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Vitamins for brain health? Experts answer your questions.
Are you taking vitamins because you think they will help your memory or keep you sharp? Do you know the facts from the myths about supplements? Get answers to your questions from our expert panelists! To participate, simply ask a question by reply post! (Ends June 26.)
This month, AARP’s Global Council on Brain Health (GCBH) released its new report, The Real Deal on Brain Health Supplements (download available). Now is the time to join our online discussion with our brain health experts who can set the record straight and provide you with tips and recommendations. Our expert panel includes:
- Sarah Lock, Senior Vice President, Policy and Brain Health, AARP, Executive Director, Global Council on Brain Health @SarahLenzLock
- Paul Coates, Ph.D., former director of the Office of Dietary Supplements, NIH @PaulCoates
- Howard Fillit, M.D., Alzheimer’s Drug Discovery Foundation @HowardFillit
Both Dr. Coates and Dr. Fillit served as contributors to the report. We’ll cover topics such as:
- Americans take a lot of supplements for their brain health and spend billions each year on them. Is it worth it?
- How do you know if supplements are safe?
Solved! Go to Solution.
- AARP Global Council on Brain Health
- brain health experts
- Howard Fillit M.D.
- Paul Coates Ph.D.
- Sarah Lock
- The Real Deal on Brain Health Supplements
@HowardFillit, what should someone look for when buying any type of supplement to make sure that they are safe and contain quality ingredients?
@AARPLynne, thank you for your question about what to look for when buying a supplement. Safety can be a concern as the quality of ingredients in supplements can vary. Unlike drugs, the ingredients in supplements are not reviewed for their purity and content by government agencies before being sold. Some supplements may contain harmful ingredients not listed on the label. Therefore, if you choose to take a supplement, you may wish to look for unbiased verification of its quality. You can look for products that have been tested by independent third parties such as: ConsumerLab, Labdoor, NSF International, and US Pharmacopeia. You may also wish to research whether a supplement's benefits are supported by high-quality research by visiting reputable sites including the National Institutes of Health Office of Dietary Supplements, the National Center for Complimentary and Integrative Health, and our CognitiveVitality website.
Howard Fillit, MD
@HowardFillit, what are some common health conditions/causes of vitamin deficiency that our audience should be aware of as they age?
@AARPLynne, thank you for your question about health conditions associated with vitamin deficiency. There are several vitamins that can become deficient depending on health conditions.
Vitamin B12: Although most people get plenty of vitamin B12 from foods (e.g., meat, fish, dairy products, eggs, and fortified breakfast cereals), older adults may become deficient in this vitamin as our ability to absorb this vitamin decreases with age. Also, people with celiac disease or other illnesses of the small intestine, and those who have undergone gastrointestinal surgery are also at risk for vitamin B12 deficiency. To learn more about vitamin B12 deficiency, please visit our blog post on this topic.
Vitamin B6: Although most people get enough vitamin B6 from their diets (e.g., poultry, fish, organ meats, potatoes, and some fruits), people with kidney disease, rheumatoid arthritis, celiac disease, Crohn’s disease, inflammatory bowel disease, and several other autoimmune disorders sometimes have low vitamin B6 levels. Symptoms of vitamin B6 deficiency can include numbness/tingling in the hands and feet, confusion, and a weakened immune system.
Vitamin D: Vitamin D can come from food (e.g., salmon, tuna, mackerel, and fortified milk), or produced by our skin when exposed to sunlight. The skin’s ability to produce vitamin D can decline with age, so vitamin D deficiency can be common in older adults. People who are obese can also be at an increased risk for vitamin D deficiency. Your doctor may also advise you to take vitamin D (and calcium) supplements if you are at a high risk for osteoporosis. For more information on vitamin D, see our vitamin D rating page on CognitiveVitality.
If you are concerned about vitamin deficiencies, talk to your doctor—a simple blood test can tell you whether you have enough of these vitamins.
Howard Fillit, MD
" Thank you very much your reply. . . Look forward to the continued discussion with you and other members of GCBH. Paul R."
Dear Paul R @PaulR427193
You clearly have done a great deal of work in the area! We appreciate you engaging on these topics. I have consulted with Paul Coates and Howard Fillit and am sending the response on behalf of us all. We look forward to seeing your report in the future and happy your group is doing further research into these topics.
