How to Take Omega 3 Supplement

Omega 3 supplements can help you improve your health and prevent disease. However, there are a couple of things you should know before you start taking them. In this article, you will learn about the correct daily dosage and the best time to take your supplement. You will also find out about the possible side effects and how Omega 3 interacts with other supplements and medications.



Omega 3 Daily Intake Recommendations

How much Omega 3 per day you should get depends on your general health and the conditions you might have.

Healthy adults should get about 500 mg of combined EPA and DHA. In addition to that, it is recommended to consume about 2 grams of ALA per day. You can do that by eating at least 2 portions of fatty fish per week and consuming enough Omega 3 rich oils, seeds, nuts, and green, leafy vegetables.

People who don't eat fish or seafood may find it difficult to get enough EPA and DHA – the biologically more important Omega 3 fatty acids. If this is the case, you might want to consider getting an Omega 3 supplement.

The following people should consume larger dosages of Omega 3 fatty acids:

People with heart disease:

1000 mg per day of combined DHA and EPA and a minimum of 2 grams per day of ALA.

People with elevated triglyceride levels:

Between 1000 and 4000 mgs of DHA and EPA per day. You will need to find the exact therapeutic dose of Omega 3. You can do that by starting with 1200 mgs per day and checking blood triglyceride levels every 3 to 4 weeks. Each time, the dose should be adjusted until you find the dose, which keeps your triglycerides within a suitable range. This process should be monitored by a physician.

Inflammatory diseases:

1000 - 3000 mg per day of combined EPA and DHA; focus on EPA rich supplements as EPA acts anti-inflammatory

Anxiety, depression, and mood disorders:

1000-3000 mg combined EPA and DHA per day (recommendation by American Psychiatric Association).

Vegans and Vegetarians

Vegetarians and vegans may find it hard to get enough EPA and DHA from food sources. That it is why it is recommended to increase your daily intake of ALA to 4 grams. This means consuming plenty of seeds, nuts, vegetable oils, and leafy vegetables. You will find it easier to reach your daily Omega 3 dosage by adding algae-based DHA supplement to your diet.

Pregnancy and Breastfeeding

It is crucial that you get enough Omega 3 fatty acids when you are pregnant or breastfeeding. All Omega 3 fatty acids are beneficial for the health of both the mother and the child. However, studies have shown that DHA plays a special role in the development of the baby during pregnancy and infancy. It is an important building block of the cells in the baby’s brain and retina (part of the eye) and essential for the development of both visual as well as nervous system of the baby.

University of Kansas study in 2004 showed that babies with higher DHA blood levels at birth have longer attention spans well into the second year of their life.

When they compared babies with low and high blood levels of DHA at 6 months of age, babies with higher DHA levels were developmentally 2 months ahead. The same babies also performed better on different visual learning tests, which were done at 1 year and 18 months.

Fish are the main dietary source of EPA and DHA. Pregnant women and infants are especially vulnerable to different contaminants in fish (mercury, PCB, other toxins). That is why they should be extra careful when choosing which fish to eat - always opting for the smaller and preferably wild-grown fish (such as sardines and anchovies).

A good alternative is to get a quality Omega 3 supplement. It must contain adequate levels of DHA. You should aim to get at least 500 mg EPA and DHA combined; of that DHA must be a minimum of 250 mg.

Children (younger than 18 years) and infants

Omega 3 fatty acids can be found in many infant formulas. Most contain only ALA and DHA (typically derived from algal and fungal sources).

It is recommended for children to eat small, fatty fish 2 times per week. Supplementation doses for children have not yet been established, so consult with your pediatrician before starting your child on an Omega 3 supplement.

When and How to Take Omega 3 Supplement

All Omega 3 supplements will be better absorbed if you take them immediately after fatty meals. The reason for this is that oils are quite difficult to break down. Eating a meal, which contains at least some fat, will trigger bile release from the gallbladder. This, in turn, will help the absorption of the Omega 3 fats.

Other things that help absorb Omega 3 fatty acids are bitter foods (like fats, they also stimulate bile production). These include digestive bitters made from herbs and strong-flavored greens.

