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Fish oil comes from many types of fish. It is rich in two important omega-3 fatty acids called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

The benefits of fish oil seem to come from its omega-3 fatty acid content. Fish that are especially rich in these oils include mackerel, herring, tuna, and salmon. The body doesn't produce many of its own omega-3 fatty acids. Omega-3 fatty acids reduce pain and swelling, and also prevent the blood from clotting easily.

Some fish oil products are approved by the FDA as prescription medications to lower triglycerides levels. Fish oil is also available as a supplement. Fish oil supplements do not contain the same amount of fish oil as prescription products, so they cannot be used in place of prescription products. Fish oil supplements are sometimes used for heart health and mental health, but there is no strong evidence to support most of these uses.

Do not confuse fish oil with EPA, DHA, cod liver oil, flaxseed oil, krill oil, or shark liver oil. See the separate listings for these topics.

NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
  • Hypertriglyceridemia.  Oral prescription fish oil products reduce triglyceride levels in patients with hypertriglyceridemia, especially in severe cases. Oral fish oil supplements may reduce triglyceride levels when used in very high doses of up to 12 capsules per dose.
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No data available.
  • Angioplasty.  Oral fish oil seems to prevent restenosis when started at least 3 weeks before percutaneous transluminal coronary angioplasty (PTCA).
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  • Cachexia.  Oral fish oil in doses of 7.5-8.1 grams daily seems to slow weight loss in patients with cachexia. Lower doses might not be effective.
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  • Cyclosporine-induced nephrotoxicity.  Oral fish oil seems to prevent cyclosporine-induced nephrotoxicity.
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  • Dysmenorrhea.  Oral fish oil seems to reduce symptoms of dysmenorrhea.
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  • Gastroenteritis-associated nausea and vomiting.  Oral fish oil during pregnancy seems to be beneficial for preventing gastroenteritis in early childhood. It is unclear if oral fish oil is beneficial for gastroenteritis prevention or treatment in children or adults.
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  • Heart failure.  Dietary fish oil seems to prevent heart failure. Also, oral fish oil seems to prevent further hospitalization, and possibly mortality, in patients with heart failure.
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  • HIV/AIDS-related dyslipidemia.  Oral fish oil seems to reduce triglyceride levels in patients with this condition. It is unclear if oral fish oil reduces levels of low-density lipoprotein (LDL) cholesterol in these patients.
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  • Hypertension.  Oral fish oil seems to reduce systolic and diastolic blood pressure in adults with moderate or severe hypertension. It is unclear if oral fish oil reduces blood pressure in patients with mild hypertension or in those using antihypertensive drugs.
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  • IgA nephropathy.  When used for 2-4 years, oral fish oil seems to slow the rate of renal function loss in high-risk patients. It is unclear if oral fish oil slows renal function loss when used for shorter time points or in low-risk patients.
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  • Nonalcoholic fatty liver disease (NAFLD).  Oral fish oil seems to reduce liver steatosis in adults and children with NAFLD.
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  • Rheumatoid arthritis (RA).  Oral fish oil seems to reduce pain and stiffness in patients with RA; however, oral fish oil does not seem to be beneficial for RA prevention when used alone.
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  • Diabetes.  Oral fish oil does not improve glycemic control or prevent cardiovascular outcomes in patients with type 2 diabetes. However, oral fish oil may lower triglyceride levels in patients with type 2 diabetes.
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No data available.
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No data available.

When taken by mouth: Fish oil is likely safe for most people in doses of 3 grams or less daily. Taking more than 3 grams daily might increase the chance of bleeding. Fish oil side effects include heartburn, loose stools, and nosebleeds. Taking fish oil supplements with meals or freezing them can reduce these issues.

Consuming high amounts of fish oil from DIETARY sources is possibly unsafe. Some fish are contaminated with mercury and other chemicals. Fish oil supplements typically do not contain these chemicals.

When applied to the skin: There isn't enough reliable information to know if fish oil is safe or what the side effects might be.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Fish oil supplements are likely safe when taken by mouth. Taking fish oil does not seem to affect the fetus during pregnancy or the baby while breast-feeding. But swordfish, king mackerel, and tilefish should be avoided during pregnancy, by those who may become pregnant, and while breast-feeding. These fish might contain high levels of mercury and may contain other toxins. Limit consumption of other fish to 12 ounces/week (about 3 to 4 servings/week). Consuming fatty fish in high amounts is possibly unsafe.

