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Complementary Medicine

How Much Fish Oil Should be Taken with Aspirin?

10/22/2002

Question:

How much fish oil (total DHA and EPA) is it safe to take daily if you are taking an 81mg aspirin and eating 3 cubes of ginger and drinking a glass of wine daily?

Answer:

This question has been forwarded by Diet & Nutrition: That`s a very good question...and one which comes up frequently. There was a randomized controlled trial (RCT)in 1998 (J Thromb Thrombolysis 1998 Jul;5(3):257-261 Effects of Marine Fish Oils on the Anticoagulation Status of Patients Receiving Chronic Warfarin Therapy. Bender, et.al.) which showed that fish oil supplementation had absolutely no effect on level of thinning of the blood in patients taking Warfarin. The study was very small, however. An earlier RCT with a larger sample size studied the effect of fish oil use in coronary artery bypass surgery patients who were also given either daily aspirin or warfarin. (Blood Coagul Fibrinolysis 1995 Feb;6(1):17-22 Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Eritsland et.al).The results showed no excess bleeding in patients given fish oil versus placebo with either aspirin or Warfarin. I often recommend fish oil supplements, diets high in cold water fish, as well as flax seed oil supplements...all very good sources of Omega-3 fatty acids, to my patients as part of an anti-inflammatory diet. 

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Response by:

Tanya I Edwards, MD, MEd Tanya I Edwards, MD, MEd
Formerly, Associate Professor of Medicine
School of Medicine
Case Western Reserve University