Is it okay to take omega-3 if you have fatty liver?

January 3, 2026 •

4 min read

Metabolic-associated steatotic liver disease (MASLD), formerly known as NAFLD, affects approximately 25% of the global population. With no FDA-approved drug, lifestyle modifications, including diet, are the cornerstone of management, leading many to consider supplements like omega-3s for liver support.

Quick Summary

Omega-3s can reduce liver fat and inflammation and improve lipid levels in fatty liver disease, but results are mixed. Supplementation should be discussed with a doctor due to potential risks, especially at high intakes.

Key Points

Generally Safe: Omega-3 fatty acids are generally considered safe for most individuals with fatty liver disease, especially when consumed under medical guidance.
Potential Benefits: Research suggests omega-3s, particularly EPA and DHA, can help reduce liver fat, combat inflammation, and improve lipid profiles in MASLD patients.
Not a Cure: Omega-3 supplements should not be seen as a standalone cure for fatty liver but rather as a complementary part of a broader treatment strategy that includes diet and exercise.
Medical Consultation is Key: High intakes of omega-3s can carry risks, such as increased bleeding, especially for individuals with advanced liver scarring or those on blood thinners. Always consult a doctor before beginning supplementation.
Dietary Sources are Preferred: Getting omega-3s from food like fatty fish, flaxseeds, and walnuts is often the safest and most holistic approach, as it provides a broader spectrum of nutrients.
Choose Pure Supplements: When using supplements, opt for high-quality, purified fish oil or algal oil to ensure high EPA and DHA content and minimize exposure to contaminants like mercury or excess vitamin A.

The Verdict: Omega-3s and Fatty Liver

For individuals with a fatty liver, particularly Metabolic-associated Steatotic Liver Disease (MASLD), taking omega-3 fatty acids is generally considered safe and may offer therapeutic benefits. However, it is not a standalone cure and should always be part of a comprehensive treatment plan supervised by a healthcare professional. The evidence on efficacy is somewhat mixed across studies, suggesting a nuanced approach is necessary, considering individual health factors and the form of omega-3 taken.

How Omega-3s Can Benefit a Fatty Liver

Omega-3s, specifically the marine-derived forms eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can benefit liver health in several ways:

Reduces liver fat: Several studies and meta-analyses suggest that omega-3 supplements can help reduce the amount of fat accumulating in the liver. This fat accumulation is the hallmark of MASLD.
Combats inflammation: Chronic inflammation is a key driver in the progression of MASLD towards more severe conditions like non-alcoholic steatohepatitis (NASH) and cirrhosis. EPA and DHA possess powerful anti-inflammatory properties that can help mitigate this process.
Improves blood lipids: Omega-3s are well-known for their ability to significantly lower high triglyceride levels, a common feature of metabolic syndrome and MASLD. They can also help balance cholesterol levels by increasing "good" HDL cholesterol.
Enhances liver enzymes: Elevated liver enzymes, such as ALT and AST, often indicate liver stress or damage. Some studies have found that omega-3 supplementation can help normalize these enzyme levels.

Potential Risks and Important Considerations

While generally safe, there are some factors to consider, especially for those with existing liver conditions:

Bleeding risk: High intakes of omega-3s can increase the risk of bleeding, particularly for individuals with liver scarring (cirrhosis) or those taking blood-thinning medication. Medical supervision is crucial in these cases.
Vitamin A toxicity: Supplements like cod liver oil are rich in both omega-3s and vitamin A. Excessive, long-term intake of vitamin A can be toxic to the liver and lead to liver damage. Choose supplements with pure fish oil or algal oil to avoid this risk.
Inconsistent efficacy: Some studies, like one involving overweight men, found no significant reduction in liver fat after 12 weeks of fish oil supplementation. The heterogeneity in research highlights the need for larger, long-term trials.

Omega-3s from Food vs. Supplements


Feature	Food Sources (e.g., fatty fish, walnuts)	Supplements (e.g., fish oil, algal oil)
Intake Control	Less precise; nutrient content can vary.	More precise; content is clearly labeled and consistent.
Additional Nutrients	Provides a broader range of nutrients, including protein, vitamins, and minerals.	Concentrated source of EPA and DHA, with fewer additional nutrients.
Potential Contaminants	Larger predatory fish can contain mercury and other toxins.	Purified versions are screened and typically low in heavy metals.
Cost	Can be more expensive than supplements, especially for fatty fish.	Generally more affordable and accessible for regular intake.
Digestive Side Effects	Less common.	Can cause mild digestive issues like burping, nausea, or diarrhea.

How to Safely Incorporate Omega-3s

For managing fatty liver, the primary focus should be on foundational lifestyle changes. Adding omega-3s should be considered a supportive measure, not a replacement for these strategies.

Lifestyle Modifications

Achieve a healthy weight: Losing excess weight is one of the most effective ways to reduce liver fat.
Increase physical activity: Regular exercise helps combat a sedentary lifestyle, a major risk factor for MASLD.
Adopt a liver-friendly diet: Focus on whole foods, fiber, and complex carbohydrates while minimizing saturated fats and added sugars. The Mediterranean diet is a good model.

Omega-3 Sourcing

Prioritize dietary sources: Incorporate fatty fish like salmon, sardines, and mackerel into your diet at least twice a week. For plant-based options, include flaxseeds, chia seeds, and walnuts.
Choose high-quality supplements: If diet alone is insufficient, select a high-quality, third-party tested supplement, like fish oil or algal oil. Ensure it is molecularly distilled to remove contaminants and contains adequate levels of EPA and DHA.

Conclusion: A Supplement with Promise, Under Guidance

For many individuals with fatty liver disease, omega-3s are a safe and potentially beneficial supplement that can aid in reducing liver fat and inflammation. However, they should be viewed as part of a larger treatment strategy that prioritizes proven lifestyle changes, such as weight management and a healthy diet. Due to the mixed research and potential risks at high intakes, particularly for those on other medications or with advanced liver disease, it is essential to consult with a healthcare provider before starting any omega-3 supplement regimen.

For further reading on managing fatty liver, consult reputable sources like the Mayo Clinic.

Frequently Asked Questions

Omega-3s are not a cure for fatty liver disease, but they can be a helpful tool in managing it. Combined with a healthy diet, weight management, and regular exercise, they can help reduce liver fat and inflammation, which can slow or potentially reverse the progression of the disease.

Fish oil is a popular and effective source of EPA and DHA, the most beneficial omega-3s for liver health. However, for those who are vegetarian, vegan, or concerned about mercury, algal oil is an excellent plant-based source that also provides EPA and DHA.

Side effects are generally mild and can include a fishy aftertaste, gastrointestinal discomfort, or loose stools. The primary risk is increased bleeding at high intakes, especially for those with liver scarring or on anticoagulant medication. It is important to discuss these potential side effects with a healthcare provider.

It is generally best to get omega-3s from natural food sources whenever possible. However, if your dietary intake of fatty fish is low, supplements can be a convenient way to ensure adequate intake. Discuss with your doctor whether food sources or supplements are best for your situation.

Metabolic-associated steatotic liver disease (MASLD) is the new name for non-alcoholic fatty liver disease (NAFLD). The change reflects a better understanding of the condition's metabolic causes and helps to destigmatize it.

Yes, some studies suggest that omega-3 supplementation can help improve liver enzyme levels, such as ALT and AST, which are often elevated in individuals with fatty liver disease.

High intakes of omega-3s can increase the risk of bleeding, which is a concern if you are also taking blood-thinning medications. It is crucial to consult your doctor before taking omega-3 supplements if you are on blood thinners to assess the risk and determine if it is safe for you.