Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

The average American consumes about 1.6 grams of omega-3 fatty acids daily. About 1.4 grams of this comes from ALA, while 0.1-0.2 grams from EPA and DHA. In Western diets, people eat about 10 times more omega-6 fatty acids than omega-3 fatty acids. These large amounts of omega-6 fatty acids come from vegetable oils such as corn oil, sesame oil, sunflower oil, and walnut oil. Because omega-6 and omega-3 fatty acids compete in the body, benefits may be reached either by decreasing omega-6 intake or increasing omega-3 intake.

The American Heart Association recommends that healthy adults eat fish at least twice weekly. Fatty fish such as catfish, halibut, salmon, striped sea bass, and albacore tuna are particularly recommended. Plant-based sources of ALA such as tofu, walnuts, and canola oil are also recommended. The World Health Organization recommends a daily EPA and DHA intake of 0.3-0.5 grams and a daily ALA intake of 0.8-1.1 grams.

To treat aggression, 1.5-1.8 grams of fish oil containing DHA plus EPA or fish oil containing 1.5 grams of DHA and 0.2 grams of EPA has been taken by mouth for 2-3 months.

To treat allergies in the infant, 1.6 grams of EPA and 1.1 grams of DHA (Bio Marin®, Pharma Nord, Vejle, Denmark) have been taken by mouth in mothers from the 25th week of pregnancy through 3-4 months of breastfeeding. Other studied doses include 3.7 grams of omega-3 fatty acids daily beginning at the 20th week of pregnancy until birth; 1.5 grams of omega-3 fatty acids daily during the first four months of breastfeeding; 0.5 grams of DHA plus 0.15 grams of EPA daily beginning at the 22nd week of pregnancy until birth; 2.7 grams of marine omega-3 fatty acids containing two milligrams per milliliter of tocopherol from the 30th week of pregnancy until birth; and 1.6 grams of EPA, 1.1 grams of DHA, and 23 milligrams of alpha-tocopherol taken by mouth daily from the 25th week of pregnancy through the end of breastfeeding.

To treat anxiety, three grams of omega-3 fatty acids have been taken by mouth daily in the form of five capsules containing 450 milligrams of EPA, 100 milligrams of DHA, and 50 milligrams of other triglyceride omega-3 fatty acids, for three months.

To treat stiff arteries, doses of one-gram capsules containing EPA plus DHA or 360-1800 milligrams of DHA plus 120-1,800 milligrams of EPA have been taken by mouth daily for 6-12 weeks. A dose of 1,800 milligrams of EPA has been taken by mouth daily for 6-12 weeks.

To treat asthma, fish oil capsules containing 2.7-3.2 grams of EPA and 1.8-2.2 grams of DHA or 0.2-1.0 gram of EPA plus DHA, 20 milliliters of fish oil, or 10-20 grams of perilla seed oil (containing ALA) have been taken by mouth daily for up to 12 months. A dose of one gram of EPA plus DHA (Liparmonyl®) has been taken by mouth daily for one year.

To improve athletic performance, eight capsules (each containing one gram of fish oil) has been taken by mouth daily for eight weeks. Fish oil capsules containing 3.2 grams of EPA plus 2.2 grams of DHA have been taken by mouth daily for three weeks.

To treat bipolar disorder, seven capsules have been taken by mouth twice daily (for a daily total of 6.2 grams of EPA and 3.4 grams of DHA) for four months along with conventional therapy. Flaxseed oil capsules containing 6.6 grams of ALA have been taken by mouth daily for 12-16 weeks. A dose of 360-6,200 milligrams of EPA plus 1,560-3,400 milligrams of DHA has been taken by mouth daily for 4-44 weeks. Seven capsules of menhaden fish body oil have been taken by mouth twice daily for four months. Fish body oil containing 6.2 grams of EPA plus 3.4 grams of DHA has been taken by mouth.

To treat weight loss in people with illness, 30 milliliters of fish oil has been taken by mouth daily, providing 4.9 grams of EPA and 3.2 grams of DHA for four weeks. A dose of 2-2.2 grams of EPA plus 0.96-1 gram of DHA have been taken by mouth daily for 3-7 weeks. A dose of 2-16 grams of fish oil has been taken by mouth daily for three months.

