Omega 3 supplements and Atrial Fibrillation

Omega 3 supplements and Atrial Fibrillation

Omega 3 ethyl esters are synthesized from omega 3 fats naturally occurring in fish through chemical processing. High doses are used to treat hypertriglyceridemia (high triglycerides in the blood). Some poor quality fish oils available on the market come in the ethyl ester form. Prescription medications Lovaza and Vascepa also contain ethyl esters. Recent research has found a dose-dependent increased risk of atrial fibrillation (AF) in pateints being treated with ethyl esters at doses higher than 1g and with the highest risk occurring at a dose of 4g a day.

One big question is whether high quality fish oils containing natural triglyceride forms of EPA and DHA also increase the risk of this dangerous arrhythmia. There is some research that specifically connects the risk of AF with increases in blood EPA levels but not DHA levels. Vascepa contains EPA without the DHA.

I am watching the data but, for now, I do not recommend the use of ethyl ester omega 3 fats. I also don’t recommend the use of EPA-only preparations. For those who have existing a. fib, I would not recommend fish oil supplementation (out of an abundance of caution). Eating small, cold water fatty fish (anchovies, sardines, salmon, mackerel, trout) 3x per week and including plenty of plant-based sources of omega 3s (flax, chia, hemp and walnuts) is a great way to get these essential fatty acids in the diet without the risk.

Dr. Leat Kuzniar ND
Dr. Leat Kuzniar ND
drkuzniar@njnaturopath.com

Dr. Kuzniar is a board member of the New Jersey Association of Naturopathic Physicians and is also a member of the Gastroenterology Association of Naturopathic Physicians. She currently holds a State of Vermont Naturopathic Physician license (as New Jersey does not yet offer licensing for Naturopathic doctors).