Natural Medicines Newsletter

Volume 1, Issue 44, 11/19/2009

Question

Does the inhibition of platelet aggregation by fish oil supplements (omega-3 fatty acids; EPA, DHA, Lovaza) affect the patient's actual risk for bleeding?

Answer

This is part two of a two part series.  In part one, the mechanism by which the omega-3 fatty acids, docosahexaenoic acid (DHA; 22:6n-3) and eicosapentaenoic acid (EPA;22:5n-3), inhibit platelet aggregation was described.(1)  This issue will answer the more important question of whether this effect on platelet function actually translates into clinically meaningful increases in bleeding risk in surgical patients or other patients taking anticoagulants or antiplatelet therapy.

This question is relevant given the fact that the American Heart Association (AHA) currently recommends 1 gram of fish oil per day for patients with coronary artery disease and 2 to 4 grams per day fish oil supplements in patients with hypertriglyceridemia.(2)  However, it is important to note that the AHA also goes on to say...  

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