Recommended Dosage and Usage of Krill Oil (EPA and DHA) Supplements
For patients with elevated triglycerides, 4 grams per day of EPA + DHA is recommended, an amount that typically requires pharmacotherapy to achieve a consistent dose on an ongoing basis. 1
General Recommendations Based on Cardiovascular Risk
For General Population (Primary Prevention):
- Dietary recommendation: Consume at least 2 servings of fatty fish per week (approximately 8 ounces total)
- Target intake: Approximately 250 mg/day of EPA + DHA 1
- Food sources: Preferably oily fish such as salmon, rainbow trout, tuna, herring, mackerel, sardines, and anchovies 1
For Patients with Documented Coronary Heart Disease (Secondary Prevention):
- Recommended dose: 1 gram of EPA + DHA (combined) per day 1
- Source options:
- Consumption of oily fish
- EPA + DHA supplements (in consultation with physician)
For Patients with Hypertriglyceridemia:
- Recommended dose: 2-4 grams of EPA + DHA per day 1
- This dosage can lower triglycerides by 20-40%
- Doses of this magnitude typically require prescription-strength supplements
Krill Oil Specific Considerations
Krill oil contains EPA and DHA primarily bound to phospholipids, which differs from fish oil where these fatty acids are predominantly bound to triglycerides. While some studies have investigated potential differences in bioavailability between krill oil and fish oil, the evidence regarding superior absorption of krill oil is mixed 2, 3, 4.
When selecting krill oil supplements:
- Look for products that clearly state the EPA and DHA content
- Higher phospholipid content in krill oil may enhance bioavailability of n-3 PUFA 5
- A typical research dose showing cardiovascular benefits used approximately 832.5 mg EPA and DHA per day 6
Safety Considerations
- Monitoring: Patients taking more than 3 grams of EPA + DHA from supplements should do so only under physician supervision 1
- Bleeding risk: Very high intakes could potentially cause excessive bleeding in some individuals 1
- Advantage of supplements: Unlike some fish sources, krill oil and fish oil supplements are generally free of methylmercury contamination 1
Clinical Pearls
- The EPA:DHA ratio in krill oil is typically around 1.8:1 6
- Krill oil supplementation has been shown to decrease the n-6/n-3 PUFA ratio in both plasma and red blood cells 6
- Unlike dietary recommendations which can be met through food, therapeutic doses for triglyceride lowering (4 g/day) generally require supplements 1
- When recommending fish consumption, advise patients to prioritize fish lower in mercury (salmon, anchovies, sardines, trout) and limit those higher in mercury (king mackerel, shark, swordfish) 1
- Patients should be advised that krill oil supplements, like fish oil, may cause a fishy aftertaste or mild gastrointestinal symptoms
For optimal cardiovascular benefit, supplementation should be consistent and long-term, particularly for those with established cardiovascular disease or elevated triglycerides.