Following this discussion I switched today from EPA/DHA to EPA only. I may also try higher dose EPA only. I don’t know whether I will notice any changes.

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Let us know how it goes! (Effect on triglycerides?)

For those interested in EPA vs DHA for CVD, see also:

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I have a blood test today at 11. I don’t expect any change by then, but I have one also at 11am next Monday.

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Exploration of the optimized portrait of omega-3 polyunsaturated fatty acids in treating depression: A meta-analysis of randomized-controlled trials 2025

  1. Omega-3 PUFAs might be effective in treating depression; 2) For Asian patients with mild to moderate depression and no other baseline medication, over 8 weeks of omega-3 PUFAs 1000–1500 mg/day with ratio of EPA/docosahexaenoic acid (DHA) between 1:1 and 2:1 might benefit the most; 3) Omega-3 PUFAs are no superior than placebo in rates of response, remission, and adverse events.
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Here’s what I tell myself about Omega 3 and mood disturbance. Take it with a grain of salt, there may be some conceptual rationale, but really this is just my own personal idea.

I used to take omega 3 and quickly become very irritable. I tried this a few times and quit because I was snappy and moody. Besides the fact I may have been taking poor quality or rancid oil, my rationale is that the omega 3 was destabilizing my cell membranes. In my mind, omega 3 was displacing Omega 6 or other membrane lipids and creating disturbance and instability. Even though Omega 3 is the preferred lipid, my very Omega 6 heavy system could not handle the rapid change. My thinking is that perhaps this instability is only temporary as the cell membranes adjust and incorporate a different lipid. In any case, I can now take omega 3 without any problems and feel great.

The large VITAL DEP trial found increased depression after 4 years. So the effects are more than just temporary.

Fair enough, and could have to do with a particular subgroup. That said, there are also many studies that show a reduction in depression with use of Omega 3s.

Not that I’m aware of. If you read the meta analyses in the thread, reduction of depressive symptoms seem to only happen with EPA, not “omega 3” in general.

From consumerlab

Suicide

An analysis of blood samples from 1,600 military personnel showed those who committed suicide had, prior to suicide, signicantlylower blood levels of DHA than personnel who did not commit suicide (Lewis, J Clin Psychiatry 2011). The population studied was predominantly male and the risk of suicide was found to be 62% greater among men with levels of serum DHA below 1.75% (% of total serum fatty acids) compared to those with higher levels. There was no such relationship with EPA levels. The researchers note that omega-3 fatty acid levels were generally low across the military personnel in the study, much lower than in the general population, and suggested that even greater risk reductions could be possible with higher serum levels of DHA.

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Was this finding confirmed by later studies? Looks like not:

Also: is there any value in a small old association study once we have massive RCTs + Mendelian randomization studies pointing to the same direction? (DHA useless or bad)

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So, I did some digging, and there are EPA only Omega-3 alternatives available. I’m going to try this one going forward.

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FWIW, I had this recommended to me by a doctor whom I asked:

https://www.amazon.com/Igennus-Triglyceride-Absorbable-Concentration-Sustainable/dp/B007TUK2IE/

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I saw that. It’s double the price for the same thing.

Yeah, and frankly what reason is there to think one is better than the other, I mean I’m relying on a doc’s recommendation, but what was he relying on? They swear up and down that it’s free from various toxins, independently tested and certified by IFOS, but what does that mean, and is it true; besides the GNC product also claims to be free from toxins. Probably makes sense to go for the lower price.

I’m sticking with this one despite the price, because I use so little of it that it lasts me a long time, so spread over that, I’m not hit over the head with the price difference. YMMV.

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My brother got omega 3 supp from our doctor, pretty good but it said ethyl ester on the label and I told him it was way less absorbable. Pick something else next time. He asked his little AI friend who said triglyceride was 70% more absorbable.

I don’t remember who brought that up here, but good job. Otherwise you’re paying for something that won’t go in anyway. The first bottle doesn’t say the form, so you have to assume it’s the bad one.

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Actually, I will have to go with the brand you recommend as GNC doesn’t ship to Hong Kong.

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Just published: Dose-response association between the intake of various subtypes of polyunsaturated fatty acids and depression 2025

Chinese paper but George Institute for Global Health, so I think it’s good.

The paper concludes:

Post-propensity score matching, multivariate logistic regression analysis revealed an inverse correlation between the intake of AA, ALA, EPA, and DHA and the risk of depression. Restricted cubic spline analysis demonstrated a linear inverse relationship between AA, ALA and EPA intake and depression. Conversely, DHA intake exhibited a nonlinear relationship with depression.
Different types of PUFAs appear to influence depression risks differently in adults, with increased intake, AA, ALA, EPA and DHA providing a protective effect against depression.

