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Is Your Brain Better with Fish Oil and Vitamin E on Board?

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Are you confused about supplements? Over the last few months we have been told by some researchers and medical thought leaders that vitamin E and fish oil were a waste of money and possibly even dangerous. Three weeks ago, however, we were informed that 2000 IU of vitamin E (alpha tocopherol) could slow the decline of mild to moderate Alzheimer's disease (JAMA, Jan 1, 2014).

This week an article in the journal Neurology suggests that women with higher levels of omega-3 fats (the type of fat found in fish oil) in their red blood cells have less brain atrophy as they age. The lead author implies that this could lead to better brain function and less dementia.

Most nutrition experts usually say that we should get our nutrients from food rather than pills. That's certainly been the case with the new fish oil study. We're told to eat fatty fish such as salmon, tuna, trout, sardines and herring. But the study in Neurology looked at levels of omega-3 fatty acids inside red blood cells. The scientists didn't distinguish between those omega-3s that came from fish or omega-3s from supplements.

What they discovered was that the participants in the Women's Health Initiative Memory Study who had the highest levels of omega-3 fats had larger brain volumes than those with the lowest levels of omega-3 fats. In particular, the part of the brain most intimately tied to memory (the hippocampus) was measurably larger on MRI (magnetic resonance imaging). The lead author noted that you would have to eat fatty fish at least twice a week or take a fish oil supplement at least five times a week to get comparable levels of omega-3 fatty acids circulating throughout the body.

This was a long-term study with eight years of follow up. In general, larger brain volume is better than smaller brain volume. As the brain atrophies or shrinks, cognitive function tends to decline.

This study of fish oil comes on the heels of a January 1, 2014 study published in The Journal of The American Medical Association showing that vitamin E (2000 IU) was beneficial in slowing the decline of mild to moderate Alzheimer's disease. In fact, one of the more commonly prescribed drugs, Namenda (memantine) was ineffective in this double-blind, placebo-controlled trial.

BOTTOM LINE:

We are the first to encourage people to get their nutrients from food. Whenever possible, shop locally at a farmer's market. But not everyone can afford two fatty fish meals a week. And some people hate the taste of fish or are vegetarians. The only way for them to get levels of omega-3 fatty acids comparable to those in the study would be to take supplements. And no matter how many green leafy vegetables you eat, there is no way to get close to the 2000 IU of vitamin E that was given out in the study without taking a supplement.

From our vantage point, there is growing evidence to suggest that both omega-3 fatty acids and vitamin E are important nutrients for optimal brain health. Regular exercise is also extremely important, since previous research shows it can help delay cognitive decline.

What are your thoughts? Share your comments below.

 

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Thanks for the very interesting article. I diligently take fish oil every day, but want to become a lacto-ovo vegetarian, for health and ethical reasons.
Since fish are animals, I should stop taking fish oil.

I find there is a new vegetarian omega-3 oil called Ovega-3. The label says that each 500 mg of this oil contains 320mg of DHA and 130 mg of EPA. The principal ingredient is algal oil. I understand that flaxseed oil is a substitute, but not a very good one, for fish oil. Hopefully, Ovega-3 is a better substitute for fish oil. Does anyone have any knowledge about vegetarian substitutes for fish oil?

WHICH OMEGA 3 SUPPLEMENT IS BETTER? I read that there is regular and another type made with small shrimp called 'krill" or something like that. ?? So any one knows which is better?

I understand that krill oil is even more effective than fish oil, is that true? I have taken fish oil for years; I just switched to krill oil.

So 2,000 IU vitamin E, but how much fish oil??
I'm still confused.

So...is canned tuna an acceptable source of the omega 3 fats? It's the only fish I eat and then there's all this talk about mercury in it!

My ophthalmologist wants all of his older patients to take Omega 3. I'm older and I take it!

I take Vitamin E, and eat ground flaxseed. I do eat a little fish, but can't take fish oil capsules. I don't trust articles telling people not to supplement their diets. I suspect there is a conflict of interest. And healthy people mean lower profits for the medical establishment. I do the research, and take what I feel I need, and what my doctor suggests.

About 10 years ago I cleaned up my diet big time, and was eating so many fresh fruits and vegetables I figured I no longer needed the multi-vitamin and fish oil I had been taking. After about a year I was feeling great physically, but could not concentrate as well as I used to. I read the term "brain fog" and thought that was definitely what I had.

I started taking fish oil again, just a 1,000 mg capsule daily. Within about a month or so my mind felt noticeably more clear and agile. I'll never stop taking fish oil as long as I can get it.

