Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), precursors of certain eicosanoids that are known to reduce inflammation in the body and improve hypertriglyceridemia.[1][2] There has been a great deal of controversy in the 21st century about the role of fish oil in cardiovascular disease, with recent meta-analyses reaching different conclusions about its potential impact.

The fish used as sources do not actually produce omega-3 fatty acids. Instead, the fish accumulate the acids by consuming either microalgae or prey fish that have accumulated omega-3 fatty acids. Fatty predatory fish like sharks, swordfish, tilefish, and albacore tuna may be high in omega-3 fatty acids, but due to their position at the top of the food chain, these species may also accumulate toxic substances through biomagnification. For this reason, the United States Environmental Protection Agency recommends limiting consumption (especially for women of childbearing age) of certain (predatory) fish species (e.g., albacore tuna, shark, king mackerel, tilefish and swordfish) due to high levels of the toxic contaminant mercury. Dioxins, like PCBs and chlordane, as well as other chlorinated cyclodiene insecticides are also present.[3] Fish oil is used in aquaculture feed, in particular for feeding farmed salmon.[4]

Marine and freshwater fish oil vary in contents of arachidonic acid, EPA and DHA.[5] The various species range from lean to fatty, and their oil content in the tissues has been shown to vary from 0.7% to 15.5%.[6] They also differ in their effects on organ lipids.[5] Studies have revealed that there is no relation between either 1) total fish intake or 2) estimated omega−3 fatty acid intake from all fish and serum omega−3 fatty acid concentrations.[7] Only fatty fish intake, particularly salmonid, and estimated EPA + DHA intake from fatty fish has been observed to be significantly associated with increase in serum EPA + DHA.[7]

As of 2019, the US Food and Drug Administration (FDA) has approved four fish oil-based prescription drugs, namely Lovaza, Omtryg (both omega-3 acid ethyl esters), Vascepa (ethyl eicosapentaenoic acid), and Epanova (omega-3 carboxylic acids).[8] None of these drugs are actually fish oil; they are all derivatives of acids found in fish oil.


Often marketed and sold for consumption as part of the diet or in dietary supplements in contemporary societies, fish oils also have found roles in external use, as emollients[9] or as general ointments[10] as well as in body art,[11] or for alleged insulation against cold temperatures.[12]

Fish oil rendering in Port Dover, Ontario, 1918

Food sources

The most widely available dietary source of EPA and DHA is cold-water oily fish, such as salmon, herring, mackerel, anchovies, and sardines. Oils from these fish have a profile of around seven times as much omega-3 oils as omega-6 oils. Other oily fish, such as tuna, also contain omega-3 in somewhat lesser amounts. Although fish is a dietary source of omega-3 oils, fish do not synthesize them; they obtain them from the algae (microalgae in particular) or plankton in their diets.[13]

EPA and DHA are available as dietary supplements most commonly as fish oil capsules, softgels, and gummies,1 krill oil, and less commonly as algae oil.2 Generally, salmon oil has more DHA than EPA while other fish oils such as herring, mackerel, anchovies, sardines, and pollock have more EPA than DHA. (See Supplements section below.)

Grams of omega-3 fatty acids per 3 oz (85 g) serving of popular fish.[14][15]
Common name grams
Herring, sardines 1.3–2
Spanish mackerel, Atlantic, Pacific 1.1–1.7
Salmon 1.1–1.9
Halibut 0.60–1.12
Tuna 0.21–1.1
Swordfish 0.97
Greenshell/lipped mussels 0.95[16]
Tilefish 0.9
Tuna (canned, light) 0.17–0.24
Pollock 0.45
Cod 0.15–0.24
Catfish 0.22–0.3
Flounder 0.48
Grouper 0.23
Mahi mahi 0.13
Orange roughy 0.028
Red snapper 0.29
Shark 0.83
King mackerel 0.36
Hoki (blue grenadier) 0.41
Silver gemfish 0.40
Blue eye cod 0.31
Sydney rock oyster 0.30
Tuna, canned 0.23
Snapper 0.22
Barramundi, saltwater 0.100
Giant tiger prawn 0.100

For comparison, note the omega-3 levels in some common non-fish foods:

Grams of omega-3 fatty acids per 3 oz (85 g) serving of common non-fish foods.[14]
Name grams
Flaxseeds 19.55
Chia seeds 14.8
Hemp seeds 7.4
Walnut 1.7
Soybean 1.1
Butter 0.27
Eggs, large regular 0.109[16]
Lean red meat 0.031
Turkey (bird) 0.030
Cereals, rice, pasta, etc. 0.00
Fruit 0.00
Milk, regular 0.00
Bread, regular 0.00
Vegetables 0.00

Health effects

Kepler cod liver oil with malt extract


Fish oil became one of the earliest dietary supplements, and by the end of the 19th century, was used as a treatment for many diseases, including such ailments as tuberculosis and hysteria.[17][18][19] The possible effects of fish oil and omega-3 fatty acids have since been studied in clinical depression,[20][21] anxiety,[22] cancer, and macular degeneration, yet they have not been proven effective.[23]

Various recommendations

In a 2009 letter on a pending revision to the Dietary Guidelines for Americans, the American Heart Association recommended 250–500 mg/day of EPA and DHA.[24] The Guidelines were revised again for 2015–2020; included is a recommendation that adults consume at least eight ounces of a variety of types of fish per week, equating to at least 250 mg/day of EPA + DHA.[citation needed] The Food and Drug Administration recommends not exceeding 3 grams per day of EPA + DHA from all sources, with no more than 2 grams per day from dietary supplements.[25]

Prostate cancer

The effect of fish oil consumption on prostate cancer is controversial.[26][27] For instance, one study showed decreased risk with higher blood levels of DPA. However, another reported increased risk of more aggressive prostate cancer with higher blood levels of combined EPA and DHA.[28] Some evidence indicated an association between high blood levels of omega-3 fatty acids and an increased prostate cancer risk.[29]

However, this evidence from the Select Trial has been challenged on the grounds of methodology and that the quantitative difference between those who developed prostate cancer and those who did not "is so small as to be biologically irrelevant".[30]


There is uncertainty about the role of fish oil in cardiovascular disease, with reviews reaching different conclusions about its potential impact. Multiple evaluations suggest fish oil has little or no reduction on cardiovascular mortality, although there may be a small reduction in the incidence of actual cardiac events and strokes with its use.[31][32][33] In 2007, the American Heart Association recommended the consumption of 1 gram of fish oil daily,[34] preferably by eating fish, for patients with coronary artery disease, but cautioned pregnant and nursing women to avoid eating fish with high potential for mercury contaminants including mackerel, shark, and swordfish.[35] (Optimal dosage was related to body weight.)

