Fish Oil for Concussions

Next Level Podcast with Host Tavis Piattoly, MS, RD, LD

Michael Lewis, MD
Graduate from the US Military Academy at West Point. Following five years in Infantry Divisions in Korea and California, Dr. Lewis graduated from Tulane University School of Medicine in New Orleans. His postgraduate training was completed at Walter Reed Army Medical Center, the Johns Hopkins University School of Public Health, and the Walter Reed Army Institute of Research and he is board-certified in General Preventive Medicine and Public Health.

While serving over 31 years in the Army, Dr. Lewis ran the primary care and flight medicine clinics at the Pentagon, developed the Emerging Infections Surveillance program at the joint US-Thai Army research lab in Bangkok, and served as the Director of the Epidemiology Division at the Uniformed Services University School of Medicine in Bethesda.

Most recently, he has several years of experience developing programs for the military on the use of omega-3 fatty acids such as fish oil for concussions, traumatic brain injury, and suicide prevention. Dr. Lewis has promoted the benefits of fish oil on brain health and pioneered the clinical use of omega-3 fatty acids for the prevention, acute treatment, and rehabilitation of brain injuries from physical and psychological trauma such as traumatic brain injury and concussions, stroke, PTSD, and other conditions. His insights and pioneering work have impacted thousands of lives and he is passionate about continuing to find improved solutions to the age old problem of brain injury.

Dr. Lewis is the President of the Brain Health Education and Research Institute.

In this podcast you will learn:

1. Michael's interest for studying head injuries and concussions.
2. How serious are concussions and should parents take precaution in letting their children play contact sports at such a young age.
3. Common treatment strategies for a head injury.
4. When Michael discovered that Fish Oil may be a potential treatment strategy for TBI/Concussions.
5. How Fish Oil is beneficial for treating a head injury.
6. Michael's current Fish Oil protocol for Concussions.
7. Current science regarding Fish Oil and TBI/Concussion.
8. Current plans to study Fish Oil therapy in current or former players with concussions.
9. Different forms of Fish Oil such and whether one form is better than another.
10. Any other benefits for using Fish Oil for brain health.
11. Should Fish Oil be part of the current treatment protocol when an athlete suffers a concussion.
12. Other nutrients that may have a benefit in treating a concussion.

Links and Resources:

Podcast Transcript

0:00 Welcome to next level podcast and introduction to Michael Lewis, MD, the president of Brain Health Education and Research Institute

3:10 When did you develop an interest in studying head injuries and concussions?

Michael was stationed at Walter Reed Military Medical Center and wanted to do something else to help.
There was an accident in January of 2006 with one survivor. The patient was treated for carbon monoxide poisoning but was still in a coma. After exhausting all options, he was treated with high levels of fish oils and long story short ended up walking out of the hospital just fine. This is what launched Michael’s interest into treating TBIs in our soldiers with fish oil.

5:28 How serious are concussions and should parents take precaution in letting their children play contact sports at such a young age?

In Michael’s personal opinion, children should not be doing contact helmeted sports like tackle football until at least 12 years old. This is his own personal opinion and not backed by science.
There are risks in all team sports, these risks just need to be mitigated.

7:19 What are common treatment strategies for concussions and head injuries?

CDC.gov/concussion this is the latest and greatest in concussion treatment
Take the kid out of the game - this is vitally important because once one injury occurs it is much more likely for a subsequent injury to be very bad. After this, they need to be completely free of any symptoms before returning to play. This is a call that only a qualified medical professional should make.

10:07 How is Fish Oil beneficial for treating a head injury?

The brain is made of fat, one of the most important is omega-3 fatty acids (DHA). This is about 30% of the brain.
There are two main omega-3s that we bring into the conversation (EPA and DHA). DHA is what is found in the brain as part of the cell membrane structure. EPA does not cross over into the brain and is much more known as the “heart healy omega-3”
EPA is a very strong antioxidant that can also help relax blood vessels which increases blood flow to the brain
DHA has also been found to be neuroprotective by helping protect the brain and brain cells from dying and help resolve the inflammation that may have occurred after an injury.

13:23 What is your current Fish Oil protocol for Concussions?

We don’t usually have a deficiency of omega-3s, but rather a surplus of omega-6s, which are very inflammatory.
We need to use higher doses of omega-3s to overcome the disproportionate ratio of omega-6s we are getting in our diet in comparison to the amount of omega-3s in order to make a significant difference in inflammation.

15:28 What is the current science regarding Fish Oil and TBI/Concussion?

The lack of literature (good randomized clinical trials) looking at fish oil in TBI treatment is very minimal.
Omega-3s are one of the most studied compounds in the literature and we know it is incredibly safe, but we just don’t have those randomized trials for traumatic brain injuries yet.

16:51 Do you have any plans to study Fish Oil therapy in current or former players with concussions?

Michael did a pilot study using 7 military veterans who were suffering from post-concussion symptoms for >6 months post-injury and found that using a high dose regimen (about 15 g of fish oil per day) yielded promising and exciting results.
Michael is also working with some well known football players to look at 100 current NFL players (50 will get omega-3s and 50 players will get a placebo) to see if these high dose fish oils are effective or not.

18:55 What are the different forms of Fish Oil and is one form better than the other?

Michael always recommends triglyceride forms for the brain
In order to clean the omega-3s, the triglyceride form is broken up and esterified (to remove heavy metals). What is left is ethyl ester, and our bodies are not great at absorbing this form compared to phospholipid and triglyceride forms.
Phospholipid form is well absorbed and tends to come from Krill, but these doses are very low (50 to 60 mg) and are likely not effective due to the fact that the body needs upwards of 1,000s of mgs.
The majority of fish oils on the shelves in stores are ethyl esters. This is the quickest, easiest, and cheapest thing and allows manufacturers to make more money.

23:17 Are there any other benefits for using Fish Oil for brain health?

Omega3-s and fish oils have been incredibly well studied. There is really good evidence for supporting heart health. Fish oil has a blood thinning effect similar to that of aspirin.
Omega3-s have also been shown to benefit symptoms of depression, anxiety, and even ADHD in children.

25:40 Should Fish Oil be part of the current treatment protocol when an athlete suffers a concussion?

Yes, not only in the treatment, but what happens when we increase the amount of fish oil prior to injury? Will it increase the resilience of the brain to withstand trauma and not have an injury in the first place?

27:51 Are there other nutrients that may have a benefit in treating a concussion?