DHA and Alzheimer’s – There’s More to the Story

A recent study published in the Journal of the American Medical Association (JAMA) found that DHA supplementation in patients with mild to moderate Alzheimer’s did not slow the rate of cognitive and functional decline. The headlines that sprung from this study include: “No Benefit for DHA in Alzheimer’s Disease,” “DHA Does Not Slow Progression of Alzheimer’s,” and so on.

The problem with this study is obvious to me. First, they should have measured baseline DHA/EPA levels in the red blood cell membrane (RBC). This gives a better picture of long-term levels of DHA/EPA in the body, due to the slow turnover of these cells. This test is available from Genova Diagnostics. Johns Hopkins also offers a much more extensive one.

Next, there is always the problem of bad bacteria oxidizing the omega-3s in the gut. If this is occurring, the omega-3s will not be beneficial and may even be even harmful. A comprehensive stool analysis (CSA) or Stool Effect test (Metametrix) would be in order at the onset to make sure the omega-3s are being well received at the gut level. If gut imbalance exists, rebalancing the gut with probiotics is recommended.

There is still a chance of oxidation of omega-3s even after they are absorbed in blood, so oxidative blood markers like lipid peroxides, hsCRP (highly sensitive C-reactive protein), hemoglobin A1C, fibrinogen, and 8OHDG (measures oxidative stress to DNA) would be good to know. If there is a lot of intravascular oxidative stress, this certainly could mean there is some oxidation of the omega-3s. This is why some data supports combining antioxidants with omega-3s to minimize oxidation.

Before taking any measures of DHA in the red blood cell membranes, the first step should be cleaning up the gut and reversing or at least decreasing inflammatory markers as mentioned above.

A follow-up RBC membrane analysis near or at end of study would be crucial. If adequate repletion of omega-3s is not found you may be able to assume in all likelihood the brain has not gotten its fair share of omega-3s either. We can’t be certain, however, since the brain could preferentially take up omega-3s over blood, but I tend to doubt it since the blood would see the omega-3s first.

This study looked at patients who had already been diagnosed with Alzheimer’s, but we know that the development of Alzheimer’s begins long before symptoms appear. Studies looking at fish oil supplementation BEFORE symptom onset have found a protective effect. Additionally, EPA is an important omega-3 also found in fish oil, but not used in the current study.

In addition, there are some small studies and anecdotal cases about the value of the saturated fat coconut oil reversing Alzheimer’s. It is thought this fat may be absorbed as a fuel by the brain, rather than glucose and may decrease insulin resistance in brain. Insulin resistance in the brain (also known as type 3 diabetes) is a major factor in all neurodegeneration, and especially Alzheimer’s disease.

I also think a person who has cleaned up vascular inflammation and gut issues could do well with stem cells for Alzheimer’s. I know of at least one woman who is doing quite well after stem cell therapy for her Alzheimer’s.

This was a typical medical study looking at one product and one end point. They found that when taking a lot of DHA, blood level and cerebrospinal fluid increased and yet, people with a significant degree of Alzheimer’s did not improve. That does not mean that fish oils are not beneficial for the brain. DHA is the most abundant fat in the brain, and resulted in positive effects when administered to patients with mild Alzheimer’s disease.1

Single nutrients (and for that matter most drugs) ARE NOT MAGIC BULLETS! Medical researchers need to take a systems biology approach—think whole symphony orchestra, not just the piano player (regardless of how well he/she plays). The role of diet, digestive health, stress reduction, inflammation reduction, detoxification of heavy metals and fat soluble toxins, adequate sleep, good elimination, moderate exercise, and psycho-emotional-spiritual balance all play a role in a person’s overall health. We need a symphony—not just a piano player—to make truly complex and beautiful music just as we need a symphony of nutrients to sustain a biochemically balanced person!

1. T. Hartmann, et al., “ Alzheimer’s disease: the lipid connection.” J Neurochem. 2007 Nov;103 Suppl 1:159-70.

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