Vitamin E and Fish Oil: Taking Them Together

Quick answer

Our sources describe no interaction between vitamin E and fish oil, and no study tested them together. Both are absorbed better with fat in the meal. Both are also linked to bleeding at high doses, so people on blood thinners should ask first. Adults need 15 mg of vitamin E a day.^1,2,3

Key facts

Adults need 15 mg of vitamin E a day. The upper limit for vitamin E from supplements is 1,000 mg a day, and it is set because of bleeding.^1,4
No recommended amount has been set for EPA or DHA in the United States. FDA has concluded that up to 5 g a day from supplements is safe when used as recommended.^2,5
About 10% of a vitamin E dose was absorbed with a fat-free breakfast, against 33% when 21% of the breakfast's calories came from fat.³
Doses of 2 to 15 g a day of EPA and DHA might lengthen bleeding time, and high doses of vitamin E supplements might increase bleeding too.^4,5
We found no study of vitamin E taken with fish oil capsules, so how much fat a softgel supplies for vitamin E is not known.^4,5

What the sources say about the pair

We looked for a statement that fish oil changes how vitamin E is absorbed, or the reverse, and found none in the NIH fact sheets for the two. The questions people raise have to be answered from each nutrient's own entries, which fall into three groups: fat, antioxidants and bleeding.^4,5

On fat, both depend on it. Vitamin E is a fat-soluble antioxidant, and fish oil is itself a fat. On antioxidants, vitamin E stops the production of reactive oxygen species when fat is oxidized, while our omega-3 sources describe no antioxidant role for EPA and DHA. On bleeding, both are on the cautions list, covered at the end of the page.^4,5

What each is graded for

Provides EPA and DHA, which contribute to normal heart function*^5,6,7

Moderate evidence

This is the nutrient-function statement authorized in the EU, on condition that the daily intake is at least 250 mg of EPA plus DHA. It rests mainly on studies linking fish and omega-3 intake with heart health. It is not a promise of fewer heart problems: in the 25,871-person VITAL trial, about 840 mg a day did not improve the trial's main heart outcome.

Amount studied: At least 250 mg of EPA plus DHA a day, the EU condition for this statement

Helps you reach the recommended daily vitamin E intake*^1,4,8

Moderate evidence

National surveys have found that the diets of most Americans provide less vitamin E than the recommended 15 mg a day, although the estimates may be low because fats added in cooking are often not counted, and clear signs of a shortage are very rare in healthy people. In a study of 90,771 adults, vitamins A and E and zinc were the nutrients whose intakes rose most when multivitamins were counted. A typical once-daily multivitamin supplies about 13.5 mg.

Amount studied: Recommended intake: 15 mg a day for adults and 19 mg while breastfeeding, from all sources

Best time to take vitamin E with fish oil

It is tempting to assume that a fish oil capsule, being fat, helps vitamin E get absorbed. The studies tested a different thing: the fat in a meal. We found no study in which vitamin E was taken with a fish oil capsule, so that assumption is untested.^3,9

In a study of 5 adults, the share of a labeled vitamin E dose absorbed was about 10% with a fat-free breakfast, 20% when 6% of the breakfast's calories came from fat, and 33% when 21% did.³

How fast each builds up^3,5,10,11
	Vitamin E	Fish oil (EPA and DHA)
After a single dose	Peaks in the blood 9 to 24 hours later	Plasma levels shift with the most recent meal
With daily use	A steady state within 4 to 5 days of large doses	Serum EPA leveled off after 4 to 8 weeks
After stopping	Levels returned to baseline 12 to 20 days later	Red blood cell levels reflect roughly the previous 120 days
Time of day	NIH names none	NIH names none

What the data show is simple: a meal with at least a little fat helps vitamin E, and it helps fish oil too, since a high-fat meal raised EPA absorption from ordinary fish oil from 69% to 90% in one study. The sources set no hour of the day for either.^3,12

Amounts and our products

Vitamin E and fish oil for adults^1,2,4,5
	Vitamin E	Fish oil (EPA and DHA)
Recommended amount	15 mg a day	None set for EPA or DHA
Upper limit	1,000 mg a day from supplements	None set; FDA considers up to 5 g a day safe
Typical supplement	A multivitamin about 13.5 mg; vitamin E alone 67 mg or more	About 1,000 mg of fish oil with 180 mg of EPA and 120 mg of DHA

What’s in ours

Omega-3: Fish oil concentrate, 1,000 mg per serving, from the label

What’s in ours

Men's Multi: Vitamin E, 13.5 mg per serving, from the label
Immune Support: Vitamin E, 15 mg per serving, from the label

Bleeding, blood thinners and who should ask first

Both nutrients touch platelets, the cell fragments that clump to stop bleeding. NIH links the bleeding seen with high-dose vitamin E to its effect on platelets and describes omega-3s at high doses as making platelets less likely to clump. Whether the two add together is not tested in any source we read.^4,5

High doses of vitamin E supplements might increase the risk of bleeding, by reducing the blood's ability to clot after a cut or injury, and of serious bleeding in the brain (hemorrhagic stroke).^1,4

Doses of 2 to 15 g a day of EPA and DHA might lengthen bleeding time by making platelets less likely to clump.⁵

For fish oil, NIH says high doses of omega-3s may cause bleeding problems when taken with warfarin or other anticoagulants, and that fish oil might prolong clotting time, measured as INR, in people taking warfarin.^2,5

Ask your pharmacist or doctor first

Vitamin E can slow the clumping of platelets and work against the clotting factors that depend on vitamin K. Taking large doses with an anticoagulant or antiplatelet medicine, such as warfarin, can therefore increase the risk of bleeding, especially when vitamin K intake is low. NIH says the amount needed to cause a clinically significant effect is not known.^1,4

Expected from how the two work, not shown in studies

Ask first if you take warfarin or another blood thinner, or an antiplatelet medicine such as aspirin.^1,2
Ask first if you have a bleeding disorder, or have surgery planned.^4,5
Ask first if you are having chemotherapy or radiotherapy, or take simvastatin with niacin, or orlistat.⁴
Ask first if you are allergic to fish or shellfish, or have atrial fibrillation or another heart rhythm problem.^5,13
Ask first if you are considering vitamin E of 400 IU a day or more, or are pregnant or breastfeeding.⁴

Questions people ask

Can you take vitamin E with fish oil?

Our sources describe no interaction and no study tested them together. The caution is bleeding at high doses of either, so ask first if you take a blood thinner or have a bleeding disorder.^4,5

What is the best time to take vitamin E and fish oil?

NIH names no hour for either. Vitamin E is absorbed better when the meal contains some fat, and fish oil is too, so take both with a meal.^3,12

Does fish oil help vitamin E absorb?

No study we found tested that. The studies on vitamin E tested the fat in meals, not fish oil capsules.^3,9

Is there enough vitamin E in a multivitamin?

A typical once-daily multivitamin supplies about 13.5 mg, close to the 15 mg adults need. Vitamin E supplements on their own commonly contain 67 mg or more.^1,4

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See the Full Measure line Omega-3 Immune Support Men's Multi

Sources

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.