We found no human trial comparing the two oils. For high triglycerides, the American Heart Association calls prescription omega-3 at 4 grams a day an effective option, and sea buckthorn’s lipid signal comes from meta-analyses with high heterogeneity. For dry eye, a 535-person fish oil trial found no benefit over placebo, and sea buckthorn’s single 100-person trial differed on one of four main outcomes, after adjustment.
The comparison
| Feature | Sea buckthorn oil | Fish oil |
|---|---|---|
| Source | Berry flesh or seeds of a shrub | Marine fish |
| Signature fats | Omega-7 and 9 (berry oil), plant omega-3 (ALA) and omega-6 (seed oil) | Omega-3 EPA and DHA |
| Triglycerides | Two pooled analyses of sea buckthorn supplements (15 and 11 RCTs) found lower triglycerides in people with abnormal lipids or cardiovascular risks. The 15-trial one names high heterogeneity as its limitation, and neither names an oil | 2020 Cochrane review of omega-3 (86 RCTs): about 15% lower. AHA 2019: prescription EPA, or EPA plus DHA, at 4 g a day is an effective and safe option |
| Heart outcomes | Lab markers only: the pooled analyses report no event outcomes | 2020 Cochrane review: little or no effect on all-cause death, cardiovascular events or stroke, and a slight reduction in coronary heart disease deaths and events that it rates low-certainty evidence |
| Dry eye | One 100-person RCT (2 g a day, three months): smaller rise in tear osmolarity in an adjusted model, no difference in the other three main outcomes | 34 RCTs of omega-3 and omega-6 supplements in the 2019 Cochrane review, which calls the long-chain omega-3 evidence 'uncertain and inconsistent'. The largest, DREAM (535 people, 12 months, 3000 mg EPA plus DHA a day), found no benefit over placebo |
| Skin | Two small trials of oral oil: hydration and texture beat placebo in the 2024 trial, and the 2009 trial had no placebo group | Tested in eczema trials. A 2012 Cochrane review found two small fish oil trials suggesting 'a possible modest benefit, but many outcomes were explored', and no convincing evidence of benefit from dietary supplements in eczema |
| Vegan fit | Yes, plant-based | No. Algal oil is a plant-based route to DHA |
| Safety notes | The trial reports we can read mention no serious adverse event, and most say little about safety. One small study found berry oil at 5 g a day reduced platelet aggregation | AHA 2019 calls prescription omega-3 at 4 g a day an effective and safe option for lowering triglycerides. The sources we cite give no other safety figure for fish oil |
| Studied dose | 0.5 to 3 g a day of oil in the dry-eye, skin and vaginal trials | DREAM: 3000 mg EPA plus DHA a day. Prescription: 4 g a day (AHA 2019). The most common amounts per dose in supplements: 180 mg EPA and 120 mg DHA (AHA 2017) |
What fish oil actually is
Fish oil supplies EPA and DHA, the long-chain omega-3s of fish. Prescription products give 4 grams a day of EPA, or of EPA plus DHA, and the American Heart Association’s 2019 advisory calls them an effective and safe option for lowering triglycerides. The AHA’s 2017 advisory reports that the most common amounts per dose in supplements were 180 mg of EPA and 120 mg of DHA, so read the EPA and DHA lines on the back panel, not the ‘fish oil 1000 mg’ on the front.
Triglycerides and heart outcomes are separate questions. The 2020 Cochrane review included 86 trials of omega-3 and found that long-chain omega-3 lowered triglycerides by about 15% and had little or no effect on all-cause death, cardiovascular events or stroke, with a slight reduction in coronary heart disease deaths and events that it rates low-certainty evidence. The AHA’s 2017 advisory calls supplements reasonable for people who already have coronary heart disease and makes no recommendation for the general population. A separate 2018 AHA advisory asks for one to two seafood meals a week.
What sea buckthorn brings instead
The fatty-acid analyses we cite list no EPA or DHA in sea buckthorn berry or seed oil. The berry oil is built on omega-7 (palmitoleic acid) and omega-9, the seed oil on the plant omega-3 ALA plus omega-6. A 2005 review of human studies found that conversion of ALA to EPA is limited and further conversion to DHA very low. So sea buckthorn oil can’t stand in for fish oil’s EPA and DHA.
Sea buckthorn’s human trials are a separate file. A 2022 meta-analysis of 15 randomized trials found lower triglycerides, total cholesterol and LDL, only in people with abnormal lipid metabolism. An 11-trial analysis from 2017 found them in people with cardiovascular risks, not in healthy people. The 15-trial analysis names high heterogeneity as its limitation, the 11-trial analysis reports I-squared of 84.8% for total cholesterol and 75.5% for LDL, and neither names an oil. For dry eye there is one 100-person trial from one research group (2 grams a day, three months). Tear osmolarity rose less on the oil than on placebo in a model adjusted for baseline values, and tear break-up time, the Schirmer test and the symptom questionnaire did not differ. The cholesterol page and dry-eye page have the detail.
