The Cooking Cardiologist

Steven from Colorado asks the Cooking Cardiologist:

I am a recently diagnosed 60 year-old who has been taking 1 gram of fish oil for the past 4 years. It really has helped control my cholesterol and other lipids. I am also on 2 meds for hypertension and now metformin for diabetes. Recently, my Doctor told me to start a low dose aspirin (81mg) daily to prevent heart attack and stroke. My question: can I safely continue taking the fish oil 800mg Omega3’s (400epa, 300dha, 100 other omega3’s) along with the aspirin? Is fish oil a blood thinner too?

The Cooking Cardiologist responds:

Steven, thank you for writing in with your question. As always, doing thorough research and receiving a professional opinion are very important when considering potential medical risks, and I am glad that you are being cautious about using this combination. The combination of fish oil and aspirin affects blood platelets, causing them to become less “sticky” and not clump together as much – in fish oil, this is caused by the high concentration of Omega-3 fatty acids. Neither aspirin nor fish oil act as blood thinners like warfarin (Coumadin), however, and their combination therefore should not result in any abnormal or serious blood thinning so long as the doses of fish oil are kept moderate. You may notice that you will bruise a bit more easily when you are taking this combination, but your dose is low enough so that it should not unsafely affect blood thinning.

Moderation is the word of the day when it comes to taking fish oil supplements. The 800mg doses that you are taking are not excessive – they are equivalent to a healthy serving of salmon or sardines. Sticking to the recommended doses is critical for using fish oil safely, as doses of 3g or larger will have much more severe impacts upon blood thinning. If you are concerned with the notion that taking this combination will affect blood platelets, keep in mind that a number of other over-the-counter medications such as Vitamin E, nonsteroidal anti-inflammitory agents, and ginkgo, also can have similar affects on blood platelets – but these medications still are safe to use when taken in moderation, and as recommended. The same goes for fish oil and aspirin. If you (or other readers) suffer from any sort of platelet disorder, it is not a good idea to take fish oil without first consulting with your doctor or health care provider. On a positive note, there are many potential benefits to incorporating moderate amounts of fish oil into your diet. Although results have been mixed, many scientific studies have indicated that the Omega-3 fatty acids in fish oil can help lower triglycerides, cholesterol, and blood pressure, as well as improving the body’s inflammatory responses to help with painful conditions such as arthritis. It appears as though the fish oil is having great success on your cholesterol.

Thanks again for writing in, and feel free to send any other questions my way if you’re in a bind when it comes to health, food, or cooking. And – as always – cook well, live long!