controlled trials
Appleton KM, Sallis HM, Perry R +2 more
Omega-3 produced a small effect on depressive symptoms of uncertain clinical importance
The Effects of Vitamin D and Marine Omega-3 Fatty Acid Supplementation on Chronic Knee Pain in Older US Adults: Results From a Randomized Trial
MacFarlane LA, Cook NR, Kim E +7 more
Our findings indicate that vitamin D and n-3 FA supplementation for a mean of 5.3 years does not reduce knee pain or improve function or stiffness in a large sample of US adults with chronic knee pain.
Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis
Su KP, et al.
This review indicates that omega-3 PUFAs might help to reduce the symptoms of clinical anxiety. Further well-designed studies are needed in populations in whom anxiety is the main symptom.
Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
Aziz T, Niraj MK, Kumar S +1 more
Omega-3 supplementation significantly decreased alanine aminotransferase (ALT) (mean difference = -2.12, 95% confidence interval (CI) = -3.36, -0.87) and aspartate aminotransferase (AST) (mean difference = -1.50, 95% CI = -2.59, -0.42).
Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss
Gopinath B, Flood VM, Rochtchina E +2 more
Participants who had >=2 servings of fish/wk compared with participants who had <1 serving of fish/wk had a significantly reduced risk (42%) of developing presbycusis at follow-up (multivariate-adjusted OR: 0.58; 95% CI: 0.35, 0.95).
Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial
Jung JY, Kwon HH, Hong JS +4 more
Omega-3 fatty acid and gamma-linoleic acid could be used as adjuvant treatments for acne patients.
Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors
Oboza P, Ogarek N, Wójtowicz M +1 more
Studies published so far showed that low intake of simple carbohydrates, fats, salt, and alcohol, and high of fresh, unprocessed foods rich in B vitamins, vitamin D, zinc, calcium, and omega-3 fat
Effects of n-3 Fatty Acid Supplements in Diabetes Mellitus (ASCEND)
Bowman L, Mafham M, Wallendszus K +3 more
There was no significant difference in the risk of serious vascular events between those who were assigned to receive n-3 fatty acid supplementation and those who were assigned to receive placebo.
Omega-3 fatty acids, BDNF and synaptic plasticity: a systematic review of human and animal evidence
Bhatia HS, Agrawal R, Sharma S +3 more
Omega-3 deficiency reduced BDNF and synapsin levels and impaired spatial learning, while repletion restored synaptic plasticity markers
Adjunctive nutraceuticals for depression: a systematic review and meta-analyses
Sarris J, Murphy J, Mischoulon D
Strongest adjunctive antidepressant evidence was for omega-3 (SMD 0.61).
Efficacy and Safety of Omega-3 Fatty Acids in the Prevention of Cardiovascular Disease: A Systematic Review and Meta-analysis
Yan J, et al.
Moderate evidence showed that the use of omega-3 fatty acids may reduce the risk of major cardiovascular events, myocardial infarction, and cardiovascular death, but the potential risk of atrial fibrillation and bleeding cannot be ignored.
Omega-3 Supplementation Improves Isometric Strength But Not Muscle Anabolic and Catabolic Signaling in Response to Resistance Exercise in Healthy Older Adults
Dalle S, et al.
Despite no changes in muscle volume, RE-induced gains in isometric strength can be further enhanced by omega-3. However, omega-3 did not improve RE-induced beneficial catabolic or inflammatory adaptations.
Effect of omega-3 supplementation on serum leptin: a systematic review and meta-analysis of randomized controlled trials
Bertrand C, Pignalosa A, Wanecq E +1 more
Omega-3 supplementation produced a small reduction in circulating leptin
The effects of omega-3 polyunsaturated fatty acids supplementation in pregnancy, lactation, and infancy: An umbrella review of meta-analyses of randomized trials
Firouzabadi FD, Shab-Bidar S, Jayedi A
Our results demonstrated evidence of moderate to high certainty that omega-3 supplementation reduced the risk of pre-eclampsia and low-birth weight and improved head circumference when used in pregnant women
Efficacy of Omega-3 PUFAs in Depression: A Meta-Analysis
Liao Y, Xie B, Zhang H +3 more
Our meta-analysis provides evidence that omega-3 PUFAs might be efficacious in improving depressive symptoms, with formulations containing EPA >= 60% showing benefit.
Oral Omega-3 Supplementation Lowers Intraocular Pressure in Normotensive Adults
Downie LE, Vingrys AJ
Elevated intraocular pressure (IOP) is the major modifiable risk factor for the sight-threatening disease glaucoma.
Marine omega-3 fatty acids and prospective change in leukocyte telomere length: the Heart and Soul Study
Farzaneh-Far R, Lin J, Epel ES +3 more
Higher baseline DHA and EPA levels predicted significantly slower telomere shortening over five years
Omega-3 fatty acids and specialized pro-resolving mediators in macrophage-mediated inflammation resolution
Serhan CN, Levy BD
Omega-3-derived mediators enhance macrophage clearance of apoptotic cells
Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies
Chang JP, Su KP, Mondelli V +1 more
Omega-3 supplementation improved clinical symptoms and cognitive performances in children and adolescents with ADHD.
Gallstone Dissolution Effects of Combination Therapy with n-3 Polyunsaturated Fatty Acids and Ursodeoxycholic Acid: A Randomized, Prospective, Preliminary Clinical Trial
Lee SY, Jang SI, Cho JH +2 more
Combination of n-3 polyunsaturated fatty acids with ursodeoxycholic acid showed potential for improved gallstone dissolution compared with UDCA monotherapy.
