Health-conscious pet parents and holistic wellness seekers love fish oil. Omega-3 fatty acids provide benefits for skin, joints, heart, and even cognitive function. Conventional wisdom suggests stopping fish oil before surgery to reduce bleeding risk, but does science support that advice? A deep dive into recent studies provides clarity.
A Closer Look at the Data
A thorough review of clinical trials up to May 2023 examined omega-3 polyunsaturated fatty acids (PUFAs) and bleeding risk. Across 120,643 human patients in 11 trials, no significant difference in bleeding events appeared between those taking omega-3 PUFAs and those who did not (rate ratio [RR], 1.09 [95% confidence interval [CI], 0.91-1.31]; P=0.34).
Concerns regarding haemorrhagic stroke, intracranial bleeding, and gastrointestinal bleeding also underwent scrutiny, but findings showed no meaningful increase in risk. However, high-dose purified eicosapentaenoic acid (EPA) increased relative risk by 50%, though the absolute rise remained modest at 0.6% compared to placebo. This shift linked directly to EPA dosage rather than concurrent antiplatelet therapy (risk difference, 0.24 [95% CI, 0.05-0.43]; P=0.02).
What About Earlier Research?
An earlier systematic review assessed the impact of fish oil on haemostasis and bleeding risk, aiming to refine surgical recommendations. Researchers followed PRISMA guidelines to select 52 studies, including 32 on healthy individuals and 20 on surgical patients.
Findings showed fish oil supplements reduced platelet aggregation in healthy individuals, but this biochemical effect failed to translate into actual bleeding complications in surgical patients. Among 20 RCTs, none found an increased need for blood transfusions or higher surgical bleeding risk.
What Does This Mean for Surgery Prep?
These comprehensive reviews challenge the long-held belief that fish oil heightens surgical bleeding risk. For most individuals, stopping omega-3 supplements before surgery offers no clear advantage. However, high-dose purified EPA users should acknowledge a slight increase in risk. Informed decision-making based on current evidence ensures patients receive appropriate preoperative guidance.
Want to dig deeper? Check out these sources: PubMed Study 1 PubMed Study 2