Children: Fish oil supplements are possibly safe when taken by mouth. In adolescents, fish oil has been used safely in doses of up to about 2.2 grams daily for 12 weeks. But young children should not eat more than two ounces of fish per week. Consuming fish oil from DIETARY sources in large amounts is possibly unsafe. Fatty fish contain toxins such as mercury. Eating contaminated fish frequently can cause serious adverse effects in children.

Bipolar disorder: Taking fish oil might increase some of the symptoms of this condition.

Liver disease: Fish oil might increase the risk of bleeding in people with liver scarring due to liver disease.

Diabetes: Taking high doses of fish oil might make it more difficult to control blood sugar levels.

Familial adenomatous polyposis: There is some concern that fish oil might further increase the risk of getting cancer in people with this condition.

Conditions in which the immune system response is lowered (including HIV/AIDS): Higher doses of fish oil can lower the body's immune system response. This could be a problem for people whose immune system is already weak.

An implanted device to prevent irregular heartbeat: Fish oil might increase the risk of irregular heartbeat in patients with an implanted defibrillator. Stay on the safe side and avoid fish oil supplements.

Fish or seafood allergy: Some people who are allergic to seafood such as fish might also be allergic to fish oil supplements. There is no reliable information showing how likely people with seafood allergy are to have an allergic reaction to fish oil. Until more is known, advise patients allergic to seafood to avoid or use fish oil supplements cautiously.

Birth control pills (Contraceptive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Fish oil is sometimes used to lower triglyceride levels. Birth control pills might reduce this effect if taken with fish oil.

Cyclosporine (Neoral, Sandimmune)

Interaction Rating=Moderate Be cautious with this combination.

Fish oil might increase how much cyclosporine is in the body. Taking fish oil with cyclosporine might increase the effects and side effects of cyclosporine.

Medications for cancer (Platinum agents)

Interaction Rating=Minor Be watchful with this combination.

Some fish oil products contain a fatty acid that might reduce the effects of some chemotherapy drugs, called platinum agents. But the amount of this fatty acid in most fish oil products is probably too low to be a concern. There is no need to stop taking fish oil if you are also taking platinum agents.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Fish oil might lower blood pressure. Taking fish oil along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Minor Be watchful with this combination.

Fish oil might slow blood clotting. Taking fish oil along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Orlistat (Xenical, Alli)

Interaction Rating=Moderate Be cautious with this combination.

Orlistat might keep the beneficial fatty acids in fish oil from being absorbed by the body. Taking fish oil and orlistat at least 2 hours apart may keep this from happening.

Sirolimus (Rapamune)

Interaction Rating=Moderate Be cautious with this combination.

Fish oil might increase how much sirolimus is in the body. This might increase the effects and side effects of sirolimus.

Tacrolimus (Prograf)

Interaction Rating=Moderate Be cautious with this combination.

Fish oil might increase how much tacrolimus is in the body. This might increase the effects and side effects of tacrolimus.

Warfarin (Coumadin)

Interaction Rating=Minor Be watchful with this combination.

Warfarin is used to slow blood clotting. Fish oil might also slow blood clotting. Taking fish oil with warfarin might slow blood clotting too much and increase the risk of bleeding. Until more is known, use cautiously in combination with warfarin. Have your blood checked regularly, as your dose of warfarin might need to be changed.

Herbs and supplements that might lower blood pressure: Fish oil might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, L-arginine, niacin, and stinging nettle.
Herbs and supplements that might slow blood clotting: Fish oil might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.
Vitamin D: Taking fish oil may increase vitamin D levels. This seems to only occur in people who have low vitamin D levels.
Vitamin E: Fish oil might reduce vitamin E levels. Researchers aren't sure if this is because fish oil keeps vitamin E from being absorbed from food or because it causes the body to use up vitamin E faster than it should.

Fish oil can be taken with or without food. But taking fish oil supplements with food might reduce the risk for side effects.

Fish oil supplements have most often been used by adults in doses of up to 6 grams daily by mouth for up to 12 weeks. Fish oil products typically provide 180-465 mg of EPA and 120-375 mg of DHA per capsule. Fish oil is also available in prescription drugs, including Lovaza, Omtryg, and Epanova. Fish oil supplements cannot be used in place of fish oil prescription drugs. Speak with a healthcare provider to find out what product and dose might be best for a specific condition.

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