omega-3 fatty acids (fish oil)

Reported Uses

• NOTE: see Herb & Supplement Effectiveness Rating Definitions table
• ADHD [Insufficient Evidence]
• age-related macular degeneration [Possibly Ineffective]
• allergic rhinitis prevention [Insufficient Evidence]
• Alzheimer dz [Insufficient Evidence]
• angina [Possibly Ineffective]
• aphthous ulcer (canker sores) [Insufficient Evidence]
• ARDS [Insufficient Evidence]
• asthma [Insufficient Evidence]
• atherosclerosis [Possibly Ineffective]
• athletic performance [Insufficient Evidence]
• atopic dermatitis (eczema) [Possibly Ineffective]
• atopic dz [Insufficient Evidence]
• atrial fibrillation [Possibly Ineffective]
• autism spectrum disorder [Insufficient Evidence]
• autoimmune thyroiditis prevention [Insufficient Evidence]
• bipolar disorder [Insufficient Evidence]
• bone loss, renal transplant-related [Insufficient Evidence]
• borderline personality disorder [Insufficient Evidence]
• bronchopulmonary dysplasia [Possibly Ineffective]
• burns [Insufficient Evidence]
• CABG [Insufficient Evidence]
• cachexia, cancer-related [Possibly Effective]
• cancer prevention [Insufficient Evidence]
• cardiovascular dz prevention [Insufficient Evidence]
• cataracts [Insufficient Evidence]
• cerebrovascular dz prevention [Possibly Ineffective]
• cirrhosis [Insufficient Evidence]
• CKD [Insufficient Evidence]
• cognitive decline, age-related [Insufficient Evidence]
• cognitive function [Possibly Ineffective]
• cognitive impairment, mild [Insufficient Evidence]
• colorectal CA [Insufficient Evidence]
• COPD [Insufficient Evidence]
• COVID-19 [Insufficient Evidence]
• Crohn dz [Insufficient Evidence]
• cystic fibrosis [Insufficient Evidence]
• dementia [Insufficient Evidence]
• depression [Insufficient Evidence]
• developmental coordination disorder [Insufficient Evidence]
• diabetes mellitus [Likely Ineffective]
• diabetic nephropathy [Insufficient Evidence]
• diabetic neuropathy [Insufficient Evidence]
• diabetic retinopathy [Insufficient Evidence]
• dry eye dz [Insufficient Evidence]
• dyslexia [Insufficient Evidence]
• dyslipidemia [Insufficient Evidence]
• dyslipidemia, HIV/AIDS-related [Possibly Effective]
• dysmenorrhea [Possibly Effective]
• endometriosis [Insufficient Evidence]
• epilepsy [Insufficient Evidence]
• exercise-induced muscle soreness [Insufficient Evidence]
• food allergies [Insufficient Evidence]
• frailty [Insufficient Evidence]
• gingivitis [Insufficient Evidence]
• glaucoma [Insufficient Evidence]
• heart failure [Possibly Effective]
• heart transplant [Insufficient Evidence]
• hemodialysis graft dysfxn [Insufficient Evidence]
• HIV/AIDS [Insufficient Evidence]
• H. pylori infection [Possibly Ineffective]
• HTN [Possibly Effective]
• HTN, cyclosporine-induced [Insufficient Evidence]
• HTN, pregnancy-induced [Possibly Ineffective]
• IgA nephropathy [Possibly Effective]
• hypertriglyceridemia [Effective]
• impaired glucose tolerance [Insufficient Evidence]
• infant development [Insufficient Evidence]
• insomnia [Insufficient Evidence]
• intrauterine growth restriction [Insufficient Evidence]
• joint pain [Insufficient Evidence]
• lung CA [Insufficient Evidence]
• Lyme dz [Insufficient Evidence]
• male infertility [Insufficient Evidence]
• mastalgia [Possibly Ineffective]
• melanoma [Insufficient Evidence]
• menopausal sx [Insufficient Evidence]
• metabolic effects, antipsychotic-induced [Insufficient Evidence]
• migraine prophylaxis [Insufficient Evidence]
• miscarriage prevention, antiphospholipid syndrome-assoc. [Insufficient Evidence]
• multiple sclerosis [Possibly Ineffective]
• muscle strength [Insufficient Evidence]
• nausea/vomiting, gastroenteritis-related [Possibly Effective]
• nephrolithiasis [Insufficient Evidence]
• nephropathy, contrast-induced [Insufficient Evidence]
• nephrotoxicity, cyclosporine-induced [Possibly Effective]
• nonalcoholic fatty liver dz [Possibly Effective]
• obesity [Insufficient Evidence]
• oral mucositis [Insufficient Evidence]
• osteoarthritis [Possibly Ineffective]
• osteoporosis [Insufficient Evidence]
• Parkinson dz [Insufficient Evidence]
• periodontitis [Insufficient Evidence]
• peripheral arterial dz [Insufficient Evidence]
• peripheral neuropathy, chemo-induced [Insufficient Evidence]
• phenylketonuria [Insufficient Evidence]
• pneumonia prevention [Insufficient Evidence]
• polycystic ovary syndrome [Insufficient Evidence]
• polymyalgia rheumatica prevention [Insufficient Evidence]
• postmenopausal conditions [Insufficient Evidence]
• postop fistula [Insufficient Evidence]
• postop infection [Insufficient Evidence]
• postop recovery [Insufficient Evidence]
• postpartum depression [Insufficient Evidence]
• post-traumatic stress disorder [Insufficient Evidence]
• pre-eclampsia [Possibly Ineffective]
• premature labor prevention [Insufficient Evidence]
• prematurity [Insufficient Evidence]
• pressure ulcer [Insufficient Evidence]
• prostate CA [Insufficient Evidence]
• pruritus [Insufficient Evidence]
• psoriasis [Insufficient Evidence]
• psychosis [Possibly Ineffective]
• PTCA restenosis prevention [Possibly Effective]
• Raynaud phenomenon [Insufficient Evidence]
• renal failure [Insufficient Evidence]
• renal transplant [Possibly Ineffective]
• rheumatoid arthritis [Possibly Effective]
• salicylate intolerance [Insufficient Evidence]
• sarcopenia [Insufficient Evidence]
• schizophrenia [Insufficient Evidence]
• sepsis [Insufficient Evidence]
• sickle cell dz [Insufficient Evidence]
• SLE [Insufficient Evidence]
• stroke prevention [Insufficient Evidence]
• ulcerative colitis [Insufficient Evidence]
• URI [Insufficient Evidence]
• venous thromboembolism prophylaxis [Insufficient Evidence]
• ventricular arrhythmias [Possibly Ineffective]
• vitamin D deficiency [Insufficient Evidence]

