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Concussion aid : Omega-3 and Creatine

Did you know that Omega-3 fatty acids and Creatine can help to recover from acute trauma such as concussion in addition to the well known health benefits like heart and eye health as well as it's anti-inflammatory properties? 


Intake of Omega 3 post concussion, more precisely the therapeutic components of Omega-3 DHA & EPA, have been found to have powerful anti-inflammatory effects in the brain, and help in recovery. Additionally, fish oil supplementation before a brain injury has been found to protect brain cells. Best natural sources of omega-3 are fatty fish, which should be eaten a couple of times a week.


Also creatine has been shown to be neuroprotective and help in the recovery of a brain trauma. Creatine levels in the brain drop after sustaining a concussion and supplementing it protects the brain from oxidative damage and hyperglycolysis as creatine has an important role in cell energy generation. Creatine treatment after the injury improves coordination, memory, reaction time as well as decreases significantly headaches, dizziness and fatigue, which are all well known effects of a concussion. So the time for recovery will be improved dramatically.



Concussion


Concussion is a mild traumatic brain injury, usually caused by some sort of bump to

the head or by a hit to the body that causes our head to move rapidly back and forth. It can occur in everyday life as well as in many different sports at any level, such as contact sports, ball games, racket sports, combat sports — you name it!

The rapid movement of the head changes the brain tissue shape making the brain cells stretch and get damaged. This also leads to chemical and metabolic changes within the brain cells as normal function and communication routes are fragmented (1).


In 2015 I received treatment from Ken Kinakin (owner of the Swis

Symposium) at the Irish Symposium who treated me for concussions. He

said that over the years, during my career of playing football (soccer),

heading the ball can cause mild concussion symptoms and affect the

brain tissue and how the brain communicates.


Concussion symptoms start immediately or delayed after the injury, and may include for example loss of consciousness, memory loss, headaches, nausea, blurred vision as well as problems with balance and concentration (1,2).


But how does omega-3 and creatine play a role in aiding concussion recovery?




Omega-3 — agent in the brain 


Omega-3 fatty acids are a group of polyunsaturated fatty acids that have many known health benefits ranging from heart and eye health to fighting inflammation.

But did you know that Omega 3 can also help to recover from acute brain trauma such

as concussion? 


The human body uses three types of omega-3 fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) both found in marine oils as well as alpha-linolenic acid (ALA) found in plant oils (3). In the brain the majority of omega-3 is found in the cell membranes in the form of DHA. It has been found that changing the DHA composition the membranes affect brain function including neuroinflammation, glucose uptake as well as neuron stability (4). In fact, both DHA and EPA have been found to have anti-inflammatory effects in the brain (5).


The effect of omega 3, more precisely DHA, after a traumatic brain injury has been studied mainly in animal models such as rodents. It has been found that a traumatic brain injury reduces DHA in the brain and deficiency of DHA is linked to more signs of injury and slower recovery (6,7).

Supplementing DHA after injury was found to improve cognitive as well as sensorimotor outcomes (8). Moreover, supplementing omega-3 and DHA improved cognitive function, reduced nerve swelling and increased nerve repair after a traumatic brain injury, but was also found having a protective effect before a brain injury (9,10).

Additionally, the uptake of fish oil rich in omega-3 among other substances, was found beneficial in american football players reversing brain damage (15).

More research is needed to verify the effect of omega-3 in sports related concussions, however there are some clinical trials on the subject (11,12).


Best natural sources of omega-3 are fatty fish, which should be eaten a couple of times per week. If this is not possible, then supplements come in handy, because the human body cannot efficiently convert plant based essential fatty acids (e.g. flaxseed

oil) to EPA and DHA (14).



Creatine — Not only for muscle growth, but also for brain protection


Another interesting substance helping to overcome concussion is creatine, which is mainly known aiding muscle mass growth. Creatine has been shown to be neuroprotective and help the brain to recover a trauma (15,16). Biochemically creatine is part of the cell energy generation and enables the generation of ATP (17). Creatine levels in the brain drop after sustaining a concussion (18) and hence, supplying creatine afterwards may enhance brain function through facilitating energy turnover (16). It has been found that creatine supplementation after a traumatic brain injury improved cognition, communication as well as decreased headaches, dizziness, and fatigue, which are all well known effects of a concussion (19,20).


In addition of concussions, creatine supplementation may protect brain function upon acute stress such as sleep deprivation, acute hypoxia and exhaustive exercise (15).

However, it is not yet known, what the best dosing strategy is that would increase brain creatine levels. 