To treat cancer, 2.02-2.2 grams of EPA plus 0.92-1.0 grams of DHA (Prosure®, Abbott Laboratories) have been taken by mouth daily for five weeks to 60 days. A dose of 1.8 grams of EPA has been taken by mouth daily for 21 days before a bone marrow transplant and continued for 180 days afterwards. Eighteen capsules of fish oil containing 3.1-3.2 grams of EPA plus 2.0-2.2 grams of DHA have been taken by mouth daily for 14-40 days. Capsules containing two grams of fish oil have been taken by mouth daily for six weeks. Two cans of a fish oil-enriched supplement containing 1.09 grams of EPA have been taken by mouth daily for three weeks.

To prevent cancer, 4.1 grams of EPA and 3.6 grams of DHA have been taken by mouth daily for 12 weeks.

To treat abnormal heart rhythms, two grams of fish oil have been taken by mouth daily for 14-379 days. Four capsules containing two grams of fish oil composed of 0.464 grams of EPA, 0.335 grams of DHA, and 0.162 grams of other n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) have been taken by mouth daily for 12 months. A dose of 1.8 grams of fish oil containing 42% EPA plus 30% DHA has been taken by mouth daily for two years. Four one-gram capsules containing 2.6 grams of EPA plus DHA have been taken by mouth for 12 months. Two, four, or six capsules of fish oil, with 260 milligrams of DHA, and 60 milligrams of EPA per one-gram capsule, have been taken by mouth for 12 weeks. A dose of six grams of DHA-rich fish oil has been taken by mouth daily for 12 weeks; DHA-rich fish oil providing 0.36 grams of EPA and 1.56 grams of DHA daily has been taken by mouth daily in the form of Hi-DHA® from Nu-Mega Ingredients Pty. Ltd. Doses of 0.85-1.24 grams of EPA plus 1.0-1.76 grams of DHA have been taken by mouth daily beginning immediately after surgery and continuing until hospital discharge. A dose of 301.5 milligrams of ALA has been taken by mouth daily beginning four weeks before surgery and continuing for one year. Doses of 1-4 grams of omega-3 have been taken by mouth daily beginning up to one week before various heart surgeries and continuing for up to six months after electrical cardioversion, two weeks after coronary artery bypass grafting (CABG), or until discharge after open-heart surgery. Doses of 4-8 grams of PUFAs have been taken daily for 24 weeks. Doses of 850-882 milligrams of EPA plus DHA in a 1:2 ratio have been taken by mouth daily for five days prior to surgery and continuing until discharge from the hospital. A dose of two milligrams to two grams of omega-3 PUFAs containing 85-88% EPA plus DHA has been taken by mouth beginning five days before coronary artery bypass grafting and continuing until hospital discharge. A dose of two grams of omega-3 fatty acids (850-882 milligrams of EPA plus DHA in a 1.2:1 ratio) has been taken by mouth daily for five days following coronary artery bypass graft surgery. A dose of four grams of omega-3 fatty acids has been taken by mouth daily before surgery, followed by two grams daily after. A dose of 1,240 milligrams of EPA plus 1,000 milligrams of DHA has been taken by mouth beginning 5-7 days before open heart surgery and continuing until hospital discharge or two weeks after surgery. A dose of two grams of omega-3 fatty acids containing 85-88% EPA plus DHA has been taken by mouth daily for five days prior to surgery. A dose of eight grams omega-3 fatty acids containing 465 milligrams of EPA plus 375 milligrams of DHA has been taken by mouth daily for seven days, followed by four grams daily for 20 weeks. A dose of one gram of omega-3 fatty acids has been taken by mouth before direct current cardioversion. A dose of three grams of omega-3 fatty acids has been taken by mouth daily until electrical cardioversion (ECV), followed by two grams daily for six months. A dose of 301.5 milligrams of ALA has been taken by mouth daily for four weeks before and for one year after cardioversion. An infusion of 100 milligrams of fatty acids per kilogram containing a 0.9:1 ratio of EPA to DHA has been given intravenously beginning 12 hours before surgery and continuing until transfer from the intensive care unit.

