Health Questions and Answers

Question: How much should a patient take?


One must first determine whether omega-3 fatty acids are being taken in order to lower triglycerides or simply to help prevent heart disease. If the intent is to lower triglycerides, 3-4 grams per day of n-3 fatty acids are required. This would require the patient to eat over 4 pounds of a low-fat fish like sole every day, or a half pound of oily fish such as mackerel, herring, or salmon. Supplementation is the only practical option. But to obtain 3-4 grams from capsules is not easy. The typical fish oil capsule at the health food store contains 30% n-3 fatty acids, which means that 10-12 capsules per day are required. More concentrated products (50%) are available via mail-order, reducing the dose to only 6-8 capsules per day. In the future, highly concentrated products containing 85% n-3 fatty acids will become available, probably by prescription, bringing the dose down to 4 capsules per day. The current cost for obtaining 3-4 grams of n-3 fatty acids from supplementation is approximately $0.75-1.00 per day

In n-3 fatty acids are being taken for cardioprotection and not for triglyceride lowering, then much lower intakes may suffice. An intake of 2-3 servings of oily fish per week was shown to reduce the incidence of fatal heart attacks in patients who had already survived one attack. This level of fish oil is equivalent to 1-2 “health food store” capsules per day. Unfortunately, there is not much solid data on these issues as we would like. However, the safety of fish oils, especially in these low doses, is beyond question. As with any treatment for the prevention of heart disease, a decision to take n-3 fatty acids should be made in consultation with the physician managing the patient’s overall care.

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