Dividing your Omega 3 supplement into several, smaller doses per day will help you decrease gastrointestinal side-effects, like heartburn, burping, and nausea.

How to Store Omega 3 Supplements

All Omega 3 Supplements quickly become rancid. Buy only quality supplement from good sources and always check the expiration date. This way you can trust that you won’t get an already spoiled product.

Once you open the container (flask), store it in a refrigerator and keep it protected from light. After opening an Omega 3 supplement, you must use it all within 1 month. After 1 month the rancidity reactions rapidly increase and the supplement is no longer safe to use. This goes the same for liquid as well as capsule-form supplements.

Warnings, side effects and interactions

Side effects

In general, taking Omega 3 supplements doesn’t cause major side effects. Most commonly reported side effects are gastrointestinal – fishy aftertaste, burping, heartburn and diarrhea. There have also been some reported cases of skin rashes and allergies.

However, when you take very high doses of Omega 3(more than 3 grams per day), more severe side effects can happen. These include:

  • Increased risk of bleeding (especially if you are also taking blood thinning medications or supplements)
  • An increase in bad cholesterol (LDL -low density lipoprotein cholesterol). Studies show that this doesn’t happen if you take Omega 3 with additional vitamin E.
  • Blood sugar problems (these are more common with people who have diabetes or are taking medications and supplements that affect blood sugar)
  • Impaired function of the immune system (Omega 3 fatty acids can in high doses suppress the action of the immune system).

FDA Safety Ruling

US FDA (US Food and Drug Administration) has ruled that it is safe to take Omega 3 supplements (EPA and DHA) in doses up to 3 grams per day.

EFSA safety recommendation

The EFSA (European Food Safety Authority) considers doses up to 5 grams per day of combined EPA and DHA safe for general adult population. 

People that Should be Cautious When Taking an Omega 3 Supplement

Prone to allergies

If you are allergic to fish, avoid Omega 3 supplements made from fish or fish oil. If you are allergic to nuts or seeds, avoid all supplements derived from them.

With bleeding disorders

People who have a bleeding disorder should take Omega 3 supplements with caution and only in small amounts.

With diabetes or hypoglycemia

In larger doses, Omega 3 fatty acids may affect blood sugar levels. People with diabetes or hypoglycemia should periodically check their blood sugar level if they are taking Omega 3 supplements.

With abnormal heart rhythms or after a heart transplant

Since Omega 3 fatty acids may affect heart rate, they should be used cautiously if you are suffering from abnormal heart rhythms or you’ve had a heart transplant.

With hormone imbalance

People with hormone imbalances or undergoing a hormone replacement therapy should take Omega 3 supplements with caution.

With liver disease

It has been reported that long-term use of Omega 3 may affect liver function tests. Be careful when taking Omega 3 supplements if you have liver disease or are using medications that are toxic to liver.

Omega 3 fatty acids and other supplements and herbs

Discuss all supplements and medications that you are taking with your doctor. This way you will make sure that there are no interactions between them and you are safely managing your health.

When you are taking an Omega 3 supplement, it is recommended that you increase your intake of vitamin E. The reason for this is that Omega 3 fatty acids are easily oxidized (they become rancid). To reduce the oxidation of Omega 3 outside and inside the body, additional antioxidants are needed.

Vitamin E is a powerful antioxidant. Many Omega 3 supplements already contain some vitamin E. If you check the label, you will usually see alpha-tocopherol included in the ingredients.

If you are taking Omega 3 supplement, increase your vitamin E intake, or look for supplements that already contain additional vitamin E.

Most widely used recommendation is to get 0.6 mg of vitamin E per gram of dietary omega 3 fatty acids.

Supplements and Herbs that Interact With Omega 3 Fatty Acids:

Supplements that raise the risk of bleeding

These include Ginkgo biloba, angelica, clove, danshen, garlic, ginger, Panax ginseng, red clover, turmeric, willow, and others.

Omega 3 fatty acids slow down blood coagulation. If you take them with these herbs and supplements, you may increase the risk of bleeding complications.

