The 7 Best Fish Oil Supplements to Get More Omega-3s

EPA and DHA from fish oil are among the most researched natural ingredients available in supplement form, says Stephanie Gray, DNP, a doctorally prepared nurse practitioner and owner of Integrative Health and Hormone Clinic in Hiawatha, Iowa.

Potential benefits of fish oil include supporting heart and brain health and lowering inflammation, Gray says. "And fish oil supplements are a great way to add omega-3s to your diet. Omega-3s are essential cornerstones of human nutrition, and are deemed essential because we need them for good health and our bodies cannot produce them on our own."

In nature, omega-3s occur in three forms:

• ‌Eicosapentaenoic acid (EPA)‌: A long-chain fatty acid primarily found in cold-water fish and is easy for the body to absorb.
• ‌Docosahexaenoic acid (DHA)‌: Another long-chain fatty acid primarily found in cold-water fish. The body can make DHA from EPA.
  
• ‌Alpha-linolenic acid (ALA)‌: Found mostly in plants. "In the liver, ALA can be turned into EPA (and then into DHA), but this tends to be a slow process with conversion rates less than 15 percent," says Michael A. Smith, MD, the director of education and spokesperson at Life Extension in Fort Lauderdale, Florida.

"The body is able to slowly convert the shorter chain ALA to the more active long-chain EPA and DHA. But many people lack the enzymes necessary for this, so we should aim to get more EPA and DHA in our diets," Gray says.

More than 90 percent of Americans get less than the recommended amount of omega-3 fats (1,100 milligrams for people assigned female at birth and 1,600 milligrams for people assigned male at birth per day) through their diets, according to a November 2017 study in ‌Lipids‌.

Read on for the best fish oil supplements and brands on the market. As with any supplement, speak with your doctor before adding fish oil to your regimen.

The FDA doesn't regulate supplement safety and efficacy like they do with prescription medications. But the FDA does establish Current Good Manufacturing Practices (CGMPs) for supplements, including requirements for preparation and storage.

We spoke to nutrition experts and included quality products that adhere to CGMP or have verification from independent quality control organizations, such as:

• NSF
• ConsumerLab
• United States Pharmacopeial Convention (USP)

Designed with heart and brain health in mind, this EPA and DHA supplement scores high marks for time from sea to shelf — a detail often overlooked, Gray says. The anchovy fish oil is processed within hours of its harvest time at a fishery in Chile.

Inspired by other ingredients in the Mediterranean diet, this fish oil supplement is also infused with olive polyphenols and sesame lignans — two compounds linked to supporting heart health and longevity, Gray says.

True, you'll take three of these soft gels per day, but even with that involved in the math, this supplement costs just around 20 cents per day. Made with anchovy, mackerel and sardine, this ConsumerLab-approved fish oil supplement offers about a two-to-one ratio of EPA to DHA omega-3s.

All Nordic Naturals products — including this lemon-flavored liquid — come in the triglyceride molecular form, which is how omega-3s are naturally found in fish. This one's deemed a top pick by ConsumerLab.

This formula features fish oil from anchovies and sardines in about a two-to-one ratio of EPA to DHA. Just be sure you're keeping and storing these the right way: "Liquids can oxidize more quickly when exposed to air so get that lid back on right away," Gray says.

If you struggle to keep pills, soft gels or liquid medicines and supplements down while you're expecting, you can get your daily omega-3 supplement via one spray of this mist.

Oil from sardine, anchovy and mackerel star in this DHA-strong prenatal omega-3 supplement. Plus, it's approved by ConsumerLab.

Sustainably sourced Alaskan Pollock offers the three-to-one EPA to DHA supplementation in these soft gels.

This brand is not only approved by ConsumerLab but it's also received a thumbs up from the Marine Stewardship Council (MSC) and earned a five-star rating from the International Fish Oil Standards (IFOS).

"For vegans and strict vegetarians, fish oil supplementation is not an option," Dr. Smith says. "Because plant-based omega-3s, like ALA, are not efficiently converted into EPA and DHA, relying solely on chia and flaxseeds could leave vegans and vegetarians EPA- and DHA-deficient. Instead, supplementing with concentrated algae oil would be a great way of getting DHA."

These ocean-borne contaminant-free soft gels are 100 percent vegan and offer both EPA and DHA via algae, and are a top pick from ConsumerLab.

