Concussion and TBI post 6 – Fish oil and Omega Fatty Acids
Nutrition has traditionally involved in supplying energy and hydration. In emerging concept of using omega-3 fatty acids to increase the resilience of the brain is appearing in many studies. Type of omega-3 fatty acid, docosahexanoic acid (DHA) is found in high concentrations in the brain. Omega-3 fatty acids exerted protective effect at the cellular and neuronal levels including the modulation of the inflammatory cascade following a traumatic brain injury.


Omega-3 fats, a natural anti-inflammatory,
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helps fight inflammation throughout your body, also helps quell inflammation in your brain. After a traumatic injury, the brain inflammation that occurs can continue for long periods of time. This is why using things like curcumin, glutathione, and omega-3 containing fish oils are so important in the face of a head injury.

Fish oil would definitely be indicated in just about any TBI, but you don’t want to take it in the absence of antioxidants. If at all possible, purchase fish oil products certified as free of significant levels of mercury, toxins, and PCBs. There are some great reviews on the website Fish oil in general is safe. The most common problem is the fishy burps. However, there are some safety concerns to consider as fish oil is thought to have a mild blood thinning effect. Although some products claim to be pharmaceutical grade this term means nothing, as the FDA has not defined what constitutes a pharmaceutical grade fish oil product.

The most important omega-3 fatty acids found in fish oil are called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). There are several studies that show taking omega 3 fatty acids in the form of EPA and DHA might prevent some of the long term cognitive decline that occurs with brain injuries. EPA and DHA are usually found in fish oil, but fish oil tends to be easily oxidized. Some manufacturers add vitamin E to fish oil capsules to keep the oil from becoming rancid. Another method is to remove all the oxygen from the capsule. Make sure that you buy the EPA and DHA that are packaged along with some things that can control oxidation of fish oil. Vitamin E and mixed tocopherols can limit the oxidation of fish oil, so look for EPA and DHA preserved in these types of oils. You can also take cod liver oil as a source of fish oil, and it works fine. Keeping your fish oil in the refrigerator might be a good idea as well to slow the oxidation.
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Krill oil is known to be a superior source of EPA and DHA because the polyunsaturated fats are packaged as phospholipids. Krill oil is also more stable because it includes astaxanthin, a powerful antioxidant, that protects the fragile fats from oxidizing. Animal-based omega-3’s from krill and fish oils are both better sources than vegetable-based omega-3’s, such as the Alpha-linolenic Acid (ALA) in flax oil. Only about 1-4% of ALA is converted into DHA, so getting those higher potency sources from krill and fish is more efficient. Vegetable-based sources, such as flax seed oil also contain oxidized inflammatory omega-6 fatty acids, which may cause the inflammation to move in the wrong direction.

The standard Western diet has a very high omega six to omega-3 ratio, and this is associated with many inflammatory conditions which is not optimal during a brain injury. By supplementing with fish oil, the omega six to omega-3 ratio is reduced, and this helps to reduce the inflammation. Realize that the benefits of fish oil may come in part through balancing the body’s ratio of omega-3 to omega six fatty acids, not so much eating as many omega-3 fatty acids as possible and decreasing omega six fatty acids. The easy way for you to remember the fishes with the highest omega-3 fatty acid content is from the acronym SMASH. S Is for Sockeye Salmon, M Is for Mackerel, a Is for Anchovies, S Is for Sardines, and H Is for Herring. Also don’t forget about trout and oysters as they contain very high amounts of Omega three fatty acids as well.

Should you take a regular dose of fish oil or a high dose? It is hard to know, but several scattered reports suggesting a high dose of fish oil is more beneficial. A 2011 study on head injury by the US military used 3 grams daily. I have seen doses much higher doses than this used without any problems. That being said, it would probably make sense to check your omega fatty acid levels through a blood test.

Finally, realize that there are no completed human-based studies specifically examining fish oil supplements in the treatment or prevention of concussions. There are so many other factors for us to consider. But it is important to realize, that there is little downside to taking fish oil supplements in the face of a brain injury and much to gain.