To reduce the risk of heart disease, six capsules providing one gram of fish oil, containing 160 milligrams of EPA plus 100 milligrams of DHA, have been taken by mouth daily in divided doses for six months (two grams with each meal). Two capsules of Omacor® (now called Lovaza®; 460 milligrams of EPA and 380 milligrams of DHA) have been taken by mouth twice daily for 12 weeks. A dose of 2,080 milligrams of omega-3 fatty acids has been taken by mouth in four capsules, each containing 310 milligrams of EPA plus 210 milligrams of DHA, for 10 weeks. A dose of four grams (42% EPA and 25% DHA) has been taken by mouth daily for 12 weeks. A dose of two grams omega-3 fatty acids has been taken by mouth daily for 10 weeks. A dose of 250 milligrams of long-chain omega-3 fatty acids has been taken by mouth daily. Doses of 12 grams of fish oil (providing 4.0 grams of omega-3 fatty acids and 8-13 grams or 35 grams of ALA), one-gram capsules containing 0.5 grams of EPA plus DHA daily, and 0.45-4.5 grams of EPA plus DHA have been taken by mouth daily for periods ranging from 14 to 360 days. Doses of 0.2-6 grams of omega-3 fatty acids have been taken by mouth daily for 6-52 weeks. Flaxseed oil containing three grams of ALA has been taken by mouth daily for 26 weeks. Three flaxseed oil capsules or 25 grams of fat spread enriched with flaxseed oil containing 0.8-1.7 grams of EPA plus DHA or 4.5-9.5 grams of ALA have been taken by mouth daily for six months. Flax oil or fish oil containing 1.2-3.6 grams of ALA has been taken by mouth daily for 12 weeks. A dose of 4.5 grams of EPA plus DHA has been taken by mouth daily for five weeks. Doses of 2-6 grams of fish oil containing 26% DHA plus six percent EPA have been taken by mouth daily for 12 weeks. Flaxseed oil containing one gram of ALA, hempseed oil containing 0.3 grams of ALA, or fish oil containing 0.6 grams of EPA plus DHA has been taken by mouth daily for 12 weeks. Eight capsules containing a total of 9.6 grams of fish oil providing 1.728 grams of EPA plus 1.152 grams of DHA have been taken by mouth daily for 12 weeks. Six capsules containing six grams of fish oil providing three grams of n-3 LC-PUFAs have been taken by mouth daily for eight weeks.

To treat chronic obstructive pulmonary disease (COPD), an omega-3 PUFA-rich diet containing 0.6 grams of omega-3 PUFAs and 0.4 grams of omega-6 PUFAs has been used for 24 months.

To improve brain function, 0.25-0.68 grams of DHA plus 0.323-1.48 grams of EPA has been taken by mouth daily for 3-6 weeks.

To treat coronary heart disease, 10 grams of fish oil has been taken by mouth for 12 weeks. Doses of 3.4-4 grams of fish oil concentrate have been taken by mouth daily for nine months after bypass surgery. Doses of 6-7 grams of omega-3 fatty acids have been taken by mouth daily for six months. Doses of 0.23-5.4 grams of EPA and 0.15-3.6 grams of DHA have been taken by mouth for up to 6.2 years. Doses of 0.6-10 grams of omega-3 fatty acids have been taken by mouth daily for up to nine years. A dose of 0.5 grams of fish oil (MaxEPA®) has been taken by mouth daily for 24 months. For improved exercise tolerance, nine fish oil capsules containing 3.15 grams of omega-3 fatty acids have been taken by mouth for four months. A dose of 10 grams of fish oil has been taken by mouth for 12 weeks. EPA-rich fish oil (MaxEPA®, 2.8 grams of EPA) has been taken by mouth daily for three months. Doses of 0.85-6 grams of fish oil have been taken by mouth daily for up to 3.5 years, with the fish oil containing 1.08-2.24 grams of EPA plus 0.72-1.12 grams of DHA.

To treat Crohn's disease, doses of 1.2-3.3 grams of EPA and 0.6-1.8 grams of DHA have been taken by mouth daily for one year in the form of capsules.

To treat toxicity caused by cyclosporine, 3-6 grams of omega-3 fatty acids have been taken by mouth for up to six months. Doses of 9-18 grams of EPA have been taken by mouth.

To treat dementia, 700-1,940 milligrams of EPA plus DHA has been taken by mouth daily for 6-24 months. Margarine containing 400 milligrams of EPA and DHA or 400 milligrams of EPA and DHA plus two grams of ALA has been taken by mouth daily for 40 months. A dose of 4.3 grams of DHA has been taken by mouth daily for 12 months.