Concussion should never be underestimated although it is usually not a life threatening condition. It can have long lasting effects; it has been for example studied that people who have had a concussion are also 1,6 times more likely to suffer a lower body injury in the following year (21).


References: 

1. What is a concussion: Concussin foundation. 

2. Concussion and sports: Brainline. 

3. Anjali Gupta et al. Treatment of Acute Sports-Related Concussion. Curr Rev Musculoskelet

Med. 2019 Jun; 12(2): 117–123. DOI 10.1007/s12178-019-09545-7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542872/

4. Saini RK, Keum YS. Omega-3 and omega-6 polyunsaturated fatty acids: Dietary sources,

metabolism, and significance - A review. Life Sci. 2018 Jun 15; 203():255-267.

5. Dyall SC, Michael-Titus AT. Neurological benefits of omega-3 fatty acids. Neuromolecular

Med. 2008; 10(4):219-35.

6. Wu A, Ying Z, Gomez-Pinilla F. Exercise facilitates the action of dietary DHA on functional

recovery after brain trauma. Neuroscience. 2013;248:655Y63. doi:

10.1016/j.neuroscience.2013.06.041.

7. Desai A, Kevala K, Kim HY. Depletion of brain docosahexaenoic acid impairs recovery from

traumatic brain injury. PLoS One. 2014;9:e86472. doi: 10.1371/journal.pone.0086472. 

8. Thau-Zuchman O, Gomes RN, Dyall SC, Davies M, Priestley JV, Groenendijk M, De Wilde

MC, Tremoleda JL, Michael-Titus AT. Brain phospholipid precursors administered post-injury

reduce tissue damage and improve neurological outcome in experimental traumatic brain

injury. J Neurotrauma. 2018;36:25–42. doi: 10.1089/neu.2017.5579. 

9. Mills JD, Bailes JE, Sedney CL, Hutchins H, Sears B. Omega-3 fatty acid supplementation

and reduction of traumatic axonal injury in a rodent head injury model. J Neurosurg. 2011

Jan; 114(1):77-84.

10. Wu A, Ying Z, Gomez-Pinilla F. Omega-3 fatty acids supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma. 2007 Oct; 24(10):1587-95

11. Bica D, Armen J. High dose omega-3 fatty acids in the treatment of sport related concussions. In: ClinicalTrials.gov [internet]. Bethesda: National Library ofMedicine (US). Available from: http://clinicaltrials.gov/show/NCT01814527 NLM identifier NCT01814527. Accessed Sep 2018.

12. Miller S. DHA for the treatment of pediatric concussion related to sports injury. In:

ClinicalTrials.gov [internet}. Bethsda: National Library of Medicine (US). Available from:

http://clinicaltrials.gov/show/NCT01903525. Accessed Sep 2018.

13. Amen et al. Reversing brain damage in former NFL players: Implications for traumatic brain injury and substance abuse rehabilitation. J Psychoactive Drugs. 43(1):1-5, 2011.  

14. Hrkal, P. Omega-3 fatty acids and concussions: Is there any benefit? 2017. Complete

concussions. 

15. Dolan, E., Gualano, B., & Rawson, E. S. (2018). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury.

European Journal of Sport Science, 1–14. doi:10.1080/17461391.2018.1500644 

16. Ashbaugh A1, McGrew C., Curr Sports Med Rep. 2016 Jan-Feb;15(1):16-9. doi:

10.1249/JSR.0000000000000219. The Role of Nutritional Supplements in Sports Concussion

Treatment.

17. Be´ard E, Braissant O. Synthesis and transport of creatine in the CNS: importance for

cerebral functions. J. Neurochem. 2010; 115:297Y313.

18. Vagnozzi R, Signoretti S, Floris R, et al. Decrease in N-acetylaspartate following concussion may be coupled to decrease in creatine. J. Head Trauma Rehabil. 2013; 28:284Y92.

19. Sakellaris G, Kotsiou M, Tamiolaki M, et al. Prevention of complications related to traumatic

brain injury in children and adolescents with creatine administration: an open label

randomized pilot study. J. Trauma. 2006; 61:322Y9.

20. Sakellaris G, Nasis G, Kotsiou M, et al. Prevention of traumatic headache, dizziness and

fatigue with creatine administration. A pilot study. Acta Paediatr. 2008; 97:31Y4.

21. Lynall, RC, et al. Acute Lower Extremity Injury Rates Increase after Concussion in College

Athletes. Med Sci Sports Exerc. 2015 Dec;47(12):2487-92. doi:

10.1249/MSS.0000000000000716.