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"How Much Omega 3 should I take?"

There are thousands of scholarly and lifestyle articles that support the importance of Omega 3 fatty acids (EPA/DHA) for heart and brain protection, as well as eye health and dry eye treatment.  If you are feeling convinced to begin increasing your Omega 3 intake but are feeling overwhelmed... where do you even start?   

In clinic, the most common question I hear when someone is wanting to start Omega 3 therapy is of course "How much should I take?"   The answer to this simple question can be complex and is likely part of the barrier for folks.  Walking my patients through how to start, I have found, is equally valuable to the actual recommendation to raise intake.   Let's break it down...

Considerations when planning to increase your Omega 3 levels (adults):

Consider your current sources 

Remember that Omega 3 (EPA & DHA) is an essential fatty acid.  This means that your body can not make Omega 3.  The foods you eat are the only source of this critical component of every cell in your body.  

With North American diets low in oily fish (main source of EPA and DHA), most of us are below the World Health Organization's daily Omega-3 recommendation of 500mg.  One daily meal of fish (like salmon) would satisfy our body's requirements but this is not practical for most individuals and is this enough to actually move your individual levels?

Achieving adequate daily levels of Omega 3 for the cardiac, neurological and eye health benefits generally requires supplementation.

What is my current status?   How can I tell if my levels low?

One can directionally determine their levels based on their current diet, however best practice is to measure your starting Omega 3 levels.  Knowing where you are starting provides invaluable information for targets, dosage, absorption.

I see FOUR clear advantages to using personal Omega 3 level testing [1] Establish personal baseline with objective levels  [2] Better understand your personal sensitivity to dietary changes and/or supplementation.  i.e. Understand what 'shifts the needle' for you. [3] See where you are on the population spectrum and [4] Optimize your levels with online calculators and optional consultation

The direct-to-consumer lab that I recommend for folks is OmegaQuant (available in US and Canada see discount code* below).  The Omega 3 Index Blood Test provides this detailed information in a simple, understandable form directly to health-interested consumers for about $50 USD before discount.

Lab analysis of your red blood cell EHA+DHA provides solid foundation to start positively enhancing levels through intake modification.  This type of testing provided a trailing 3 month history of levels (akin to HbA1c for diabetes) and is much more useful than testing blood plasma Omega 3 levels.  Plasma levels are naturally dynamic can be influenced by many factors.

Risks / Interactions of Supplements

Although regarded as very safe, some individuals need to approach Omega 3 supplements with caution.  Ethyl Ester Omega 3's can reduce the blood's ability to clot and for those on blood thinners or with blood disorders, this effect can be additive.  If you have very low blood pressure, Omega 3 can have a blood-pressure lowering effect.   Speak to your medical professional if you have cardiac or blood issues prior to starting supplements.

If you have a shellfish allergy, approach supplements with caution as most all Omega 3 is derived from fish.  


We have a blog article on the (low) toxin risk of Omega-3 supplements and how best to mitigate this concern of some folks.

High doses of Omega 3 can lead to some GI upset.   Try dividing your dose and take with food


What form of Supplement is best?

Beyond softgels and liquid, there are different available preparations of Omega 3.  The common forms for consumer use are the preferred, bioavailable triglyceride form, the weaker phospholipid form and the Ethyl Ester form which is generally prescription EPA (mEYEspa only sells Triglyceride form (TF).  See our premium Omega 3 options

Quality over quantity!  Low quality supplements often have fishy tastes because they are less purified.  Higher purity supplements generally cost a bit more due to the extra EPA/DHA condensing/purification processes but you will not need as much to get to a target dose.

Averages vs. personalized dosage of EPA  and DHA


Finally to the question "How much should I take"... OmegaQuant.com has a great calculator for individualizing your dose of Omega 3 to achieve optimal levels in three months. This level of personalized planning does understandably require that you know your baseline Omega 3 Index but it is the most objective way we have found to plan intake for a patient. 

Without personalization, our standard clinic recommendation for dry eye therapy (higher than recommendations for heart and brain health) is 1200mg/day** of triglyceride form DHA + EPA.