The US National Institutes of Health lists three conditions for which fish oil and other omega-3 sources are most highly recommended: hypertriglyceridemia (high triglyceride level), preventing secondary cardiovascular disease, and hypertension (high blood pressure). It then lists 27 other conditions for which there is less evidence. It also lists possible safety concerns: "Intake of 3 grams per day or greater of omega-3 fatty acids may increase the risk of bleeding, although there is little evidence of significant bleeding risk at lower doses. Very large intakes of fish oil or omega-3 fatty acids may increase the risk of hemorrhagic (bleeding) stroke."[23]

There were studies to determine if fish oil had an effect on certain abnormal heart rhythms,[36][37] although a 2012 meta-analysis found no significant effect.[38]

A 2008 meta-study found fish oil supplementation did not demonstrate any preventative benefit to cardiac patients with ventricular arrhythmias.[39] A 2012 meta-analysis covering 20 studies and 68,680 patients, found that omega-3 fatty acid supplementation did not reduce the chance of death, cardiac death, heart attack, or stroke.[40] A 2018 meta-analysis of 77,000 participants found a 3% reduction in the relative risk for those who supplemented fish oil; however, this effect was deemed insignificant.[41]


There have been some human trials that have concluded that consuming omega-3 fatty acids slightly reduces blood pressure (DHA could be more effective than EPA). Because omega-3 fatty acids can increase the risk of bleeding, a qualified healthcare provider should be consulted before supplementing with fish oil.[42]

Mental health

A 2008 Cochrane systematic review found that limited data is available. In the one eligible study, omega-3s were an effective adjunctive therapy for depressive but not manic symptoms in bipolar disorder. The authors found an "acute need" for more randomised controlled trials.[43]

A 2009 metastudy found that patients taking omega-3 supplements with a higher EPA:DHA ratio experienced fewer depressive symptoms. The studies provided evidence that EPA may be more efficacious than DHA in treating depression. However, this metastudy concluded that due to the identified limitations of the included studies, larger, randomized trials are needed to confirm these findings.[44]

In a 2011 meta-analysis of PubMed articles about fish oil and depression from 1965 to 2010, researchers found that "nearly all of the treatment efficacy observed in the published literature may be attributable to publication bias."[45]

A 2014 meta-analysis of eleven trials conducted respectively on patients with a DSM-defined diagnosis of major depressive disorder (MDD) and of eight trials with patients with depressive symptomatology but no diagnosis of MDD demonstrated significant clinical benefit of omega-3 PUFA treatment compared to placebo. The study concluded that: "The use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD."[46]


A 2019 meta-analysis concluded that EPA ≥ 60% at a dosage of ≤1 g/d may have antidepressant effect.[47]

Alzheimer's disease

A Cochrane meta-analysis published in June 2012 found no significant protective effect for cognitive decline for those aged 60 and over and who started taking fatty acids after this age. A co-author of the study said to Time, "Our analysis suggests that there is currently no evidence that omega-3 fatty acid supplements provide a benefit for memory or concentration in later life".[48]


Diets supplemented with cod liver oil have shown beneficial effects on psoriasis.[49]


Some studies reported better psychomotor development at 30 months of age in infants whose mothers received fish oil supplements for the first four months of lactation.[50] In addition, five-year-old children whose mothers received modest algae based docosahexaenoic acid supplementation for the first 4 months of breastfeeding performed better on a test of sustained attention. This suggests that docosahexaenoic acid intake during early infancy confers long-term benefits on specific aspects of neurodevelopment.[50]

In addition, provision of fish oil during pregnancy may reduce an infant's sensitization to common food allergens and reduce the prevalence and severity of certain skin diseases in the first year of life. This effect may persist until adolescence with a reduction in prevalence and/or severity of eczema, hay fever and asthma.[51]

Crohn's disease

A 2014 Cochrane review found that, based on two large studies, fish oil supplements did not appear to be effective for maintenance of remission in Crohn's disease.[52]


Fish oil capsules

Fish oil is a commonly used dietary supplement, with sales in the US alone reaching $976 million in 2009.[53] By 2020 the global omega-3 supplement market size had reached $5.58 billion, and fish oil based supplements accounted for 63.1% of that market.[54]


Fish oil supplements are available mainly as liquids or capsules. Most of these capsules are single-piece gel capsules or softgels. Also available are enteric-coated capsules that pass through the stomach before dissolving in the small intestine, thus helping prevent indigestion and "fish burps". Poorly manufactured enteric-coated products have the potential to release ingredients too early., a for-profit supplement testing company, reported that 1 of the 24 enteric-coated fish oil supplements it evaluated released ingredients prematurely.[53] Fish oil products may use other techniques to hide the fishy taste. For example, added lemon or strawberry flavor tends to produce a more agreeable product[55] and are usually present in fish oil gummies.

