Omega 3 supplements and warfarin

Just a quickie for you all,

Does anyone take Omega 3 supplements and if so does it affect your INR? I'm guessing it can raise it but by how much?

Reason I ask my cholesterol levels where borderline a while back and I'm due for a re-test in a couple of weeks. I don't want to have to take Statins just yet :-)

Please no lectures about taking a well balanced diet / exercise and all that ;-)


28 Replies

  • HI there, I do not take Warfarin so can't advise on any difference, but I can tell you that I have taken Omega fish oil with other supplements for decades. I enclose a medical paper.....


  • Significant rise in INR I see. Shame I don't self test otherwise I could keep my eye on the readings. Looks like I may well have to discuss that with my Doctor.

    Thanks for the link MaryF

  • I am literally saturated in the stuff, surprising I have not actually turned into a fish! My mother started me on it when I was ten as I appeared to have sore joints! MaryF

  • Hehe MaryF.

    So with your experience can you recommend a good product that has high levels of the good Omega 3, EPA and DHA?

  • I just research carefully on line and get well known and trusted brands. Nothing too cheap and cheerful MaryF

  • Yes, and as I take it every day the effect (whatever it may be) is constant so is taken into account. One of the advantages of self-testing, you may wish to discuss with your INR team.

  • I agree Tim47. Self testing is the way to go but it's soooooooooo expensive. So for me at this time its the 2 or 3 monthly visits to the hospital (Although if a reading is out that turns into weekly visits?)

  • I was told it is a definate no. Be very careful and read the contents of the capsules. Many omega 3 capsules contain krill oil. Krill oil has a high concentration of phospholipids and should be avoided at all costs, for obvious reasons.

    Good luck from here InSpain.

  • Thanks In Spain, I'll defo be chatting with my Doc first:-)

  • Hi, sorry to butt in. Can you tell me, why should Krill oil/high phospholipids be avoided in APS? (I don't have DX of APS, suspected it due to long term migraines & other symptoms, Dr refused test, joined this group for more info).

    I ask because I took a course of Krill along with other 'natural' remedies to lower an unusually high cholesterol which had no discernible cause, and had two/three weeks of massively increased neurological symptoms, flashing lights aura every day, balance/dizziness problems, speech completely jumbled, weird sensation of brain speeding up but speech not keeping up with it. This reverted to usual levels after I finished the cholesterol lowering remedies and Krill oil (and my cholesterol came down). Dr not interested in the symptoms, didn't reply when I mentioned them.

  • Hi Frodo.

    When you take an anticoagulant such as Warfarin you have to be very careful. Essentially warfarin is a very good drug, however, many natural remedies (in this instance the krill oil I mentioned), and even some prescribed medications have an impact on how it works. Therefore, anything that antagonises warfarin should be used with caution. It can alter your INR by making it too low, which could cause problems or it could make it too high and there could be a risk of hemorrhaging. Just the same as foods rich in vitamin k can do too.

    Hope this answers your question!


  • Yes, thanks, it's interesting and useful to learn about drug/supplement interactions.

    But what I'm wondering is - what effect exactly does the fish oil, and Krill in particular (high phospholipids), have on the blood? What effect would it have on 'normal' blood, and what effect on 'sticky' blood (say you weren't taking Warfarin)? Does it make sticky blood less sticky? Or thinner?

    Is there a good article about this anywhere? Thanks again!

  • Yes I was told that too just eat fresh fish it's much better .

  • I am also on warfarin and selftest etc.

    A "famous" Rheumatologist here in Sweden told me to stop take Omega 3 capsules when I had started warfarin. Earlier I took strong Omega 3.

    I eat a lot of Salmon (3 - 4 times a week though) nowadays. As I know he knows a lot I did what he told me to do. I take Statins. Is it dangerous to take Statins?

    Best wishes from Kerstin in Stockholm

  • I take statins too Kerstin. I have never been told that it was dangerous.

    Happy birthday for yesterday! xxx

  • Not me either that it is dangerous in any way.

    Oh, thank you! You are very nice!


  • My doctor wanted me to start on statins, but I chose not to as I have so much body aches and pains including from muscles:

  • Thank you so much for your answer and with a link about statins also.