We know that the GCBH report is not the "final word" in this area and we want and encourage greater scientific exploration. One of the recommendations the GCBH makes is for supplement manufacturers to conduct rigorous clinical trials (e.g., randomized double-blind placebo-controlled trials) to test their claims for brain health and to have the data independently reviewed by other scientists who can evaluate the supplements' effects in an unbiased way.
You asked for a source of information on numbers of people deficient in vitamins in the US. We had the biggest question about B12 so we looked most closely at that. Relatively few people in the U.S. have a vitamin B12/folate deficency. In the report we generously estimated up to 15% in U.S. and 20% in UK based on reliable estimates because we didn't want to exaggerate the numbers but wanted to be fair for people who may be concerned. It is estimated that 4.4% of US. adults 50+ are low on vitamin B12, and even fewer are low on folate. See, Evatt, M.L. et al. (2010) ”Association between vitamin B12- containing supplement consumption and prevalence of
biochemically defined B12 deciency in NHANES III (Third National Health and Nutrition Survey).Public Health Nutr.: 13(1), 25–31. See also https://www.cdc.gov/nutritionreport/
pdf/Second-Nutrition-Report-Overview-Factsheet.pdf See also, Allen, L. H, Am J Clin Nutr 2009;89(suppl):693S–6S.
We could not go into each and every supplement because there are far too many, and some are not widely-used. However as part of the community dialog, we did want to respond with the summary provided by Cognitive Vitality under Howard’s leadership at ADDF. The GCBH does not recommend any of these supplements because each of them lack sufficiently reliable evidence to support their use.
Here is a summary of the information from Cognitive Vitality on the five specific types of supplements you mention:
Acetyl-L-carnitine (ALCAR): ALCAR may improve cognitive function in elderly adults with fatigue based on two clinical trials from the same researchers, but no studies show that ALCAR can prevent Alzheimer's disease. For more information, visit the CognitiveVitality rating page: https://www.alzdiscovery.org/cognitive-vitality/ratings/acetyl-lcarnitine
Lion's mane mushroom: Lion’s mane mushroom has received some attention since a small double-blind controlled study suggested it provided benefit in Alzheimer's patients (in 2009). But the positive effect on cognitive function went away after 4 weeks of discontinuing the Lion’s mane extract. This pilot trial has not been replicated so we don't yet know if there is true benefit for brain health.
L-theanine: Based on a few short-term human studies, L-theanine has shown small benefits, though the long-term effects of L-theanine on cognitive health are unknown. For more information, visit the CognitiveVitality rating page: https://www.alzdiscovery.org/cognitive-vitality/ratings/l-theanine
Citicoline: Short-term treatment with citicoline was beneficial in individuals with lower cognition at the beginning of studies, but there is insufficient evidence that it is beneficial in healthy people with otherwise good cognition. No studies examined whether citicoline can prevent dementia. For more information, visit the CognitiveVitality rating page: https://www.alzdiscovery.org/cognitive-vitality/ratings/citicoline
Bacopa monnieri: Small clinical trials have confirmed that bacopa can improve some cognitive test scores, though the effects are modest and may not yield an improvement noticed by the individual in daily life. No studies have tested whether bacopa monnieri can protect from cognitive decline or dementia. For more information, visit the CogntiveVitality rating page: https://www.alzdiscovery.org/cognitive-vitality/ratings/bacopa-monnieri
Like vitamins and minerals, there are optimal levels for neurotransmitters--usually there is an inverted-U shaped curve where too little or too much are not good for your brain. So without knowing where you stand in terms of brain levels of relevant neurotransmitters, it is difficult to know what supplements you would benefit from. Too much can be harmful and if you have optimal levels, supplements that increase those levels will worsen brain health.
The GCBH is moving on to other topics now that our members are interested in, but we agree science evolves all the time and hope that new evidence is developed someday showing greater efficacy.
Thanks to Dr. Yuko Hara of ADDF for helping point us to this information.
Dear Sarah (@SarahLenzLock),
Thank you so much for your thoughtful reply. If I may, I'd like to respond with a few suggestions:
1. It may be critical to draw a clearer line between prevention of dementia and short-term benefits for cognitive health. The majority of consumers are not expecting dietary supplements to solve complex problems. People take supplements to support their daily life activities and their always not perfect daily nutrition. A reduction in symptoms of some chronic disorders is usually viewed as a positive bonus, and the way people judge supplements is by how they "feel" after starting to take them.
