Statins are prescription drugs that can lower cholesterol and triglyceride levels. While over-the-counter fish oil (OTC) may have general heart health benefits, it’s not a recommended treatment for cholesterol.
Fish oil contains omega-3s, a type of essential fatty acid that can have a number of benefits. However, because OTC fish oil can come from different sources, the amount of omega-3 in these supplements can vary significantly.
In this article, we’re going to discuss the differences between statins and fish oil supplements. We’ll also examine the benefits and side effects of each.
Statins are drugs that doctors prescribe to help people:
Doctors also call statin drugs hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors.
Statins bind to HMG-CoA reductase, a protein that is involved in the production of cholesterol in the liver. By reducing the cholesterol production in the liver, the body makes more LDL receptors.
This means the liver can store more LDL and remove it from the bloodstream.
Fish oil is a dietary supplement that companies can make from a number of different oily fish, such as herring, mackerel, or anchovy. It contains two important omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Some studies suggest that EPA and DHA can have positive effects on overall health. However, OTC fish oil supplements vary greatly in quality, purity, and chemical composition. They can deliver very different EPA and DHA levels depending on the type and brand.
As a result, they are not a reliable treatment for any disease, including high cholesterol.
The Food and Drug Administration (FDA) has approved special omega-3 products to lower triglycerides. These are different from OTC fish oil in that they have to follow strict guidelines to ensure their chemical makeup is consistent. They are only available by prescription.
OTC fish oil supplements are no better than statins for treating high cholesterol.
People can use OTC fish oil supplements to support their overall health. However, the FDA has not approved fish oil supplements for treating any specific disease.
A 2020 review comparing dietary fish oil to prescription omega-3 found that there was little evidence of the use of OTC fish oil in medical conditions.
In contrast, statins are effective at improving cholesterol levels. Various drugs from the statin family of drugs are effective in treating atherosclerosis and preventing heart attacks and strokes.
Some people may be able to take fish oil in addition to statins. However, EPA and DHA have different effects on LDL. Some studies suggest that combining statins with DHA can increase LDL, which can be a problem for people who take statins to lower their LDL levels.
EPA has little or no lowering effect on LDL. If DHA could be harmful, you should consult a doctor before ingesting fish oil or any other product containing it.
There are also prescription omega-3 formulas that are more effective than regular fish oil. Examples include icosapent ethyl (Vascepa), which contains EPA only, and omega-3 acid ethyl ester (Lovaza), which contains EPA and DHA.
People over the age of 18 with very high triglyceride levels (500 milligrams / deciliter) can take these products and eat healthily at the same time.
Both statins and fish oil supplements can cause side effects. Usually, however, people get along well with both of them.
The side effects of fish oil are typically mild. They include:
The following table lists possible side effects of prescription omega-3 products:
Side effects from statins can be more serious. Some of the most common side effects are:
While these are some of the most common reactions to statins, they are rare. People who have muscle pain, tenderness, or weakness will find that these side effects go away once they stop taking the medication.
If you experience side effects while taking statins, you should see a doctor.
Some people cannot tolerate statins and may need an alternative. Doctors may suggest a combination of diet changes and one or more lipid lowering drugs, such as:
- Nicotinic acid
- Bile acid sequestrants
- Proprotein convertase subtilisin / kexin type 9 inhibitors
Each of these drugs have different effects and not all are direct substitutes for statins. Some people may need to take more than one lipid lowering prescription drug to control their cholesterol.
Diet can also play a role in treating people who are intolerant to statins. Doctors may recommend a diet that:
- is low in saturated fat
- is high in fiber
- contains plant sterols that humans can obtain from fruits, vegetables, seeds and nuts
Chinese red yeast rice can also be an additional option for some people. This dietary supplement produces substances that also inhibit the HMG-CoA reductase enzyme, the target of statin drugs.
Statins have greater cholesterol-lowering potential, however, and as an OTC supplement, Chinese red yeast rice can vary in potency and quality, just like OTC fish oil supplements. Some products can also contain harmful impurities.
Because of this, it is important to speak to a doctor before using Chinese red yeast rice for any health problem.
While OTC fish oil has a reputation for promoting heart health, it’s not a medical treatment for the conditions that statins can treat. Most fish oils are dietary supplements and their effectiveness can vary.
There are prescription omega-3 products that, like statins, can help treat high triglyceride levels. However, depending on the product, they can work differently.
People with high triglycerides or high cholesterol should consult a doctor before trying any additional supplements or when trying any prescription omega-3.