I have taken vit e and fish oil supplement daily for years and (thera tears) to alleviate dry eyes. Successful, and really feel a difference when run out for a time. This winter in south. calif. extremely dry, and cannot go without above. Surely, hope above info is accurate as it would be a bonus of my consideralbly costly treatment for eyes, to know it hasn't hurt another part of body. Thank you for your column and information.

My friend with vit b12 defeciency is taking 1 injection a month, has a presumably permanent balance problem, and depression, but, cognitive ability has improved some, and now walks with cane. She saw 4 docs all of 2013 and no one dx'd the deficiency until she fell hit her head on tile floor and was in icu 3 days... astute neurologist ordered level and it was 126! I wrote about this dilemma in dec or nov 2013. just wanted to update you for the info. Many thanks again. Mary

I would like to hear more about this subject.

Preparing salmon patties is my favorite method of getting two weekly servings of salmon. From one $5 to $6 can of red salmon, I am able to prepare 5 patties thus five meals. What a deal!! Add sauteed onions and celery, spices, panko and wrap 4 in freezer paper for future meals then enjoy that 5th one that very day. Delicious!

Eat the damn foods, people! That's the natural container for those recommended supplements. God made fish, the Devil makes drug companies (I'm kidding, or am I?)

I'm a vegan and take fish oil and always will. That's why I read sites and sign up such as to this site. I spend hours reading health and nutritional article I search out well known MDs and compare notes. Thank you for the People's Pharmacy.

I have attention deficit disorder and my naturopath has had me on 4-5 capsules of ProDHA 1000 (180 EPA/900 DHA) per day.
She tells me that this combination is essential for brain and heart health. I have also noticed that when I don't take it for two weeks I begin to have joint problems. I do yoga twice a week, work out in the gym and walk regularly, so I know it isn't inactivity.

She has also told me that ProDHA (Nordic Naturals) is the brand that she knows is consistently tested for quality.

According to my understanding of veganism, you are not one if you take fish oil. This is why I asked for information about vegetarian sources of Omega-3. Fish are animals too, and if you are not going to eat animal products, you might now want to eat fish oil either.

I too, cannot take fish oil supplements. No matter how they make them, they cause digestive problems for me, including horrible belching. I try to get flaxseed in my diet but don't like the taste. Anyone know of a good flax supplement?

What about Ovega-3, made from algae?

This information is interesting, but I think there's more that needs to be considered before one begins taking vitamin E: According to the National Institutes of Health (http://ods.od.nih.gov/factsheets/VitaminE-QuickFacts/), the highest safe level of vitamin E for an adult is 1500IU/day of the natural form and 1100IU/day of the synthetic form, so the 2000IU/day dosage is a concern.

That agency also states that vitamin E can increase the risk of bleeding and strokes and that it may interact with blood thinners, cholesterol medication and some cancer treatments. It would be worth knowing if results similar to the ones in the JAMA study could be achieved with a lower (safer) dose or if a lower dose will help maintain brain function in people without dementia.

I've been taking clonazepam (Klonopin) for 40 years to help control painful spasms and cramps due to a nearly deadly motor cell brain injury followed by a month-long coma. The clonazepam messed up my triglycerides so that blood tests made me appear to be an alcoholic until I started taking 2,000 mg. of fish oil (recommended by Duke Med. School) each time I take any clonazepam.

I now take 6,000 mg. of fish oil or more each day as I take clonazepam three times a day. It only controls the spasms so I can walk for six hours following each dose regardless of how much I take, though I can take less before periods when I walk less, such as at bedtime.

The fish oil bottles claim it may contribute to heart health, but I doubt that and only use it to keep my triglycerides under control. I view any possible contribution to heart health or brain function as a bonus if it's true, but I haven't noticed any.

I come from a long line of heart attacks. An ultrasound of my heart a few years ago showed hardening of the arteries around my heart and congestion inside it.

In a long article denouncing almost all vitamins and supplements, Consumer Reports wrote that Vit. E was the worst, but there seem to be 3 different types. People need to specify (as this site does) the type they're talking about when discussing Vit.E. When not specified, I avoid all Vit. E as well as multivitamins/minerals. Calcium in pill form contributes to an 80% greater chance of heart attack according to CR.

I do take 1,000 IU of D, 250 mg. of magnesium and a B-complex pill daily as I get little sun, no Mag. and very little B in my mostly vegetarian diet. I also don't get the bacteria and viruses common in meat and contribute little to the increasing ineffectiveness of antibiotics in treating human infections due to their use to fatten livestock.
tutorjb1

I have bipolar disorder. Several years ago peer-research began to indicate a growing awareness of the efficacy of omega-three fish oils as an adjunct to standard pharmacological therapies used to treat depressive episodes. Studies upon the Inuit people suggested that their diet, rich in omega-three oils, was possibly responsible for the low incidence of depressive disorders among their population. Yet I am not aware of any double-blind studies being performed.

