Fish Oil for Brain Injury?*

April 27, 2014 · 8 mins read

We receive a lot of inquiries about how to use Omega-3 for brain injury recovery. I need to be upfront about a few things:

We don't know with certainty whether fish oil can heal brain injuries. But we know that fish oil should be part of the nutritional foundation for improving recovery.
Don't do this on your own. Work with your doctor. This is outside the scope of most people's self-care skills.
If you think you or someone you know has suffered from brain injury, get medical help immediately.
And finally, the FDA wants you to know that dietary supplements cannot treat concussions.

A very short history of use

Omega-3's potential for helping with brain injury was first investigated in the Sago mine collapse in 2006. Randy McCloy was the only survivor of the collapse. When the rescuers found him in the rubble, he had brain, heart, liver and kidney failure. He was barely clinging to life. After he was transported to West Virginia School of Medicine, the hospital neurosurgeons tube-feed him very large doses of fish oil.   Randy has since made a remarkable recovery. “I certainly think it played a big role,” said Dr. Julian Bailes, then Chair of the Department of Neurosurgery. “How can he rebuild his brain, if he doesn’t have the substrate to do it?” Dr. Barry Sears of 'Zone Diet' fame was a consultant for Randy's treatment and has been at the forefront of this new therapy.

Omega-3 and the brain

The brain, after all, is 60% fat and a big chunk of it is Omega-3.*

The cell walls of neurons are largely Omega-3*
Omega-3s keep brain cells alive (neuro-protection)*
Omega-3s reduce swelling in the brain*
Omega-3s promote synaptogenesis - growth and branching of brain cells*

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

In the news again...

Fish oil and brain injury was, once again, in the news: teenager Grant Virgin was struck by a hit-and-run driver and taken to a trauma center. Doctors were preparing family members for the worst. (Because modern medicine does not have a treatment for brain trauma.) Grant's family contacted Dr. Barry Sears. When the boy's doctors dismissed fish oil as untested and unproven, the family began sneaking a few grams of fish oil into his feeding tube. Two months later, when he was moved from ICU to a rehabilitation center, his parents told the doctors at the new facility that their son was receiving 20 grams (20,000 mg) of fish oil per day, a far bigger amount than what they had been sneaking into the feeding tube. (This is merely a report of an unrecognized protocol that some doctors use to treat traumatic brain injury. OmegaVia is not intended to treat traumatic brain injury or any other disease. You should not follow this protocol unless instructed to do so by a medical practitioner. We do not recommend this dose using OmegaVia or any Omega-3 product on your own.) Forty eight hours after the near-comatose boy had begun taking the mega dose, he asked a nurse for a cell phone to call his mom. He's since made an impressive recovery. Watch a video about this here. Part 2. For another similar story about a teenager and fish oil, read Bobby Ghassemi's story here.

Many questions with few answers

Did the fish oil have anything to do with the recovery?
Can Omega-3 help older injury victims?
Are there risks that we're unaware of?
Would Grant Virgin have recovered sooner if he'd been given the 20 gram dose immediately after injury?
Is there a therapeutic window that closes after a period of time?

We don't know all the answers. What we do know is:

DHA is a building block of your brain. If your brain is built with DHA, it simply makes sense that you will need a lot of it to repair damaged brains.*
Injury causes swelling. Sadly, the skull prevents swelling and this in itself can be extremely dangerous. It is not uncommon for army physicians treating soldiers with brain trauma to remove portions of the skull to allow the brain to swell.

EPA and DHA may help support healthy inflammation response.* *Individual results may vary. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. It's this secondary effect that Omega-3 may help with. Dr. Michael Lewis, whom I met briefly earlier this year, is a retired army colonel. He directs the non-profit Brain Health Education and Research Institute in Potomac, Maryland. He, along with Drs Barry Sears, Joe Hibbeln and Julian Bales are the handful of leading authorities in this field. "If you have a brick wall and it gets damaged, wouldn't you want to use bricks to repair that wall?" asks Dr. Lewis describing his simple approach. He receives so many requests for help from families of brain injury victims that he has set up a website with a clear protocol for nourishing the the brain with Omega-3 after brain injuries*. Dr. Sears has done something similar. I suggest you read both because Dr. Sears offers more detailed product selection insight.