However, I bought the full paper I think it’s a bit more complex for DHA:

Daily intake of n-3 and n-6 PUFAs was assessed using two 24-h dietary recall interviews, with average intake values used for analysis.
Participants were categorized into depression (cases) and non-depression (controls) groups based on their PHQ-9 scores.
Model 1 adjusted for age, sex, and race, while Model 2 further adjusted for marital status, education, BMI, Poverty Income Ratio (PIR), alcohol consumption, smoking status, physical activity, diabetes, hypertension, kidney failure, heart failure, CHD, stroke, liver disease, and cancer.
PUFAs were initially analyzed as continuous variables and later categorized into quartiles for comparison of interquartile increases. A four-node restricted cubic spline (RCS) was used in Model 2 to assess the dose-response relationship between PUFAs intake and depression risk, with nodes at the 5th, 35th, 65th, and 95th percentiles. Statistical analyses were performed using R version 3.6.1, with significance defined as a two-tailed P-value of <0.05.

Daily intakes (after PSM):

  • EPA (mg/day), median [IQR]: 8.00 [3.50;17.0]
  • DHA (mg/day), median [IQR]: 26.0 [7.00;62.0]

They don’t give the values for the quartile.

As a continuous variable (“per 1 mg/day increment”), after adjustments (Model 2) and propensity score matching, there’s a tiny beneficial effect for both EPA and DHA:

If I interpret Fig. 2 and Fig. 3 correctly, for both EPA and DHA, the potential protective effect is stronger in young (<60), non-smoking, non-drinking, non-diabetic, non-hypertensive women.

For EPA, it seems that the more, the better (linear dose-response relationship), whereas for DHA, it’s non-linear and the confidence interval goes above 1 past some point, so we cannot exclude that high-dose DHA causes depression:

Our study addresses a gap in the literature by demonstrating that both EPA and DHA intake are negatively correlated with depressive symptoms. Specifically, DHA intake showed a nonlinear association with depression risk, whereas EPA intake exhibited a linear relationship. Despite both being n-3 PUFAs, EPA and DHA appear to have distinct impacts on depression. For example, some studies have shown that EPA-enriched supplements are more effective than DHA-enriched supplements in preventing and treating depression (Liao et al., 2019; Grosso et al., 2014; Su et al., 2014). Additionally, EPA was shown to be more effective than DHA in mitigating weight loss and depressive-like behavior in a mouse model (Peng et al., 2020). Moreover, a study has indicated that EPA is effective in improving depressive symptoms, whereas DHA does not demonstrate such efficacy (Hallahan et al., 2016). The results of our study indicate that consumption of DHA within a specific range may also be associated with a reduced risk of depression. These findings indicate a need for further research to clarify the comparative effectiveness of EPA and DHA in treating depression. Furthermore, the multivariate logistic regression analysis indicated a significant linear trend in the association between DHA intake and depression risk, suggesting that higher DHA intake is generally associated with a lower risk of depression. However, the RCS analysis revealed a significant nonlinearity, with a plateau observed at higher intake levels. This suggests that while higher DHA intake is beneficial, the protective effect may not continue to increase linearly beyond a certain threshold. Further research, particularly longitudinal studies, could help determine the optimal intake level for DHA’s protective effects. Our analysis also revealed a negative correlation between DPA intake and depression, but this association disappeared after PSM, potentially due to confounding factors. Further research is needed to explore the relationship between DPA intake and depression.

Based on the dosage-response charts, the optimal daily dose might be 500 mg EPA + 300 mg DHA. However, VITAL-DEP used a similar dose (465 mg EPA + 375 mg DHA) and found an increased risk of depression after 5 years in their RCT.

My own conclusion: I think this paper strengthens the case for EPA and against high-dose DHA supplementation (anything above 100 mg/day being high-dose, given that Q3 = 62 mg/day). For DHA, 62 mg/day = 434 mg/week. A single serving of salmon, anchovies, mackerel, sardines, or herring gives you more than that.

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I believe the IFOS is pretty credible. Any product listed as tested by them can be looked up on the website by lot code.

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That brand has some DHA. Didn’t you want to avoid it?

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@DeStrider, on @LaraPo ’s point

It’s more expensive, but is there any way you can get the epa rx Vascepa shipped to Hong Kong?

It might have been Anuser who posted you can get it for under $100 for 120 pills. That seems like a great deal and it’s apparently the ‘best’ one available.

I was even tempted to get over my fear of fish (vegan) and try it, but google said one might taste fish… and then I would hurl, so I’m out :frowning:

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