Q: My father had a heart episode a few years ago and is now on Coumadin. It was originally believed he had a heart attack, but a subsequent specialist said that this was probably not the case. He does have reduced heart capacity, however. Is it possible for him to safely benefit from a high-dose fish oil regimen? Is there anything we can find out from his doctor or tell him that would help the doctor make a better recommendation?
A: Supplemental fish oil rich in EPA and DHA has a significant cardiovascular benefit. If he remains on the Coumadin, I would suggest gradually increasing the EPA and DHA and seeing how it affects the pro-thrombin time. In the literature, the effect of EPA and DHA is variable. In some cases, it decreases amount of Coumadin required, in some cases there is no change, and still in other cases it requires a greater increase in Coumadin levels. Bottom line, it is best to test.