Blood draw
Omega-3 Fatty Acid Profile
EPA, DHA, total fatty acids and the omega-3 index in whole blood.
€ 87,00
All tests
Heart and vessels · Blood
EPA
The omega-3 fish fatty acid eicosapentaenoic acid; the amount in the blood mainly reflects how much oily fish or fish oil you take in.
At a glance
- Measured in blood
- In 2 test panels
- No special preparation
Explanation
EPA: what is measured?
EPA (eicosapentaenoic acid) is an omega-3 fatty acid found mainly in oily fish such as salmon, herring and sardines, and in fish oil and algae oil. The body can only make small amounts of EPA itself from the plant-based omega-3 fatty acid ALA, so the value depends mainly on diet. EPA is built into the walls of cells, including red blood cells. The laboratory measures the amount of EPA in whole blood (EDTA blood), in milligrams per liter. Together with DHA, EPA is the basis of the omega-3 index: EPA plus DHA as a percentage of total fatty acids.
What can it detect?
- Low intake of fish fatty acids, for example when eating little or no fish
- The effect of eating more fish or using fish oil or algae oil
Result
What does the result mean?
EPA too high
A high EPA usually fits eating oily fish regularly or using a fish oil supplement. On its own it has no harmful meaning. However, according to the Netherlands Nutrition Centre (Voedingscentrum), high doses of supplements with EPA and DHA can increase the risk of heart rhythm disorders, especially around 4 grams per day, and slow blood clotting from a few grams per day. A high EPA does not mean that cholesterol, blood pressure or smoking count for less.
EPA too low
A low EPA usually fits eating little or no fish, for example with a vegetarian or vegan diet. It causes no symptoms itself and is not a disease. The Health Council of the Netherlands advises eating fish once a week, preferably oily fish, which provides about the recommended 200 milligrams of fish fatty acids (EPA and DHA) per day. Whether a low blood value on its own increases the risk of heart disease has not been established.
After an abnormal result
An abnormal EPA value usually does not lead to follow-up tests by the GP. With a low value, the general dietary advice of the Health Council of the Netherlands is the starting point: fish once a week, preferably oily fish, or a supplement with EPA and DHA for those who do not eat fish.
Reliability
How reliable is the test?
There are no Dutch cut-off values for this test. The value is mainly a measure of fish or fish oil intake over the past weeks to months. The multidisciplinary guideline on cardiovascular risk management does not recommend fish oil supplements to lower LDL cholesterol or the chance of cardiovascular disease, and neither does the Dutch GP guideline (NHG) for lowering LDL; an EPA result does not change that advice. A single EPA value is less informative than the omega-3 index, which reflects EPA and DHA together.
What can affect the result?
- This result is an amount in whole blood (mg/l). Studies and other laboratories often measure in red blood cells or plasma, or give a percentage; those numbers cannot be compared one to one with this result.
- A meal with oily fish or a fish oil capsule shortly before the sample collection can temporarily raise the value.
- Starting or stopping supplements changes the value gradually, over weeks.
- The reference values differ by laboratory and have not been set by a Dutch professional association.
Who it is for
Who is the test useful for?
Useful for
The test is mainly informative if you want to know whether your intake of fish fatty acids is sufficient, for example with a vegetarian or vegan diet or when using a supplement. For dietary advice the test is usually not needed: according to the Health Council of the Netherlands, if you eat oily fish once a week you get enough fish fatty acids. The test is not suitable for estimating the risk of cardiovascular disease.
How common is it?
There are no Dutch figures on EPA values in the blood. A low value is to be expected in people who eat little or no fish and do not use a supplement with EPA and DHA.
No Dutch figures available
Drawbacks and risks
- A low value can cause worry about the heart and blood vessels, while it has not been shown that raising it prevents heart disease.
- A result can prompt high doses of fish oil, which can increase the risk of heart rhythm disorders and slow blood clotting.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results- Voedingscentrum: Omega 3 en omega 6 (advies Gezondheidsraad)
- FMS Richtlijnendatabase, richtlijn CVRM: Voeding bij CVRM
- Harris WS. The omega-3 index as a risk factor for coronary heart disease. Am J Clin Nutr 2008;87:1997S-2002S (PubMed-samenvatting)
- NHG-Standaard Cardiovasculair risicomanagement (M84)