One Out, One In #8: fish-oil gummy → ~1 g EPA+DHA, or skip

One you drop. One you take instead.

Read the EPA mg and DHA mg lines. Ignore “fish oil 1,000 mg”: that's the oil's weight, mostly carrier.

The NIH Office of Dietary Supplements (NIH ODS) says a typical capsule contains 1,000 mg of oil with about 180 mg EPA and 120 mg DHA, or 300 mg combined. Australia matches that 18/12 pattern.

A 2021 US label survey of 231 products (Ward, Journal of Pharmacy Practice, not a neurology journal) found a mean of 697 mg combined per labelled serving, with a range of 60–2,684. Gummies sat at the bottom. Only two products reached ≥2,000 mg in one serving. That 2,000 mg bar is the authors’ cholesterol framing, not the American Heart Association (AHA) triglyceride dose. The AHA's advisory for triglycerides (TG) is 4 g/day prescription. These are labels, not a lab assay.

If you bought it for heart, brain or “omega,” park the gummy. Keep prescribed high-dose EPA. Keep eating fish.

If you already eat oily fish two or three times a week and nobody has you on a triglyceride or coronary heart disease (CHD) protocol, skip is a valid IN. Heart Foundation says food is enough for most people. One cooked salmon serving is already more than a gram of EPA+DHA.

If you want a capsule, look for about 1 g combined EPA+DHA from an oil that actually prints both numbers. Prefer a product with independent testing (USP, NSF or IFOS) or a published assay. Named AU concentrates that get close in one capsule:

That is the AHA existing-CHD ballpark under a physician. It's not a REDUCE-IT dose or a dementia pill. To reach ~1 g from a standard 18/12 “1000 mg” oil (180 mg EPA / 120 mg DHA per capsule), you need about three or four capsules. That's arithmetic, not an order.

Not the automatic IN

Oxidation is the quality issue, not mercury. ODS says mercury is stripped in processing. The Global Organization for EPA and DHA Omega-3s (GOED) sets palatability limits of peroxide 5 / anisidine 20 / TOTOX (total oxidation value) 26. TGA’s listed-oil spec is looser. A 2015 NZ survey looked bad; a 2016 accredited-lab set of ten AU/NZ bottles looked fine. We don't have a 2026 Chemist Warehouse TOTOX count. Prefer a tested concentrate. Don't invent a fail rate.

About 1 g in primary prevention: VITAL and ASCEND found no significant win on the main heart-attack / stroke / cardiovascular (CV) death composite.

Cochrane 2020 (searches to 2019) found little or no effect on all-cause death or CV events. CV death: probably little or no difference. CHD effects were low-certainty. Don't print “slightly reduces CV mortality” as a firm win. Triglycerides fell about 15% (high-certainty), but that's still not a licence to dose 4 g from this email.

A 4 g prescription is a different object. REDUCE-IT used 4 g icosapent ethyl (EPA-only) in statin-treated people with raised triglycerides and reported a 25% relative drop in a composite. The mineral-oil placebo argument is attached. STRENGTH used 4 g EPA+DHA carboxylic acids and was neutral, with more atrial fibrillation. Don't paste REDUCE-IT onto a supermarket capsule.

Brain: Cochrane 2012 found no dementia-prevention trial that even measured incident dementia. Cochrane 2016 found no convincing effect in mild-to-moderate Alzheimer’s. Don't print a brain-gummy claim.

FDA's allowed line is already timid: “supportive but not conclusive,” and supplement labels should not recommend more than 2 g/day EPA+DHA.

“The fish-oil gummy I take lists very little EPA and DHA. If I don't eat oily fish, is a tested oil with about a gram of EPA+DHA combined useful for me, or should I skip the pill and eat fish?”

If you have existing heart disease, very high triglycerides, atrial fibrillation (AF), anticoagulants, allergy or pregnancy, that question belongs with your GP.