Omega-3 (EPA/DHA)
Fish or algae oil supplying EPA and DHA; it lowers triglycerides, but trials show little effect on survival or cognition in most people.
Longevity
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Research
REALITY CHECK // Omega-3 supplements reliably lower blood triglycerides.
Levels: how we grade evidence. Grey = evidence of no benefit; amber = evidence it makes this goal worse.
Ratings are self-reported by a self-selected group of users: how it felt, not proof that it works.
>_ Protocol data coming soon: label checker ("Check your bottle"), study snapshot and form comparison for Omega-3 (EPA/DHA).
How it was studied
Summary
Omega-3 supplements reliably lower blood triglycerides. In a Cochrane review of 86 RCTs, this did not translate into longer life: little or no effect on all-cause mortality. One trial of prescription high-dose pure EPA cut cardiovascular events in high-risk statin users; ordinary fish oil is not the same product. It may slightly reduce coronary heart disease events. RCTs have not shown cognitive benefit.
Mechanism
EPA and DHA are built into cell membranes, reduce the liver's output of triglyceride-rich particles, and shift the balance of inflammation-signalling molecules. DHA is a structural fat in the brain and retina.
Typical studied dose
Trials in the Cochrane review used 0.5 g to more than 5 g of EPA+DHA per day. Triglyceride lowering was clearer above 2 g/day. The REDUCE-IT trial used 4 g/day of prescription EPA (icosapent ethyl).
Upper limit
EFSA (2012): supplemental EPA+DHA up to 5 g/day raises no safety concerns for adults. The FDA advises not exceeding 3 g/day of EPA+DHA in total, with no more than 2 g/day from supplements.
Popular stacks with Omega-3 (EPA/DHA)
Not enough stack data yet. A combination with Omega-3 (EPA/DHA) appears here once 5 people rate the same set.
Red flags: interactions and who should avoid it
Interactions
Anticoagulants and antiplatelet drugs (warfarin, DOACs, aspirin, clopidogrel): possible extra bleeding risk at high doses. In REDUCE-IT, serious bleeding was 2.7% versus 2.1% on placebo, a difference that was not statistically significant. Other blood-thinning supplements add to this. Cod liver oil also supplies vitamins A and D.
Avoid or ask a doctor first if
History of atrial fibrillation: in large trials AF risk rose with dose, more so above 1 g/day. Fish or shellfish allergy (algal oil is an option). Before surgery, ask whether to pause high doses. In pregnancy, agree the product and dose with your clinician.
Sources (PubMed)
- Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.
PMID 32114706 · 2020 · Cochrane systematic review and meta-analysis of 86 RCTsLittle or no effect on all-cause mortality (high-certainty evidence).
- Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia.
PMID 30415628 · 2018 · Phase III RCT, 8,179 high-risk patients on statinsPrescription EPA 4 g/day cut cardiovascular events; more AF hospitalisations.
- Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis.
PMID 34612056 · 2021 · Systematic review and meta-analysis of 7 RCTsAF risk rose 25% overall, more above 1 g/day.
- Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose-Response Meta-Analysis of Randomized Controlled Trials.
PMID 37264945 · 2023 · Dose-response meta-analysis of 90 RCTsTriglycerides fall roughly linearly with dose, clearer above 2 g/day.
- Fish consumption and omega-3 fatty acid supplementation for prevention or treatment of cognitive decline, dementia or Alzheimer's disease in older adults - any news?
PMID 27977429 · 2017 · Narrative review (RCTs and cohorts)Large 5-year trial found no cognitive effect; fish-intake benefits are observational.
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