Vitamin E vs Omega-3: Key Differences

Quick answer

Vitamin E is a fat-soluble antioxidant vitamin with a recommended 15 mg a day, while omega-3s are fats, mainly EPA and DHA from fish oil, with no US recommended amount. Large vitamin E trials did not show long-term benefits, and a large fish oil trial did not significantly change its main heart outcome.^1,2,3

Key facts

Adults need 15 mg of vitamin E a day. No recommended amount has been set in the US for EPA or DHA.^1,4
Vitamin E is an antioxidant that stops the production of reactive oxygen species when fat is oxidized. EPA and DHA are built into cell membranes, with DHA concentrated in the retina and brain.^2,5
Large randomized trials of vitamin E supplements have not shown that routine use brings long-term health benefits.²
In the 25,871-person VITAL trial, about 1 g of fish oil a day did not significantly change the main combined heart outcome.^3,5
The upper limit for vitamin E from supplements is 1,000 mg a day. No upper limit is set for EPA and DHA, and FDA considers up to 5 g a day safe.^1,4

What each one is

Vitamin E is the name for a group of eight related fat-soluble compounds, four tocopherols and four tocotrienols. Only alpha-tocopherol is recognized as meeting human needs, because the liver sends mainly that form back into the blood and breaks down the others. It works as an antioxidant, stopping the production of reactive oxygen species formed when fat is oxidized.²

Omega-3s are a family of fats, not a vitamin. The body builds EPA and DHA into the membrane around every cell, and uses them to make signaling molecules. It can make a little from the plant omega-3 ALA, at reported rates under 15%, so seafood and fish oil are the practical sources. Fish oil is one supplement type; others are cod liver oil, krill oil and algal oil.^4,5

Side by side

Vitamin E and omega-3 compared^{1,2,4,5,6,7,8}
	Vitamin E	Omega-3 (fish oil)
What it is	A fat-soluble vitamin, eight related compounds	A family of fats: ALA, EPA and DHA
Recommended amount	15 mg a day for adults	ALA 1.6 g (men) or 1.1 g (women); none for EPA or DHA
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
Upper limit	1,000 mg from supplements, set because of bleeding	None; FDA considers up to 5 g of EPA plus DHA a day safe
Food sources	Wheat germ oil, sunflower seeds, almonds, other vegetable oils	Fatty fish such as salmon, mackerel and herring; ALA from flaxseed, chia and walnuts
Diet versus recommendation	Most American diets provide less than 15 mg, yet a shortage is rare	US adults get about 90 mg of EPA and DHA a day from food
EU health statement	Protection of cells from oxidative stress	Heart function at 250 mg of EPA plus DHA; brain and vision at 250 mg of DHA
Best absorbed	With fat in the meal	With fat in the meal

What the evidence shows

Helps protect cells from oxidative stress*^1,2,6

Moderate evidence

This is a well-established nutrient function. NIH describes vitamin E as a fat-soluble antioxidant that stops the production of reactive oxygen species when fat is oxidized, and EU regulators permit the statement that vitamin E contributes to the protection of cells from oxidative stress for foods that are at least a source of it. It describes a normal function, not a measured health outcome. Large trials of high-dose vitamin E supplements did not show the long-term health benefits that were hoped for.

Amount studied: The recommended intake: 15 mg a day for adults, from food and supplements together

Helps you reach the recommended daily vitamin E intake*^1,2,9

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

Raises EPA and DHA levels in the blood*^5,10

Strong evidence

In a five-month randomized trial in 115 healthy adults, 600 mg a day of EPA plus DHA from standard fish oil raised the omega-3 index (the share of EPA and DHA in red blood cell membranes) by 59%, with no change on placebo. NIH notes that all the common forms of omega-3 supplement raise blood EPA and DHA. Typical US intake from food is only about 90 mg a day.

