Any time you use a nutritional supplement to support brain health, and especially when you are using nutrition to support brain health in Alzheimer's, you have to be ready for consequences of success. If you really can restore memory, judgment, and mobility, you need to be ready to deal with a person who remembers, makes choices that you may or may not agree with, and who can get around. More than most other conditions, Alzheimer's disease is a condition in which good intentions can lead to unexpected consequences.
Fish Oil for Alzheimer's Disease
That being said, some people in the early stages of Alzheimer's disease benefit from taking up to 2,000 mg of fish oil every day. People with Alzheimer's who carry the APOέ-4 gene won't benefit from fish oil supplements, but others in the early stages of the disease may decline more slowly. Fish oil contains two essential fatty acids, DHA and EPA. It is probably necessary to supplement both fatty acids to get any benefits. A brand of fish oil that is higher in DHA than in EPA, but which provides both DHA and EPA, like Xtend-Life, is probably a better choice.
Microalgae products are expensive and probably won't help because they only provide DHA. A clinical study of microalgae-derived DHA for preventing loss of brain mass in Alzheimer's disease that was reported in the Journal of the American Medical Association in November 2010 found that a supplement that only provided DHA, with no EPA, did not slow progression of the disease.
If You Are Only Going to Try One Supplement, Try Fish Oil
The main advantage of supplementing with fish oil is that (1) it may help slow progression of Alzheimer's symptoms and (2) it does not have to be given with any other supplements to ensure balanced nutrition. That is not the case with antioxidant therapy for Alzheimer's disease. Here is why it is a mistake to pick and choose antioxidant supplements for Alzheimer's.
- Beta-carotene is especially effective at capturing free radicals of oxygen, but it only works when there is adequate oxygen in the bloodstream. When oxygen concentrations are low, as in the case of vascular disease, vitamin E is a more effective antioxidant.
- Beta-carotene and vitamin E protect the parts of the cell that contain cholesterol, such as the cell membrane (the lining of the cell has to be “fatty” to keep the contents of the cell from dissolving into the bloodstream), but vitamin C protects the water-soluble components of the cell inside. Too much vitamin C or vitamin E causes the vitamin to act as a pro-oxidant, that is, to become tissue-destructive, in the parts of the cell it does not usually protect. Too little vitamin C makes it difficult for the brain to use vitamin E, because vitamin C recycles vitamin E as it captures free radicals.
- The mitochondria, or energy centers, in cells in the brains of people at high risk for AD often have a defect that can be compensated by additional coenzyme Q10 and NADH. Coenzyme Q10 neutralizes peroxide radicals better than vitamin E, but it is not as effective in quenching other kinds of radicals. Coenzyme Q10 also recharges vitamin E, but not as effectively as vitamin C.
- In doses above 500 milligrams (mg) per day for more than two weeks, n-acetyl cysteine (NAC) acts as a chelator of zinc, that is, it removes zinc from circulation. After two weeks of taking 500 mg of NAC a day, it is necessary either to take supplemental zinc or to lower the dosage of NAC. Alpha-lipoic acid can also deplete zinc.
- Vitamin E in megadoses can cause bleeding. Aspirin in high doses can cause bleeding. Vitamin E and aspirin together even in moderate doses can cause bleeding. When vitamin E is accidentally dosed at a rate of more than 3,000 IU per day, it is necessary to take vitamin K to prevent bleeding (a single 5 mg tablet is sufficient).
- The half- life of antioxidants in the human bloodstream is only 6 to 12 hours, so half of each dose of antioxidants has to be taken twice a day.
I am not listing all these problems with antioxidant therapies to tell you that you should never try antioxidant therapy for Alzheimer's disease. I am just saying that making it work is quite complicated. If you are going to start with an easy nutritional intervention for Alzheimer's that just may work and that won't cost you a lot of money, choose fish oil.
Brands that pack the most essential fatty acids into the smallest capsules, such as Nordic Naturals, New Vitality, and Xtend-Life, are the easiest to administer and cost about the same as the brands that cost less per bottle but deliver a lot less of the essential fatty acids in each capsule. "Red krill oil" capsules are smaller and easier to swallow, but a lot more expensive per dose.