Regardless, I took it upon myself to begin a daily regime of using omega-three fish oil capsules being that I dislike seafood. I was wary of the placebo effect, and my "seat-of-the-pants" approach. But I must report that after a month or two, I did notice an improvement in my overall cognitive functioning, and a marked decrease in depressive episodes.

It is hard to describe the experience. Suffice it to say my mind and perceptions seemed clearer overall. Nothing drastic. Less mind chatter, and greater overall focus and attention. Upon discontinuation of these supplements, after about three weeks I began to notice the old symptoms returning. Again, I acknowledge the empirical nature of my experiences. The effect was similar to when I was accidentally switched from brand to generic medication for my bipolar condition. I had no reason to doubt the quality of the generics I was prescribed. Yet after about three weeks, my symptoms returned and remained for months until I returned to brand medications, and within a week's time all symptoms had vanished.

The only hesitation I have follows reading new research that suggests omega-three supplements may increase the risk of prostate cancer in men by approximately 40 - 50%. The report was posted on one of the national news websites. I would prefer to maintain an omega-three protocol for the brain benefits it seems to provide. Yet the thought of having it create greater a cancer risk does not seem like a good tradeoff.

Frankly, I'm not sure what to do. Omega-three seems to hold much promise. Year's ago I remember a coal miner with brain injuries who was revived by massive doses of omega-three. I remember watching it on the news as well. That's what precipitated my inquiry into omega-three use. But now I am more confused than ever . . .

I have taken Omega 3 capsules for about 6 years. It is hard to say if they are really working because I have had Chronic Fatigue Syndrome for 12 years and that does affect people neurologically.

But I am actually writing this about my husband who took them for about the same amount of time. A few years ago he began taking Coumadin given by the doctor. Both his primary and cardiac doctors knew he was taking Omega 3 and no one said to stop taking them. He kept getting huge bruises all over his body and then I heard that if one takes Coumadin they should not also take Omega 3. I stopped giving them to him and the huge bruises disappeared.

A 2012 study showed that bipolar people are generally deficient in DHA, but not in the other omega-3 fatty acids. So J.T., you might do well with a high-DHA, low-EPA supplement.

This is the study:

Pomponi M, Janiri L, La Torre G, Di Stasio E, Di Nicola M, Mazza M, Martinotti G, Bria P, Lippa S, Natili R, Pomponi MF. Plasma levels of n-3 fatty acids in bipolar patients: Deficit restricted to DHA. J Psychiatr Res. 2012 November
Institute of Psychiatry and Clinical Psychology, Catholic University of the Sacred Heart (UCSC), Rome, Italy.

Reply to Barbara

I was placed on coumadin by my cardio 2 years prior to mitrail valve replacement. Within a few years, he also placed me on 4000 iu. omega 3
Fish oil daily. I have since relocated and have the number 1 cardio in the area as well as an outstanding internist. Both are aware that I take fish oil daily and have not informed me of problems pertaining to the two rx's. I'd like to know the source of your information.

I realize medicine is constantly changing and I try to keep up with the latest. I am well aware Dr.s don't know everything. I informed my cardio of the recall on my St. Jude silzone valve. He admitted he was not aware of this and placed a call to st. Jude to confirm my valve is indeed on recall. My advice to every one is take an active roll in your health care.

I look forward to your reply.

SOOOO, let me get this straight: Say I eat a small serving of salmon, giving me "x" grams of fish oil. Along with this fish meal, I take a krill oil supplement which provides "xx" additional grams of fish oil, for a total of "xxx" grams in my body from that meal. HOW the heck is my body supposed to tell the difference between the 2 fish oil sources and differentiate accordingly?!

I've always been confused re this question, i.e., if you take supplements WITH healthy foods, then how the heck does that supplement fail to benefit your body synergistically? Aren't you still getting all those subtle chemical interactions that come from the ingestion of whole foods? I can certainly understand that you can't just down a handful of pills and think you're good to go. But: WITH healthy foods? I just can't understand the reasoning that supplements wouldn't be beneficial in that case. Thank you.

People's Pharmacy response: Quite right. Your body can't tell the difference. Presumably taking the supplement alone, without the food, throws the balance off.

A recent study found that men with higher levels of omega-3 fatty acids had more, and more agressive, prostate cancer than men with lower omega-3 fatty acids. This finding has me concerned, especially about taking omega-3 supplements. I would appreciate the People's Pharmacy's thoughts on this issue.

