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Head-to-head evidence comparison — which supplement is right for you?
Omega-3 vs VSL#3 / Visbiome: Omega-3 has the stronger overall evidence (9 vs 6.5/10); they're alternatives for inflammation-related symptoms — the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
Omega-3 wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Probably helps
10 of 15 studies with measurable effects showed benefit.
Top outcomes
Verdict
Too few graded studies
Top outcomes
2-3g combined EPA+DHA daily (a typical label dose, not the dose used in the cited trials, which gave 1 g or 3.25 g of omega-3 a day, or 1 to 4 g of fish oil a day without stating its EPA+DHA content)
With meals containing fat
Triglyceride form fish oil
Prevention and maintenance are DIFFERENT doses and are often conflated. Preventing the first onset of acute pouchitis used 900 billion CFU/day (1 sachet). Maintaining remission in established chronic or refractory pouchitis — where the effect size is largest — used 6 g/day, which at 5 x 10^11 viable bacteria per gram is about 3 trillion CFU/day, in both maintenance trials. As a ulcerative colitis add-on, 3.6 trillion CFU daily; the active-UC induction trial went highest at 3.6 trillion CFU TWICE daily (7.2 trillion/day), and the paediatric trial lowest at 450 billion/day weight-based
Any time of day
Refrigerated sachet of the De Simone Formulation
4-8 weeks
2-4 weeks
Immediate
4-12 weeks
9-12 months
12 months
8-12 weeks
n/a
Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer
The New England journal of medicine (2019) · Rct · n=25871
During a median follow-up of 5.3 years, a major cardiovascular event occurred in 386 participants in the n-3 group and in 419 in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.80 to 1.06; P=0.24).
Omega-3 fatty acids for intermittent claudication
The Cochrane database of systematic reviews (2024) · Meta analysis · n=1830
Omega-3 compared with a control may have little to no effect on ankle-brachial index (MD -0.02, 95% CI -0.08 to 0.04; 3 studies, 168 participants; very low-certainty evidence).
A systematic review and meta-analysis of the omega-3 fatty acids effects on brain-derived neurotrophic factor (BDNF)
Nutritional neuroscience (2024) · Meta analysis · n=587
12 RCTs with 587 subjects: omega-3 supplementation increased serum BDNF versus placebo (SMD 0.72, 95% CI 0.28 to 1.15), with high heterogeneity (I2 = 84.39%).
Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Cochrane Database Syst Rev (2019) · Meta analysis
Chronic pouchitis maintenance: 85% (34/40) maintained remission at 9-12 months vs 3% (1/36) placebo — RR 20.24 (95% CI 4.28-95.81), low certainty
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial.
Gastroenterology (2000) · Rct · n=40
Relapse in 3/20 (15%) on the probiotic vs 20/20 (100%) on placebo, P<0.001
Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis.
Gut (2004) · Rct · n=36
Remission maintained at 1 year in 17/20 (85%) vs 1/16 (6%) placebo, p<0.0001
The points are the dose bands of a meta-analysis of 10 randomised trials with 1,426 adults (PMID 37028202): EPA-rich products at 1 to under 2 g of EPA a day reduced depression severity (SMD -0.43), while 2 g a day or more did not (SMD -0.20, not significant), so the 2 g point is plotted as no effect. Doses are grams of EPA, not EPA plus DHA. The Cochrane review of 33 placebo-controlled trials found a small to modest effect, unlikely to be clinically meaningful and rated very low certainty, with no difference in remission or response (PMID 34817851). No trial compared doses directly.
AI-estimated from published studies. Interpret as directional guidance.
Omega-3 has a higher evidence score (9/10 vs 6.5/10) and wins in 2 of 3 categories.
For inflammation-related symptoms, Omega-3 has a higher relevance score (85 vs 70).
No known interactions between Omega-3 and VSL#3 / Visbiome have been documented in our database. However, always consult a healthcare provider before combining supplements.
The honest tier list — proven staples vs situational vs mostly marketing. The hub the other guides feed into.
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Caffeine+L-theanine works; bacopa needs weeks; most "brain pills" are hype. The honest tier list.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.