Table of ContentsView AllTable of ContentsDoes Fish Oil Lower Cholesterol?It Lowers TriglyceridesDHA May Increase HDL (Good Cholesterol)EPA May Increase LDL (Bad Cholesterol)What Is Fish Oil?SafetyPotential Side EffectsPrecautionsChoosing a Fish OilAlternatives
Table of ContentsView All
View All
Table of Contents
Does Fish Oil Lower Cholesterol?
It Lowers Triglycerides
DHA May Increase HDL (Good Cholesterol)
EPA May Increase LDL (Bad Cholesterol)
What Is Fish Oil?
Safety
Potential Side Effects
Precautions
Choosing a Fish Oil
Alternatives
Fish oil is one of the most commonly used supplements in the United States.
It is a potent source of theomega-3 fatty acidsdocosahexaenoic acid(DHA) andeicosapentaenoic acid(EPA). Studies suggest these nutrients may have numerous potential health benefits.
In addition to supplements, DHA and EPA are also found in sardines, anchovies, mackerel, and salmon.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements like prescription drugs. This means some supplement products may not contain what the label says. Whenchoosing a supplement, look for third-party tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.
Pranithan Chorruangsak / Getty Images
Studies suggestomega-3 fatty acidsin fish oil supplements have helped reducetriglyceridelevels.
Still, fish oil’s effects oncholesterol levelsare less established.
Some of fish oil’s benefits may be attributed to itsanti-inflammatoryproperties, which help protect against cellular damage.
Lipidsare fatty, wax-like substances and includecholesterolandtriglycerides.
High levels of lipidscontribute toplaque build-up in your arteriesand increase the risk ofheart disease.
Triglyceridesare a type of fat the body uses for energy.High levels of triglyceridesare associated with an increased risk of heart disease and heart attack.
Combined DHA and EPA or EPA-only supplements have effectively reduced triglyceride levels.However, a review suggested that DHA-only supplements may more effectively reduce triglycerides.
High-densitylipoprotein(HDL) cholesterol, also known as “good cholesterol,” helps the body remove excess cholesterol from the bloodstream.
Higher HDL cholesterol and lower low-density lipoprotein (LDL) cholesterol levels are typically associated with a lower risk of heart disease andstroke.
LDL cholesterol is also known as “bad cholesterol” because high levels are associated with a greater risk of heart disease.
You may be considering increasing your HDL levels to help your heart health. However, increasing HDL cholesterol alone may be challenging.
As mentioned earlier, fish oil contains both EPA and DHA. Some fish oil or omega-3 supplements may contain different amounts of these two nutrients.
DHA-only omega-3 supplements have increasedbothHDL and LDL cholesterol levels in people with slightly elevated triglycerides.
Generally, DHA-only supplements arenotrecommended to help with lowering cholesterol.
Fish oil supplements to lower cholesterol contain a mix of DHA and EPA or are just EPA.
Although EPA appears effective atreducing triglyceride levels, evidence is less conclusive on the effects of EPA on LDL cholesterol.
The American Heart Association’s (AHA) scientific advisory statement concluded that EPA-only fish oil supplements do not raise LDL cholesterol levels among people with high triglycerides.
However, fish oil supplements containing EPA and DHA may slightly raise LDL cholesterol.
Another study observed a 15% to 36% increase in LDL cholesterol among individuals with very high triglycerides who took EPA and DHA-combined fish oil.
However, the increase may reflect an increase in the size of the LDL cholesterol particle and not a change in circulating levels of LDL cholesterol.
Smaller LDL particles are known to contribute to the accumulation of plaque in arteries.
The magnitude of change in triglycerides may influence the effects of fish oil on LDL cholesterol.
Significant triglyceride decreases may contribute to increased LDL cholesterol observed with fish oil supplements.
Ultimately, additional research is needed to fully understand fish oil’s effects on LDL cholesterol.