EPA and DHA content

Generally, oily fish have more EPA than DHA versus salmon which has more DHA than EPA. To illustrate the amounts of EPA and DHA in supplements, a softgel capsule containing fish oil derived from pollock might contain a total of 642 mg of total fish oil, of which 584 mg are omega-3 fatty acids, with 377 mg EPA and 158 mg DHA.3 That same company's salmon oil softgel contains 1008 mg of total fish oil, of which 295 mg are omega-3 fatty acids, with 95 mg EPA and 118 mg DHA.4

According to tests, the concentrations of EPA and DHA in supplements can vary from between 8 and 80% fish oil content. The concentration depends on the source of the omega-3s, how the oil is processed, and the amounts of other ingredients included in the supplement.[56] However, the bioavailability of EPA and DHA from both capsular and emulsified fish oils has been shown to be high.[57] A publication in 2010 stated that 3 of 24 fish oil supplements tested contained less EPA and/or DHA than was claimed on the label.[53] A 2012 report stated that 4 of 35 fish oil supplements that were tested contained less EPA or DHA than was claimed on the label, and 3 of 35 contained more.[56]

Quality and concerns

Problems of quality have been identified in periodic tests by independent researchers of marketed supplements containing fish oil and other marine oils. These problems may include contamination, inaccurate listing of EPA and DHA levels, spoilage, and formulation issues.[58]


A report by the Harvard Medical School studied five popular brands of fish oil, including Nordic Ultimate, Kirkland and CVS. They found that the brands had "negligible amounts of mercury, suggesting either that mercury is removed during the manufacturing of purified fish oil or that the fish sources used in these commercial preparations are relatively mercury-free".[59] There appears to be little risk of contamination by microorganisms, proteins, lysophospholipids, cholesterol, and trans-fats.[60]

Dioxins and PCBs

Dioxins and PCBs may be carcinogenic at low levels of exposure over time. These substances are identified and measured in one of two categories, dioxin-like PCBs and total PCBs. While the US FDA has not set a limit for PCBs in supplements, the Global Organization for EPA and DHA (GOED) has established a guideline allowing for no more than 3 picograms of dioxin-like PCBs per gram of fish oil. In 2012, samples from 35 fish oil supplements were tested for PCBs. Trace amounts of PCBs were found in all samples, and two samples exceeded the GOED's limit.[56] Although trace amounts of PCBs contribute to overall PCB exposure, claims the amounts reported by tests it ordered on fish oil supplements are far below those found in a single typical serving of fish.[56]


Peroxides can be produced when fish oil spoils. A study commissioned by the government of Norway concluded there would be some health concern related to the regular consumption of oxidized (rancid) fish/marine oils, particularly in regards to the gastrointestinal tract, but there is not enough data to determine the risk. The amount of spoilage and contamination in a supplement depends on the raw materials and processes of extraction, refining, concentration, encapsulation, storage and transportation.[60] reports in its review that it found spoilage in test reports it ordered on some fish oil supplement products.[56]

Prescription fish oil-based medications

See also: Omega-3 acid ethyl esters and Fish oil (medical use)

Fish oil itself is available as a prescription, but the majority of fish oil products available via prescription are derivatives of fish oil. Such products are described elsewhere in this article. These preparations, with the purpose of treating or preventing medical disorder, are only available with a doctor's prescription. In the US, such prescriptions undergo the same Food and Drug Administration (FDA) regulatory requirements as other prescription medications, including with regard to both efficacy and safety.[61] Purity is also regulated by the FDA. The prescription fish oil derivative medicines differ from over-the-counter fish oil supplements.[62] Prescription fish oil is considered a safe and effective option to reduce triglycerides. There are various prescription fish oil products that have been approved and permitted by the FDA for decreasing triglyceride levels. Prescription fish oil products having DHA work by raising LDL-C levels to reduce triglycerides, like fibrates.[63] Heart experts advise that prescription fish oil helps in decreasing additional levels of blood fats. Prescription fish oils might only help when triglycerides reach a specific upper level.[64] Prescription fish oil pills, capsules and tablets have more omega-3 fatty acids than those which are non-prescription. The FDA regularly monitors prescription fish oil for standards like purity and for quality and safety.[65]

As of 2019, four fish oil-based prescription drugs have been approved in the United States for the treatment of hypertriglyceridemia,[8] namely:

  1. Epanova (omega-3 carboxylic acids) was approved on 23 April 2014.[66][67][68] Clinical trial on mixed dyslipidaemia (hypertriglyceridemia with hypocholesterolemia) started in 2014[69] found that it has no medical benefits, and the clinical trial was called off on 13 January 2019.[70] Although FDA-approved, Epanova is not available in any market.
  2. Lovaza (omega-3 acid ethyl esters) was approved on 10 November 2004.[71][72][73][74]
  3. Omtryg (omega-3 acid ethyl esters) was approved on 23 April 2014.[75][76][77]
  4. Vascepa (ethyl eicosapentaenoic acid; icosapent ethyl) was approved on 26 July 2012.[78][79][80] On 13 December 2019, the FDA also approved it as the first drug specifically "to reduce cardiovascular risk among patients with elevated triglyceride levels." Vascepa is not approved as a monotherapy for lowering TGs: it must be taken with a statin, per product labeling.[81]

Some fish-oil products are approved for parenteral nutrition:

  1. Omegaven, approved in July 2018, is indicated as a source of calories and fatty acids in children with parenteral nutrition-associated cholestasis (PNAC).[82][83][84]
  2. Smoflipid, approved in July 2016, is indicated in adults as a source of calories and essential fatty acids for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.[85][86][87]


A 2013 review concluded that the potential for adverse events among older adults taking fish oil "appear mild–moderate at worst and are unlikely to be of clinical significance".[88]

Maximum intake

The FDA recommends that consumers do not exceed more than 3 grams per day of EPA and DHA combined, with no more than 2 grams from a dietary supplement.[89] This is not the same as 3000 mg of fish oil. A 1000 mg pill typically has only 300 mg of omega-3; 10 such pills would equal 3000 mg of omega-3. According to the European Food Safety Authority's (EFSA) Panel on Dietetic Products, Nutrition and Allergies, supplementation of 5 grams of EPA and DHA combined does not pose a safety concern for adults.[90] A 1987 study found that healthy Greenlandic Inuit had an average intake of 5.7 grams of omega-3 EPA per day which had many effects including prolonged bleeding times, such as slower blood clotting.[91]


Two 2021 systematic reviews and meta-analyses concluded that more than 1 g/d marine omega-3 fatty acids is associated with an increased risk of atrial fibrillation.[92][93]


The liver and liver products (such as cod liver oil) of fish and many animals (such as seals and whales) contain omega-3, but also the active form of vitamin A. At high levels, this form of the vitamin can be dangerous (Hypervitaminosis A).[94]

Toxic pollutants

Consumers of oily fish should be aware of the potential presence of heavy metals and fat-soluble pollutants like PCBs and dioxins, which are known to accumulate up the food chain. After extensive review, researchers from Harvard's School of Public Health in the Journal of the American Medical Association (2006) reported that the benefits of fish intake generally far outweigh the potential risks.

