Many people with ADHD take omega 3 fatty acids or
"omega 3's" for their symptoms, but a quick tour down the grocery
aisle (or the internet) reveals a dizzying number of options all touting a
number of characteristics which you probably have never considered. Isn't
fish oil, well... fish oil? This article will help you understand the
characteristics which are important in selecting an omega 3 supplement to fit
your needs, as well as the basics of dosage and side effects.
Is the source of the omega 3 fatty acids important? The major omega 3 fatty acids used by the brain
are DHA and EPA. The body can also make DHA and EPA from ALA (made by plants), but you must consume
a much higher amount of ALA
Most omega 3’s are regulated as supplements and do not receive the
same scrutiny for effectiveness that drugs do from the FDA. There are some prescription omega 3 fatty
acids that have been available as drugs but not for ADHD. There is also a prescription medical food for
ADHD containing omega 3 fatty acids which does not receive the same level of
regulation as a drug would.
Why are mercury, PCBs, and dioxin critical?
Fatty fish accumulate toxins such as mercury, PCBs, and dioxins in
their oil/fat. Mercury poisons the nervous system. PCBs and dioxins
have been implicated in possibly causing diabetes, thyroid disorders, and
cancer. People taking fish oil should check the label to make sure their
supplement is certified free of mercury, PCBs and dioxins because larger doses
of fish oil over longer periods of time are needed to treat ADHD than other
common disorders.
Is EPA or DHA more important? The bottom line is that no one knows
for sure right now. Different studies give conflicting answers and high quality
studies haven’t been designed to answer this question.
Is omega 6 necessary? Experts are divided because small trials of omega 3s
combined with omega 6s have shown effectiveness in treating ADHD symptoms,
which is not what one would expect since omega 6's opposite effects to omega
3's studies done investigating heart health.
What doses should be used? Experts generally
recommend a target dose of 300-600mg omega 3/30-60mg omega 6 daily for children,
and 1-3 g of DHA for adults. Most authorities recommend
starting at a lower dose and increasing gradually to the target dose in order
to avoid upset stomach and diarrhea. The
dose is high compared to the dose sizes available. Be sure to take the number and size of pills
into account when you purchase a fish oil supplement.
When will I see an effect? Most clinical trials that have
demonstrated an effect have run for 8-12 weeks or longer. Experts
recommend at least a 2 to 3 month trial at an adequate dose. If you
haven’t seen an effect at that time and your diet isn’t deficient in omega 3
fatty acids, you can stop the supplement.
What are the side effects of omega 3 fatty acid supplements? The vast majority of patients notice nothing. The most common side effects,
especially at higher doses, include a fishy aftertaste/burps and
diarrhea/stomach upset. Less common side effects include raising LDL (aka
"bad") cholesterol (though without an increase in heart attacks), and
prolonged bleeding. The largest problem
is that fish oil can taste fishy, a flavor not all patients find appetizing.
Are there any other things I should be aware of? Some supplements may contain “inactive”
ingredients which may worsen symptoms of ADHD. For example, some may
contain gluten, artificial flavoring, or glucose (sugar). Check the label
to be sure.
Gummies and soft gels can become stuck together in summer heat,
leaving you with a blob of pills that have to picked apart. If you are ordering online, this can be a
particular issue and it is best to order a good supply before summer gets too
warm, in order to avoid this inconvenience.
Why can’t I just eat more
fish? Some recent studies conclude that only people deficient in
omega 3 fatty acids benefit from supplementation. This may mean that getting omega 3’s from
your diet may be equally beneficial, however it does mean that you eat a lot of
fish. It would probably be best to
supplement if your diet contains less fish than 2 servings a week.
References:
Bloch, M. H., and A. Qawasmi. "Omega-3 Fatty Acid
Supplementation for the Treatment of Children with
Attention-deficit/hyperactivity Disorder Symptomatology: Systematic Review and
Meta-analysis." Journal of the American Academy
Cooper, R. E., C. Tye, J. Kuntsi, E. Vassos, and P.
Asherson. "Omega-3 Polyunsaturated Fatty Acid Supplementation and
Cognition: A Systematic Review and Meta-analysis." Journal of Psychopharmacology29.7
(2015): 753-63. Web.
Millichap, J. G., and Michelle M. Yee. "The
Diet Factor in Attention-Deficit/Hyperactivity Disorder." Pediatrics 129.2
(2012): 330-37. Print.
Sinn, Natalie, Catherine Milte, and Peter R. C.
Howe. "Oiling the Brain: A Review of Randomized Controlled Trials of
Omega-3 Fatty Acids in Psychopathology across the Lifespan." Nutrients 2.2
(2010): 128-70. Print.
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