Fish oilis extracted from fatty fish like sardines, salmon, mackerel, and herring.Fish oilsupplements are generally encapsulated in a gel capsule.
The main components of fish oil are DHA and EPA omega-3 fatty acids.
EPA and DHA are long-chain fatty acids because their structure comprises multiple molecules.
The AHA recommends 2 to 4 grams of DHA and EPA fish oil daily.
Benefits appear to be dose-dependent, up to 4 grams daily. Moreover, the 4-gram dosage appears more effective than the 2-gram dosage in people with high triglyceride levels.
Studies notice improvements in triglyceride levels after 8 to 12 weeks of supplementation.
However, there is no established length of time for taking fish oil.
Instead, it should be taken under the guidance of a healthcare provider who can help determine how long you might need to take the medication.
Bloodwork and your medical history also influence a fish oil regimen.
Is Fish Oil Safe for Me?
Fish is a major, common allergen. Avoid fish oil if you’re allergic to it or its components (parts).
If you have asevere allergic reaction(itching, hives, shortness of breath), seek immediate medical attention.
Fish oil may cause minorgastrointestinal-related side effects like the following:
Fish oil capsules may also leave a fishy or unpleasant taste in the mouth.
One more serious potentialside effect of fish oilisatrial fibrillation(irregular heartbeat).
The risk ofatrial fibrillationmay depend on your individual medical history.
Higher doses of fish oil may increase the risk of atrial fibrillation.
One analysis found a greater risk of atrial fibrillation with each one-gram increase in fish oil among people taking fish oil daily for nearly five years.
Other research indicates a higher risk of atrial fibrillation with more than 4 grams daily in people with or at a high risk of heart disease.
Fatty fish is safe and encouraged duringpregnancy.
The Dietary Guidelines and the Food and Drug Administration recommend that people who are pregnant consume two to three servings of fish weekly. One serving is four ounces of precooked fish.
Mercury can negatively affect fetal brain development.
Salmon, sardines, anchovies, and Pacific chub mackerel are lower in mercury.
King mackerel has a high mercury content. It is recommended that people who are pregnant avoid king mackerel.
A lower dosage of fish oil is recommended during pregnancy to support fetal development and reduce the risk of preterm birth.
Supplements should contain 250 milligrams (mg) of DHA, well below the therapeutic amount for cholesterol.
People with very high LDL cholesterol should consult their healthcare provider before taking fish oil.
Fish oils, particularly those containing DHA, may increase LDL cholesterol.
If you are considering taking fish oil to help lower cholesterol, talk to your healthcare provider about a prescription.
Prescription fish oil supplementsare more closely regulated than over-the-counter fish oil.
The American Heart Association recommends prescription fish oil for people with elevated triglyceride levels looking to lower cholesterol.
Alternative Ways to Lower Your Cholesterol
Lifestyle and dietary modifications canlower cholesterol. Food, movement, stress management, medications, and supplements affect cholesterol.
It’s important to speak with your healthcare provider about other options you may be considering.
Summary
Significant evidence indicates fish oil lowers triglyceride levels. However, its effects on LDL and HDL cholesterol are less clear.
The decision to take fish oil is nuanced and should be made with your healthcare provider.
However, lifestyle and dietary changes like eating fatty fish twice weekly and adding more fiber to your diet are effective and relatively risk-free modifications to help reduce cholesterol.