Fish oil supplements came under scrutiny in 2006, when the Food Standards Agency in the UK and the Food Safety Authority of Ireland reported polychlorinated biphenyl (PCB) levels that exceeded the European Union maximum limits in several fish oil brands,[95][96] which required temporary withdrawal of these brands. To address the concern over contaminated fish oil supplements, the International Fish Oil Standards (IFOS) Program, a third-party testing and accreditation program for fish oil products, was created by Nutrasource Diagnostics Inc. in Guelph, Ontario, Canada.[97]

A March 2010 lawsuit filed by a California environmental group claimed that eight brands of fish oil supplements contained excessive levels of PCBs, including CVS/pharmacy, Nature Made, Rite Aid, GNC, Solgar, Twinlab, Now Health, Omega Protein and Pharmavite. The majority of these products were either cod liver or shark liver oils. Those participating in the lawsuit claim that because the liver is the major filtering and detoxifying organ, PCB content may be higher in liver-based oils than in fish oil produced from the processing of whole fish.[98][99]

An analysis based on data from the Norwegian Women and Cancer Study (NOWAC) with regards to the dangers of persistent organic pollutants (POPs) in cod liver came to the conclusion that "in Norwegian women, fish liver consumption was not associated with an increased cancer risk in breast, uterus, or colon. In contrast, a decreased risk for total cancer was found."[100]

Microalgae oil is a vegetarian alternative to fish oil. Supplements produced from microalgae oil provide a balance of omega-3 fatty acids similar to fish oil, with a lower risk of pollutant exposure.[101]