To treat depression, one gram of E-EPA (derived from 96% pure fish oil) has been taken by mouth two times daily for four weeks. One 1,000-milligram capsule (400 grams of EPA plus 200 milligrams of DHA) or two 500-milligram capsules (if unable to swallow the larger capsule; 190 milligrams of EPA plus 90 milligrams of DHA) have been taken by mouth daily for 16 weeks. A dose of 1.05 grams of ethylester-EPA plus 0.15 grams of ethyl-DHA has been taken by mouth daily in three divided doses for eight weeks. Four capsules (each containing 180 milligrams of EPA and 120 milligrams of DHA) have been taken by mouth daily for 12 weeks. Doses of 0.5-6 grams of omega-3 fatty acids have been taken by mouth daily for 6-8 weeks, from the third trimester until up to six months after giving birth, or for eight weeks beginning at 16-32 weeks of pregnancy. A dose of 1.1 grams of EPA plus 0.8 grams of DHA has been taken by mouth daily beginning at 12 weeks of pregnancy and continuing until six months after birth. Doses of 400-6,200 milligrams of EPA plus 150-3,400 milligrams of DHA have been taken by mouth for 4-24 weeks. Doses of 100-2,200 milligrams of EPA plus 800-1,200 milligrams of DHA have been taken by mouth daily for eight weeks or beginning at less than 21 weeks of pregnancy and continuing until birth. A dose of 4.4 grams of EPA plus 2.2 grams of DHA have been taken by mouth twice daily for eight weeks.

To treat diabetes, 0.6-4.6 grams of fish oil have been taken by mouth daily for four weeks to one year. Doses of 2-4 grams of omega-3 fatty acids have been taken by mouth daily. The following doses have been taken by mouth: 10 grams of fish oil concentrate composed of 30% omega-3 fatty acids daily for three weeks, 3.6 grams of fish oil containing n-3 LC-PUFAs daily for three months, six grams of fish oil daily, 3.6 grams of n-3 LC-PUFAs daily for three months, or 3.4 grams of ALA daily for 10 weeks. A dose of two grams omega-3 fatty acids has been taken daily for 10 weeks. A dose of one gram of omega-3 ethyl esters has been taken by mouth 2-3 times daily for 2-4 months.

To treat painful menstrual cramps, 2.5 grams of fish oil has been taken by mouth daily for 3-4 months.

To treat eczema, six grams of concentrated omega-3 fatty acids has been taken by mouth daily for four months during winter. A dose of 10 grams of fish oil has been taken by mouth for 12 weeks. The following doses have been taken by mouth: 12 capsules of fish oil daily (providing 2.0 grams of EPA plus 1.3 grams of DHA daily) or six one-gram capsules (containing 51% EPA, 32% DHA, and 3.6 international units per gram of DL-alpha-tocopherol) for 12-16 weeks. Doses of 1,800-3,060 milligrams EPA plus 1,200-1,920 milligrams of DHA has been taken by mouth. A dose of 1.6 grams of EPA plus 1.1 grams of DHA has been taken by mouth daily beginning at 25 weeks of pregnancy through 3-4 months of breastfeeding.

To improve exercise performance, 1,000 milligrams of fish oil, containing 180 milligrams of EPA plus 120 milligrams of DHA, has been taken by mouth during and after exercise for 12 weeks. Six capsules of one gram of fish oil (260 milligrams of DHA plus 60 milligrams of EPA per capsule) have been taken by mouth for five weeks.

To treat high blood pressure, 2-4 grams of omega-3 fatty acids has been used daily for up to one year.

To treat high triglycerides, doses of up to two grams of omega-3 fatty acids from EPA and DHA have been taken by mouth daily. Doses of 2-4 grams of omega-3 fatty acids taken by mouth daily have been studied. Doses of 0.3-6 grams of EPA, 0.7-3.72 grams of DHA, and two grams of ALA have been taken by mouth daily for at least six months. Doses of 0.045-15 grams of fish oil have been taken by mouth daily for six weeks to 3.5 years. Doses of 3-6.3 grams of ALA have been taken by mouth daily for 26 weeks to two years. Doses of 2-3 grams of MaxEPA® (180 milligrams of EPA plus 120 milligrams of DHA per capsule) have been taken by mouth three times daily for 4-6 weeks. A dose of five grams of Omega Rx, containing 400 milligrams of EPA plus 200 milligrams of DHA in each capsule, as well as 100 milligrams of vitamin E, has been taken by mouth for 13 weeks. Fish oil containing 180-1,750 milligrams of EPA plus 120-1,150 milligrams of DHA has been taken by mouth 1-3 times daily for 8-24 weeks. A dose of 300 milligrams of omega-3 fatty acids has been taken by mouth daily for four weeks. Doses up to 10 milligrams of EPA and DHA daily have been studied. A dose of two grams of Omacor® has been taken twice daily for 12-24 weeks. A dose of three grams of DHA (7.5 grams of DHA oil) has been taken by mouth daily for 90 days. A dose of 1.8 grams of tuna oil has been taken by mouth daily. Doses of four grams of omega-3 ethyl esters, three grams of salmon oil, six grams of fish oil, or 12.5 grams of omega-3 fatty acid liquid formulation (Omacor®, Pronova BioPharma, Norway, AS) have been taken by mouth daily for 4-16 weeks. The following doses have been taken by mouth: eight grams of marine-lipid concentrate daily for eight weeks; six grams of fish oil daily; 3.4 grams of ALA daily for 10 weeks; 0.8-1.7 grams of EPA plus DHA or 4.5-9.5 grams of ALA daily for six months; fish oil containing 180 milligrams of EPA plus 120 milligrams of DHA daily for three months; 15 milliliters of flaxseed oil containing 8.1 grams of ALA daily for 12 weeks; three grams of n-3 LC-PUFAs daily for 15 weeks; and two grams of fish oil daily for four weeks.