Omega-3 fatty acids, mTOR signalling and muscle protein synthesis in older adults: a randomized controlled trial
Smith GI, Julliand S, Reeds DN +3 more
Omega-3 supplementation increased thigh muscle volume and handgrip strength in older adults
Omega-3 supplementation and verbal fluency in older adults: randomized controlled trial
Witte AV, Kerti L, Hermannstadter HM +5 more
Omega-3 improved executive function and was accompanied by increased grey matter volume
Omega-3 fatty acid, carotenoid and vitamin E supplementation improves working memory in older adults: A randomised clinical trial
Power R, Nolan JM, Prado-Cabrero A +1 more
Following 24-month supplementation, individuals in the active group recorded significantly fewer errors in working memory tasks than individuals receiving placebo.
Omega-3 supplementation in the treatment of polycystic ovary syndrome (PCOS) - a review of clinical trials and cohort
Melo V, et al.
Omega-3 fatty acids promote indirect benefits in the treating of women with PCOS. However, to reveal well-defined standards for dosage and supplementation time, further studies are needed.
Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials
Senftleber NK, Nielsen SM, Andersen JR +3 more
Marine oil supplementation had a small but statistically significant effect on arthritis pain compared with placebo.
Omega-3 fatty acids, BDNF and synaptic plasticity in humans: a systematic review of intervention trials
Bhatt DH, Kumar A, Sharma S
Omega-3 supplementation raised circulating BDNF and improved plasticity-linked cognitive measures
Marine Omega-3 Fatty Acids and Inflammatory Processes
Calder PC
Marine omega-3 fatty acids give rise to specialised pro-resolving mediators and dampen inflammatory processes.
Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits
Shahidi F, Ambigaipalan P
Omega-3 fatty acids, particularly DHA, are essential structural components of neuronal membranes and influence brain function and behaviour.
Association of Omega-3 Fatty Acids With Incident Atrial Fibrillation: A Meta-Analysis
Lombardi M, Chiabrando JG, Vescovo GM +7 more
Omega-3 fatty acid supplementation was associated with an increased risk of incident atrial fibrillation, with a dose-response relationship.
Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis
Sundstrom B, Stalnacke K, Hagfors L +1 more
High-dose omega-3 supplementation significantly reduced BASDAI disease activity versus low dose in ankylosing spondylitis.
Safety Information
Potential Side Effects
Fishy aftertaste, belching, and mild gastrointestinal upset are the common complaints and are reduced by taking capsules with food or freezing them. Loose stools can occur at multi-gram doses. Bleeding risk rises modestly above 3 g/day.
Contraindications
High-dose omega-3 (above roughly 3 g/day of EPA+DHA) modestly extends bleeding time; combine with warfarin, direct oral anticoagulants or dual antiplatelet therapy only under medical supervision, and pause before elective surgery. Large trials of high-dose preparations have reported a small increase in atrial fibrillation, which is worth weighing in people with a history of arrhythmia. Fish oil is contraindicated in fish or shellfish allergy — algal oil is the alternative.
Drug Interactions
- Warfarin and direct oral anticoagulants — additive effect on bleeding time at doses above 3 g/day
- Antiplatelet agents including aspirin and clopidogrel — monitor for bruising and bleeding
- Antihypertensives — omega-3 lowers blood pressure modestly and effects may add
- Orlistat — reduces absorption of fat-soluble supplements; separate dosing
Pregnancy & Breastfeeding
Pregnancy: likely_safe
Breastfeeding: likely_safe
Dosage Guidelines
Dosage Used in Studies
1000-4000 mg EPA+DHA
Best Time to Take
With the largest fat-containing meal of the day
Best Form
Re-esterified triglyceride (rTG) fish oil, or algal oil for plant-based diets
Bioavailability
Triglyceride forms absorb roughly 50% better than ethyl esters; both are markedly improved by taking with dietary fat.
Dosing by Goal
| Goal | Dose | Notes |
|---|---|---|
| General health maintenance | 250-500 mg combined EPA+DHA daily | Roughly what two servings of oily fish a week provides. Read the label for EPA+DHA, not total fish oil. |
| Elevated triglycerides | 2-4 g combined EPA+DHA daily | This range is prescription territory and should be supervised. Expect 20-30% reductions at the upper end. |
| Inflammatory joint pain | 2.7-3 g combined EPA+DHA daily | The dose used in rheumatoid arthritis trials. Allow 12 weeks before judging effect. |
| Pregnancy | 200-300 mg DHA daily on top of general intake | Choose a product tested for mercury and other contaminants, and confirm the dose with your obstetric provider. |
Forms Compared
Triglyceride (rTG) fish oil
Best for General use
Re-esterified triglyceride form. Absorption is better than ethyl ester, particularly when taken without a fatty meal.
Ethyl ester (EE) fish oil
Best for High-dose, cost-sensitive use
The form used in most prescription products and many cheaper supplements. Requires a fat-containing meal for good absorption.
Algal oil
Best for Vegans and vegetarians
Sourced from the microalgae that fish acquire omega-3s from. DHA-dominant; EPA content varies by product.
Krill oil
Best for People who dislike fish-oil burps
Phospholipid-bound and well absorbed, but EPA+DHA per capsule is usually low, so cost per gram is high. Contains shellfish protein.
Flaxseed / ALA oil
Best for Dietary fat quality, not EPA/DHA repletion
Conversion of ALA to EPA is under 15% and to DHA lower still. Not a substitute when the target is long-chain omega-3 status.
Food & Timing
Take with a meal containing fat. Ethyl ester products in particular absorb poorly on an empty stomach. Splitting larger doses across two meals reduces reflux and aftertaste.
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.