Reported Doses

Safety/efficacy may not be established; reported doses may be derived from limited or potentially inadequate studies w/ variable regimens, multi-ingredient products, or where concentration of active ingredients may vary widely

Special Note

[formulation clarification]

Info: fish oil products contain varying amounts of omega-3-acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); see omega-3-acid ethyl esters for FDA-approved Rx product; all other preparations are not FDA-approved

Effectiveness Ratings

[see Herb & Supplement Effectiveness Rating Definitions table]

ADHD, adult pts

[Insufficient Evidence]

Dose: 5.2 g fish oil PO qd

ADHD, peds pts

[Insufficient Evidence]

Dose: 0.051-2.513 g fish oil PO qd in pts 7-12 yo; Alt: 0.25 g omega-3 fatty acids PO qd in pts 8-13 yo

allergic rhinitis prevention

[Insufficient Evidence]

Dose: 4 g fish oil providing 32% EPA and 23% DHA PO qd; Info: used in late-phase pregnancy for childhood prevention

Alzheimer dz

[Insufficient Evidence]

Dose: 0.6 g EPA and 1.7 g DHA PO qd; Alt: 1 g fish oil providing 0.15 g EPA and 0.5 g DHA PO qd

aphthous ulcer (canker sores)

[Insufficient Evidence]

Dose: 1 g omega-3 fatty acids providing 0.18 g EPA and 0.12 g DHA PO qd

asthma prevention

[Insufficient Evidence]