To treat IgA nephropathy (kidney disease in which there is a buildup of IgA antibodies), doses of 4-8 grams of omega-3 fatty acids containing 1.88-3.76 grams of EPA plus 1.47-2.94 grams of DHA have been taken by mouth daily for two years. Fish oil containing 0.85 grams of EPA plus 0.58 grams of DHA have been taken by mouth daily for four years. Doses of 4-12 grams of fish oil have been taken by mouth daily for 36 weeks to two years. Omega-3 fatty acids ranging from 1.4-5.1 grams have been taken by mouth daily for 6-48 months. Doses of 4-12 grams have been taken by mouth daily. A dose of 15 capsules of an unknown concentration taken by mouth daily for 2-12 months has been studied.

To improve appetite in people who have dementia, four one-gram capsules (1.7 grams of DHA and 0.6 grams of EPA) have been taken by mouth daily for 12 months.

To promote infant development, the following doses have been taken by mouth by mothers: 4-4.5 grams of fish oil containing 790-920 milligrams of DHA plus 620-1,280 milligrams of EPA daily beginning at 30 weeks of pregnancy and continuing until birth, or beginning at birth and continuing until the fourth month of breastfeeding; 10 milliliters of cod liver oil containing 1,183 milligrams of DHA plus 803 milligrams of EPA daily beginning at 18 weeks of pregnancy and continuing until the third month of breastfeeding; 1.5 grams of omega-3 fatty acids daily during the first four months of breastfeeding; and 10 milliliters of cod liver oil daily beginning at 18 weeks of pregnancy until three months after birth.

To promote eye and brain development in infants, 4.5 grams of fish oil have been taken by mouth daily by mothers during the first four months of breastfeeding. Mothers have taken fish oil capsules (containing DHA 200-2,200 milligrams and EPA 33-1,800 milligrams) by mouth daily beginning at 15-25 weeks of pregnancy until birth. Mothers have taken fish oil containing 1.5 grams of omega-3 fatty acids as capsules or cod liver oil containing 1.183 grams of DHA, 0.803 grams of EPA, and vitamins A, D, and E by mouth for 18 weeks. Fish oil containing 2.2 grams of DHA plus 1.1 grams of EPA has been taken by mouth daily by mothers beginning at 20 weeks of pregnancy to birth.

To treat inflammatory bowel disease, 2.4-5.6 grams of omega-3 fatty acids has been taken by mouth in one or two divided doses daily for up to two years. Omega-3 fatty acid capsules containing 1.2-2.2 grams of EPA and 0.6-0.9 grams of DHA have been taken by mouth daily for at least two months. The following doses have been taken by mouth: 5-6 grams of fish oil, 5.1 grams of fish oil capsules, or 20 milliliters of fish oil daily for 6-24 months (containing 3.2 grams of EPA plus 2.2 grams DHA), as well as doses of 6-15 grams daily or 20 milliliters daily of fish oil for 2-24 months.

To improve sensitivity to insulin, 0.138-4 grams of omega-3 fatty acids has been taken by mouth daily for eight weeks to six months.

To treat liver disease, 0.83-13.7 grams of omega-3 fatty acids has been taken by mouth daily for eight weeks to 12 months.

To treat lupus erythematosus (a chronic disease causing inflammation), doses of 15-20 grams of MaxEPA® (EPA) have been taken by mouth daily for 34 weeks. Doses of 20-440 grams have been taken by mouth daily for 12 weeks to 12 months.

To treat symptoms of menopause, 500 milligrams of E-EPA omega-3 fatty acid have been taken by mouth three times daily for eight weeks.

To treat migraine, three grams of omega-3 PUFAs have been taken by mouth twice daily for four months.

To treat muscle soreness, 324 milligrams of EPA plus 216 milligrams of DHA have been taken by mouth daily as Viva omega-3™ for 30 days before and two days following exercise.

