NutriStack
Atorvastatin and Fish Oil, a synergy.
Fish oil omega-3 fatty acids can add triglyceride lowering to statin therapy. Randomized studies of high-dose omega-3 fatty acids added to atorvastatin showed improved triglyceride and non-HDL cholesterol measures without major safety signals. The main value is residual hypertriglyceridemia, not additional LDL lowering.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Atorvastatin and Fish Oil
- Pair type
- Synergy
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Moderate evidence
Synergy
What is happening. Fish oil omega-3 fatty acids can add triglyceride lowering to statin therapy. Randomized studies of high-dose omega-3 fatty acids added to atorvastatin showed improved triglyceride and non-HDL cholesterol measures without major safety signals. The main value is residual hypertriglyceridemia, not additional LDL lowering.
Mechanism. Atorvastatin lowers hepatic cholesterol synthesis and LDL particle burden, while omega-3 fatty acids reduce hepatic VLDL-triglyceride production and enhance triglyceride clearance. These complementary lipid effects can improve residual hypertriglyceridemia.
Recommendation. Consider fish oil with atorvastatin when triglycerides remain elevated despite statin therapy, using a consistent EPA/DHA dose and product. Recheck fasting lipids because some mixed EPA/DHA products can raise LDL cholesterol in certain patients.
Sources (2)
- Woo JS, Hong SJ, Cha DH, Kim KS, Kim MH, Lee JW, et al. Comparison of the Efficacy and Safety of Atorvastatin 40 mg/omega-3 Fatty Acids 4 g Fixed-dose Combination and Atorvastatin 40 mg Monotherapy in Hypertriglyceridemic Patients who Poorly Respond to Atorvastatin 40 mg Monotherapy: An 8-week, Multicenter, Randomized, Double-blind Phase III Study. Clin Ther. 2021;43(8):1419-1430. PMID 34332788
- Jun JE, Jeong IK, Yu JM, Kim SR, Lee IK, Han KA, et al. Efficacy and Safety of Omega-3 Fatty Acids in Patients Treated with Statins for Residual Hypertriglyceridemia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Diabetes Metab J. 2020;44(1):78-90. PMID 31237134
Stack Score
How this pair moves the number.
Effect on the composite score
If both Atorvastatin and Fish Oil are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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