Dose: 1.2-4 g fish oil PO qd; Alt: 0.65-3.7 g omega-3 fatty acids PO qd; Info: used in late-phase pregnancy for childhood prevention

asthma tx

[Insufficient Evidence]

Dose: 20 g fish oil providing 3.2 g EPA and 2 g DHA PO qd; Alt: 17-26.8 mg/kg/dose EPA and 7.3-11.5 mg/kg/dose DHA PO qd

athletic performance

[Insufficient Evidence]

Dose: 1 g fish oil PO qd; Alt: 0.551 g EPA and 0.551 g DHA PO bid

autism spectrum disorder, adult pts

[Insufficient Evidence]

Dose: 5.2 g fish oil PO qd

autism spectrum disorder, peds pts

[Insufficient Evidence]

Dose: 1 g omega-3 fatty acids providing 0.18 g EPA and 0.12 g DHA PO qd; Alt: 1.5 g fish oil providing 0.84 g EPA and 0.7 g DHA PO qd in pts 5-17 yo

bipolar disorder

[Insufficient Evidence]

Dose: 6.2 g EPA and 3.4 g DHA PO qd; Alt: 1 g EPA and 1 g DHA PO qd; 1-2 g EPA PO qd; 1.68 g EPA and 0.88 g DHA PO qd

burns

[Insufficient Evidence]

Dose: 3 g fish oil PO qd; Info: used w/ collagen peptides

CABG

[Insufficient Evidence]

Dose: 4 g fish oil providing 2.04 g EPA and 1.3 g DHA PO qd; Start: day after surgery

cachexia, cancer-related

[Possibly Effective]

Dose: 30 mL fish oil providing 4.9 g EPA and 3.2 g DHA PO qd; Alt: 7.5 g fish oil providing 4.7 g EPA and 2.8 g DHA PO qd; 2.18 g EPA and 1.92 g DHA PO qd

CKD

[Insufficient Evidence]

Dose: 1.93-9.65 g omega-3 fatty acids PO qd

cognitive impairment, mild

[Insufficient Evidence]

Dose: 3 g fish oil providing 0.45 g EPA and 1.29 g DHA PO qd

colorectal CA

[Insufficient Evidence]

Dose: 2 g fish oil providing 0.36 g EPA and 0.24 g DHA PO qd

COVID-19

[Insufficient Evidence]

Dose: 2 g omega-3 fatty acids PO qd

Crohn dz

[Insufficient Evidence]

Dose: 2.7 g omega-3 fatty acids PO qd; Alt: 1.2-3.3 g EPA and 0.6-1.8 g DHA PO qd

cystic fibrosis

[Insufficient Evidence]

Dose: omega-3 fatty acids as 1.3% of total caloric intake PO qd

depression, adult pts

[Insufficient Evidence]

Dose: 6 g fish oil PO qd in divided doses; Alt: 0.6-4 g EPA and 0.15-2.4 g DHA PO qd; 1.5 g fish oil providing 1.05 g EPA and 0.15 g DHA PO qd; 1-2 g EPA PO qd

depression, peds pts

[Insufficient Evidence]

Dose: 1 g fish oil PO qd; Info: for pts 6-12 yo

developmental coordination disorder, peds pts

[Insufficient Evidence]

Dose: 558 mg EPA and 174 mg DHA PO qd; Info: for pts 5-12 yo; used w/ evening primrose oil

diabetic nephropathy

[Insufficient Evidence]

Dose: 1.86 g EPA and 1.5 g DHA PO qd

dry eye dz

[Insufficient Evidence]

Dose: 360-1680 mg EPA and 240-560 mg DHA PO qd

dyslexia, peds pts

[Insufficient Evidence]

Dose: 480 mg DHA PO qd; Info: for pts 5-12 yo

dyslipidemia

[Insufficient Evidence]

Dose: 1-6 g fish oil PO qd

dyslipidemia, HIV/AIDS-related

[Possibly Effective]

Dose: 920 mg EPA and 760 mg DHA PO bid

dysmenorrhea

[Possibly Effective]

