Attention Deficit-Hyperactivity Disorder (ADHD) creates problems throughout life for many people. It can impair their ability to get along with others socially as well as causing difficulty in school or with employment. ADHD is a common condition that affects an estimated 3% to 7% of people worldwide.

This problem is often treated with stimulant drugs, such as amphetamines or methylphenidate (Ritalin), that speed other people up. But the drugs seem to have the opposite effect on ADHD patients, slowing down their thoughts and activities as well as helping with impulsiveness.

The traditional drugs for ADHD can cause side effects in some and may not be effective in others. So, it is not surprising that researchers continue to look for other treatments for ADHD.

However, it was surprising to me that someone would think of using fish oil for this purpose.

In fact, recent research suggests that omega-3 fish oil supplements can improve attention in some children with attention deficit hyperactivity disorder just as much as other drug treatments. But it looks like it is only true in those whose blood level of one omega-3 fatty acid is low.

Researchers in Britain and Taiwan who conducted a placebo-controlled trial with 92 children aged 6 to 18 years with ADHD said their findings suggest a “personalized medicine” approach should be adopted in this and other conditions.

The omega-3 supplements only seemed to work in children that had lower levels of eicosapentaenoic acid (EPA) in their blood, as if the intervention was replenishing a lack of this nutrient.

In the study, the children were given either high doses of the omega-3 fatty acid EPA or a placebo for 12 weeks.

The children with the lowest blood levels of EPA showed improvements in focused attention and vigilance after taking the omega-3 supplements.

While the amount of improvement in attention and vigilance from methylphenidate is generally 0.22 to 0.42, the effect seen in children with low levels of EPA in the trial was larger, at 0.89 for focused attention and 0.83 for vigilance.

However, in children with normal EPA levels, omega-3 supplements made no improvement, and in those with high EPA, the supplements had bad effects on impulsivity symptoms.

This research suggests that parents of children with ADHD might consider checking with their health care provider to have a blood test for their omega-3 EPA level. If the EPA level is low, omega-3 supplementation may benefit the child. If the level is normal or high, they should not give their children fish oil supplements.

Since we are on the subject, I want to make it clear that EPA is not the only omega-3 fatty acid found in fish oil. It is simply the one that seemed to be of interest in the study of ADHD in children.

For other people, EPA and other omega-3 fatty acids can create other health benefits.

Fish oil supplements can lower elevated blood triglyceride levels. Triglycerides are fats that can put you at risk for heart disease and stroke.

In rheumatoid arthritis, fish oil supplements may decrease stiffness and joint pain. Omega-3 supplements also seem to boost the effectiveness of anti-inflammatory drugs.

Some researchers have found that cultures that eat foods with high levels of omega-3s have lower levels of depression. The effect of fish oil supplements on depression has been mixed with more research needed to see if there is really a connection.

Omega-3 may even help protect against Alzheimer’s disease and dementia. It may have a positive effect on gradual memory loss linked to aging. But that is not certain yet.

If you want to consume foods rather than supplements, you might try to eat non-fried, oily fish high in omega-3 fatty acids at least two times a week. These include anchovies, bluefish, herring, mackerel, marlin, orange roughy, salmon, sardines, sturgeon, lake trout and tuna.

While eating more fatty fish is a good idea, some are likely to have higher levels of mercury, polychlorinated biphenyls (PCBs), or other toxins. These include mackerel, wild swordfish, tilefish and shark. Fish like wild trout and wild salmon are safer.

Non-fish food sources of other omega-3 fatty acids include walnuts, flaxseed and flaxseed oil, canola oil, soybean oil and chia seeds. Algae oil may also be a good option for people who do not eat fish.

The most common side effects from fish oil are indigestion and gas. Getting a supplement with a coating might help.

Omega-3 supplements can make bleeding more likely, especially if you have a bleeding condition or take medicines that could increase bleeding, like apixaban (Eliquis), betrixaban (Bevyxxa), clopidogrel (Plavix), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), warfarin (Coumadin) and some arthritis and pain relievers.

So, talk to your health care provider before using any omega-3 supplements for any reason.

Dr. Terry Gaff is a physician in northeast Indiana. Contact him at drgaff@kpcmedia.com or on Facebook. To read past columns and to post comments go to kpcnews.com/columnists/terry_gaff.

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