Dr. Sears' approach:

Choose high purity fish oil with less than 5 ppb PCBs. The industry maximum of 90 parts per billion is like setting the limbo pole 10 feet off the ground. How do you tell if your fish oil has less than 5 ppb of PCB? Go to IFOS Consumer Reports. There are several very good brands you can choose from.
The fish oil must contain both EPA and DHA. A minimum of 60% total Omega-3 is a must.
Use 10,000 to 15,000 mg of total EPA + DHA per day to 'put out the fire in the brain before you can rebuild it.' (Note that this level exceeds the upper limit of most government health bodies. This is a decision that your doctor needs to make.)
Prefers 2:1 ratio of EPA to DHA.
Track your AA/EPA ratio with a simple finger-stick blood test.

Dr. Lewis' approach:

Begin with molecular distilled, concentrated fish oil supplement. May be capsules or liquid.
Begin taking Omega-3 as soon as possible after the injury.
Take 3000 mg of EPA + DHA three times a day for 7 days. (Note that this level exceeds the upper limit of most government health bodies. This is a decision that your doctor needs to make.)
Reduce dosage to 3000 mg EPA + DHA twice a day for week 2.
Continue a lower dose maintenance dose.

See Dr. Michael Lewis' detailed protocol here. Note that none of these methods have been approved by the FDA. The US FDA considers Omega-3 to be GRAS (Generally Recognized as Safe) and considers doses up to 3 grams of EPA + DHA to be without adverse events. EU's upper limit is 5 grams per day. When using higher amounts of EPA and DHA, it is important that you do so only under the supervision of your doctor.

Case studies: how much Omega-3 did they use?

Patient Bobby Ghassemi was given a higher dose than described above - almost 20,000 mg of EPA + DHA per day. And he stayed at that dose for a year without any documented side effects. Grant Virgin was eventually moved to 20,000 mg per day of fish oil per day, a lower Omega-3 dose than what Bobby was given. The risks associated with such mega doses of Omega-3 have not been studied. There may be increase risk of bleeding, but this risk has been shown to be unfounded when used at levels suggested by FDA and EU.

Then what?

Dr. Lewis: 'Every individual is different. Patients typically notice results within the first week, often in the first several days.' Dr. Sears: 'Each case is different. Based on my experience if you are using the correct amount of omega-3 fatty acids, you should see the beginnings of a response within 60 days. In Grant’s case, it was two days.'

Which fish oil should you use?

Well, if you are going to add Omega-3 to a feeding tube, then buy liquid fish oil. Do not buy capsules and squeeze the oil out. Try liquid fish oils from Nordic Naturals, Dr. Sears' Zone, Barleans or Carlsons. Most liquid fish oils have more EPA than DHA - this is fine. But if you are looking for equal parts EPA and DHA, look into Salmon oil. VitalChoice has a good liquid salmon oil. If the person can swallow capsules, your options are wide open. Reduce the number of pills by buying products with at least 1000 mg of Omega-3 per pill. This allows you to take just 3 pills three times a day if you're following Dr. Lewis' approach or 4-5 pills three times a day with the Sears approach. Check IFOS Consumer Reports for brands. Do not use DHA-only or EPA-only formulas. You need both fatty acids. There is a liquid fish oil-based product called Oxepa that some hospitals have access to. This product contains very little Omega-3.

What else can you do?

Most experts agree that you should reduce your Omega-6 load. But this can't be done quickly. How much Omega-3 you need depends on how much Omega-6 and its byproducts you have in your body. This is why the Sears approach relies heavily on Arachidonic Acid (AA) to EPA ratio - AA is a byproduct of Omega-6. The average AA/EPA ratio for Americans is about 20. It needs to be close to 5. It's too late to worry about Omega-6 after a brain injury, so the higher this ratio the more fish oil you will need to reduce inflammation.

How to reduce Omega-6 levels:

Eliminate all processed foods
Eliminate all fast foods (they're cooked in high Omega-6 soybean oil)
Eliminate foods cooked outside the home (see above)
Change your cooking oil to coconut oil or butter
Eliminate all sources of vegetable seed oils
Reduce seeds and poultry consumption.

A modified Paleo diet with lots of fresh vegetables, wild seafood, grass-fed meats and fruits is very good for reducing your AA/EPA ratio to healthy levels. "There are no magic pills; there are no magic cures for TBI (Traumatic Brain Injury)," states Dr. Lewis. "There will never be a cure for TBI." However, providing your brain with all the nutrients it needs to heal itself may give you better odds at regaining your old life.

What about you?

Do you know anyone who's suffered from brain injury or trauma? What was their medical experience? Did their doctor suggest more Omega-3?

Additional reading:

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