To treat neck and shoulder pain, 1,200 milligrams of fish oil have been taken by mouth daily for one month.

To promote weight loss, six grams of tuna fish oil (approximately 1.9 grams of omega-3 fatty acids, containing 260 milligrams of DHA and 60 milligrams of EPA) has been taken by mouth for 12 weeks along with regular exercise. Five capsules of omega-3 PUFAs, with each capsule containing 1,000 milligrams of EPA plus 200 milligrams of DHA, have been taken by mouth daily for six months. The following doses have been taken by mouth: six fish oil capsules (0-3 grams of omega-3 fatty acids) daily for eight weeks, three grams of fish oil capsules containing 1.08 grams of EPA plus 0.72 grams of DHA daily for two months, six grams of tuna fish oil containing 260 milligrams of DHA plus 60 milligrams of EPA daily for 12 weeks, and five capsules containing one gram of fish oil (1.3 grams of EPA plus 2.9 grams of DHA) daily for 24 weeks.

To treat peripheral vascular disease (blocked blood flow to the limbs), a dose of 15 grams of fish oil has been taken by mouth daily for four weeks. Doses of 2-4 grams of omega-3 PUFAs have been taken by mouth daily.

To treat personality disorder, 2.1 grams of EPA plus 0.9 grams of DHA has been taken by mouth daily for 12 weeks.

To treat skin rash caused by the sun, five capsules each containing one gram of fish oil composed of 18% EPA plus 12% DHA have been taken by mouth daily for three months.

To treat high blood pressure associated with pregnancy, fish oil capsules (Pikasol®) containing 0.9-2.1 grams of DHA plus 1.3-2.9 grams of EPA have been taken by mouth daily, beginning at 20-33 weeks of pregnancy. Fish oil capsules containing 1.8 grams of EPA plus 1.2 grams of DHA have been taken by mouth daily. A dose of three grams of EPA plus some DHA has been taken by mouth daily for 27 weeks. A dose of 1.62 grams of EPA plus 1.08 grams of DHA has been taken by mouth daily for 14 weeks.

For pregnancy and labor, doses of 0.1-2.8 grams of EPA and DHA have been taken by mouth daily from week 17-27 of pregnancy until birth. A dose of 2.7 grams of omega-3 fatty acids (four one-gram capsules of Pikasol® oil) have been taken by mouth at 30 weeks of pregnancy. A dose of 2.7 grams of omega-3 fatty acids has been taken by mouth from 18-30 weeks of pregnancy until birth. Fish oil capsules (Pikasol®) containing 0.9-2.1 grams of DHA plus 1.3-2.9 grams of EPA have been taken by mouth daily, beginning at 20-33 weeks of pregnancy. Omega-3 fatty acid-enriched capsules containing three grams of EPA plus some DHA have been taken by mouth daily for 27 weeks. A dose of 1.62 grams of EPA plus 1.08 grams of DHA has been taken by mouth daily for 14 weeks. Doses of 1.10-3 grams of EPA plus up to 2.20 grams of DHA have been taken by mouth daily for 14-27 weeks.

To treat premenstrual syndrome (PMS), fish oil containing 18% EPA plus 12% DHA has been taken by mouth twice daily for three months.

To prevent graft failure after heart bypass surgery, a dose of four grams of fish oil concentrate has been taken by mouth daily.

To prevent blood vessel narrowing after coronary angioplasty, 15 capsules daily of one gram of fish oil (2.7-4.1 grams of EPA and 1.8-2.8 grams of DHA) have been taken by mouth for three weeks before surgery and continued for six months after. Doses of 0.045-5.4 grams of fish oil have been taken by mouth daily for six weeks to two years. Before surgery, 10 capsules containing three grams of fish oil composed of 1.8 grams of EPA plus 1.2 grams of DHA have been taken daily for six months.

To treat psychosis, omega-3 fatty acids containing 0.84 grams of EPA plus 0.70 grams of DHA have been taken by mouth daily. A dose of 1.2 grams of omega-3 fatty acids has been taken by mouth daily for three months.

To treat Raynaud's phenomenon (blocked blood flow to the limbs), 12 fish oil capsules (3.96 grams of EPA with 2.64 grams of DHA) have been taken by mouth daily for 17 weeks.

