Tier B

Cod Liver Oil (Vitamin A · D · EPA · DHA combined)

Also known as: Cod-liver oil · Hippoglossus or Gadus liver oil · CLO

1 PMID anchor · CARDIO · BONE · VISION · REPRODUCTIVE · Last reviewed 2026-06-04

Mechanism of action

  • Combined delivery of EPA/DHA (omega-3 pathway) with preformed vitamin A (retinol) and vitamin D3 (cholecalciferol)
  • Phospholipid-supported absorption from native triglyceride form
  • Maternal-to-infant DHA transfer during pregnancy and lactation (Helland 2003)

Molecular + tissue targets

  • Cardiovascular EPA+DHA pool
  • Vitamin A retinoid status
  • Vitamin D3 25(OH)D status
  • Maternal DHA reserves and infant cognitive development

Dosage range

10 mL/day cod liver oil during pregnancy from 18 weeks through 3 months postpartum (Helland 2003 PMID 12509593 Pediatrics double-blind RCT n=84 children at age 4 · cod-liver-oil group MPC 106.4 vs corn-oil 102.3 · maternal DHA supplementation associated with higher cognitive performance in offspring); modern commercial doses typically 5-10 mL providing ~1,000-2,500 mg EPA+DHA combined plus ~ 800-1,200 IU vitamin D and ~ 2,500-4,500 IU vitamin A

Safety notes

WATCHPOINT: excess preformed vitamin A (retinol) intake in pregnancy can be teratogenic (>10,000 IU/day cumulative) · check the per-serving retinol content before stacking with multivitamins or other vitamin-A sources; vitamin D3 contribution should be counted toward the daily 25(OH)D target; standard fish-allergen disclosure

Cross-market regulatory status

🇺🇸 FDA

GRAS · DSHEA dietary supplement · qualified health claims under the omega-3 framework (EPA+DHA + CHD risk · 2003Q-0401; EPA+DHA + blood pressure · 2014Q-0337); vitamin A and D structure/function claims permitted within DVs

🇪🇺 EFSA

Authorized claims Reg 432/2012 EPA+DHA cardiovascular, vitamin D calcium-phosphorus, vitamin A vision and immune function — applicable when the source thresholds are met per serving

🇧🇷 ANVISA

RDC 243/2018 dietary supplement · IN 28/2018 Anexo V alegação funcional verbatim: "Os ácidos graxos ômega 3 EPA e DHA auxiliam na redução dos triglicerídeos." (≥ 1.500 mg EPA+DHA/dia)

Authorized claims · verbatim (4)

Direct quotes from each jurisdiction's framework · never paraphrased · with framework reference and conditions of use.

🇪🇺 EFSA · 3 claims

Reg 432/2012

EPA and DHA contribute to the normal function of the heart.

Conditions: Reg 1924/2006 art 10(2): claim may be used only for food which provides a daily intake of at least 250 mg of EPA and DHA; consumer informed that the beneficial effect is obtained with a daily intake of 250 mg of EPA and DHA

Authorized 2012

Reg 432/2012

Vitamin D contributes to normal absorption and utilisation of calcium and phosphorus.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin D"

Authorized 2012

Reg 432/2012

Vitamin A contributes to the maintenance of normal vision.

Conditions: Reg 1924/2006 art 10(2) + Annex: claim may only be used for food which is at least a "source of vitamin A"

Authorized 2012

🇧🇷 ANVISA · 1 claim

IN 28/2018 Anexo V alegação funcional

Os ácidos graxos ômega 3 EPA e DHA auxiliam na redução dos triglicerídeos.

Conditions: IN 28/2018 Anexo V: alegação restrita a suplementos que forneçam ao menos 1.500 mg de EPA + DHA por dia

Authorized 2018

Common use cases

  • cardiovascular EPA+DHA threshold with vitamin A+D co-intake (Northern-latitude winter context)
  • maternal supplementation when fish intake is low
  • traditional dietary insurance pattern in cold-climate populations
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