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Omega-3 Index

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Omega-3 Index

Omega-3 Index | Tulsa preventive cardiologyThe Omega-3 Index

The Omega-3 Index measures the amount of Omega-3 fatty acids in the membrane of red blood cells (RBCs). There are 2 Omega-3 fatty acids that are important here: Eicosapentanoic Acid (EPA – 20c) and Docosahexanoic Acid (DHA – 22c).

The membranes of cells are made up of phospholipid bilayers as depicted in the image above. This means that there are 2 layers of phospholipids organized so that the the polar phosphate portion is on the outside of the membrane and the 2 lipid, or fatty acid, tail structures are in the middle of the membrane. The tail of the phospholipid is a fatty acid.

Different fatty acids change the characteristics of the membrane and alter cellular health. The Standard American Diet (SAD) is high in Omega-6 fatty acids which is not a good thing and changes the balance towards higher levels of inflammation. Omega-3 fatty acids (EPA & DHA) can help counterbalance this pro-inflammatory effect and restore healthy balance.

The result is expressed as a percentage of the total membrane fatty acids. Over 40 studies have been published using the Omega-3 Index.

Omega-3 Index | Tulsa Functional Medicine



Goal – > 8.0%

There are 3 ranges for Omega-3s on the Omega-3 Index:

  1. High Risk: < 4%. There is a 90% increased risk of sudden cardiac death!
  2. Intermediate Risk: 4-8%
  3. Low Risk: > 8% – this is our goal!

How to improve your Omega-3 Index

The primary intervention is to improve the Omega-3/Omega-6 ratio. The best way to do this is to increase Omega-3 intake and decrease Omega-6 intake. In other words, eat a clean diet with high amounts of fish or take a fish oil supplement.

It is extremely rare that we see patients with an Omega-3 Index above 8% if they aren’t taking a fish oil.  It is very easy to do but rare that anyone actually does it. If you want to increase your Omega-3 Index with diet along then I would recommend Sardines from Vital Choice. Of course, wild caught salmon is another excellent source.

Omega-3 Supplements (Fish Oil)

Omega-3 supplementation is the most common, effective, and easy way to get the Omega-3 Index above 8%. The amount of Omega-3’s required will vary from patient to patient but is often between 1 & 4 grams of EPA & DHA.

Make sure you are taking a high quality source of omega-3s that have the proper amounts of EPA/DHA.

You can think of Omega-3s as fragile little glass beads because they are highly susceptible to oxidation. Many of the good fish oils levels have Vitamin E added to them as an antioxidant. Even still, the oxidative stress can be a real problem especially when some of these supplements are stored in warehouses in over 100 degree heat. These fragile Omega-3s can degrade quickly.

While our Omega-3s are our strong recommendation, some patients choose to get them elsewhere. Sometimes they ask us what we think about the ones they are taking. Most of the time we simply don’t know. However, I’ll usually send them to the International Fish Oil Standards (IFOS) website.

IFOS is an independent, 3rd-party lab who certifies fish oils. They have several tests that they perform and then rank the fish oil. There is a page on their website with a list of all of the ‘certified’ fish oils along with the testing done on each of them.


  2. William S Harris, The omega-3 index as a risk factor for coronary heart disease, The American Journal of Clinical Nutrition, Volume 87, Issue 6, June 2008, Pages 1997S–2002S,