Dry eye: both have been tested
Fish oil has the larger trial file, and its result is mixed. The 2019 Cochrane review included 34 trials of omega-3 and omega-6 supplements for dry eye (4314 adults) and concluded that its findings suggest a possible role for long-chain omega-3 supplements, although the evidence is uncertain and inconsistent. The largest, DREAM, randomized 535 people with moderate-to-severe dry eye to 3000 mg a day of EPA plus DHA or an olive oil placebo for 12 months. Symptom scores improved by 13.9 points on fish oil and 12.5 on placebo, and the difference was not significant (P = 0.21).
Sea buckthorn has one trial, and the Cochrane review counted it among its 34, in a group of four trials of combined omega-3 and omega-6 supplements. It enrolled 100 people, ran three months from autumn into winter and was funded in part by the oil’s maker. Tear osmolarity rose less on the oil in an adjusted model, the symptom questionnaire, tear break-up time and the Schirmer test did not differ, and the worst-redness and worst-burning results each held in only one of two analyses. No independent group has repeated it. The dry-eye trial page has the detail.
Two different shopping lists
It helps to see why people confuse these bottles. Both are oils in softgels sold side by side, both mention omegas on the label, and both get recommended for “heart health” in content that never defines the term. The omega numbers are the tell: fish oil is omega-3, sea buckthorn is omega-7 plus a plant omega-3 that the body converts to EPA only to a limited extent. If a page claims sea buckthorn replaces fish oil, it is counting on you not reading the fatty acid panel. Our omega-7 glossary entry explains what the 7 actually does.
The vegan fork
Fish oil is fish, so plant-based readers need another route. Algal oil is a plant-based route to DHA. Sea buckthorn oil is plant-based too. Its trials cover dry eye and skin, and sea buckthorn supplements of unnamed form have pooled lipid trials. The two oils supply different fatty acids, so neither stands in for the other.
Choose fish oil if
- Your triglycerides run high and your doctor agrees omega-3s are worth a place in the plan, over-the-counter or prescription.
- You want an omega-3 with a large trial record. The 2020 Cochrane review included 86 trials and found about 15% lower triglycerides, little or no effect on all-cause death, cardiovascular events or stroke, and a slight reduction in coronary heart disease deaths and events.
- You eat little oily fish and want the marine fats directly.
- Your doctor mentioned EPA, DHA, or your omega-3 index specifically. The analyses we cite list no EPA or DHA in sea buckthorn oil.
Choose sea buckthorn if
- Your labs show abnormal lipids and you want to raise sea buckthorn supplements with your doctor. The pooled trials found lower triglycerides, total cholesterol and LDL only in people with abnormal lipid metabolism or cardiovascular risks, and they name no oil.
- Dry eye is on your list and you accept that the file is one 100-person trial from one research group. Fish oil’s larger trial record is mixed too, so neither choice is settled. Skin hydration has two small trials, one without a placebo group. The studied products are in our oil guide.
- You want a plant-based oil. Sea buckthorn oil is plant-based, though algal oil, not sea buckthorn, is the plant-based route to DHA.
- Fish burps have ended your previous omega-3 attempts and you want an oil you will actually keep taking.
One caution: sea buckthorn berry oil at 5 grams a day reduced platelet aggregation in one small study, so the blood-thinner conversation is worth having before either oil if you take anticoagulants.
More matchups live on the comparisons hub, including sea buckthorn vs rosehip oil for the topical side of the family.
Frequently asked questions
Is sea buckthorn oil a good substitute for fish oil?
Not if your goal is EPA and DHA. The fatty-acid analyses we cite list no EPA or DHA in sea buckthorn berry or seed oil, and a 2005 review of human studies found that conversion of the plant omega-3 ALA to EPA is limited and further conversion to DHA very low. Both have been tested for triglycerides and for dry eye, each in its own trials, and we found no human trial that compared them.
Can you take sea buckthorn and fish oil together?
We found no study of the two oils taken together. One small study found sea buckthorn berry oil at 5 grams a day reduced platelet aggregation, so if you take a blood thinner or have surgery planned, tell your prescriber about both oils and everything else you take.
Which is better for cholesterol, fish oil or sea buckthorn?
We found no human trial that compared them, so neither can be called the winner. For triglycerides, a 2020 Cochrane review of 86 omega-3 trials found about 15% lower levels, and the American Heart Association calls prescription EPA, or EPA plus DHA, at 4 grams a day an effective and safe option. For sea buckthorn, the 2022 meta-analysis of 15 trials found lower triglycerides, total cholesterol and LDL, only in people with abnormal lipid metabolism, and names high heterogeneity as its limitation. Neither replaces statins or medical care, and a lab result that worries you is a doctor conversation first.
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