Fish Oil Supplements and Leaky Heart Valve

I don’t have the leaky valve condition, but have taken fish oil daily for my dry eye per instruction of my ophthalmologist for years, however, last year my primary told me there was no proven heart benefit from fish oil regimen. I was shocked. Still, my recent carotid artery ultrasound revealed no plaque in my arteries,so…..I intend to continue per direction of my ophthalmologist. I have read it works as a blood thinner too.

Was the doctor your husband spoke with his cardiologist? I’d ask for clarification, so he can know what to do.

Thanks; the doctor must have been a resident or "on call" doctor associated with the pulmonary rehab facility. He just sort of popped up out of nowhere to review hubby's case. Hubbs doesn't really have a cardiologist (yet). Has never needed one, but did schedule an echocardiogram with his primary care doc last week, based on what the mystery "traveling" doc recommended to check on his "leaky heart valve" which nobody's ever been concerned about before. There's a one-month wait. They did not discuss the fish oil thing. I just found this out tonight when we were discussing getting plenty of omega-3 in diet to help lower LDL, and asked him if he'd been taking his fish oil, so it was quite a surprise.

The first thing I think of is starting to accompany each other to appointments so that one of you can take notes. Has he called or used his patient portal to confirm what he believes he heard.

Thanks, Gravity — and normally we do that, but this was Pulmonary rehab where he’s been going to one-hour workout sessions on his own for a couple of months. The doctor wrote all this down for him, and he brought it home. He wasn’t expecting to see a doctor at his pulmonary rehab.

Yeah, fish oil supplements may not be helpful for heart disease.

Icosapent Ethyl (Vascepa in US and Vazkepa in Europe) may provide some improvements in heart health - it is the large percentage of eicosapentaenoic acid (EPA) - prescription strength - that is different than the EPA in fish oil.

Your husband’s doctor’s advice is correct. The active components in fish oil is EPA and DHA and they both have been shown in recent research to be pro-arrhythmic and can cause AFIB and other arrhythmias, particularly at higher doses and in older people. Above 1 gram per day is generally considered high dose.

Fish oil also promotes bleeding and hemorrhagic stroke and is contraindicated in people taking anti-platelet, anticoagulant, aspirin, etc. medications. Fish oil could potentially cause your husbands leaky heart valve to leak even more from its blood thinning effects.

Similarly, other peer reviewed research shows the benefit of taking fish oil is no better than a placebo and can actually be dangerous in some people.

The one indication for taking fish oil is for people with high triglycerides that can’t be controlled by diet or other medications.

Is you hubby on blood thinners? I am right there at 85 like he is. I have a leaky mitral valve, not very bad according to my cardiologist. But I also have Afib and am on Eliquis to thin my blood. I have taken a fish oil supplement for years but when I started Eliquis I was having eye bleeds (whites of my eyes turned all red) about every other week. I quit the fish oil after reading it also has blood thinning qualities, and I have never had another eye bleed. Also the excessive bruising due to blood thinner has gotten less. Talked to my cardio at next appt and he said some people have an issue with fish oil and blood thinners and some do not. But he advised me to NOT take it in the future.

Here's the core conclusion - however, there are a LOT of side factors that could have come into play.

"Conclusions Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements."

Yes, that is often the boilerplate recommendation to meta-analyses these days, and with reason. Still....