Latest Science and Research: What is the right omega-3 dose? Are there any side-effects?

No matter what age you are, you have most likely faced the challenge of dementia in your loved ones – parents, grandparents, partners, friends or even your dogs.

My mother was affected by this condition too, and in a way, I lost her twice – once to the grip of dementia, and again when she left this world. This experience, but also witnessing a decline other people and patients in my life, has driven me to learn as much as I could about the mysteries of dementia, Alzheimers and cognitive decline in both, dogs and people.

Today, I would like to share some most recent research, studies and findings on the topic, that directly or indirectly affects all of us, our families and also our dogs. 

In this article I will explain why I take 3000 – 4000 mg (3-4 grams a day) and why I am very diligent in giving 2 grams of omega-3 oil to my dog Pax daily.

Several large studies have found an association between higher dietary intake or blood levels of omega-3 fatty acids and a reduced risk of cognitive decline and dementia.

How do omega-3 fatty acids work in preventing dementia and memory loss?

Here is a list of the protective effects of omega-3 fatty acids:                          

• reducing brain and nerve inflammation

• improving vascular function

• promoting neuronal health

• protecting the blood brain barrier that helps to prevent toxins and harmful substances reaching the brain and causing damage.

Omega-3 make us smarter and have better memory!

A study published in Neurology in 2022 involving over 2,000 participants found that higher levels of omega-3 fatty acids in midlife were associated with better cognitive function and larger brain volumes in areas related to memory and thinking.

-Satizabal, C. L., Himali, J. J., Beiser, A. S., Ramachandran, V., van Lent, D. M., Himali, D., Aparicio, H. J., Maillard, P., DeCarli, C. S., Harris, W. S., & Seshadri, S. (2022). Association of Red Blood Cell Omega-3 Fatty Acids With MRI Markers and Cognitive Function in Midlife—The Framingham Heart Study. Neurology, 99(23), e2572-e2582.  

Higher levels of omega-3’s reduce the level of dementia.

A study co-led by the Hospital del Mar Research Institute and published in Nutrients in 2023, analyzed data from 260,000 participants in the UK Biobank database. It found that high blood levels of omega-3 fatty acids were associated with a lower risk of dementia and Alzheimer’s disease, particularly in men, those over 60 years old, and for dementias other than Alzheimer’s.

-Sala-Vila A, Tintle N, Westra J, Harris WS. Plasma Omega-3 Fatty Acids and Risk for Incident Dementia in the UK Biobank Study: A Closer Look. Nutrients. 2023 Nov 23;15(23):4896. doi: 10.3390/nu15234896. PMID: 38068754; PMCID: PMC10708484.

What is the right, optimal dose of omega-3’s for brain function?

Several studies suggest that higher doses of omega-3 supplements, particularly DHA, may be needed to achieve meaningful increases in brain levels and potential cognitive benefits:

A pilot study from USC (3) found that while taking 2000mg (2 grams) of DHA daily for 6 months led to a 200{83d5ae5893d4cc2381f1688c49d7c9d88858c8d0f47c18be8cfe1b1e840bf463} increase in blood DHA levels, the increase in cerebrospinal fluid (a marker of brain levels) was only 28{83d5ae5893d4cc2381f1688c49d7c9d88858c8d0f47c18be8cfe1b1e840bf463}. This suggests higher doses may be required to significantly raise brain DHA levels.

Your genetics may matter!

The same USC study reported that those carrying the APOE4 gene variant linked to Alzheimer’s disease had lower increases in brain omega-3 levels compared to non-carriers, despite taking the same 2g DHA dose. This indicates gene-specific dosing may be needed.

Why 1000mg is not enough

The researchers concluded that with a lower 1g dose typically used in trials, “you can expect a less than 10{83d5ae5893d4cc2381f1688c49d7c9d88858c8d0f47c18be8cfe1b1e840bf463} increase in omega-3s in the brain, which may not be considered meaningful.” They are now conducting a larger trial using higher doses.

-Arellanes, I. C., Choe, N., Solomon, V., He, X., Kavin, B., Martinez, A. E., et al. (2020). Brain delivery of supplemental docosahexaenoic acid (DHA): A randomized placebo-controlled clinical trial. EBioMedicine, 59, 102883.https://doi.org/10.1016/j.ebiom.2020.102883

Yes! Omega-3 slows down aging

A 2023 review in Nutrients noted that in a trial giving 3.36g of combined EPA/DHA daily to cognitively healthy individuals with coronary artery disease, cognitive aging was slowed by 2.5 years compared to placebo.

-Welty, F. K. (2023). Omega-3 fatty acids and cognitive function. Current Opinion in Lipidology, 34(1),12-21.

2-3 grams are the minimal required dose

While optimal dosing likely varies based on factors like age, genetics, and cognitive status, the evidence points to doses of at least 2-3 grams of combined EPA/DHA being required for potential brain and cognitive benefits, which is higher than typical supplementation levels. 

-Arellanes, I. C., Choe, N., Solomon, V., He, X., Kavin, B., Martinez, A. E., et al. (2020). Brain delivery of supplemental docosahexaenoic acid (DHA): A randomized placebo-controlled clinical trial. EBioMedicine, 59, 102883. https://doi.org/10.1016/j.ebiom.2020.102883

-Welty, F. K. (2023). Omega-3 fatty acids and cognitive function. Current Opinion in Lipidology, 34(1), 12-21.

-Gunnars, K. (2024, March 29). How Much Omega-3 Should You Take per Day? Healthline.

Do omega-3 fatty acids interfere with blood thinners?

There is substantial evidence that omega-3 fatty acids do not significantly increase the risk of bleeding or negatively interact with blood thinners

Here are some key findings:

1. A 2016 review published in JAMA Internal Medicine concluded that “the assertions that fish oils cause bleeding and adversely interact with blood thinners are not evidence based.

2. A study published in 2016 monitored 144 patients taking warfarin along with either omega-3 or with no omega-3 supplements. They found no significant difference between omega-3 users and non-users.

3. Another study from 2016 [7] conclude that “omega-3 supplementation with fish and krill oil does not significantly affect long-term warfarin control and bleeding.”

4. A large study by Eritsland et al with 610 patients on warfarin found that 4g of omega-3 supplementation did not lead to excess bleeding events compared to placebo [3].

5. The Mayo Clinic  states there is “strong evidence” for the benefits of fish oil for conditions like high triglycerides, with no mention of bleeding risks when taken with medications.

From the above reviews and clinical studies, we clearly see that omega-3 fatty acid supplements can be safely taken in conjunction with blood thinners.

Are there any other side-effects of omega-3?

Omega-3 fatty acids are essential nutrients that offer numerous health benefits, particularly for heart and brain health. They help reduce inflammation, support cardiovascular health, and enhance cognitive functions.

While generally safe, they may cause minor side effects such as a fishy aftertaste, bad breath, and stomach upset in individuals sensitive to a particular omega-3 source.

Personally, I have witnessed the above very infrequently.