    I did not get Statins from the beginning (in 2011 when i started warfarin) and i do not have high cholesterole either.

    When the Cardiologs noticed my Pulmonary Hypertension and also 2 leaking heartvalves my Rheumatologist suggested I should be on a low dose of Statin (only 10 mg).

    I today read about the sideeffects of statins and they say there that if you get muscle weekness and pain you should tell your doctor. I have practically no pain and a very low dose (10 mg) so I intend to continue as i think that I need them.

    I read in your link that woman without heartdisease should not have statins just like that.

    Thanks again,


  • Your welcome. Like anything else, each patient is a case by case on statins or for that matter all medications and supplements.

  • You are so right there.

    As a matter of fact I have not thought about taking or not taking statins as i trust my Rheumatologist. Very good to read about it though and discover that it was a very low dose.


  • Hi all. I tried a lot of statins but they all made me ache even more than usual. That is until rosuvostatin. I'm only on 10mg daily taken at night. I still ache, but that is normal for me. I have just started on plaquinil and expect to have to wait 3-4 months minimum for it to have a good effect.

    Hope this helps. X

  • I was reluctant to start statins (another medicine!) but Professor Hunt told me that they actually smooth the lining of the blood vessels so are good for us Hughies. So i relented.


  • That's how my mind is working Ann, having to take warfarin for life is something I've come to terms with but then statins on top?! Mind you I think the name puts me off a bit as well! I'd like to put off as many of the drugs until later in life but hey ho.

    Thanks for all the replies guys and gals :-)

  • Hi I took statins for about a year but then started getting unexplained muscle pains so had to stop taking them. Apparently this is a common side affect. Mind you these days I seem to get all sorts of pains. Getting old I guess.

  • I have taken fish oil for years. Yes, it does raise INR, but as I take the same amount every day I have no problem with keeping the INR stable. And remember: nearly all living cells on the planet -- either uni or multi cellular -- have membranes made of phospholipids. The phospholipids our immune system targets is a specific kind of phospholipid, so phospholipids in general are not an issue for us.

    I have read else where (?) on line that the overly generic label of "antiphospholipid syndrome" dates from back when the blood testing was not as specific and that our disease should be renamed. (My internal response? Our disease already goes by so many monikers -- APS, APLS, Hughes, Antiphospholipid Syndrome, Sticky Blood Syndrome, Sludge Blood -- that I would hate to add another to the mix.)

    I had an informal encounter with one doctor who I do not see professionally, but I overheard him speaking with a fellow hiker on a trail club outing about fish oil. I rudely butted into the conversation when I heard him say that many brands of fish oils are really useless because they are not formulated in a way that makes it possible for the body to metablize it. He graciously responded to my rude interruption and I found that I was not taking a US brand of fish oil which is easily absorbed. I switched brands to "Ultimate Omega" (one of the 2 he suggested) about 2 years ago. I recall that I monitored my INR carefully as I slowly switched brands. Andy yes, sure enough, the Ultimate Omega thins my blood more then the previous brand. So all I did was reduce my daily warfarin dosage by 2.5 mgs and -- back in the right INR range. I take my fish oil at the same time every day.

    Fish oil seems to help control inflammation and stabilize out-of-whack immune systems. --even the skeptical doctos I have seen (who doubt if APS is a legitimate disease) all urge me to stay on fish oil. At my last appointment with my eye doctor, as he peered at my retina while I tried to not blink into that bright light he said, "Let me guess. You take a good brand of fish oil, don't you?" "Yes, " I answered. "Well I can tell because your blood vessels back here look squeaky clean."

  • Gina,

    Regarding the fish oil brand - Thank you. I will compare it to the one we take.

    We take the one rated # 10. I have no idea what the criteria was for this rating.

  • The hiker/doctor who clued me into the difference among brands was an opthamologist. He suggests fish oil added to diet in a lot of his patients as fish oil and omega 3 is most helpful in delaying the consequences of macular degeneration. I don't know if you are in the US or the UK or where -- but perhaps a local eye doc's office could give you some applicable advice?

  • --and I will add that "Ultimate Omega" label says it is made from anchovies and sardines.

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