** This is not softgel size - please review this blog article to ensure that you understand the difference between softgel size and serving size and recommended dose.


Timeline for expected increase in levels

Plan for three months before making judgement on the effectiveness of Omega 3 supplement therapy.  You will not be able to notice the heart and brain benefits but reduced dry eye symptoms and reduced joint pain could be improvements that you feel with supplementation. 

Genetic variability and adjusting intake



Not all of us absorb and integrate Omega 3 equally.  The same dose administered to different people can have different outcomes. This is likely a genetic influence that is not possible to predict.  The best way to mitigate this unknown is to retest your Omega 3 index at ~3mths.   If you are way off target (either too low or too high) - adjust your total intake accordingly.   It is really only possible to understand and adjust with an objective test such as the Omega 3 index.  

Take with food

The last recommendation that I pass along to patients is to take their Omega 3 supplements with food.   Absorption seems to be negatively influenced if you take Omega 3 on an empty stomach.  It does not matter if you take a divided dose or all-at-once.

mEYEspa Premium High Potency Omega 3 Supplements

Full disclosure and personal note on the Omega 3 Index Lab test - I personally find monitoring with objective lab tests motivating to keep my own supplement plans on track.  mEYEspa received referral fees from OmegaQuant gives a 5% discount to mEYEspa shoppers when the referral link is used with discount code '6M3UAMHH1F'

Good luck on your Omega 3 learning journey!   
I hope we can help,
Dr Morris

Related topics: Children's Dosages or Omega 3,  Can Omega 3 help your retina?, How much Omega 3 to take - Understand Labels, Toxin risk of Omega-3 supplements, Beyond Eye Benefits of EPA/DHA

Cardiac health:  Omega 3 has been extensively studied and in high enough doses, can lower LDL cholesterol, lower blood pressure, thins blood and reduces inflammation of blood vessel walls.  This ultimately reduces the risk of health disease [1].

Brain health: Appears to play a role in reducing risk of neuro-degenerative diseases [2], studies suggest the Omega 3 can reduce anxiety, improve mood and support mental health [4], suggested to support neuro-development in children.

Muscle & Skeletal health:  Lowers joint [5] and muscle inflammation 

Immune health: Positively influences immune system activity and effectiveness.

Prenatal health: The World Health Organization (WHO) advises additional 200 mg/day of DHA for pregnant women for fetal nervous system development.

Endocrine system health:  Can lower blood triglyceride levels [6]

Skin health: Promotes skin elasticity and hydration [7], hair and nail growth, possible wound healing improvement

Eye health:  Common clinically-used treatment for dry eye (for inflammation control and enhanced oil layer production), less commonly endorsed for macular degeneration (AMD) and for retinopathy support. [3]

Dr Morris

References:
[1] In 2004 the FDA recognized the claim for EPA and DHA-containing foods and dietary supplements “consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease”

[2] Tully AM, Roche HM, Doyle R, Fallon C, Bruce I, Lawlor B, Coakley D, Gibney MJ (2003) Br J Nutr 89:483–489 Low serum cholesteryl ester-docosahexaenoic acid levels in Alzheimer's disease: a case-control study - PubMed

[3] SanGiovanni JP, Chew EY (2005)  Prog Retin Eye Res 24:87–138. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina - PubMed

[4] Kuan-Pin Su, MD; PhD Ping-Tao Tseng, MD; Pao-Yen Lin, MD, PhD; et al (2018) JAMA Open Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis

[5] Robert J Goldberg, Joel Katz (2007) Pain. 2007; 129:210-223 A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain

[6] A scientific statement from the American Heart Association (AHA) reviewed the role of omega-3 fatty acids in managing hypertriglyceridemia. The AHA concluded that omega-3 fatty acids effectively reduce triglyceride levels, with higher doses leading to more substantial reductions. 

[7] Linus Pauling Institute - Oregon State University Omega-6 (n-6) and omega-3 (n-3) polyunsaturated fatty acids (PUFAs) play a critical role in normal skin function and appearance.