What supplements are recommended for concussion healing?

Supplements for Concussion Healing

Omega-3 fatty acids are the most promising supplement for concussion healing, with the strongest evidence supporting their use for neuroprotection and reducing neuroinflammation after traumatic brain injury. 1, 2

Evidence-Based Supplement Recommendations

Primary Recommendation: Omega-3 Fatty Acids

• Dosage: Early and optimal doses of omega-3 fatty acids (DHA and EPA)
• Mechanism: Helps decrease inflammation, reduce neural damage, and maintain adequate energy supply to the brain following injury 3
• Evidence Quality: Strongest evidence among all supplements for concussion recovery
• Timing: May be effective when administered post-injury (not just as prophylaxis) 4
• Safety Profile: Unsurpassed safety and tolerability 1

Secondary Options with Emerging Evidence

1. Melatonin

   • May improve sleep disturbances often experienced post-concussion 3
   • Has shown some benefit for persistent post-concussion symptoms 2

2. Pinus radiata (Enzogenol)

   • May have benefit for persistent post-concussion symptoms 2
   • Requires additional multi-center studies before definitive conclusions

3. N-Acetylcysteine (NAC)

   • Has demonstrated positive short-term effects on blast injuries in soldiers if administered within 24 hours 4
   • No specific studies in sports-related concussion yet

4. Other Potential Supplements:

   • Creatine monohydrate: May help maintain energy supply to the brain 3
   • Magnesium: Under investigation for neuroprotective effects 3
   • B vitamins: Lower levels of certain vitamins pre-injury associated with worse outcomes in animal studies 4

Important Considerations

Timing of Supplementation

• Early intervention appears critical for most supplements
• Post-injury administration of omega-3s can be as effective as prophylactic use 4

Cautions

• Caffeine: May be detrimental if taken after sports-related concussion 4
• FDA Warning: No supplement has been definitively proven to treat concussions 4
• Evidence Gap: Most positive findings come from animal studies on severe TBI, which may not directly translate to sports-related concussions 4

Nutritional Status Assessment

• Consider checking for pre-existing deficiencies, particularly:
  • Vitamin D
  • Vitamin C
  • Vitamin E
  • Correction of deficiencies may be beneficial 4

Micronutrient Considerations

Clinical guidelines recommend that all nutritional prescriptions should include appropriate doses of multivitamins and trace elements 5, which is particularly relevant in concussion recovery:

• Selenium: Important for antioxidant defense, which is especially challenged in injured patients 5
• Zinc: May require supplementation (15 mg/day) as part of recovery 5
• Vitamin C: May require supplementation (100 mg three times daily) 5

Future Directions

Current ongoing human trials may provide more information on new options for concussion recovery, including:

• Probiotics
• Lactate
• Amino acids 6

While more clinical research is needed, the preclinical evidence and clinical experience suggest that optimizing nutrition with omega-3 fatty acids and addressing micronutrient deficiencies offers a promising approach to improving outcomes from concussion.