If a proven even partial prevention of dementia is a criterion, it'd automatically axe all dietary supplements as not having enough proof to support their claims.
If some compound has been proven to really work for treatment of dementia / Alzheimer's disease, and has gone through the whole nine yards of clinical trials, it would simply become a prescription drug for treating an existing or emerging disease. If something really works, it usually means it has strong positive effects, yet such effects cannot be isolated and have a complex effect on processes in our body, including negative side effects. Therefore prescription drugs have to be regulated and administered only with a doctor supervision.
But in most cases, people expect from supplements short-term effects on their daily life. And some supplements do deliver well on their promise, and are already what we can say a common knowledge. Therefore your report that pretty much axes all dietary supplements for any brain health support, may be confusing and controversial for so many people, while you are basically axing only those that claim to prevent dementia, yet it may look like you are dismissing pretty much all dietary supplements for any brain related activity.
An artist painting a picture naturally focuses too much on details, so not to lose the bigger picture and to keep the perception of how it will be perceived by the viewers, a common centuries-old technique is to literally step back once in a while for a very brief break to better see the picture you've drawn so far. Or to collect feedback on perception of your report from readers outside of your team.
Better short-term memory (for the day!), improved concentration and focus, improved alertness, better sleep quality, anxiety reduction, relaxation effect, mood improvement, etc. - all these and others can be achieved with dietary supplements and there is no argument about this. In this regard, dietary supplements simply target biochemical processes in our bodies, just like food does, but with more focus on certain functionality. This is what most people reading your report expect - to see which supplements have what efficacy in what functional areas.
A mere categorization of dietary supplements into, for instance [prevention of dementia], [short-term memory improvement], [improved focus and alertness], [relaxation effect, improved sleep quality] may prove to be very helpful in making it more clear what works or not.
If there is no such information, then everyone will keep taking shortcuts and abuse the intake of stimulants like caffeine, sugar, alcohol, etc. Which definitely work very short-time too, yet with a range of negative side effects on health.
To give one example, I occasionally use a blend of [3g of glycine, 200 mg of L-theanine and 200 mg of Magnesium] for better relaxation and improving sleep quality.
There are not so many dietary supplements with claimed improved cognitive effect, maybe within 50 and many can actually be evaluated (and dismissed) with a few hour research.
2. You wrote "The GCBH does not recommend any of these supplements because each of them lack sufficiently reliable evidence to support their use."
You actually don't really have to "judge" each supplement. No need for "pollice verso" (thumb up or down used in the context of gladiatorial combat in Ancient Rome). In the modern world with overwhelming amount of information, and freedom to make your own decisions on dietary supplements, what people may welcome is a tool that simplifies, sieves out false claims and summarizes scientific studies on each dietary supplements, while giving a "ranking" on some key claimed areas. The Cognitive Vitality rating tool is perfect for this, and may just need more evaluated dietary supplements, possibly with a support of contributors. In contrast, there are too many websites that simply summarize and accumulate all possible claims for each supplement, making it sound like each dietary supplement is nothing less than a miracle. For example, listing "10 health benefits" for each dietary supplement.
3. A quick note on prevention of dementia through dietary supplements. Alzheimer's disease, and other forms of dementia, cannot be prevented or healed with dietary supplements. Just because of the complexity of processes leading to and in cases of people with Alzheimer's.
Here is a good graphical summary:
From this analytical report:
One part of it gives a very clear and short description that simply nails it:
"Low levels of acetylcholine are not the reason for Alzheimer's. But acetylcholine slows down Alzheimer's progression by giving a boost to cognitive skills."
* Acetylcholine is a neurotransmitter responsible for what we know as learning and memory. Its concentration and level of response in our brain determines our daily mental performance, so it's pretty important for us. There are ways to increase acetylcholine activity in our brain directly through improved acetylcholine response or through inhibiting cholinesterase enzyme (AChEI - chemicals whose primary toxic effect is to block the normal breakdown of acetylcholine). There are many ways to possibly influence either of them in some form. Even deep breathing meditation stimulates vagus nerve, leading to a temporary boost in acetylcholine release! There are other mental and physiological tricks to slightly boost levels of dopamine or serotonin.
So basically no supplement can claim really preventing or fixing something as complex as Alzheimer's, BUT an acetylcholine support through supplementation can give a boost to cognitive skills.
4. You mentioned: "One of the recommendations the GCBH makes is for supplement manufacturers to conduct rigorous clinical trials..."