M.R.

Thank you for sharing about the 2012 report regarding deficient DHA in people with bipolar. I will also look into a high DHA, low EPA version of omega-3. J.T.

I've got fish oil covered. For years and without any ill effect, I've been taking 6,000 mg./day of fish oil to keep the clonazepam I need to handle a disabling injury from throwing my triglycerides out of whack.

In 2012, in their Dangers of Vitamins and Supplements issue, Consumer Reports published that Vit. E was about the worst supplement one could take, but there appear to be 3 different kinds of Vit. E.

I'd like to know what they are and how to tell them apart or at least how to know I'm getting the one used in the study above/

Thanks,
tutorjb1

I could not take fish oil capsules. I could not keep that taste from my mouth. When I belched,it would be that horrible taste.... I cannot stand fish of any kind.
When I asked my Dr. if there was something else I could take,she told me to try keeping my fish oil in my freezer. That would make it easy to swallow and that fishy taste would stay in my stomach and not come up.
IT WORKED! She was right. A great suggestion for taking any huge ,hard to swallow capsule. Try it and be surprised,,,,,,,,,,

I could not take fish oil capsules. I could not keep that taste from my mouth. When I belched,it would be that horrible taste.... I cannot stand fish of any kind.
When I asked my Dr. if there was something else I could take,she told me to try keeping my fish oil in my freezer. That would make it easy to swallow and that fishy taste would stay in my stomach and not come up.
IT WORKED! She was right. A great suggestion for taking any huge ,hard to swallow capsule. Try it and be surprised,,,,,,,,,,

I could not take fish oil capsules. I could not keep that taste from my mouth. When I belched,it would be that horrible taste.... I cannot stand fish of any kind.
When I asked my Dr. if there was something else I could take,she told me to try keeping my fish oil in my freezer. That would make it easy to swallow and that fishy taste would stay in my stomach and not come up.
IT WORKED! She was right. A great suggestion . Try it and be surprised,,,,,,,,,,

I could not take fish oil capsules. I could not keep that taste from my mouth. When I belched,it would be that horrible taste.... I cannot stand fish of any kind.
When I asked my Dr. if there was something else I could take,she told me to try keeping my fish oil in my freezer. That would make it easy to swallow and that fishy taste would stay in my stomach and not come up.
IT WORKED! She was right. A great suggestion . Try it and be surprised,,,,,,,,,,

I could not take fish oil capsules. I could not keep that taste from my mouth. When I belched,it would be that horrible taste.... I cannot stand fish of any kind.
When I asked my Dr. if there was something else I could take,she told me to try keeping my fish oil in my freezer. That would make it easy to swallow and that fishy taste would stay in my stomach and not come up.
IT WORKED! She was right. A great suggestion . Try it and be surprised

I also had that problem w/fish oil. My Dr. suggested I keep my FishOil in my freezer. It worked. Try it and be amazed.

For years I took Vit. E, then read it is not good. I am unable to recall the reasoning but it was convincing enough for me to stop.

It has been many years since I have taken 200 mg[?] or could have been units--do not remember.
Here in 2014 it is again recommended.......more confusion.

Please confirm Vit. E is necessary and the exact type or formula, and amount.

I need to get on the right track with the right amount and type of Vit. D [3 only, or 2 as well?] as well as the Vit. E.

Perhaps I am not reading the articles correctly and it is not as difficult as it seems to me?
Joe and Terry, please put my mind at ease and give me some direction!
Thank you

For men, flaxseed oil has good things for the prostate. My husband takes that instead of the fish oil. To answer someone else's question, flaxseed capsules are available in the same places you can get fish oil--Walmart, etc. or mail order

"... not everyone can afford two fatty fish meals a week."

Sure they can. Canned pink salmon sells for less than $4 a can, and a can provides four servings. In our area, both CVS and Walgreens have frequent sales when the price drops to $2.50, or even $2. And salmon is delicious. We eat it, not two times a week, but every day.

Look for "wild Alaska" on the label. Wild Alaska salmon is highest quality, and it comes from a sustainable, well-managed fishery. Mercury levels in salmon are usually so low as to be undetectable.

If you buy fresh salmon, be sure it is wild-caught Pacific salmon. Most Atlantic salmon is farmed -- low quality and environmentally damaging.

Sardines are another option at about $1 a can/serving, especially useful for picnics/camping/traveling. Again, fishing stocks of sardines are generally copious and resilient, and mercury levels are negligible.