See also


  1. ^ Moghadasian, Mohammed H. (2008). "Advances in Dietary Enrichment with N-3 Fatty Acids". Critical Reviews in Food Science and Nutrition. 48 (5): 402–10. doi:10.1080/10408390701424303. PMID 18464030. S2CID 41311376.
  2. ^ Cleland, Leslieg; James, Michaelj; Proudman, Susannam (2006). "Fish oil: What the prescriber needs to know". Arthritis Research & Therapy. 8 (1): 679–81. doi:10.1186/ar1876. PMC 1526555. PMID 16542466.
  3. ^ Venus Nandi (9 February 2020). "Best fish to eat". Retrieved 9 February 2020.[permanent dead link]
  4. ^ FAO: World Review of Fisheries and Aquaculture 2008: Highlights of Special Studies|date=February 2020 |bot=InternetArchiveBot |fix-attempted=yes )) Rome.
  5. ^ a b Innis, Sheila M.; Rioux, France M.; Auestad, Nancy; Ackman, Robert G. (1995). "Marine and freshwater fish oil varying in arachidonic, eicosapentaenoic and docosahexaenoic acids differ in their effects on organ lipids and fatty acids in growing rats". The Journal of Nutrition. 125 (9): 2286–93. doi:10.1093/jn/125.9.2286. PMID 7666244.
  6. ^ Gruger EH, Nelson RW, Stansby ME (1 October 1964). "Fatty acid composition of oils from 21 species of marine fish, freshwater fish and shellfish". Journal of the American Oil Chemists' Society. 41 (10): 662–67. doi:10.1007/BF02661403. S2CID 84057431.
  7. ^ a b Philibert A, Vanier C, Abdelouahab N, Chan HM, Mergler D (December 2006). "Fish intake and serum fatty acid profiles from freshwater fish". The American Journal of Clinical Nutrition. 84 (6): 1299–307. doi:10.1093/ajcn/84.6.1299. PMID 17158409.
  8. ^ a b Skulas-Ray, Ann C.; Wilson, Peter W.F.; Harris, William S.; Brinton, Eliot A.; Kris-Etherton, Penny M.; Richter, Chesney K.; Jacobson, Terry A.; Engler, Mary B.; et al. (2019). "Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association". Circulation. 140 (12): e673–e691. doi:10.1161/CIR.0000000000000709. PMID 31422671.
  9. ^ Talakoub, Lily; Neuhaus, Isaac M.; Yu, Siegrid S. (2008). "Chapter 2: Cosmoceuticals". In Alam, Murad; Gladstone, Hayes B.; Tung, Rebecca (eds.). Cosmetic Dermatology. Requisites in dermatology. Elsevier Health Sciences. p. 9. ISBN 9780702031434. Retrieved 23 October 2014. Other oils used as emollients include fish oil, petrolatum, shea butter, and sunflower seed oil.
  10. ^ Burch, Ernest S. (2006). Social Life in Northwest Alaska: The Structure of Iñupiaq Eskimo Nations. University of Alaska Press. p. 278. ISBN 9781889963921. Retrieved 23 October 2014. Oil was also used externally as an ointment to heal cold sores, cuts, insect bites, frostbite, rashes - in short, skin problems of all kinds. Duck or goose body-cavity fat was apparently as useful as seal or fish oil in dealing with skin problems.
  11. ^ Heartney, Eleanor (2007). "Zhang Huan: Becoming the Body". Zhang Huan: Altered States. Charta and Asia Society. ISBN 978-8881586417. Archived from the original on 4 March 2016. Retrieved 23 October 2014. This becomes abundantly clear in the work of Chinese body artist Zhang Huan. In the course of his career, Zhang Huan has subjected himself to painful trials: sitting motionless for hours in an outhouse covered in honey and fish oil while flies crawled over his body [...].
  12. ^ Ilse Schreiber: Die Schwestern aus Memel (1936), quoted, and extract translated in: Strzelczyk, Florentine (2014). "16: 'Fighting against Manitou': German Identity and Ilse Schreiber's Canada Novels Die Schwestern aus Memel (1936) and Die Flucht in Paradies (1939)". In McFarland, Rob; James, Michelle Stott (eds.). Sophie Discovers Amerika: German-Speaking Women Write the New World. Studies in German Literature Linguistics and Culture. Vol. 148. Boydell & Brewer. p. 207. ISBN 9781571135865. Hoffentlich zogen die Eltern in eine Gegend, wo es recht viele Eingeborene gab. Indianer, die nur von Jagd und Fischfang leben. Ach, und womöglich Eskimos, die sich mit Tran einschmieren, um sich gegen die Kälte zu schützen und rohes Fleisch essen [...]. [She hoped her parents would move to an area where there were many aboriginals. Indians who live solely by hunting and fishing. Oh, and if possible Eskimos who smear themselves with fish oil to protect themselves from the cold, and who eat raw meat.]
  13. ^ Falk-Petersen, S.; Sargent, J. R.; Henderson, J.; Hegseth, E. N.; Hop, H.; Okolodkov, Y. B. (1998). "Lipids and fatty acids in ice algae and phytoplankton from the Marginal Ice Zone in the Barents Sea". Polar Biology. 20 (1): 41–47. doi:10.1007/s003000050274. S2CID 11027523. INIST 2356641.
  14. ^ a b "Fish, Levels of Mercury and Omega-3 Fatty Acids". American Heart Association. Archived from the original on 9 July 2010. Retrieved 6 October 2010.
  15. ^ Kris-Etherton, Penny M.; William S. Harris, Lawrence J. Appel (2002). "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease". Circulation. 106 (21): 2747–57. doi:10.1161/01.CIR.0000038493.65177.94. PMID 12438303.
  16. ^ a b "Omega-3 Centre". Omega-3 sources. Omega-3 Centre. Archived from the original on 18 July 2008. Retrieved 27 July 2008.
  17. ^ "The Man with a Fish on His Back". Science History Institute. Retrieved 21 September 2023.
  18. ^ Grad, Roni (2004). "Cod and the Consumptive: A Brief History of Cod-Liver Oil in the Treatment of Pulmonary Tuberculosis". Pharmacy in History. 46 (3): 106–120. ISSN 0031-7047. JSTOR 41112218.
  19. ^ GUY, RUTH A. (1 August 1923). "The history of cod liver oil as a remedy". American Journal of Diseases of Children. 26 (2): 112–116. doi:10.1001/archpedi.1923.04120140011002. ISSN 0096-8994.
  20. ^ Su, Kuan-Pin; Huang, Shih-Yi; Chiu, Chih-Chiang; Shen, Winston W. (2003). "Omega-3 fatty acids in major depressive disorder". European Neuropsychopharmacology. 13 (4): 267–71. doi:10.1016/S0924-977X(03)00032-4. PMID 12888186. S2CID 6025091.
  21. ^ Nemets, B.; Stahl, Z; Belmaker, RH (2002). "Addition of Omega-3 Fatty Acid to Maintenance Medication Treatment for Recurrent Unipolar Depressive Disorder". American Journal of Psychiatry. 159 (3): 477–79. doi:10.1176/appi.ajp.159.3.477. PMID 11870016.
  22. ^ Green, Pnina; Hermesh, Haggai; Monselise, Assaf; Marom, Sofi; Presburger, Gadi; Weizman, Abraham (2006). "Red cell membrane omega-3 fatty acids are decreased in nondepressed patients with social anxiety disorder". European Neuropsychopharmacology. 16 (2): 107–13. doi:10.1016/j.euroneuro.2005.07.005. PMID 16243493. S2CID 31447173.
  23. ^ a b "Omega-3 Supplements: In Depth". MedlinePlus, US National Library of Medicine. 1 April 2018. Retrieved 21 September 2023.
  24. ^ "Re: 2010 Dietary Guidelines for Americans" (PDF). Jan 2009. American Heart Association. Archived from the original (PDF) on 10 August 2017. Retrieved 12 December 2012.
  25. ^ "2004 – FDA Announces Qualified Health Claims for Omega-3 Fatty Acids". Retrieved 25 May 2016.
  26. ^ Heinze, VM; Actis, AB (February 2012). "Dietary conjugated linoleic acid and long-chain n-3 fatty acids in mammary and prostate cancer protection: a review". International Journal of Food Sciences and Nutrition. 63 (1): 66–78. doi:10.3109/09637486.2011.598849. PMID 21762028. S2CID 21614046.
  27. ^ Crowe, Francesca L.; Appleby, Paul N.; Travis, Ruth C.; Barnett, Matt; Brasky, Theodore M.; Bueno-de-Mesquita, H. Bas; Chajes, Veronique; Chavarro, Jorge E.; Chirlaque, Maria-Dolores (1 September 2014). "Circulating fatty acids and prostate cancer risk: individual participant meta-analysis of prospective studies". Journal of the National Cancer Institute. 106 (9): dju240. doi:10.1093/jnci/dju240. ISSN 1460-2105. PMC 4188122. PMID 25210201.
