Omega-3 in the Treatment of Brain Concussions [ISSFAL 2012]
Lewis, D.M., Brain Health Education and Research Foundation, Arlington, Virginia, USA
(The present report is filed on-site by the DHA/EPA Omega-3 Institute from the 10th Congress of the International Society for the Study of Fatty Acids and Lipids held in Vancouver, BC)
Various experimental studies in cellular systems and in animal models have indicated that the long-chain omega-3 fatty acids as DHA/EPA have considerable anti-inflammatory potential. These previous studies also indicate that the high concentration of DHA omega-3 fatty acid in the brain can provide a favourable attenuation of the so-called ‘inflammatory cascade’ following brain injury. At the ISSFAL conference, Dr. Lewis (MD,MPH,FACPM) presented the clinical outcomes in a series of two dozen patients who were managed following brain injury including two stroke patients and one severe patient with severe TBI (traumatic brain injury) from a motor vehicle accident. With the exception of the latter patient, all cases (mostly with mild TBI) reported elimination of post-concussive symptoms within 48 hours after the consumption of high doses of DHA/EPA from fish oil. The one patient with severe TBI responded over a period of several months by recovering most daily functionality. The author stated in his presented material that ‘while not a drug or cure for brain injury, n-3 fatty acid(s) are a powerful tool that can be used to assist the brain to heal itself following injury’. He added that ‘given the safety profile, availability, and affordability, omega-3s should be considered for use after concussions, head trauma, and other neurologic injuries as soon as possible after injury. Finally, the following ‘omega-3 protocol for head injury’ was suggested : begin by taking 3000 mg of (DHA plus EPA) at a time three times a day (total of 9000 mg/day) for one week followed by 3000 mg taken twice daily (total of 6000 mg/day) on the second week followed by 3000 mg per day as an ongoing maintenance dose and for prevention of head injury.
Dr. Holub's Comments:
On behalf of the DHA/EPA Omega-3 Institute , Dr. Holub interviewed Dr. Lewis at the meeting site who provided the following quotation: “It's reasonable to maintain athletes involved in contact sports on a moderate omega-3 dosage as a protective strategy during the playing season. There are some preliminary studies that clearly demonstrate that omega-3s can increase the resilience of the brain to withstand some injury and have favorable effects for improving the outcome if an injury were to occur. If a head injury does occur, our clinical experience suggests to immediately put the athlete on a much higher dosage for a week and gradually work back down to the maintenance dose as they become asymptomatic under the supervision, of course, of a healthcare provider experienced and qualified to treat concussions. Moreover, it might be a prudent strategy to have athletes such as hockey and football players who receive repetitive hits to the head take high-dose DHA plus EPA omega-3 for approximately one-month at the end of each playing season. This may decrease the amount of long term, terrible effects we're now seeing in these athletes long after they've retired from the sport."
Dr. Holub notes that the U.S. Food and Drug Administration recommends that the summed intake of (EPA plus DHA) not exceed 3000 mg/day while the American Heart Association advises that up to 4000 mg/day can be used via supplementation for lowering blood triglyceride levels. To date, only a few clinical trials have been conducted using doses above these latter levels such as in the recent and most interesting findings as reported at the ISSFAL conference in Vancouver by Dr. Lewis.