From the Research
Risk of Bleeding with Omega-3 Fatty Acid Supplementation
- The risk of bleeding associated with omega-3 fatty acid (fish oil) supplementation has been evaluated in several studies 1, 2, 3, 4, 5.
- Clinical trial evidence has not supported increased bleeding with omega-3 fatty acid intake, even when combined with other agents that might also increase bleeding, such as aspirin and warfarin 1, 2.
- A systematic review of 52 publications found that fish oil supplements reduced platelet aggregation in healthy subjects, but did not increase bleeding or blood transfusions during or after surgery 3.
- A study of 1,523 patients with acute myocardial infarction found no association between the omega-3 index and bleeding risk 4.
- A meta-analysis of 11 randomized clinical trials found no difference in bleeding events between patients receiving omega-3 PUFAs and those in the control group, although high-dose purified eicosapentaenoic acid (EPA) was associated with a modest increase in bleeding risk 5.
Key Findings
- Omega-3 fatty acid supplementation does not appear to increase the risk of bleeding in most patients 1, 2, 3, 4.
- High-dose purified EPA may be associated with a modest increase in bleeding risk, but the clinical significance is unclear 5.
- The benefits of triglyceride lowering with omega-3 fatty acids may outweigh any theoretical risks for increased bleeding 2.