  28. ^ Chua, Michael E.; Sio, Maria Christina D.; Sorongon, Mishell C.; Morales Jr, Marcelino L. Jr. (May–June 2013). "The relevance of serum levels of long chain omega-3 polyunsaturated fatty acids and prostate cancer risk: a meta-analysis". Canadian Urological Association Journal. 7 (5–6): E333–43. doi:10.5489/cuaj.1056. PMC 3668400. PMID 23766835.
  29. ^ Brasky TM, Darke AK, Song X, et al. (August 2013). "Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial". J. Natl. Cancer Inst. 105 (15): 1132–41. doi:10.1093/jnci/djt174. PMC 3735464. PMID 23843441.
  30. ^ Brenna JT, Burdge GC, Crawford MA, Clayton P, Cunnane SC, Gow R, Hibbeln JR, Sinclair AJ, Stein J, Willatts P. RE: Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial. J Natl Cancer Inst. 2014 Apr;106(4):dju015. doi: 10.1093/jnci/dju015. Epub 2014 Mar 31. PMID: 24685922; PMCID: PMC3988458.
  31. ^ Abdelhamid, Asmaa S.; Brown, Tracey J.; Brainard, Julii S.; et al. (29 February 2020). "Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease". The Cochrane Database of Systematic Reviews. 2020 (3): CD003177. doi:10.1002/14651858.CD003177.pub5. ISSN 1469-493X. PMC 7049091. PMID 32114706.
  32. ^ Abdelhamid, AS; Martin, N; Bridges, C; Brainard, JS; Wang, X; Brown, TJ; Hanson, S; Jimoh, OF; Ajabnoor, SM; Deane, KH; Song, F; Hooper, L (November 2018). "Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease". The Cochrane Database of Systematic Reviews. 11 (11): CD012345. doi:10.1002/14651858.CD012345.pub3. PMC 6517012. PMID 30484282.
  33. ^ John M. Eisenberg Center for Clinical Decisions Communications Science (2007). "Omega-3 Fatty Acids and Cardiovascular Disease: Current State of the Evidence". Comparative Effectiveness Review Summary Guides for Clinicians. PMID 30763028.
  34. ^ "Fish oil supplements provide some benefit after heart attack, heart failure". American Heart Association. Retrieved 6 October 2020.
  35. ^ "Fish and Omega-3 Fatty Acids". American Heart Association. Retrieved 9 February 2007.
  36. ^ Charnock John S (1999). "The role of omega-3 polyunsaturated fatty acid-enriched diets in the prevention of ventricular fibrillation" (PDF). Asia Pacific Journal of Clinical Nutrition. 8 (3): 226–30. doi:10.1046/j.1440-6047.1999.00115.x. PMID 24394167. Archived from the original (PDF) on 26 May 2012. Retrieved 4 December 2011.
  37. ^ Li GR, Sun HY, Zhang XH, Cheng LC, Chiu SW, Tse HF, Lau CP (2009). "Omega-3 polyunsaturated fatty acids inhibit transient outward and ultra-rapid delayed rectifier K+currents and Na+current in human atrial myocytes". Cardiovasc Res. 81 (2): 286–93. doi:10.1093/cvr/cvn322. PMID 19029136.
  38. ^ Khawaja, Owais; Gaziano, J. Michael; Djoussé, Luc (1 February 2012). "A meta-analysis of omega-3 fatty acids and incidence of atrial fibrillation". Journal of the American College of Nutrition. 31 (1): 4–13. doi:10.1080/07315724.2012.10720003. ISSN 1541-1087. PMID 22661621. S2CID 30454093.
  39. ^ Nair, G. M.; Connolly, S. J. (2008). "Should patients with cardiovascular disease take fish oil?". Canadian Medical Association Journal. 178 (2): 181–82. doi:10.1503/cmaj.071654. PMC 2174997. PMID 18195293.
  40. ^ Rizos, E. C.; Ntzani, E. E.; Bika, E; Kostapanos, MS; Elisaf, MS (2012). "Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events: A Systematic Review and Meta-analysis". Journal of the American Medical Association. 308 (10): 1024–33. doi:10.1001/2012.jama.11374. PMID 22968891.
  41. ^ Aung, Theingi; Halsey, Jim; Kromhout, Daan; et al. (1 March 2018). "Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals". JAMA Cardiology. 3 (3): 225–233. doi:10.1001/jamacardio.2017.5205. ISSN 2380-6583. PMC 5885893. PMID 29387889.
  42. ^ "Omega-3 fatty acids, fish oil, alpha-linolenic acid". Mayo Clinic. Retrieved 4 February 2014.
  43. ^ Montgomery P, Richardson AJ (2008). Montgomery P (ed.). "Omega-3 fatty acids for bipolar disorder". Cochrane Database of Systematic Reviews (2): CD005169. doi:10.1002/14651858.CD005169.pub2. PMID 18425912.
  44. ^ Martins, Julian G (2009). "EPA but Not DHA Appears to Be Responsible for the Efficacy of Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation in Depression: Evidence from a Meta-Analysis of Randomized Controlled Trials". Journal of the American College of Nutrition. 28 (5): 525–42. doi:10.1080/07315724.2009.10719785. PMID 20439549. S2CID 26466917.
  45. ^ Bloch, M H; Hannestad, J (2011). "Omega-3 fatty acids for the treatment of depression: Systematic review and meta-analysis". Molecular Psychiatry. 17 (12): 1272–82. doi:10.1038/mp.2011.100. PMC 3625950. PMID 21931319.
  46. ^ Grosso, G.; Pajak, A.; Marventano, S.; Castellano, S.; Galvano, F.; Bucolo, C.; Caraci, F. (2014). "Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials". PLOS ONE. 9 (5): e96905. Bibcode:2014PLoSO...996905G. doi:10.1371/journal.pone.0096905. PMC 4013121. PMID 24805797.
  47. ^ Liao, Y; Xie, B; Zhang, H; He, Q; Guo, L; Subramanieapillai, M; Fan, B; Lu, C; McIntyre, RS (2019). "Efficacy of omega-3 PUFAs in depression: A meta-analysis". Translational Psychiatry. 9 (1): 190. doi:10.1038/s41398-019-0515-5. PMC 6683166. PMID 31383846.
  48. ^ Sifferlin, Alexandra (13 June 2012). "Fish Oil Fail: Omega-3s May Not Protect Brain Health After All". Time. Retrieved 19 June 2012.
  49. ^ Wolters, M. (2005). "Diet and psoriasis: experimental data and clinical evidence". British Journal of Dermatology. 153 (4): 706–14. doi:10.1111/j.1365-2133.2005.06781.x. PMID 16181450. S2CID 1426074.
  50. ^ a b Jensen, Craig L.; Voigt, Robert G.; Llorente, Antolin M.; Peters, Sarika U.; Prager, Thomas C.; Zou, Yali L.; Rozelle, Judith C.; Turcich, Marie R.; Fraley, J. Kennard; Anderson, Robert E.; Heird, William C. (2010). "Effects of Early Maternal Docosahexaenoic Acid Intake on Neuropsychological Status and Visual Acuity at Five Years of Age of Breast-Fed Term Infants". The Journal of Pediatrics. 157 (6): 900–05. doi:10.1016/j.jpeds.2010.06.006. PMID 20655543.
  51. ^ Calder, Philip C.; Kremmyda, Lefkothea-Stella; Vlachava, Maria; Noakes, Paul S.; Miles, Elizabeth A. (2010). "Is there a role for fatty acids in early life programming of the immune system?". Proceedings of the Nutrition Society. 69 (3): 373–80. doi:10.1017/S0029665110001552. PMID 20462467. S2CID 3629264.
  52. ^ Lev-Tzion, R; Griffiths, AM; Leder, O; Turner, D (28 February 2014). "Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease". The Cochrane Database of Systematic Reviews. 2 (2): CD006320. doi:10.1002/14651858.CD006320.pub4. PMC 8988157. PMID 24585498.
  53. ^ a b c " Finds Quality Problems with Nearly Thirty Percent of Fish Oil Supplements Reviewed; "Fishy" Claims Identified: Softgels and Liquids for Adults, Children and Pets Tested, Including Krill Oil and Algal Oil Supplements". 28 September 2010. Retrieved 20 October 2012.[dubious ]
  54. ^ "Omega 3 Supplements Market Size & Share Report 2020-2027". Grand View Research. October 2021. Archived from the original on 20 February 2022. Retrieved 8 April 2022.
  55. ^ Yılmaz, Emin; Öǧütcü, Mustafa; Arifoglu, Nazan (2015). "Assessment of Thermal and Textural Characteristics and Consumer Preferences of Lemon and Strawberry Flavored Fish Oil Organogels". Journal of Oleo Science. 64 (10): 1049–1056. doi:10.5650/jos.ess15113. PMID 26369597.
  56. ^ a b c d e " Review: Fish Oil and Omega-3 Fatty Acid Supplements Review (Including Krill, Algae, and Calamari Oil)". 13 August 2012. Retrieved 19 October 2012.(registration required)