To treat rheumatoid arthritis, doses containing 0.5-4.6 grams of EPA and 0.2-3.0 grams of DHA, or 54 milligrams of EPA per kilogram plus 36 milligrams of DHA per kilogram, have been used daily for up to 15 months. A dose of 30 milliliters of seal oil containing two grams of EPA, 2.2 grams of DHA, and 0.9 grams of DPA has been taken in three divided doses daily for six months. A liquid nutritional supplement containing 16 milligrams of ALA, 211 milligrams of DHA, 40 milligrams of DPA, and 1.4 grams of EPA has been taken by mouth daily for four months. A dose of one gram per 10 kilograms of body weight of menhaden oil containing 245.3 milligrams of EPA and DHA has been taken by mouth daily for eight months. A dose of two grams of Neptune krill oil has been taken by mouth daily for eight days before and two days during menstruation for three months. A dose of 30 grams of flaxseed oil containing 32% ALA has been taken by mouth daily for three months. The following doses have been taken by mouth: 240 milligrams of EPA from fish oil daily, 10 capsules daily, and 18 grams daily for 10 days to 12 months. Omega-3 fatty acids have been given intravenously at doses of 0.1-0.2 milligrams per kilogram daily for seven days as add-on therapy. Omega-3 fatty acids (0.2 grams of fish oil emulsion per kilogram) have been given intravenously daily for 14 consecutive days, followed by 0.05 grams of fish oil taken by mouth daily for 20 weeks.

To prevent further heart problems in people with a history of heart disorders, 200-400 grams of oily fish has been taken by mouth each week (equal to 500-800 milligrams of daily omega-3 fatty acids). Fish oil and omega-3 supplements (containing 0.85-1.8 grams [850-1,800 milligrams] of EPA + DHA) have been taken by mouth. The following doses have been taken by mouth: 0.5 grams of fish oil (MaxEPA®) daily for 24 months, 1.8 grams of EPA plus 1.2 grams of DHA daily for seven months, 1.5 grams of omega-3 daily for 24 months, 2-4 grams of omega-3 fatty acids for 3.5-4.6 years, 0.3-4.1 grams of EPA plus 0.6-2.8 grams of DHA daily for 6-42 months, 1-5.1 grams of omega-3 fatty acids daily for 6-12 months, 400 milligrams of EPA and DHA daily for 40.8 months, three grams of fish oil (MaxEPA®) containing 0.54 grams of EPA plus 0.36 grams of DHA daily for 108 months, 2-5 grams of ALA daily for 24-46 months, 0.6-10 grams of DHA plus EPA daily for one month to nine years, 0.35 grams of DHA plus 0.51 grams of EPA daily for two years, 2.6 grams of omega-3 fatty acids daily for one year, 3.3 grams of omega-3 fatty acids daily for three months followed by 1.7 grams daily for 21 months, 0.23-2.9 grams of EPA plus 0.15-1.9 grams of DHA daily for one to 6.2 years, 1.7-6 grams of omega-3 daily for three months to 2.3 years, 0.96-2.6 grams of omega-3 fatty acids daily for 1-2 years, 0.85 grams of omega-3 daily for 3.9 years, 0.5 grams of omega-3 fatty acids daily for one year, 0.4-0.6 grams of omega-3 fatty acids daily for 4.7 years, 1-3.4 grams of omega-3 fatty acids daily for 1-1.5 years, or 0.27-4.8 grams of EPA plus DHA and 1.8-6.3 grams of ALA daily for up to five years.

To treat sepsis (shock), 7.2 grams of fish oil containing 1.1 grams of 20:5 n-3 fatty acids and 0.7 grams of 22:6 n-3 fatty acids have been taken by mouth daily for 3-4 weeks.

To treat sickle cell disease, 0.25 grams of menhaden fish oil per kilogram has been taken by mouth daily for one year.

To aid recovery from surgery, the following doses have been studied: enteral nutrition (feeding through a tube in the nose) containing 2.8-4.0 grams of EPA plus 1.4-1.9 grams of DHA daily for seven days after surgery, and 2.3 grams of EPA plus 1.0 gram of DHA taken by mouth daily five days before surgery and continuing as enteral nutrition for 21 days after surgery. Nutrition with the addition of Lipoplus™ containing omega-3 fatty acids from fish oil has been given through a feeding tube immediately after surgery until five days after surgery. Omegaven® (Fresenius Kabi) has been given through a feeding tube at a dose of one milliliter per kilogram containing 10% omega-3 fatty acids from hospital admission until discharge from the intensive care unit. A formula containing 10-20% fish oil has been given through a feeding tube for five days after surgery (Lipoplus® 20%, B. Braun; SMOFlipid®, Fresenius Kabi; Lipoplus®; olive oil emulsion containing 16.6% fish oil).