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Health Office of Dietary Supplements.Omega-3 fatty acids.Skulas-Ray AC, Wilson PWF, Harris WS, et al.Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association.Circulation. 2019;140(12):e673-e691. doi:10.1161/CIR.0000000000000709MedlinePlus.Lipid profile test.The Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.Innes JK, Calder PC.The differential effects of eicosapentaenoic acid and docosahexaenoic acid on cardiometabolic risk factors: A systematic review.Int J Mol Sci. 2018;19(2):532. Published 2018 Feb 9. doi:10.3390/ijms19020532National Institutes of Health National Center for Complementary and Integrative Health.Omega-3 supplements: in depth.Gencer B, Djousse L, Al-Ramady OT, et al.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. 2021;144(25):1981-1990. doi:10.1161/CIRCULATIONAHA.121.055654U.S. Food and Drug Administration.Advice about eating fish.U.S. Food and Drug Administration.Questions & answers from the FDA/EPA advice about eating fish for those who might become or are pregnant or breastfeeding and children ages 1 to 11 years.Sagiv SK, Thurston SW, Bellinger DC, Amarasiriwardena C, Korrick SA.Prenatal exposure to mercury and fish consumption during pregnancy and attention-deficit/hyperactivity disorder-related behavior in children.Arch Pediatr Adolesc Med. 2012;166(12):1123-1131. doi:10.1001/archpediatrics.2012.1286Cetin I, Carlson SE, Burden C, et al.Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth.Am J Obstet Gynecol MFM. 2024;6(2):101251. doi:10.1016/j.ajogmf.2023.101251Rimm EB, Appel LJ, Chiuve SE, et al.Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: a science advisory from the American Heart Association.Circulation. 2018;138(1):e35-e47. doi:10.1161/CIR.0000000000000574The Centers for Disease Control and Prevention.Fiber: the carb that helps you manage diabetes.Whitehead A, Beck EJ, Tosh S, et al.Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials.Am J Clin Nutr. 2014;100(6):1413-1421. doi:10.3945/ajcn.114.086108Ho HV, Sievenpiper JL, Zurbau A, et al.The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials.Br J Nutr. 2016;116(8):1369-1382. doi:10.1017/S000711451600341XNational Institute of Health National Heart, Lung, and Blood Institute.Cholesterol & your heart: what you need to know fact sheet.Lin X, Zhang X, Guo J, et al.Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials.J Am Heart Assoc. 2015;4(7):e002014. doi:10.1161/JAHA.115.002014Liang M, Pan Y, Zhong T, et al.Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis.Rev Cardiovasc Med. 2021;22(4):1523-1533. doi:10.31083/j.rcm2204156U.S. Department of Health and Human Services.Physical activity guidelines for Americans.MedlinePlus.Fibrates.The Centers for Disease Control and Prevention.Cholesterol-lowering medicines.National Institute of Health National Center for Complementary and Integrative Health.Red yeast rice: what you need to know.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Health Office of Dietary Supplements.Omega-3 fatty acids.Skulas-Ray AC, Wilson PWF, Harris WS, et al.Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association.Circulation. 2019;140(12):e673-e691. doi:10.1161/CIR.0000000000000709MedlinePlus.Lipid profile test.The Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.Innes JK, Calder PC.The differential effects of eicosapentaenoic acid and docosahexaenoic acid on cardiometabolic risk factors: A systematic review.Int J Mol Sci. 2018;19(2):532. Published 2018 Feb 9. doi:10.3390/ijms19020532National Institutes of Health National Center for Complementary and Integrative Health.Omega-3 supplements: in depth.Gencer B, Djousse L, Al-Ramady OT, et al.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. 2021;144(25):1981-1990. doi:10.1161/CIRCULATIONAHA.121.055654U.S. Food and Drug Administration.Advice about eating fish.U.S. Food and Drug Administration.Questions & answers from the FDA/EPA advice about eating fish for those who might become or are pregnant or breastfeeding and children ages 1 to 11 years.Sagiv SK, Thurston SW, Bellinger DC, Amarasiriwardena C, Korrick SA.Prenatal exposure to mercury and fish consumption during pregnancy and attention-deficit/hyperactivity disorder-related behavior in children.Arch Pediatr Adolesc Med. 2012;166(12):1123-1131. doi:10.1001/archpediatrics.2012.1286Cetin I, Carlson SE, Burden C, et al.Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth.Am J Obstet Gynecol MFM. 2024;6(2):101251. doi:10.1016/j.ajogmf.2023.101251Rimm EB, Appel LJ, Chiuve SE, et al.Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: a science advisory from the American Heart Association.Circulation. 2018;138(1):e35-e47. doi:10.1161/CIR.0000000000000574The Centers for Disease Control and Prevention.Fiber: the carb that helps you manage diabetes.Whitehead A, Beck EJ, Tosh S, et al.Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials.Am J Clin Nutr. 2014;100(6):1413-1421. doi:10.3945/ajcn.114.086108Ho HV, Sievenpiper JL, Zurbau A, et al.The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials.Br J Nutr. 2016;116(8):1369-1382. doi:10.1017/S000711451600341XNational Institute of Health National Heart, Lung, and Blood Institute.Cholesterol & your heart: what you need to know fact sheet.Lin X, Zhang X, Guo J, et al.Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials.J Am Heart Assoc. 2015;4(7):e002014. doi:10.1161/JAHA.115.002014Liang M, Pan Y, Zhong T, et al.Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis.Rev Cardiovasc Med. 2021;22(4):1523-1533. doi:10.31083/j.rcm2204156U.S. Department of Health and Human Services.Physical activity guidelines for Americans.MedlinePlus.Fibrates.The Centers for Disease Control and Prevention.Cholesterol-lowering medicines.National Institute of Health National Center for Complementary and Integrative Health.Red yeast rice: what you need to know.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Health Office of Dietary Supplements.Omega-3 fatty acids.Skulas-Ray AC, Wilson PWF, Harris WS, et al.Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association.Circulation. 2019;140(12):e673-e691. doi:10.1161/CIR.0000000000000709MedlinePlus.Lipid profile test.The Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.Innes JK, Calder PC.The differential effects of eicosapentaenoic acid and docosahexaenoic acid on cardiometabolic risk factors: A systematic review.Int J Mol Sci. 2018;19(2):532. Published 2018 Feb 9. doi:10.3390/ijms19020532National Institutes of Health National Center for Complementary and Integrative Health.Omega-3 supplements: in depth.Gencer B, Djousse L, Al-Ramady OT, et al.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. 2021;144(25):1981-1990. doi:10.1161/CIRCULATIONAHA.121.055654U.S. Food and Drug Administration.Advice about eating fish.U.S. Food and Drug Administration.Questions & answers from the FDA/EPA advice about eating fish for those who might become or are pregnant or breastfeeding and children ages 1 to 11 years.Sagiv SK, Thurston SW, Bellinger DC, Amarasiriwardena C, Korrick SA.Prenatal exposure to mercury and fish consumption during pregnancy and attention-deficit/hyperactivity disorder-related behavior in children.Arch Pediatr Adolesc Med. 2012;166(12):1123-1131. doi:10.1001/archpediatrics.2012.1286Cetin I, Carlson SE, Burden C, et al.Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth.Am J Obstet Gynecol MFM. 2024;6(2):101251. doi:10.1016/j.ajogmf.2023.101251Rimm EB, Appel LJ, Chiuve SE, et al.Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: a science advisory from the American Heart Association.Circulation. 2018;138(1):e35-e47. doi:10.1161/CIR.0000000000000574The Centers for Disease Control and Prevention.Fiber: the carb that helps you manage diabetes.Whitehead A, Beck EJ, Tosh S, et al.Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials.Am J Clin Nutr. 2014;100(6):1413-1421. doi:10.3945/ajcn.114.086108Ho HV, Sievenpiper JL, Zurbau A, et al.The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials.Br J Nutr. 2016;116(8):1369-1382. doi:10.1017/S000711451600341XNational Institute of Health National Heart, Lung, and Blood Institute.Cholesterol & your heart: what you need to know fact sheet.Lin X, Zhang X, Guo J, et al.Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials.J Am Heart Assoc. 2015;4(7):e002014. doi:10.1161/JAHA.115.002014Liang M, Pan Y, Zhong T, et al.Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis.Rev Cardiovasc Med. 2021;22(4):1523-1533. doi:10.31083/j.rcm2204156U.S. Department of Health and Human Services.Physical activity guidelines for Americans.MedlinePlus.Fibrates.The Centers for Disease Control and Prevention.Cholesterol-lowering medicines.National Institute of Health National Center for Complementary and Integrative Health.Red yeast rice: what you need to know.
