Interaction among Omega 3, Ezetimibe and HDL

Ezetimibe is known to reduce absorption of Omega 3 fatty acids. That made me wonder whether I should keep taking it. But I had a new thought about all this and would welcome inputs.

My HDL has always been very high. For years I have been eating salmon every week and taking large-ish doses of EPA/DHA. But I assumed the sky-high HDL (it was 125) was mostly genetic.

After months on Repatha + Ezetimibe, all lipids were way down. And HDL was down to 114 – still sky high, but down.

So now I am thinking – not to worry about Ezetimibe blocking the EPA/DHA – may-be that (together with the salmon) is what is partly what’s driving the HDL. Perhaps I should even reduce the amount of EPA/DHA that I am taking. And restart a bit of the stanols.

This group has been so helpful to me in my efforts to hone my protocol.
Thank you

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Ezetimibe is generally known to raise HDL though?

Currently waiting for my Omega 3 Quant test results. Lab received the sample, results should be available within a week. I’ve been on ezetimibe for well over a decade, current n-3 intake is low dose daily krill oil, also 1/4 cup walnuts and 1 tablespoon ground flax in morning smoothie and occasional salmon for dinner.

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That will be an extremely interesting test result. I have recently paused Ezetimibe because of concerns over Omega 3 absorption.

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I try to keep at least an 18 hour gap after taking Ezetimibe and consuming anything with ALA/EPA/DHA and vitamin K.
It’s the best way I can think of doing it if taking Ezetimibe daily.


Do you have any mimimum time between omega 3 intake and ezetimibe? I have used to wait 3 hours, eating fat fish around 7 pm and ezetimibe around 10 pm. If chat gpt is to be trusted (no time for anything more) “Fatty fish can take a few hours to be fully digested and for its nutrients, including omega-3 fatty acids, to be absorbed. A safe window to wait might be 2-3 hours post-meal, but this can vary based on the amount of fish consumed and individual digestion rates”.

With one meal a day I eat a huge portion of fat fish. Stimulated by this thread I will increase the safety margin by putting my ezetimibe next to my floss for intake just prior to bed time.

Plus will have an omega 3 test to check.

This forum is great.


I don’t think that measures alpha-linolenic acid, which probably has benefits outside of weak conversion to EPA and DHA, and ALA is what ezetimibe might block. I don’t think anyone has suggested it blocks EPA and DHA.


There is indeed a study floating around on one of these threads strongly suggesting it blocks EPA/DHA absorption.

(Edit: no there isn’t)

Link? A fast search doesn’t find it…

Oops you’re right – I was thinking about the ALA study. I actually found another pilot study that specifically found ezetimibe does not block absorption of EPA:


It may, however, inhibit vitamin E absorption:

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Thanks! I’d been looking for a study. That matches up with what users here, @Joseph_Lavelle , have been reporting.


I wonder if this would work for ALA as well? Seems like it should.

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I take ezetimibe in AM. I take fish oil in AM and PM, and I eat fish most nights. So I mostly used the 4 hours gap or more. My omega index was 12%