  57. ^ Raatz, SK; Redmon, JB; Wimmergren, N; Donadio, JV; Bibus, DM (2009). "Enhanced absorption of omega-3 fatty acids after emulsified compared with encapsulated fish oil". Journal of the American Dietetic Association. 109 (6): 1076–81. doi:10.1016/j.jada.2009.03.006. PMC 2701654. PMID 19465191.
  58. ^ Reviews of Supplements and Health Products ConsumerLab.
  59. ^ Foran, Stacy E.; Flood, James G.; Lewandrowski, Kent B. (2003). "Measurement of Mercury Levels in Concentrated Over-the-Counter Fish Oil Preparations: Is Fish Oil Healthier Than Fish?". Archives of Pathology & Laboratory Medicine. 127 (12): 1603–05. doi:10.5858/2003-127-1603-MOMLIC. PMID 14632570.
  60. ^ a b Aursand, Marit; Mozuraityte, Revilija; Hamre, Kristin; Knutsen, Helle; Maage, Amund; Arukwe, Augustine (2011). Description of the processes in the value chain and risk assessment of decomposition substances and oxidation products in fish oils (PDF). Norwegian Scientific Committee for Food Safety. ISBN 978-82-8259-035-8. Archived from the original (PDF) on 9 September 2016. Retrieved 19 October 2012.[page needed]
  61. ^ Bays H E (19 March 2007). "Safety Considerations with Omega-3 Fatty Acid Therapy". The American Journal of Cardiology. 99 (6 (Supplement 1)): S35–S43. doi:10.1016/j.amjcard.2006.11.020. PMID 17368277.
  62. ^ "Prescription fish oil pill lowers heart attack risk in those already on statins". Retrieved 25 September 2019.
  63. ^ "AHA Endorses Prescription Fish Oil for High Triglycerides". 20 August 2019. Retrieved 25 September 2019.
  64. ^ "Heart Experts Support Use of Prescription Fish Oil". WebMD. Retrieved 25 September 2019.
  65. ^ "Omega-3 Fish Oil: Supplements and Prescriptions". WebMD. Retrieved 25 September 2019.
  66. ^ "Epanova (omega-3-carboxylic acids) capsules, for oral use". DailyMed. 8 September 2014. Retrieved 12 May 2020.
  67. ^ "Drug Approval Package: Epanova (Omega-3-carboxylic acids)". U.S. Food and Drug Administration (FDA). 28 March 2016. Retrieved 12 May 2020.
  68. ^ "Epanova". Drug Information Portal. Retrieved 12 May 2020.
  69. ^ Nicholls, Stephen J.; Lincoff, A. Michael; Bash, Dianna; Ballantyne, Christie M.; Barter, Philip J.; Davidson, Michael H.; Kastelein, John J. P.; Koenig, Wolfgang; et al. (2018). "Assessment of omega-3 carboxylic acids in statin-treated patients with high levels of triglycerides and low levels of high-density lipoprotein cholesterol: Rationale and design of the STRENGTH trial". Clinical Cardiology. 41 (10): 1281–1288. doi:10.1002/clc.23055. PMC 6489732. PMID 30125052.
  70. ^ "AstraZeneca to discontinue Epanova trial, expects $100 million writedown". Reuters. 13 January 2020. Archived from the original on 14 January 2020. Retrieved 15 January 2020.
  71. ^ "Lovaza- omega-3-acid ethyl esters capsule, liquid filled". DailyMed. 3 April 2019. Retrieved 12 May 2020.
  72. ^ "Lovaza: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 15 January 2020.
  73. ^ "Drug Approval Package: Omacor (Omega-3-Acid Ethyl Esters) NDA #021654". U.S. Food and Drug Administration (FDA). Retrieved 12 May 2020.
  74. ^ "Lovaza". Drug Information Portal. Retrieved 12 May 2020.
  75. ^ "Omtryg- omega-3-acid ethyl esters capsule". DailyMed. 31 March 2016. Retrieved 12 May 2020.
  76. ^ "Drug Approval Package: Brand Omtryg capsules NDA 204977". U.S. Food and Drug Administration (FDA). 18 December 2014. Retrieved 12 May 2020.
  77. ^ "Omtryg". Drug Information Portal. Retrieved 12 May 2020.
  78. ^ "Vascepa- icosapent ethyl capsule". DailyMed. 30 January 2020. Retrieved 12 May 2020.
  79. ^ "Drug Approval Package: Vascepa (icosapent ethyl) NDA #202057". U.S. Food and Drug Administration (FDA). 6 March 2013. Retrieved 12 May 2020.
  80. ^ "Vascepa". Drug Information Portal. Retrieved 12 May 2020.
  81. ^ "FDA approves use of drug to reduce risk of cardiovascular events in certain adult patient groups". U.S. Food and Drug Administration (FDA). 17 December 2019. Retrieved 15 January 2020.
  82. ^ "Omegaven- fish oil injection, emulsion". DailyMed. 6 August 2018. Retrieved 12 May 2020.
  83. ^ "Drug Approval Package: Omegaven (fish oil triglycerides)". U.S. Food and Drug Administration. 24 August 2018. Retrieved 12 May 2020.
  84. ^ "Omegaven". Drug Information Portal. Retrieved 12 May 2020.
  85. ^ "Smoflipid injection, emulsion". DailyMed. 30 August 2019. Retrieved 12 May 2020.
  86. ^ "Smoflipid (Lipid Injectable Emulsion)". U.S. Food and Drug Administration. 12 January 2018. Retrieved 12 May 2020.
  87. ^ "Smoflipid". Drug Information Portal. Retrieved 12 May 2020.
  88. ^ Villani, Anthony M; Crotty, Maria; Cleland, Leslie G; James, Michael J; Fraser, Robert J; Cobiac, Lynne; Miller, Michelle D (2013). "Fish oil administration in older adults: Is there potential for adverse events? A systematic review of the literature". BMC Geriatrics. 13 (1): 41. doi:10.1186/1471-2318-13-41. PMC 3664575. PMID 23634646.
  89. ^ "FDA Announces Qualified Health Claims for Omega-3 Fatty Acids". Food and Drug Administration. 8 September 2004. Archived from the original on 22 July 2009. Retrieved 21 August 2017.
  90. ^ "Scientific Opinion on the Tolerable Upper Intake Level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA)". EFSA Journal. 10 (7). 2012. doi:10.2903/j.efsa.2012.2815. hdl:2434/257879. S2CID 202696719. Retrieved 14 September 2014.
  91. ^ Kantha, SS (1987). "Dietary effects of fish oils on human health: A review of recent studies". The Yale Journal of Biology and Medicine. 60 (1): 37–44. PMC 2590235. PMID 3551346.
  92. ^ Jia, X; Gao, F; Pickett, JK; Al Rifai, M; Birnbaum, Y; Nambi, V; Virani, SS; Ballantyne, CM (August 2021). "Association Between Omega-3 Fatty Acid Treatment and Atrial Fibrillation in Cardiovascular Outcome Trials: A Systematic Review and Meta-Analysis". Cardiovascular Drugs and Therapy. 35 (4): 793–800. doi:10.1007/s10557-021-07204-z. PMID 34057665. S2CID 235250288.
  93. ^ Gencer, B; Djousse, L; Al-Ramady, OT; Cook, NR; Manson, JE; Albert, CM (2021). "Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis". Circulation. 144 (25): 1981–1990. doi:10.1161/CIRCULATIONAHA.121.055654. PMC 9109217. PMID 34612056. S2CID 238410903.
  94. ^ Lips, Paul (2003). "Hypervitaminosis a and Fractures". New England Journal of Medicine. 348 (4): 347–49. doi:10.1056/NEJMe020167. PMID 12540650.
  95. ^ Jess Halliday (13 April 2006). "Dioxins prompt second UK fish oil withdrawal". Retrieved 8 February 2007.
  96. ^ "Pollutants found in fish oil capsules". BBC News. 6 April 2002. Retrieved 8 February 2007.
  97. ^ International Fish Oil Standards Archived 18 May 2012 at the Wayback Machine.
  98. ^ Elisabeth Leamy (3 March 2010). "Lawsuit Raises Fish Oil Supplement Concerns". ABC News. Retrieved 5 March 2010.
  99. ^ "Lawsuit says fish oil supplements contain PCB", San Francisco Chronicle, 3 March 2010.
  100. ^ Brustad, Magritt; Sandanger, Torkjel Manning; Andersen, Vegard; Lund, Eiliv (2007). "POP exposure from fish liver consumption and risk of cancer?the Norwegian Women and Cancer Study". Journal of Environmental Monitoring. 9 (7): 682–6. doi:10.1039/B706302B. PMID 17607388.
  101. ^ Doughman, Scott D.; Krupanidhi, Srirama; Sanjeevi, Carani B. (2007). "Omega-3 Fatty Acids for Nutrition and Medicine: Considering Microalgae Oil as a Vegetarian Source of EPA and DHA". Current Diabetes Reviews. 3 (3): 198–203. doi:10.2174/157339907781368968. PMID 18220672.


