Omega-3: EPA, DHA, and your triglycerides

Read the back of the bottle, not the front

A "1000 mg fish oil" softgel might contain only 300 mg of EPA+DHA — the rest is other fats. The number that matters is the combined EPA+DHA per serving on the supplement-facts panel. This single check eliminates most low-value products.

What the evidence actually supports

• Triglycerides — the most consistent, dose-dependent effect: ~2–4 g/day of EPA+DHA lowers triglycerides meaningfully (this is also the basis of prescription-strength omega-3). If your lipid panel shows high triglycerides — especially with a triglyceride-to-HDL ratio above ~3 — this is the marker to watch.
• Cardiovascular support — the picture is nuanced: benefits are clearest in people with elevated triglycerides or low fish intake, more modest in people already eating fish twice a week.
• Joints and general inflammation — moderate evidence for symptom relief in inflammatory joint conditions at higher doses.
• Mood and brain — EPA-forward formulas show modest supportive evidence; DHA is structurally important in pregnancy and early development.

Choosing a product

• Freshness is the quality axis. Rancid (oxidized) fish oil smells fishy, burps fishy, and may lose benefit. Prefer brands publishing TOTOX/oxidation values or carrying third-party seals (IFOS, USP).
• Triglyceride (rTG) form absorbs somewhat better than the cheaper ethyl-ester form; check the label.
• Vegan? Algae oil provides the same EPA/DHA (fish get it from algae in the first place) — flax and chia provide ALA, which converts to EPA/DHA poorly (~5–10%).
• Take with meals — absorption of these fats roughly doubles alongside dietary fat, and it prevents the fishy-burp complaint.

Cautions

High doses (3 g+/day) have a mild blood-thinning effect — worth a doctor conversation if you take anticoagulants or antiplatelets, and standard practice is to pause high doses before surgery. If you're on statins or fibrates, omega-3 combines safely but belongs in the same conversation.