Fact checked by Nick Blackmer
Fish oil supplements provide omega-3s.
Credit: Kinga Krzeminska / Getty Images
Combining fish oil with gingko biloba or vitamin E can increase your risk of bleeding.
A doctor can help you decide whether taking fish oil supplements is safe for you.
It’s best to get omega-3 fatty acids through your diet before trying supplements.
Fish oil contains omega-3 fatty acids, known for their heart and brain health benefits. However, certain drugs and supplements may dangerously interact with fish oil.
1. Anticoagulants and Blood Thinners
Omega-3 supplements can inhibit blood-clotting, which usually is not an issue when they are taken on their own, said Aaron Emmel, PharmD, founder and director of educational programs at Pharmacy Tech Scholar.
Mixing omega-3s with medications that have similar effects, such as anticoagulants like warfarin or antiplatelet drugs like aspirin, could increase the risk of bleeding, he said.
Talk with a doctor before adding fish oil. They may want to monitor your international normalized ratio, which measures how long it takes for your blood to clot, noted Amy Goldsmith, RDN, LDN, owner of Kindred Nutrition & Kinetics in Frederick, Maryland.
2. Ginkgo Biloba
Ginkgo biloba, an herbal supplement, also has antiplatelet properties that make it more difficult for blood to clot, said Brynna Connor, MD, ABFM, a board-certified family medicine physician and healthcare ambassador at NorthWestPharmacy.com.
This is why combining it with fish oil increases the risk of bruising or bleeding, she told Health.
3. Vitamin E
Vitamin E—an antioxidant linked to immune, heart, and eye health—also thins the blood. It can further raise the risk of bleeding or bruising when taken alongside fish oil.
Most adults can meet the recommended 15 milligrams per day of vitamin E through foods like vegetable oils, nuts, seeds, spinach, and broccoli.
4. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs such as ibuprofen and naproxen ease pain and inflammation. However, they can increase the risk of internal bleeding, especially in the gastrointestinal tract.
Because omega-3s have anticoagulant properties, taking both at the same time can be risky.
5. Blood Pressure Medication
Omega-3s can slightly decrease blood pressure.
Blood pressure can drop too low when combined with blood pressure-lowering medications like ACE inhibitors, beta blockers, and calcium channel blockers, said Emmel.
“This doesn’t mean that you absolutely can’t take fish oil with these supplements,” Emmel told Health. “However, if you take them together, do so with caution.”
How Should You Take Fish Oil?
Any side effects from fish oil usually happen with higher doses—more than 3,000 milligrams of combined EPA and DHA per day.
“Generally, the standard OTC dose is 1,000-2,000 milligrams of total fish oil daily, and it should be safe as long as it’s monitored and guided by your doctor,” said Emmel.
Many people may not need to take fish oil at all. All three experts recommended getting omega-3s from your diet before turning to supplements.
You can likely meet the recommended intake by eating 2-3 servings of fish per week (a 3-ounce serving of salmon, for example, has about 2,000 milligrams of DHA and EPA).
“Supplements are best for those individuals who don’t eat fish, or those who need therapeutic supplementation for conditions like high triglycerides, cardiovascular disease risk, and rheumatoid arthritis,” Dr. Connor told Health.
For those who do need supplements, Dr. Connor suggested choosing ones in triglyceride or re-esterified triglyceride form, which your body absorbs better. Take them with a meal that includes some dietary fat to boost absorption.
Read the original article on Health