Are Omega-3s Important for Brain Healing?
There are three types of omega-3 fatty acids: ALA, DHA, and EPA.
ALA (alpha-linolenic acid), found in flax seeds, walnuts, and chia seeds, cannot be synthesized in the body and therefore must be consumed in the diet. DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) are almost exclusively found in fish.
DHA and EPA have been shown to play a crucial role in brain development. They are involved in neurotransmitter synthesis and functioning. DHA is necessary for the functional maturation of the retina and visual cortex . Infants of mothers who supplemented with DHA had higher mental processing scores, hand-eye coordination, and psychomotor development .
Omega-3 supplementation has been shown to improve cognitive functioning in the mature brain as well. Studies have correlated accelerated cognitive decline and mild cognitive impairment with low tissue levels of DHA and EPA . Additionally, omega-3 consumption is associated with a decreased risk for dementia and Alzheimer’s disease .
To be completely transparent, there isn’t much research on the use of omega-3s to aid brain healing after a TBI or stroke. However, there is evidence testifying to the crucial role of omega-3s in brain development and linking DHA and EPA to improved cognitive performance. To me this evidence makes a strong case for the use of omega-3s in a brain recovery program.
Top 5 Reasons to use Omega-3’s for Brain Healing
DHA is proven essential to brain development
DHA is required for the development of the sensory, perceptual, cognitive, and motor neural systems during fetal and childhood brain growth. Specifically, DHA is vital for the neuronal formation of axons and dendritic extensions and for proper synaptic functioning. EPA’s importance for the brain’s development is unclear, but colostrum and breast milk do contain EPA. Omega-3 deficiencies during development have been linked to deficits in retinal structure, visual acuity development, and cognitive performance .
Has been shown to reduce aggression
I was pleasantly surprised by this benefit. The mechanism by which it works is unknown, but several double-blind studies have shown decreased physical aggression and impulsivity after omega-3 supplementation. DHA in particular has been shown to help prevent aggression resulting from mental stress .
Linked to improved cognitive performance
Researchers have concluded that DHA and EPA supplementation can improve higher brain functions – sense of wellbeing, reactivity, attention, cognitive performance, and mood. Additionally, omega-3s have been shown to decrease cognitive decline and lower dementia risk .
Beneficial for affective disorders
Affective disorders that respond to DHA/EPA include major depressive disorder, manic depression, schizophrenia, and borderline personality disorder. EPA seems to provide the most benefit when it comes to decreasing depression and managing mood .
EPA reverses cellular inflammation, including inflammation in the brain. The primary mediators of inflammation in the body are derived from arachidonic acid, an omega-6 fatty acid. When omega-3 consumption is increased, EPA blocks the production of these pro-inflammatory mediators .
What is the Best Source of Omega-3s?
For ALA (alpha-linolenic acid) I would suggest simply adding a daily tablespoon of ground flax seed to your diet.
DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) are almost exclusively found in fish. While DHA and EPA can be synthesized from ALA in the body, the conversion rate is very low – it’s thought to be around 1% of the total intake of ALA.
Seaweed and microalgae are the only plant sources of DHA and EPA. However, they are found in very low concentrations. While a healthy individual may get by on a plant based omega-3 supplement, it would be very difficult consume the high quantities recommended after a brain injury.
For high doses of EPA and DHA, go with a good quality, highly purified fish oil. For more information on choosing a good quality fish oil see: Choosing the Best Fish Oil Supplement for Brain Health.
But isn’t Fish Oil a Blood Thinner?
I think Dr. Lewis addresses this concern best,
“There is a theoretical risk that high dose omega‐3s may cause bleeding or stroke. Biochemical pathways tell us this is a valid concern. However, not a single study in the scientific literature has shown this to be of any clinical significance.” 
I personally believe that the benefits of fish oil outweigh the risks. I would however recommend that you discuss it with your doctor before using high doses of fish oil, especially if you are on a prescription blood thinner. Do your own research first so that you are prepared to discuss the pros and cons with them (even doctors don’t know everything).
How much Fish Oil should You Take?
Currently there is not a set recommendation for daily intake of DHA/EPA for brain function. For healthy individuals, I have seen recommendations ranging from 0.5 grams up to 5 grams. In individuals with brain injury, most of the existing literature suggests much higher doses are needed. Here is the information that I have found relating to dosage:
Week 1 – Take 3 g of EPA + DHA 3 times a day for a total of 9 g per day.
Week 2 – Take 3 g of EPA + DHA 2 times a day for a total of 6 g per day.
Maintenance dose – Take 3 g of EPA + DHA once a day.
Dr. Lewis suggests starting at an even higher dose and maintaining it for longer if the brain injury is severe. If you explore his website a bit, you will find that he has lots of good information regarding fish oil and brain injury. I particularly liked this article: High Dose Omega-3s in Severe Brain Injury.
Dr. Sears doesn’t lay out an exact protocol, but he does recommend using 10 – 15 grams of EPA + DHA per day.
How soon should You see Results?
While I have read testimonies of people seeing almost immediate results, this seems to be the exception not the rule. You should begin to see results within 2 months, but it could take up to 3 months.
It took around 3 months for us to really start seeing improvements with my dad.
Which Supplement should You use?
Since you will be taking high doses, it is vital that you take a high quality supplement.
I have found both Nordic Naturals* and NutriGold* to be very good brands. There are many other brands available though, just make sure the one you choose is third party tested. For more information on choosing a brand read: Choosing the Best Fish Oil Supplement for Brain Health.
* Links denoted with an * are affiliate links. I will receive a small commission (at no cost to you) if you purchase something through the one of these links. For my full disclosure click here. Thank you for your support!