Does Taking Fish Oil Lower Cholesterol?

By Bo Martinsen, MD

Many people believe that incorporating omega-3s into their diet will solve their cholesterol woes. But the truth is much more nuanced; it’s not as simple as taking a daily fish oil capsule or drinking a teaspoon of cod liver oil.

In this article, we’ll uncover how these essential fatty acids impact your lipid profile – plus look at how much omega-3 you need to reap the benefits.

Cholesterol Is More Than One Thing
The term “cholesterol” often gets tossed around as though it were a single concept. But really, cholesterol includes several measurements. When you take a lipid test, the results are broken down into a few main components:

Triglycerides: Our bodies convert the extra calories, fat and sugars we eat into triglycerides. Having too high triglyceride levels is bad.

LDL: LDL, or low-density lipoproteins, is commonly referred to as the “bad” cholesterol. It builds up plaque in the arteries. LDL can be further analyzed by particle size. Small, dense particles are considered more harmful than large, fluffy particles.

HDL: HDL, or high-density lipoproteins, are the “good” cholesterol. Having a higher number is better.

Total Cholesterol: Your total cholesterol number is based on the other three components. Here’s the formula: HDL + LDL + 20% triglycerides = total cholesterol.

Omega-3s impact these numbers in different ways. Let’s take a closer look at what the science shows.

Triglyceride Levels
Studies show that taking omega-3s will consistently lower triglyceride levels. But the effect depends on how much you consume.

Higher doses of EPA and DHA omega-3s are needed to significantly reduce triglyceride levels. For example, a 2020 review from researchers in Norway highlighted the following trend:

• 850 mg of EPA/DHA lowered triglycerides by only 3.4%.

• 2400 mg of EPA/DHA lowered triglycerides by 16%.

• 5100 mg of EPA/DHA lowered triglycerides by 27%.

On average, studies report that taking between 3000 – 4000 mg of EPA/DHA will translate to a 25% drop in triglyceride levels.

Of course, the actual impact for any individual will depend on many factors, like genetics, age, gender, and your baseline triglyceride levels. There’s also the quality of the omega-3 product to consider, including the freshness level of the oil.

Can Fish Oil Pills Lower Triglyceride Levels?
Most regular fish oil capsules contain only 300 mg of EPA/DHA. With that serving size, you would need to take 10 or more capsules every day to get an adequate dose.

Concentrated omega-3 products can deliver higher doses of EPA and DHA in fewer servings. But even with prescription omega-3 oils aimed at managing hyperlipidemia, you have to take at least 4 capsules daily.

At Omega3 Innovations, we offer 3000 mg EPA/DHA in a pre-measured, drinkable single serving. This liquid form makes it easier for people to meet their omega-3 needs and experience beneficial effects.

LDL Cholesterol
While the benefits of omega-3s for triglyceride levels are widely known and accepted, their effects on LDL levels are more complex.

Again, there are different types of LDL cholesterol. On a lipid panel, people typically pay the greatest attention to the LDL-C value. Most studies show that omega-3s don’t really impact LDL-C. However, one exception seems to be for people with very high triglyceride levels (>500mg/dl). For these people, omega-3s may increase LDL somewhat.

There’s also Lp(a), or a type of low-density LDL that can create plaque in your arteries. Most studies (but not all) note a modest decrease in this value with omega-3s, which is good.

Finally, omega-3s seem to facilitate a shift from small dense LDL particles to bigger and lighter large buoyant LDL. This is positive, since small dense LDL is more likely to create arterial plaque. Indeed, shifting from small dense to large buoyant LDL is associated with lower heart disease risk.

HDL Cholesterol
When it comes to HDL cholesterol, research suggests that omega-3s have little effect in general.

The exception is again for people with very high triglycerides. In these cases, omega-3s may increase the HDL levels by more than 10%. This is positive, since HDL is the “good” cholesterol.

What’s the Best Measure of Heart Disease Risk?
Many studies show that your ratio of triglycerides to HDL may be a more important number than looking at your total cholesterol. Having a high triglyceride: HDL ratio is associated with heart disease, insulin resistance, and low testosterone levels in men. Interestingly, the risk seems to be independent of bad cholesterol numbers or medication use.

Taking sufficient doses of omega-3s will typically reduce the triglycerides to HDL ratio. This improvement could be one of the reasons for the purported heart health benefits of these fatty acids.

For the full article and references, please visit:

https://omega3innovations.com/blog/does-taking-fish-oil-lower-cholesterol/

Bo Martinsen, MD
Dr. Martinsen is an omega-3 specialist, innovator, and advocate for natural foods. As co-founder and CEO of Omega3 Innovations, he has created several medical food products that combine effective doses of omega-3s with fibers and other nutrients. Before Omega3 Innovations, Dr. Martinsen practiced medicine in Norway for over 20 years.

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