Getting your dose of fish oil right

Confusion often stems from the simplest of calculations: dose of fish oil.

Actually, you and I don't take fish oil for fish oil. We take fish oil for its content of omega-3 fatty acids, the dominant ones being EPA and DHA. The contents of fish oil outside of its EPA + DHA content likely exert little or no benefit (beyond that of other dietary oils).

To determine what you are currently taking, simply examine the back of your fish oil bottle and look for the EPA + DHA composition. This should be clearly and prominently labeled. If not, don't buy that brand again. Add up the EPA + DHA content per capsule, then multiply by the number of capsules you take per day. That yields your daily EPA + DHA intake.

The only other substantial source of omega-3 fatty acids is fish. Other food sources, such as non-fish meats, eggs, etc., contribute little or none. Processed foods that bear health claims of "contains heart healthy omega-3" often contain linolenic acid or flaxseed oil, which contributes very little to total EPA + DHA, or contain relatively trivial quantities of DHA. What are you doing eating processed foods, anyway?

What should the total daily dose of EPA + DHA dose be? That depends on what your goals are.

If your goal is to modestly reduce the risk of dying from heart attack, then just eating fish a couple of times per month will begin to exert an effect, or just taking a dose of 300 mg EPA + DHA per day from a low-potency capsule will do it. However, that's an awfully unambitious goal.

Our starting omega-3 dose in the Track Your Plaque program has, over the years, increased and now stands at 1800 mg EPA + DHA per day. However, the dose for 1) full reduction of triglycerides and/or triglyceride-containing abnormal lipoproteins, 2) reduction of Lp(a), and 3) the ideal dose for coronary and carotid plaque control are substantially higher.

But once you know your desired daily target of total EPA + DHA, you can easily determine the quantity of capsules to take by doing the above arithemetic, totaling the EPA + DHA per capsule. For example, if you have been instructed to take 6000 mg per day EPA + DHA, and your capsule contains 750 mg EPA + DHA, then you will need to take 8 capsules per day (6000/750).

Comments (11) -

  • JoeEO

    12/24/2008 4:27:00 PM |

    Merry Christmas, Dr. Davis!

    Peace

    Joe E O

  • Anonymous

    12/24/2008 5:15:00 PM |

    Now this I can understand! Thanks for blogging so clearly.

    Smile

    Stevie

  • rabagley

    12/24/2008 9:15:00 PM |

    I have no idea why people mess around with capsules when the bottled lemon-flavored fish oil is so much more palatable and easier to take.

    1.5 tablespoons of Carlson's finest fish oil (which is about what the large spoons in my kitchen drawer hold) contains:

    3600mg EPA
    2250mg DHA
    1350mg other O-3 fatty acids

    And all of that goes down in one smooth, lemon-flavored swallow.

    I take enough supplements as pills already without having to choke down six or nine more of those fish oil capsules.

  • Anonymous

    12/24/2008 9:43:00 PM |

    Dr Davis, I know you no longer post here, but I wanted you to know that you gave me a great Christmas present. Diagnosed with high LP(a) of 87 I couldn't get it below 35-45 even with 1500mg of Niacin daily. Reading your blogs I increased my Fish capsules to 1800 3 months ago along with the 1500 Niacin. Just got my blood workup back and after 6 yrs of trying my LP(a)is now "normal" at 11.
    I think the D helped too that I learned about on your blog.
    You deserve a Santa hat and my gratitude. Thank You and Happy holidays......... Over&Oout

  • Craig

    12/24/2008 11:22:00 PM |

    My fish oil has total 300mg. of epa/dha.  The label then indicates 300mg of omega 3's.  Do those count for any heart benefits?  The bottle label claims these are 1,000mg fish oil softgels but I can't find anything that adds up to
    1,000mgs.  So, my question is am I getting 300, 600, or 1,000mgs in one capsule?  Your posted explanation is very clear, but I need a bit more clarification.

    Thanks.

  • Rich

    12/25/2008 3:21:00 PM |

    I second the vote for the liquid fish oil - the only way to go if you are trying to take a therapeutic dose of fish oil.  I’ve been using various liquid brands for many years – also avoids the “burps” you get with some softgels.

    The only downside to the liquid is if you travel, as it needs to be kept refrigerated, which can be inconvenient.  I keep a small supply of softgels around for when I am travelling.

    In response  to Craig:  on your bottle, all you care about is the amount of EPA+DHA listed in the ingredients – in your case, apparently a total of 300 mg EPA+DHA per softgel.   So, for example, if you want a dose of 1800 mg EPA+DHA per day, you will need 6 softgels.

  • Jack Cameron

    12/27/2008 12:32:00 AM |

    In my opinion high vitamin cod liver oil is the best way to get a base amount of fish oil. One tablespoon provides about 1 mg of EPA + DHA and all the vitamin A and D you need. I use fish oil tablets to supplement the cod liver oil.

  • Anonymous

    1/2/2009 1:38:00 AM |

    I have posted a couple of times here and I guess I will join the TYP since I have found good guidance in general. When I started out at the end of 2002 with angina problems, I was encouraged by a U.Guelph study discussing the benefits of a combination of fish oil and Garlic (Adler et al) Here, on Track your Plaque, the mega-dose of fish oil is also recommended.
      
    BUT..... Chris Masterjohn, who appears to provide well researched and ref. articles, states clearly that it is only DHA that is desired and that excess EPA can inhibit the conversion of ALA....
    SO...... Good or bad, high fish oil intake with EPA ?

    are there any sources of just DHA?

  • Anonymous

    5/15/2009 12:21:00 AM |

    Cod liver oil has too much vitamin A.  Fish oils make a big contribution to overfishing, much more than eating fish.  You can get algae-derived DHA supplements, and two companies make a DHA/EPA product from algae :www.water4.net, maker of V-Pure; and www.source-omega.com, maker of Pure One.

  • buy jeans

    11/3/2010 10:33:05 PM |

    If your goal is to modestly reduce the risk of dying from heart attack, then just eating fish a couple of times per month will begin to exert an effect, or just taking a dose of 300 mg EPA + DHA per day from a low-potency capsule will do it. However, that's an awfully unambitious goal.

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