For kidney transplants, 1.9-3.0 grams of EPA plus DHA have been taken by mouth daily beginning 1-3 days after surgery and continuing for one month to one year. Doses of 1.2-5.4 grams of EPA plus DHA have been taken by mouth daily beginning 16 weeks to at least one year following surgery and continuing for three months to 26 weeks. For heart transplants, 3.0-3.4 grams of EPA plus DHA have been taken by mouth daily starting four days to 12 years after surgery. For liver transplants, 3.6 grams of EPA plus DHA has been taken by mouth.

To treat critical illness, Lipoplus® 20%, containing 90% medium-chain and long-chain triglycerides and 10% omega-3 fatty acids, has been given through a feeding tube for 12 hours. Omegaven® (Fresenius Kabi) containing 10% omega-3 fatty acids has been given through a feeding tube for seven days.

To treat inflammation of the pancreas, 0.15-0.2 grams of fish oil per kilogram has been given through a feeding tube daily for five days (Omegaven®, Fresenius, Germany). A dose of 0.2 grams of fish oil emulsion per kilogram has been given intravenously daily for two weeks.

To treat psoriasis, daily infusions with an omega-3 lipid emulsion (200 milliliters daily of 4.2 grams of EPA and DHA) have been given. A dose of 100 milliliters of omega-3 fatty acid-based lipid infusion (2.1 grams of EPA and 21 grams of DHA) has been given daily for 10 days.

Children (younger than 18 years)

Omega-3 fatty acids are used in some infant formulas, although information on effective doses is still unclear. Fresh fish intake should be limited in young children due to the risk of harmful contaminants from the environment. Fish oil capsules should not be used in children except under a healthcare professional's supervision.

To treat asthma, 84 milligrams of EPA and 36 milligrams of DHA (the daily dosages of EPA and DHA were 17-26.7 and 7.3-11.5 milligrams per kilogram of body weight, respectively) have been taken by mouth. A dose of 300 milligrams of EPA plus DHA has been taken by mouth daily for six weeks. A dose of 0.72 grams of EPA plus 0.48 grams of DHA plus ALA or 300-500 milligrams of fish oil containing 0.8-26.8 milligrams per kilogram of EPA plus 3.6-11.5 milligrams of DHA have been taken by mouth daily for up to 12 months.

To treat attention-deficit hyperactivity disorder (ADHD), 120 milligrams of ALA has been taken by mouth for seven weeks. Doses of 80-1,000 milligrams of EPA plus 2.7-558 milligrams of DHA have been taken by mouth daily for up to 30 weeks.

To treat autism, 1.3-1.5 grams of omega-3 fatty acid has been taken by mouth daily for 6-12 weeks.

To treat bipolar depression, 380-2,200 milligrams of EPA and 180-1,200 milligrams of DHA have been taken by mouth daily for 4-16 weeks. A dose of 6,600 milligrams of ALA has been taken by mouth daily for 16 weeks.

To improve brain function or treat metabolic disorders, 500 milligrams of fish oil (Ameu®, Omega Pharma, Berlin Germany) providing 18% EPA and 12% DHA has been taken by mouth daily for three months. Fish oil with final doses of 15 milligrams of DHA per kilogram has been taken by mouth daily for three months.

To treat cystic fibrosis, four one-gram capsules of fish oil have been taken by mouth twice daily for six weeks. A dose of 50 milligrams per kilogram of EPA plus DHA has been taken by mouth daily for three months.

To treat depression, 380-2,200 milligrams of EPA and 180-1,200 milligrams of DHA have been taken by mouth daily for 4-16 weeks. A dose of 6,600 milligrams of ALA has been taken by mouth daily for 16 weeks.

To treat painful menstrual cramps in adolescent girls, fish oil (1,080 milligrams of EPA and 720 milligrams of DHA) and 1.5 milligrams of vitamin E have been taken by mouth daily for two months.

To treat eczema, 1,800-3,060 milligrams of EPA plus 1,200-1,920 milligrams of DHA have been taken by mouth.

To prevent illness in children ages 9-12, fish oil (200 milligrams of EPA plus one gram of DHA), given in ultrahigh-temperature-processed (UHT) chocolate milk, has been used for five days per week for six months.

To promote infant development and motor skill development, 20 milligrams of liquid DHA has been taken by mouth daily for the first year of life.

To improve school attendance in children ages 9-12, six capsules (0.65 grams of DHA and 0.10 grams of EPA each) have been taken by mouth daily for three months.

To treat sepsis (shock), 100 milligrams of DHA (Neuromins for Kids, Martek Biosciences, Columbia, MD) has been given through stomach tube daily for 14 days.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com