Amount studied: 300 to 1,800 mg of EPA plus DHA a day; the 59% rise was at 600 mg a day for about five months

Provides EPA and DHA, which contribute to normal heart function*^3,5,7

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

Forms

Vitamin E comes in natural and synthetic versions, which differ in potency by weight. For omega-3s the differences are in the chemical form and the source.^1,5

Natural vitamin E is usually labeled d-alpha-tocopherol and synthetic vitamin E dl-alpha-tocopherol. The synthetic form is half as active by weight, so 1 mg of vitamin E equals 1 mg of the natural form or 2 mg of the synthetic form.^1,2

Omega-3s in supplements come in the natural triglyceride form, as re-esterified triglyceride, as free fatty acids, as ethyl esters or as phospholipids. The triglyceride and free fatty acid forms are absorbed somewhat better than ethyl esters, but every form raises EPA and DHA in the blood.⁵

Who might pick which

Food comes first for both, and it can answer the question without a supplement.^1,8

For vitamin E, dry-roasted sunflower seeds have 7.4 mg per ounce, almonds 6.8 mg and a tablespoon of sunflower oil 5.6 mg, against the 15 mg adults need.²
For EPA and DHA, 3 ounces of cooked farmed Atlantic salmon has about 1.24 g of DHA and 0.59 g of EPA. The Dietary Guidelines advise at least 8 ounces of seafood a week.^5,8
People who eat no fish can look to algal oil, a vegetarian source of DHA, while flaxseed oil supplies ALA and not EPA or DHA.^5,8
For people who cannot absorb fat well, NIH notes that water-miscible forms of vitamin E are used, and it links a vitamin E shortage almost always to conditions where fat is not digested or absorbed.^2,11

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

Safety differences

The two share a bleeding caution at high doses and differ in almost everything else. Vitamin E's caution is the reason its upper limit exists, while omega-3s have no upper limit but a heart rhythm finding at high doses.^2,5

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).^1,2

Two large trials found that 4 g a day for several years slightly raised the risk of atrial fibrillation, an irregular heart rhythm, in people with or at high risk of heart disease. Across seven large trials, the rise was larger above 1 g a day than at 1 g or less.^5,12

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.^1,2

Expected from how the two work, not shown in studies

Your doctor may want to check on you

High doses of omega-3s may cause bleeding problems when taken with warfarin or other anticoagulants, and fish oil can have antiplatelet effects at high doses. Fish oil might also prolong clotting time, measured as INR, in people taking warfarin. The label of a prescription omega-3 medicine says people who also take an anticoagulant or an antiplatelet medicine should be monitored periodically.^4,5,13

On the medicine's label

Ask first if you take warfarin or another blood thinner, or an antiplatelet medicine such as aspirin, or have a bleeding disorder.^1,4
Ask first if you are having chemotherapy or radiotherapy, or take simvastatin with niacin, or orlistat, which matter for vitamin E.²
Ask first if you are allergic to fish or shellfish, which matters for fish oil and not vitamin E.¹³
Ask first if you are pregnant or breastfeeding and considering more than a multivitamin contains, or under 18.^2,4

Questions people ask

Is vitamin E the same as fish oil?

No. Vitamin E is a fat-soluble vitamin that works as an antioxidant. Fish oil is a source of omega-3 fats. They share a need for fat to be absorbed and a bleeding caution at high doses.^2,5

Which one is better, vitamin E or omega 3?

The question assumes the two do the same job, and they do not. Vitamin E has an antioxidant role that EU regulators accept, and most Americans eat less than 15 mg a day without clear signs of a shortage. Fish oil reliably raises EPA and DHA, and the EU accepts a heart function statement at 250 mg.^1,6,7

Can you take vitamin E and omega 3 together?

Our sources describe no interaction. Both are absorbed better with fat, and both are linked to bleeding at high doses, so ask first if you take a blood thinner.^2,5

How much vitamin E is too much?

The adult upper limit for vitamin E from supplements is 1,000 mg a day, set because of the bleeding caution. Vitamin E in food needs no limit.¹

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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.