Form Comparison

Ethyl Ester Fish Oil vs Triglyceride Fish Oil

How ethyl ester fish oil and triglyceride fish oil differ in potency, absorption, tolerance, and cost.

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Quick verdict. Natural triglyceride oil is the native form and absorbs well, but at about 30% EPA+DHA it takes many capsules to pass 1 g. Ethyl ester is concentrated and cheaper per gram of EPA+DHA at high doses, but depends on a fatty meal for good absorption. Choose triglyceride oil for 250-1,000 mg maintenance, and ethyl ester when you need 2-4 g for triglycerides and will take it with food.

Side by Side

Ethyl Ester Fish Oil Natural Triglyceride Fish Oil
Absorption Moderate High
How it is absorbed Fatty acids esterified to ethanol to allow concentration by distillation. The ethyl ester bond is hydrolyzed more slowly by pancreatic lipase, so absorption depends heavily on taking it with a fat-containing meal. EPA and DHA on a glycerol backbone, the form found in fish. Pancreatic lipase releases free fatty acids and monoglycerides for micellar absorption.
Typical dose 1-4 g EPA+DHA daily 250-1,000 mg EPA+DHA daily for general use
Common uses high-dose triglyceride lowering, concentrated capsules general cardiovascular nutrition, low fish intake
Side effects Similar to triglyceride oil. Fishy aftertaste, burping, loose stools at high doses.
Cost Low Low
Also called EE fish oil, omega-3-acid ethyl esters TG fish oil, natural TG
Labels in index 83 31

When to Choose Ethyl Ester Fish Oil

Choose ethyl ester fish oil when you need a high concentrated dose and will take it with a fatty meal. Prescription omega-3s (omega-3-acid ethyl esters, icosapent ethyl) use this form. Take with the largest meal of the day.

Ethyl Ester Fish Oil

The form of both prescription products and most budget concentrates. Fine with a fatty meal, poorly absorbed without one.

What to look for: EPA plus DHA per serving rather than per softgel. Take with the largest meal of the day.

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When to Choose Natural Triglyceride Fish Oil

Choose triglyceride fish oil when you need a modest dose and want the native form at low cost. Unconcentrated oil typically holds about 30% EPA+DHA, so doses above 1 g EPA+DHA need many capsules.

Natural Triglyceride Fish Oil

Choose triglyceride fish oil when you need a modest dose and want the native form at low cost.

What to look for: Natural Triglyceride Fish Oil named on the Supplement Facts panel, with the amount per serving stated.

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Products on Titrate

In Titrate's index of NIH label data, 83 labels in the Fish Oil and Omega-3 category list ethyl ester fish oil and 31 list triglyceride fish oil.

Open supplement search

Supplement Search loads one category at a time. Choose the Fish Oil and Omega-3 tab, then type a form such as "triglyceride" under Must contain, or a form to avoid under Must not contain.

Related

References

NIH Office of Dietary Supplements. Omega-3 Fatty Acids: Fact Sheet for Health Professionals.

Harris WS, von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39(1):212-220.

Dyerberg J, et al. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010;83(3):137-141.

Neubronner J, et al. Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters. Eur J Clin Nutr. 2011;65(2):247-254.

Albert BB, et al. Fish oil supplements in New Zealand are highly oxidised and do not meet label content of n-3 PUFA. Sci Rep. 2015;5:7928.

Bhatt DL, et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N Engl J Med. 2019;380(1):11-22.

Manson JE, et al. Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. N Engl J Med. 2019;380(1):23-32.

Nicholls SJ, et al. Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial. JAMA. 2020;324(22):2268-2280.

Gencer B, et al. Effect of Long-Term Marine omega-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation. 2021;144(25):1981-1990.