Supplements that affect blood sugar levels

These include niacin, DHEA, melatonin, glucosamine sulfate, and cinnamon.

Omega 3 fatty acids are known to have an effect on blood sugar. If you take any of these supplements along with Omega 3 supplement, you need to monitor blood glucose levels and adjust the doses accordingly.   

Herbs and supplements that lower blood pressure

These include magnesium, vitamin C, Coenzyme Q10, resveratrol, melatonin, Acetyl-L-carnitine, etc.

Studies have shown that Omega 3 decreases blood pressure. If you take Omega 3 along with these supplements, you must monitor you blood pressure to make sure that it doesn’t fall to low.

Interaction Between Omega 3 Fatty Acids and Prescription Medications

Omega 3 Fatty Acids interact with the following medications:

Medications that affect blood clotting (anticoagulants, antiplatelet drugs, and nonsteroidal anti-inflammatory drugs NSAIDs)

High doses of Omega 3 fatty acids slow down blood clotting. That is why you should take extra care when using Omega 3 along with other medications that have a similar effect on blood coagulation:

  • Aspirin
  • Blood thinning medications, such as warfarin (Coumadin, Jantoven, Marevan, Uniwarfin), and heparin
  • Antiplatelet  medications, such as clopidogrel (Plavix)
  • NSAIDs, such as ibuprofen (Advil, Motrin, Nurofen) and naproxen (Aleve, Naprosyn)

Medications that affect blood sugar

Blood sugar lowering drugs include:

  • Glipizide (Glucotrol and Glucotrol XL)
  • Glyburide (Micronase or Diabeta)
  • Glucophage (Metformin)
  • Insulin

Omega 3 fatty acids also affect blood sugar levels, so you need to regularly monitor your blood sugar if you are taking both Omega 3 and medications for the management of blood sugar.

Drugs that lower blood pressure

These medications include:

  • Diuretics (typically a thiazide diuretic)
  • ACE inhibitors , such as enalapril (Vasotec), lisinopril (Prinivil, Zestril) and ramipril (Altace)
  • Calcium channel blockers, such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor XR) and nifedipine (Adalat CC, Procardia)
  • Beta blockers, such as metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and atenolol (Tenormin)
  • Angiotensin II receptor blockers, including losartan (Cozaar), candesartan (Atacand) and valsartan (Diovan)

Since Omega 3 also lowers blood pressure, it may increase the effect of these medications.

Cholesterol-lowering medications

Omega-3 fatty acids can increase the action of some cholesterol lowering medications. These medications are also called statins and include atorvastatin (Liptor), lovastatin (Mevacor), and simvastatin (Zocor).

Cyclosporine

Cyclosporine (Sandimmune) therapy causes some toxic side effects, including kidney damage and high blood pressure. Taking Omega 3 fatty acids may reduce these side effects.

Etretinate and topical steroids

Topical treatment for psoriasis usually includes etretinate (Tegison) and topical corticosteroids. Adding Omega 3 fatty acids (especially EPA) to the treatment may help improve the symptoms of psoriasis.



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Sources and References: 
  1. Mayo Clinic. Omega 3 Supplement. http://www.mayoclinic.org/drugs-supplements/omega-3-fatty-acids-fish-oil-alpha-linolenic-acid/dosing/hrb-20059372
  2. Omega 3 Oregon State. http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/
  3. Scientific Opinion on the Tolerable Upper Intake Level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA). EFSA Journal 2012. http://www.efsa.europa.eu/en/efsajournal/pub/2815.htm
  4. Harvard School of Public Health. AHA Scientific Statement. Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease. Penny M. Kris-Etherton, PhD, RD; William S. Harris, PhD; Lawrence
  5. Fish Oil on Medline Plus. http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html
  6. University of Maryland Medical Center (UMMC). http://umm.edu/health/medical/altmed/supplement-interaction/possible-interactions-with-omega3-fatty-acids
  7. Fish oil on WebMd. http://www.webmd.com/vitamins-supplements/ingredientmono-993-fish%20oil.aspx?activeingredientid=993&activeingredientname=fish%20oil

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