Bleeding DisordersOmega-3 Fatty Acids

Fish oil and the risk of bleeding following surgery

Concern over bleeding due to changes in platelet function has led to prohibiting omega-3 supplements before surgery.

Researchers at the Hospital for Special Surgery, in New York City, reviewed the records of spinal surgery patients in order to determine the risk of bleeding.

First, the details.

  • 95 consecutive patients who underwent posterior-only lumbar decompression by a single surgeon were included.
    • Lumbar decompression attempts to relieve pain due to pinched nerves by removing bone from over the nerve in order to provide more healing space.
  • Patients who had taken omega-3 fatty acids within 14 days of surgery were compared with a control group.
  • Demographics, preoperative use of other blood thinners, time in surgery, estimated blood loss, and postoperative complications were compared.

And, the results.

  • 16 patients took omega-3 fatty acid supplements and stopped an average of 2.3 days before surgery.
  • There were no significant differences between groups in demographics, use of other anticoagulants, and surgical time.
  • Estimated blood loss did not differ between groups.
  • There were 2 complications related to bleeding in the control group and none in the omega-3 fatty acids group.

The bottom line?

The authors concluded there was “no increase in intraoperative blood loss or postoperative bleeding complications associated with preoperative use of omega-3 fatty acid supplements [taken] up to an average of 2.3 days before surgery.”

These findings support an earlier review of 182 patients where high-dose fish oil (average 3 grams per day) taken in combination with aspirin and clopidogrel (Plavix) did not increase the risk of bleeding compared to aspirin and clopidogrel alone.

The American Heart Association website tells us, “Patients taking more than 3 grams of omega-3 fatty acids from capsules should do so only under a physician’s care. High intakes could cause excessive bleeding in some people.” However, the statement isn’t linked to a supporting study.

3/23/11 19:47 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.