Well ,I am confused again.
1--Fish Oil: At this time I have been taking 2 capsules of Nature Made 1200mg. Fish Oil.
Mostly take 2 because I do not do it consistently.
Front label reads:
360 mg. OMEGA-3.
Back label reads
Fish oil concentrate 2400 mg.,
Total Omega 3 fatty acids= 720 mg.,
Omega 3 EPA = 360 mg.,
Omega 3 DHA = 240 mg.,
Omega 3 ''Other''[?] = 120 mg.

I am now insecure about the equation AND the brand.

One comment spoke about ADHD, which is certain I have. Although the 'H' has greatly lessened, still the ADD. In that comment it is said higher DHA is needed.
In Neurology the talk is of high Red Blood Cell EPA needed.
Have I missed somewhere what the best equation is, because I am unable to find any info on that. Thought I was set, now worried.
While trying to do the best, do not want to do harm.
Plus the expense if not taking the right thing.

2-Andrew Weil sometime ago [?] recommended 200 [IU? mg.?] Vitamin E. Then there was bad press so I stopped. Now here it says 2000 IU necessary!

Please help me figure out what and how much I should be taking of each.
Whether the fish oil is the correct equation for a 65 year old, or what it should be.
And when the vit. E requirements changed.
Clarification would certainly help my anxiety on this subject...

Thank you for all you do to help us all,
mary

JBG, All good suggestions. However, Mom tried to feed us canned salmon and to this day I have trouble eating it still.

Perhaps you would share some recipes because this a perfect low cost solution.
Although I have 2 cans in the pantry I push them aside every time I see them.
Would really love to be eating it.
[Especially with Wild caught Alaskan selling for 17.99/lb.]

As for the sardines I have a problem with only finding those from Asian countries, and that makes me feel uncomfortable. Any particular brand you recommend?

Mary -- We eat a single, super-simple recipe, given below. To find more complicated things, Google on strings like:
bumble bee pink salmon recipes
There are slews of recipes out there.

Combination Meal -- Cover a big hunk of the day's nutrition in one swipe. We make four or eight at once and refrigerate them. Adjust proportions to suit taste.
¼ can of pink salmon
½ cup of cooked greens (turnip. collard, mustard, beet, kale, or chard)
½ cup of cooked orange vegetable (yam, winter squash, pumpkin, carrots)
1/3 cup of canned beets (Freshlike Sliced Beets are low on salt and sugars)
1/3 cup of chopped onions, cooked or raw
1/3 cup of tomato puree
2 ounces of mushrooms, cooked or raw
1 tablespoon of olive oil
1 ounce of apple cider vinegar
Mix up with a tablespoon. Serve microwaved or cold as desired.
We cycle through both the greens and the orange vegetables since the nutrients vary.
The mushrooms are included only occasionally. They powerfully suppress estradiol (often good for men).
Greens can be frozen or fresh. Organic is best since greens are often strongly pesticided.

Mary, re sardines, both Beach Cliff and Brunswick sardines are from Canada. We use the ones packed in water.

JBG- thank you, I will be on the hunt for the sardines from Canada. Now please salmon patty recipes would be greatly appreciated. AND if there are some without breadcrumbs, daughter gluten sensitivity. Probably put quinoa in coffee grinder to substitute wheat?
But need more on this.

Thank you, mary

A FEW NOTES ON FISH OIL: First, it seems absolutely SILLY to eschew fish oil supplements just because you're vegan or veggie... Good Grief! The stiff is pretty far removed from the actual fish by the time it's processed into oil.

Second, I too was alarmed by the recent reports that fish oil could be ineffective, even damaging to one's health. I was told by SEVERAL people "in the know" that YES THAT'S TRUE... but it's all because of the oil possibly going rancid at room temperatures before it's consumed. IF IT GOES RANCID, then apparently yes, it can be damaging. So, you should ALWAYS keep your fish oil supplements in the fridge after opening. Nutritionists say there is some kind of "vacuum sealing" that's done with fish oils that keeps them fresh before opening, so just keep unopened bottles in a cool dark place and they should be fine. In the summer, I usually put even unopened bottles in the fridge just to be on the safe side. NORDIC NATURALS are supposed to be the best fish oils for not going rancid.

Third, I don't think it's necessary to stress over the exact dosage one should take q day. I take 2 or 3 krill oil capsules per day and it seems to work fine for me (I'm 66). Whatever the brand, I just follow the recommended dosage on the bottle and add a bit more. I've had many, many sports injuries, broken bones, strains, sprains, torn ligaments, etc... and I still ski EXPLOSIVELY and also distance swim, bike, hike, etc. I owe my joint health to fish oil and hyaluronic acid, as both those things help lubricate the joints besides providing many other good benefits.

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