Dose: 0.18-1.08 g EPA and 0.12-0.72 g DHA PO qd; Alt: 0.5-2.5 g fish oil PO qd

epilepsy, adult pts

[Insufficient Evidence]

Dose: 1-2.8 g omega-3 fatty acids PO qd

epilepsy, peds pts

[Insufficient Evidence]

Dose: 1-2.8 g omega-3 fatty acids PO qd; Alt: 1 g fish oil providing 0.18 g EPA and 0.12 g DHA PO qd

exercise-induced muscle soreness

[Insufficient Evidence]

Dose: 1.8-2.4 g fish oil providing 0.3-0.6 g EPA and 0.2-0.26 g DHA PO qd; Alt: 0.551 g EPA and 0.551 g DHA PO bid; 4.8 g EPA and 2.08 g DHA PO qd

heart failure

[Possibly Effective]

Dose: 0.6-4.3 g omega-3 fatty acids PO qd; Alt: 1 g fish oil providing 0.85-0.882 g of 1:1.2 ratio EPA:DHA

heart transplant

[Insufficient Evidence]

Dose: 4 g fish oil providing 46.5% EPA and 37.8% DHA PO qd

hemodialysis graft dysfxn

[Insufficient Evidence]

Dose: 4 g fish oil PO qd; Alt: 1.6-3.4 g omega-3 fatty acids PO qd

HTN

[Possibly Effective]

Dose: 4-15 g/day fish oil PO qd or in divided doses; Alt: 2.04 g EPA and 1.4 g DHA PO qd; 3-15 g omega-3 fatty acids PO qd

HTN, cyclosporine-induced

[Insufficient Evidence]

Dose: 3-4 g fish oil PO qd after heart transplant; Alt: 2-18 g fish oil providing 0.6-5.4 g EPA and DHA PO qd after kidney transplant

hypertriglyceridemia

[Effective]

Dose: 1-15 g fish oil providing 1.45-2.7 g EPA and 1.05-1.8 g DHA PO qd

IgA nephropathy

[Possibly Effective]

Dose: 1-12 g fish oil PO qd; Alt: 3 g fish oil providing 85% EPA and DHA PO qd

impaired glucose tolerance

[Insufficient Evidence]

Dose: 1.53 g/day EPA and 1.05 g/day DHA PO divided tid

infant development

[Insufficient Evidence]

Dose: 4 g fish oil providing 1.3 g EPA and 0.9 g DHA PO qd: Info: used in late-phase pregnancy

insomnia

[Insufficient Evidence]

Dose: 1200 mg EPA and 600 mg DHA PO qd

joint pain

[Insufficient Evidence]

Dose: 370 mg fish oil PO tid; Start: 370 mg fish oil PO 6x/day x5wk

lung CA

[Insufficient Evidence]

Dose: 1.6 g EPA and 0.8 g DHA PO qd

male infertility

[Insufficient Evidence]

Dose: 0.132-1.112 g EPA and 0.4-0.72 g DHA PO qd

menopausal sx

[Insufficient Evidence]

Dose: 1 g fish oil providing 0.18 g EPA and 0.12 g DHA PO qd; Alt: 0.3-1.8 g fish oil PO qd

metabolic effects, antipsychotic-induced

[Insufficient Evidence]

Dose: 720 mg EPA and 480 mg DHA PO qd

migraine prophylaxis

[Insufficient Evidence]

Dose: 1.5 g fish oil PO qd

miscarriage prevention, antiphospholipid syndrome-assoc.

[Insufficient Evidence]

Dose: 5.1 g fish oil providing 1.5 ratio EPA:DHA PO qd

muscle strength

[Insufficient Evidence]

Dose: 4.5 g fish oil providing 2.275 g EPA and 1.575 g DHA PO qd

nausea/vomiting, gastroenteritis-related

[Possibly Effective]

Dose: 2.4 g fish oil providing 55% EPA and 37% DHA PO qd; Start: 24 wk gestation; Info: for childhood prevention

nephrotoxicity, cyclosporine-induced

[Possibly Effective]

Dose: 12 g fish oil providing 18% EPA and 12% DHA PO qd after liver transplant; Alt: 3-6 g fish oil providing 30% EPA and 20% DHA PO qd after kidney transplant

nonalcoholic fatty liver dz

[Possibly Effective]