Just to make sure we are on the same page, supplement manufacturers are not exactly the same as drug manufacturers and do not do clinical trials like the latter. Supplement manufacturers rely on existing clinical trials. Then there is a level of dietary ingredient manufacturers (who may be the supplement manufacturers, e.g. the final product manufacturer), who manufacture the raw ingredients, and depending on their geographical location, are only required to have some general manufacturing license and, as you know, as not regulated in what they manufacture and even ISO standards, such as ISO 9000 that are only voluntarily. What is possible to do with dietary supplements / dietary ingredient, is to have them tested in an independent lab for the actual content of the active ingredients. For example, acetyl-L-carnitine can be manufactured virtually anywhere, but the quality and its bioavailability may range significantly and in some cases a product may not have any performance whatsoever. In this example, a testing method for acetyl-L-carnitine may be for " for the amount of acetyl-L-carnitine by High Performance Liquid Chromatography (HPLC) using Ultra Violet (UV) detection."
The only way for consumers to know if a product works is to see some independent test report on some particular product / brand, as well as rely on existing scientific studies by evaluating them and making pretty much a personal educated call, on if the evidence of its efficacy is sufficient or not.
5. Thank you for your response to some particular examples of supplements I gave. However, as mentioned above, it's not all only about dementia / Alzheimer's when it comes to brain health. Every single supplement and even many approved drugs may be axed and legitimately criticized if judged by this criteria for strong efficacy. Short-term effects are what real, important and enough for many consumers.
As GCBH mentioned in its report, a healthy lifestyle, including balanced healthy nutrition, physical activity (let's also add sleep quality and keeping to learn new things to push the brain to generate more neurons) are the best natural strategy for prevention of dementia. By expanding your report to other brain health areas outside dementia, and including all other supplements, the value of your report may improve even further. Cognitive Vitality rating may be a perfect tool to focus on, expand and promote.
1) This report mentions the potential efficacy of B12 and EFAs. The mechanisms are not well understood, correct? Is the issue that supplements "don't work", or, that there isn't a market driver to fund the necessary, and expensive, research (i.e. no patenable molecules)? I present this question earnestly: 8 years ago lifestyle interventions were scoffed at in serious AD discussion. Might there be efficacy in "supplementation" but we lack the research, and research funding, to seriously study them? Said with serious concern about false marketing, and also in the spirit of identifying and inquiring into what we don't know.
2) DASH, MIND, MED, Finn diets show promising efficacy, but consuming that amount of fish is near impossible, and expensive. Does EFA / DHA supplementation directly replace and act in lieu of consuming high amounts of fish? Concerns or qualifications in this approach? Thank you!
but consuming that amount of fish is near impossible, and expensive.
Not to mention that some of us do not care for fish, at lease non shellfish. Because of this study I actually bought two cans of sardines thinking that people have been eating them for decades, field hands I worked with as a child would consume them as their meals, surely I can.
Nope. I consume half of one can before I couldn't take it anymore and the memory of taste stayed with me for several days after. Still trying to figure out what to with the other can.
@RickM670682 I hear you! There are lots of people who don’t like the taste. Even one of AARP’s researchers who I worked closely with on the nutrition report and surveys and is convinced of the benefit of fish swears she won’t touch the stuff! Fish is a good source of protein and omega 3s but fatty acids are also found in sources other than fish. Plant sources of omega-3 fatty acids include flaxseed, oils (olive, canola, flaxseed, soybean), nuts and other seeds (walnuts, butternut squash and sunflower). Replacements for vegans/ vegetarians exist that are not supplements, but the evidence is not as robust for plant sources of omega-3s. I like fish - even canned sardines and pickled herring! That’s my Swedish heritage coming through I think. But if you don’t like the fishy taste, you went immediately hard core! What about tuna? The milder white fishes such as haddock may not be as high in Omega 3s as salmon or mackerel but they get you past the strong flavor. I have seen frozen fish that’s very easy to prepare, tastes mild, and is much more affordable than fresh. But what about the nut and seed options? Some milk is also fortified with it and eggs contain fatty acids. As for your second can, what about donating it to your local food bank? Here are some more links with nutrition suggestions.