National Institute of Health Office of Dietary Supplements.Omega-3 fatty acids.
Skulas-Ray AC, Wilson PWF, Harris WS, et al.Omega-3 fatty acids for the management of hypertriglyceridemia: a science advisory from the American Heart Association.Circulation. 2019;140(12):e673-e691. doi:10.1161/CIR.0000000000000709
MedlinePlus.Lipid profile test.
The Centers for Disease Control and Prevention.LDL and HDL cholesterol and triglycerides.
Innes JK, Calder PC.The differential effects of eicosapentaenoic acid and docosahexaenoic acid on cardiometabolic risk factors: A systematic review.Int J Mol Sci. 2018;19(2):532. Published 2018 Feb 9. doi:10.3390/ijms19020532
National Institutes of Health National Center for Complementary and Integrative Health.Omega-3 supplements: in depth.
Gencer B, Djousse L, Al-Ramady OT, et al.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. 2021;144(25):1981-1990. doi:10.1161/CIRCULATIONAHA.121.055654
U.S. Food and Drug Administration.Advice about eating fish.
U.S. Food and Drug Administration.Questions & answers from the FDA/EPA advice about eating fish for those who might become or are pregnant or breastfeeding and children ages 1 to 11 years.
Sagiv SK, Thurston SW, Bellinger DC, Amarasiriwardena C, Korrick SA.Prenatal exposure to mercury and fish consumption during pregnancy and attention-deficit/hyperactivity disorder-related behavior in children.Arch Pediatr Adolesc Med. 2012;166(12):1123-1131. doi:10.1001/archpediatrics.2012.1286
Cetin I, Carlson SE, Burden C, et al.Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth.Am J Obstet Gynecol MFM. 2024;6(2):101251. doi:10.1016/j.ajogmf.2023.101251
Rimm EB, Appel LJ, Chiuve SE, et al.Seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease: a science advisory from the American Heart Association.Circulation. 2018;138(1):e35-e47. doi:10.1161/CIR.0000000000000574
The Centers for Disease Control and Prevention.Fiber: the carb that helps you manage diabetes.
Whitehead A, Beck EJ, Tosh S, et al.Cholesterol-lowering effects of oat β-glucan: a meta-analysis of randomized controlled trials.Am J Clin Nutr. 2014;100(6):1413-1421. doi:10.3945/ajcn.114.086108
Ho HV, Sievenpiper JL, Zurbau A, et al.The effect of oat β-glucan on LDL-cholesterol, non-HDL-cholesterol and apoB for CVD risk reduction: a systematic review and meta-analysis of randomised-controlled trials.Br J Nutr. 2016;116(8):1369-1382. doi:10.1017/S000711451600341X
National Institute of Health National Heart, Lung, and Blood Institute.Cholesterol & your heart: what you need to know fact sheet.
Lin X, Zhang X, Guo J, et al.Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials.J Am Heart Assoc. 2015;4(7):e002014. doi:10.1161/JAHA.115.002014
Liang M, Pan Y, Zhong T, et al.Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis.Rev Cardiovasc Med. 2021;22(4):1523-1533. doi:10.31083/j.rcm2204156
U.S. Department of Health and Human Services.Physical activity guidelines for Americans.
MedlinePlus.Fibrates.
The Centers for Disease Control and Prevention.Cholesterol-lowering medicines.
National Institute of Health National Center for Complementary and Integrative Health.Red yeast rice: what you need to know.
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