Anxious? Try some fish oil!

Dear Dr. Mo: I read the post about fish oil supplements – I am taking it daily so I was wondering if this supplementation is still good for anything or not?

Dear reader: There has been a lot of enthusiasm but little evidence for fish oil supplements to have any meaningful health benefit (I must emphasize here that I am talking about capsules, not an actual fish on your plate).
But hold the phone, not all hope for fish oil is lost.

Recent evidence* points to true anxiolytic effects of omega-3 polyunsaturated fatty acids a.k.a. Omega-3 PUFAs (found in fish oil), which were found to reduce anxiety symptoms in study groups when compared to controls in both placebo-controlled and non-placebo-controlled trials.

This anxiety reducing effect is dose-dependent however: the studies found that the anxiolytic results of Omega-3 PUFAs were significantly better than that of controls ONLY in subgroups with a higher dosage (at least 2000 mg/day) and not in those with a lower dosage (less than 2000 mg/day). 

Typical capsule of fish oil is usually 1000-1200 mg so for these effects to take place, according to this insight, taking it twice daily would be necessary. However, a consultation with a doctor prior to such decision is advisable.

Some of these Omega-3 acids are labeled on different supplements available in stores so let me provide a quick context here:

Omega-3 PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (now try these as a tongue twister exercise), are essential nutrients. As such they seem to have potential preventive  and therapeutic effects on psychiatric disorders such as anxiety and depression as well as comorbid depression and anxiety in people who are otherwise sick and even in pregnant women. 

Preclinical data support the effectiveness of Omega-3 PUFAs as a treatment for anxiety disorders.

Song et al as well as some other researchers found that EPA-rich diet could reduce the development of anxiety related behaviors as well as contextual fear behaviors in lab animals.

A number of trials also have found that Omega-3 PUFAs might reduce anxiety under serious stressful situations.

More on all these trials can be found on JAMA.

These trials provided the first meta-analytic evidence, as far as I can tell, that Omega-3 PUFA treatment may be associated with anxiety reduction. The beneficial anxiolytic effect of Omega-3 PUFAs (i.e. found in fish oil) is likely to be stronger in individuals with specific clinical diagnosis than in those without them.

More well-designed clinical trials should be performed to generate further evidence in support of these anxiolytic effects but it seems to me that there is already a tangible benefit from taking a higher dose Omega-3s in people who suffer from anxiety.

So while your ticker probably won’t benefit from these giant capsules, your mind likely will..

Yours in health,

Dr. Mo

* Evidence came out of a systematic review and meta-analysis of 19 clinical trials from 11 countries

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