- You highlight an important part of the problem. There is an issue that we need more research into the effectiveness of supplements. But that is not the only reason. We also do not have universally recognized recommended levels established for human consumption for all essential fatty acids (EFAs). We note the recommended amount of ALAs set forth from the National Academy of Sciences, Engineering and Medicine. The existing studies of Omega-3 supplements did NOT show they reduced the risk of Alzheimer’s Disease, and the other studies relating to supplements' impact on mild cognitive impairment were too few and too small to be confident in the results. That is why the GCBH calls for more research. But as you point out, where there are not financial incentives for manufacturers to engage in large rigorous studies, we are far less likely to have them be accomplished. This is especially true when there is no regulatory requirement that pre-market testing happen. But that doesn’t seem to have stopped academic centers from doing the evaluation of the effectiveness of food on brain health.
- It’s not impossible to consume a healthy amount of fish that has shown positive impact for people’s brain health. As mentioned above, not everyone agrees that you need super high doses of EFAs that some supplements offer. The GCBH simply says we need to encourage people to eat greater amounts of fish and seafood. The MIND diet advocates for fish at least once a week. National recommendations from Canada say to eat at least two servings of fish each week, Sweden says two to three times a week, Greece says eat five or six servings of fish each week and China calls for appropriate amounts. Our GCBH experts have also pointed out that you can get the same nutritional value from fresh, frozen or canned foods. So for more affordable options, look for frozen or canned fish, and ones without lots of added breading, salt, sugar and fat.
- Here's what the GCBH has said about fish, along with some links for more info:
“Fish is a good source of protein and omega-3 fatty acids, and it constitutes an important part of the Mediterranean, Nordic, DASH, Okinawan and MIND diets as described earlier. Those who typically eat fish or other seafood every week report better brain health compared to those who never ate fish or seafood, according to the 2017 AARP Brain Health and Nutrition survey. In fact, 67% of those who eat fish or seafood reported their brain health as “excellent” or “very good.” See appendix 9, figure 3. …. It should also be noted that omega-3 fatty acids are found in sources other than fish. Plant sources of omega-3 fatty acids include flaxseed, oils (olive, canola, flaxseed, soybean), nuts and other seeds (walnuts, butternut squash and sunflower). Replacements for vegans/ vegetarians exist that are not supplements, but the evidence is not as robust for plant sources of omega-3 fatty acids.”
@s804940b You bring up an interesting and controversial topic! Canola oil has less saturated fats than other oils but because of production concerns and debate over health effects it has generated lots of debate. Yet relatively few independent, high quality studies have been accomplished to settle the questions. Depending upon production methods, compared to other types of oils, canola oil is relatively high in Omega 3s (generally a good thing) but also in Omega 6s (maybe not so great). It is sometimes found in hydrorogenated forms that are the trans fats which have been found to increase risk of heart disease stroke and type 2 diabetes. So you have to ask yourself what form is it in and compared to what other oil options when you make the decision whether to consume it.
I just came across this forum and I just want to say that the body has to be looked at as one unit so I really think that concentrating on mind-body as one brings a balanced lifestyle. I had the opportunity of coming across an article in Wired that discussed brain regeneration of brain cells after different forms of severe trauma. Neuroscientist Michael Merzenich of BrainHQ along with his colleagues have done outstanding work proving that exercising the mind in addition to taking supplements ( my opinion) can work wonders.
Have a great day!
ah4946, thanks for joining the forum! Totally agree that leading a healthy, balanced lifestyle helps both the brain and other parts of the body experience better physical and mental health. As a physician, I have always had a healthy respect for body’s ability to heal itself given appropriate sleep, exercise and nutrition. I haven’t seen the article you mentioned about regeneration of brain cells after trauma but it sounds interesting. My colleagues on the GCBH issued an earlier report discussing the evidence around exercising your mind and brain health you might find informative. Check out the report on exercising you brain – what we call challenging your thinking here: https://www.aarp.org/health/brain-health/global-council-on-brain-health/cognitively-stimulating-acti...
You could also see www.CognitiveVitality.org
Howard Fillit, MD, is a geriatrician, neuroscientist, and innovative philanthropy executive, who has led the Alzheimer’s Drug Discovery Foundation (ADDF) since its founding in 1998. Dr. Fillit has held faculty positions at The Rockefeller University, the SUNY-Stony Brook School of Medicine and the Cornell University School of Medicine. In 1987, he joined the Mount Sinai School of Medicine, where he is a clinical professor of geriatric medicine and palliative care, medicine and neuroscience. Dr. Fillit also maintains a limited private practice in consultative geriatric medicine with a focus on Alzheimer's disease and related dementias.