  1. Omega-3 fish oil supplements have no standard doses and vary considerably by producers and producers' products, but salmon oil consistently has more DHA than EPA while other fish oils have more EPA than DHA. For example, one supplier, Trident Food's Pure Alaska salmon oil product label reports per serving DHA 220 mg and EPA 180 mg (total omega-3 = 600 mg), but their fish oil based on pollock has DHA 144 mg and EPA 356 mg (total omega-3 = 530 mg). Equivalent products from another producer, Fish Oils, Puritan's Pride, reports DHA 180 mg and EPA 150 mg for their salmon oil product (total omega-3 = 420 mg), but DHA 204 mg and EPA 318 mg for fish oil derived from anchovy, sardine, and mackerel (total omega-3 = 600 mg). For information and comparison purposes only, no endorsements are implied.
  2. Plant-based omega-3s are rich in ALA but completely lack EPA and DHA, so vegetarians and vegans seeking non-fish sources turn to more expensive algae derived oils. There is generally a pattern of more DHA than EPA in most of these products. For example, Nordic Naturals reports per serving DHA 390 mg and EPA 195 mg (total omega-3 = 715 mg), Calgee reports DHA 300 mg and EPA 150 mg (total omega-3 = 550 mg) and so on, but iwi Life reports DHA 100 mg and EPA 150 mg (total omega-3 = 252 mg). For information and comparison purposes only, no endorsements are implied.
  3. Trident Seafoods Pure Alaska Alaskan Omega-3 625 mg
  4. Trident Seafoods Pure Alaska Omega Wild Alaskan Salmon Oil 1000 mg Certificate of Analysis

Further reading