Krill oil options are often among the best fish oil supplements for those with arthritis or achy joints, and this one's a top pick from ConsumerLab. "Krill and green-lipped mussels have been primarily studied to promote joint health," Dr. Smith says.

"Krill oil is also a natural source of astaxanthin, an antioxidant that inhibits inflammation in joints." This certified sustainable soft gel option delivers a two-to-one ratio of EPA to DHA.

As you may have noticed in the list of fish oil supplement brands, there are different forms of EPA and DHA including ethyl ester fish oil, triglyceride fish oil and phospholipid krill oil.

"All three forms provide benefits and each has been independently validated in clinical studies," Dr. Smith says.

• The ethyl ester form by far has the most clinical research showing benefits, per the U.S. National Library of Medicine. It tends to be more cost-effective by providing higher concentrations of EPA and DHA per serving.
• The triglyceride form may offer a slight advantage in bioavailability over the ethyl ester form, but over time both have been found to be well absorbed, per a July 2010 study in ‌Prostaglandins Leukotrienes and Essential Fatty Acids‌.
• Krill oil provides both the triglyceride and phospholipid forms of EPA and DHA. Krill's unique phospholipid form can help encourage more effective transport of omega-3 fats in the body. The phospholipid form of DHA shows more rapid uptake into the brain, per a November 2015 study in ‌Lipids in Health and Disease‌. But, krill oil contains a lower percentage of EPA and DHA compared to the same amount found in fish oil, which can make obtaining higher potencies more costly with krill oil, per a separate August 2011 study in ‌Lipids in Health and Disease‌.

The best fish oil supplements are sourced from small fish, like sardines and anchovies, because they tend to contain lower levels of heavy metals like mercury, Gray explains.

"I typically start my patients with 1 to 2 grams, or 1,000 to 2,000 milligrams, per day of a combined EPA and DHA daily," Gray says, then performs blood tests throughout the following months to monitor progress.

To highlight the best fish oil supplements you can buy, we referred to ConsumerLab's omega-3 supplement review. The USP seal is also a mark of a safe, high-quality supplement.

Another indicator of a quality fish oil supplement is a 5-star rating from International Fish Oil Standards (IFOS), which can be found as a seal on the bottle. IFOS is a third-party testing organization that rates fish oil quality.

Five stars is the highest rating given for purity, potency and freshness, and it means the supplement has passed tests regarding rancidity (oxidation), potency, pollutants (heavy metals, dioxins, furans and PCBs) and radiation.

You can also reach out to the company to request a certificate of analysis (COA), Dr. Smith says.

"A COA is the analysis of the finished product that tests for purity and potency. It provides proof that the label is accurate for potency and what is in the bottle is not contaminated with microbes or heavy metals. Reputable companies will test each batch, so be sure to look for the lot number on the COA," he says.

"Supplementing with high doses of EPA and DHA have been linked to improvements in heart and brain health, lower levels of inflammation and better joint mobility," Dr. Smith says.

"The ideal omega-6 to omega-3 ratio is as close to 1:1 as possible. Unfortunately, with modern American diets, this is extremely difficult to achieve even with supplementation. About 100 years ago, it's estimated that Americans had anywhere between a 3:1 to 5:1 omega-6 to omega-3 ratio," Gray explains. "Today, it's estimated that we are looking at a 15 to 25:1 omega-6 to omega-3 ratio."

This is likely because omega-6 oils, such as soybean, cottonseed, corn and canola oil are the most used vegetable oils in the U.S. as they have a longer shelf life than omega-3 oils, per the Harvard T.H. Chan School of Public Health.

On top of all the potential omega-3 benefits listed above, Gray says that the best fish oil supplements have been linked to improvements in:

• Cholesterol
• Blood sugar levels
• Mental health
• Memory
• Pain
• Inflammation-related skin conditions, such as psoriasis, eczema and acne
• Chronic headaches
• Menstrual cramps

Anyone with allergies to the specific fish oil in the omega-3 supplement should steer clear.

Although generally safe, overdoing it on omega-3s (particularly EPA and DHA) might suppress the immune system, according to the Mayo Clinic.

Those with low blood pressure may want to be particularly careful as well, because supplementation may lower blood pressure even more. People with any bleeding disorders should talk to a hematologist — omega-3s are generally contraindicated.

Stop taking any omega-3s one week before any procedure or surgery to reduce the risk of bleeding.