Paul Coates, PhD, is previously Director of the Office of Dietary Supplements at the National Institutes of Health. Member of the Board of the American Society for Nutrition. Member of the Expert Panel advising the Global Council on Brain Health on matters related to dietary supplements.
Sarah Lock is Senior Vice President for Policy and Brain Health in AARP’s Policy, Research and International. She leads policy initiatives on brain health and care for people living with dementia and is Executive Director of the Global Council on Brain Health, an independent collaborative of scientists, doctors and policy experts convened by AARP to provide trusted information on brain health. Ms. Lock serves on the Steering Committee for the National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers, on HHS’ Administration on Community Living Aging and Cognitive Health Technical Expert Advisory Board, and on Dementia Friendly America’s National Council. Prior to AARP, she served at the Department of Justice, the office of Congressman Michael D. Barnes, and the firm Arent, Fox, Kintner, Plotkin, & Kahn. She holds a JD from the University of Maryland.
Are Omega 3 good for brain health?
They may well be @m466452a. The GCBH's report provides context and background that are helpful in understanding why the GCBH recommends consuming fish rather than taking an Omega 3 supplment. The full report on dietary supplments for brain health from the GCBH is available https://www.aarp.org/content/dam/aarp/health/brain_health/2019/06/gcbh-supplements-report-english.do...
One of the consensus statements from the GCBH report is: "Consumption of fatty fish, as well as other types of seafood, may benefit cognitive function. This may be due to their omega-3 fatty acid content, in particular DHA, but this is not proven. Overall, there is insufficient evidence to recommend taking a fish oil-derived omega-3 supplement for brain health."
But check out the discussion section of the report, reproduced below, that goes in-depth into Omega-3 fatty acids.
Omega-3 fatty acids and fish oil
Omega-3 fatty acids make up an important part of the membranes that surround each cell in your body. The three main omega-3 fatty acids are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is an essential fatty acid; the body converts some ALA into EPA and DHA. Your body cannot make these fatty acids, so you must get them from the foods you eat. DHA is a building block of the brain. ALA is found mainly in plant oils such as flaxseed, soybean and canola oils, as well as nuts and seeds. DHA and EPA are found mainly in fish and other seafood. Fatty cold-water fish such as salmon, mackerel, tuna, herring and sardines are especially rich in DHA.
There have been numerous studies about omega-3 fatty acids and health including studies focused on heart health, rheumatoid arthritis and brain health, including depression. Research has found that people who eat more seafood have a lower risk of a decline in memory and thinking skills, including Alzheimer’s disease. Therefore, the GCBH previously recommended the consumption of fish for protecting brain health. For more details, see Brain Food: GCBH Recommendations on Nourishing Your Brain Health.
Omega-3 supplements, however, have not been found to reduce the risk of Alzheimer’s disease. A few small studies have found that DHA supplements may benefit people with mild cognitive impairment, a condition that sometimes, but not always, leads to Alzheimer’s disease. Additionally, there is evidence that the use of omega-3 supplements is effective in the treatment of older people with mild to moderate depression, and that women with low levels of omega-3 tend to have higher rates of depression with more severe symptoms. Levels of omega-3 may be affected by many factors, including fish consumption, and some research has found that those who have low levels of DHA may benefit from supplements. However, the weight of the existing evidence does not sufficiently demonstrate benefit, and we do not recommend omega-3 supplements for brain health. If you can’t or don’t eat fish, ask your health care provider about whether you should take a supplement containing DHA and EPA.
Omega-3 supplements are made of fish oil, krill or algae and are offered in a wide range of doses and forms. Independent labs have found enormous variation in the content and the quality of various omega-3 supplements on the market. Omega-3 supplements can increase the risk of internal bleeding for those with bleeding disorders or for those who are taking medications that keep blood from clotting, such as warfarin (Coumadin), so make sure you talk to your health care provider about possible interactions between omega-3 supplements and medications. The 2019 AARP survey showed that 20 percent of Americans 50 and older are taking an omega-3 supplement.
NOTE: Experts have not established recommended amounts for omega-3 fatty acids, except for ALA. Average daily recommended amounts for ALA are listed below in grams (g).
Recommended Amount of ALA
Source: Food and Nutrition Board of the National Academy of Sciences, Engineering, and Medicine.