In order to lower triglycerides (450) which is the right amount to take in regard to Omega 3. Have seen one answer saying 1000 mg per day and another saying 2000 mg per day. How much is too much?

Research on omega-3 fatty acids have been incorporated into many dietary guidelines because the therpeutic effect is fairly compelling. While general recommendations are to eat fish (one of the best sources of omega-3s) there are several ways to get the omega-3s you are looking for to lower triglyceride levels.

According to the American Heart Association Guidelines the dose recommendation for lowering triglycerides is between 2 to 4 grams (2000-4000 mg) per day with the important note that you should be under a physician's supervision while taking any supplements.

As with pretty much any medication (supplements at this level should be considered as medications), there can be side effects that you and your health care providers should watch for ranging from fishy taste to gastrointestinal upset and diarrhea, bruising and bleeding, a decline in glycemic control (blood sugar control) in glucose intolerance and diabetes, and an increase in LDL cholesterol -- a problem seen in patients taking omega-3 supplements when triglycerides are high. Because you fit at least one of the profiles for potential side effects you may want to limit your intake to under 3 grams (3000 mg) per day.

You can eat fish, but according to the FDA you should probably avoid swordfish, mackeral, shark, tilefish and keep overall fish consumption to around 12 ounces per week to err on the side of safety because you are in a "vulnerable population group" being HIV infected. You can get 2-4 grams fairly easily and well-under the recommended 12 ounces eating certain types of fish. Here are some examples of serving sizes to get 2 grams of omega-3s (to "eyeball" serving size: 3-4 ounces looks about the size of a deck of cards):

5 ounces sockeye salmon 3-5 ounces of farmed Atlantic salmon 4-6 ounces of sardines 4-7 ounces of wild Atlantic salmon 5 ounces Pacific oysters (or 6 oundes Eastern oysters)

Fish oil supplements generally provide 300 mg per capsule (180 mg EPA and 120 mg DHA). If you decide to opt for supplements, first talk with your doctor and then (after they consider the potential for problems in your case and their okay) work up to a 2 gram dose (about 7 capsules) over the period of a week or two. Cod liver oil provides about 2 grams of omega-3s in 2 teaspoons.

Then remember to keep an eye out for any problems and report them immediately to your health care team. Because of the increased risk for bleeding, if you are planning any surgery, you should talk with your doctor about other ways to lower your triglycerides until you are recovered from surgery.

Best wishes!