Fish oil contains two active ingredients; EPA and DHA. Commercial fish oils vary in their content of EPA and DHA. The discussion of dosage below outlines the amounts of combined EPA and DHA used in human clinical studies of fish oil for various health targets. For certain health targets research suggests that an oil higher in EPA or DHA may be appropriate. These situations are highlighted when appropriate. For a description of the research from which the table below was constructed please review the discussion below. 

Cardiovascular Health

Low doses of EPA and DHA (900mg of EPA and DHA combined per day or less) have been shown to dramatically reduce heart disease risk (Daviglus 1997, Jacobson 2007, Kris- Etherton 2003, Marchioli 2002, Yokoyama 2007). This has been shown both in otherwise healthy individuals, as well as in individuals who have existing heart disease. Most of the benefit appears to come from reduced risk of sudden cardiovascular death (a sudden, fatal heart attack).

Larger dosages deliver benefits above and beyond those achieved with smaller ones (Jacobson 2007, Yokoyama 2007). Larger dosages (2000-4000mg of EPA and DHA combined per day) do not appear to further reduce the risk of sudden cardiovascular death. They do, however, appear to reduce the risk of non fatal cardiovascular events (non- fatal heart attack, for example).

Low dosages (900mg of EPA and DHA combined per day) reduce the risk of sudden cardiovascular death by 50% or more. Larger dosages (2000-4000mg of EPA and DHA combined per day) reduce the risk of non- fatal cardiovascular complications by approximately 20- 30% (Daviglus 1997, Jacobson 2007, Kris- Etherton 2003, Marchioli 2002, Yokoyama 2007).

Larger dosages (2000-4000mg of EPA and DHA combined per day) benefit cholesterol levels. At this dosage fish oil reduces levels of harmful triglycerides by 20-40%, and raises beneficial HDL- cholesterol by approximately 10%(Jacobson 2007, Kris- Etherton 2003).

Improved Mood

The following has been taken from a position statement of the American Psychiatric Association (Freeman 2006). “All adults should eat fish >/= 2 times per week. Patients with mood, impulse- control, or psychotic disorders should consume 1g EPA + DHA per day. A supplement may be useful in patients with mood disorders (1-9g per day). Use of  > 3g per day should be monitored by a physician”.

1000mg of EPA per day appears to help contribute to a balanced mood. At this dosage EPA appears to elevate a depressed mood (Fontani 2005, Zanarini 2003, Su 2003, Peet 2002, Nemets 2002, Stoll 1999, Lin 2007, Freeman 2006), and also stabilize a manic or excessively positive mood (Wozniak 2007, Frangou 2006, Sagduyu 2005, Osher 2005, Stoll 1999). The oil should contain significantly more EPA than DHA.

Many of the human studies which have examined fish oil for improving/ stabilizing mood have used 100% EPA concentrates (Frangou 2006, Osher 2005, Fontani 2005, Zanarini 2003, Peet 2002, Nemets 2002). Studies which have used oils high in EPA but containing some DHA have also been shown to be very beneficial. All of the human studies which have used high DHA oils have failed to produce benefit to mood (Grenyer 2007, Marangell 2006, Silvers 2005, Marangell 2003, Llorente 2003).

Dosages of up to 4000mg per day of combined EPA and DHA appear to be safe for adult use. Most adults obtain maximal mood benefit from 1000mg of EPA per day.

Childhood Attention Mood Concentration

As little as 500-600mg of EPA per day has been shown to benefit concentration, attention, and academic performance in children ages 5 and up, as well as improve mood (Nemets 2006, Richardson 2005, Sinn 2007). Larger dosages have been shown to successfully improve/ stabilize mood in children (Wozniak 2007).

One study benefited concentration and attention in children using very large dosages (Sorgi 2007). Although no adverse effects were observed, such dosages are not required, nor advisable unless directly directed to do so by your healthcare practitioner.

The oil should contain significantly more EPA than DHA. Of 5 studies which used high DHA oils to benefit attention, mood, and/ or concentration in children, 4 failed to produce any benefit (Hirayama 2004, Itomura 2005, Stevens 2003, Voigt 2001). The fifth achieved benefit to only 7 of 14 parameters studied (Richardson 2002).

500-1000mg of EPA per day appears to be a reasonable dosage in children ages 5 and up. Combined dosage of EPA and DHA should be kept below 1500mg per day, unless directed otherwise by your healthcare provider.

Joint Health

2000-4000mg per day of combined EPA and DHA has been shown to provide significant relief from joint pain. This has been shown for pain from arthritis (Adam 2003, Kremer 1995, Geusens 1994), spine pain from the neck or back (Maroon 2006, Sundstrom 2006), joint pain from inflammatory bowel disease (Goldberg 2007), chronic fatigue syndrome (Puri 2004), fibromyalgia (Ozgocmen 2000), Lupus (Wright 2007), and other painful situations.

Pregnancy and Breastfeeding

No less than 300mg per day of DHA is recommended for pregnant women (Simopoulos 1999). DHA supplementation in human studies of pregnant women has been shown to have a number of benefits for both the mother and the developing fetus (Denburg 2005, Jensen 2005, Judge 2007). For a discussion of these benefits, please visit fishoil and your health. 

Under most circumstances the oil used in pregnancy should contain more DHA than EPA. If mood improvement benefits are required during pregnancy, an oil high in EPA may be considered. 

Bowel Health

2000-4000mg per day of combined EPA and DHA has been shown to benefit bowel health in human studies of individuals who have inflammatory bowel disease (Romano 2005, Seidner 2005, Trebble 2004).

Respiratory Health

2000-4000mg per day of combined EPA and DHA has been shown to improve respiratory function in human studies of individuals who have asthma or other respiratory issues (Matsuyama 2005, Mickleborough 2006).

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