Dose: 2.7 g omega-3 fatty acids PO qd; Alt: 0.735 g EPA and 1.6 g DHA PO qd

obesity

[Insufficient Evidence]

Dose: 250-3360 mg omega-3 fatty acids PO qd

oral mucositis

[Insufficient Evidence]

Dose: 2 g fish oil providing 0.36 g EPA and 0.24 g DHA PO qd

periodontitis

[Insufficient Evidence]

Dose: 180 mg EPA and 120 mg DHA PO qd; Alt: 2600 mg EPA and 1800 mg DHA PO qd; Info: used w/ scaling and root planing

phenylketonuria, peds pts

[Insufficient Evidence]

Dose: 15 mg/kg/dose DHA PO qd

polycystic ovary syndrome

[Insufficient Evidence]

Dose: 2.148 g EPA and 1.452 g DHA PO qd; Alt: 2 g fish oil PO qd; Info: used w/ vitamin D3

postmenopausal conditions

[Insufficient Evidence]

Dose: 0.285-14 g fish oil PO qd

postop fistula

[Insufficient Evidence]

Dose: 5.42 g fish oil PO qd; Start: 7 days before surgery

postop recovery

[Insufficient Evidence]

Dose: 5.42 g fish oil PO qd; Start: 7 days before surgery

postpartum depression

[Insufficient Evidence]

Dose: 2200 mg EPA and 1638 mg DHA PO qd

preterm labor prevention

[Insufficient Evidence]

Dose: 2.7-6.1 g omega-3 fatty acids providing 1.3-2.9 g EPA and 0.9-2.1 g DHA PO qd; Start: 20-33 wk gestation

pressure ulcer

[Insufficient Evidence]

Dose: 0.125-0.282 g/100 mL EPA and 0.144-0.309 g/100 mL DHA PO qd; Alt: apply 2 mL fish oil topically qd

pruritus

[Insufficient Evidence]

Dose: 2-6 g fish oil PO qd

psoriasis

[Insufficient Evidence]

Dose: 3.6 g EPA and 2.4 g DHA PO qd; Alt: apply dressing topically qd x6h/day

PTCA restenosis prevention

[Possibly Effective]

Dose: 6 g fish oil PO qd x1mo before procedure, then 3 g PO qd; Alt: 15 g fish oil providing 2.7 g EPA and 1.8 g DHA PO qd starting 3wk before procedure

Raynaud phenomenon

[Insufficient Evidence]

Dose: 3.96 g EPA and 2.64 g DHA PO qd

renal failure, adult pts

[Insufficient Evidence]

Dose: 1.95 g fish oil providing 1.05 g EPA and 0.69 g DHA PO qd; Info: up to 9 g/day fish oil has been used

renal failure, peds pts

[Insufficient Evidence]

Dose: 2 g fish oil PO qd; Info: for pts 8-17 yo

rheumatoid arthritis

[Possibly Effective]

Dose: 10 g fish oil providing 0.5-4.6 g EPA and 0.2-3 g DHA PO qd; Alt: 130 mg/kg/dose omega-3 fatty acids PO qd; 3-5.5 g omega-3 fatty acids PO qd

salicylate intolerance

[Insufficient Evidence]

Dose: 10 g fish oil PO qd; Info: may give in divided doses

schizophrenia

[Insufficient Evidence]

Dose: 2.2 g EPA and 2.2 g DHA PO qd; Alt: 540 mg EPA and 360 mg DHA PO qd

sickle cell dz

[Insufficient Evidence]

Dose: 0.25 g/kg/dose fish oil providing 12% EPA and 18% DHA PO qd

SLE

[Insufficient Evidence]

Dose: 3-20 g fish oil PO qd

ulcerative colitis

[Insufficient Evidence]

Dose: 4.2 g fish oil PO qd; Alt: 4.5 g EPA PO qd

URI

[Insufficient Evidence]

Dose: 2.4 g fish oil providing 55% EPA and 37% DHA PO qd; Start: 24 wk gestation; Info: for childhood prevention