What supplements are recommended for patients recovering from a concussion?

Recommended Supplements for Concussion Recovery

There are no FDA-approved supplements specifically for concussion recovery, but several nonpharmacological interventions and certain supplements may be considered as part of a comprehensive treatment approach for patients recovering from concussion. 1, 2

Evidence-Based Nonpharmacological Interventions

First-Line Approaches

1. Early Education and Information

   • Systematic education about symptom management and self-care within first 4 weeks after concussion 1
   • Reduces overall symptom burden, memory problems, and impact on leisure/work activities

2. Graded Physical Exercise

   • Begin after initial 24-48 hour rest period
   • Progressive return to activity following this stepwise approach:
     • Level 1: No activity
     • Level 2: Light aerobic exercise
     • Level 3: Sport-specific training
     • Level 4: Non-contact training drills
     • Level 5: Full contact training (only after medical clearance) 3
   • Only progress if asymptomatic at current level; return to previous level if symptoms recur

3. Targeted Rehabilitation for Specific Symptoms

   • Vestibular rehabilitation for persistent dizziness/balance issues
   • Manual therapy for neck and spine if pain is present
   • Psychological treatment for emotional symptoms 1

Supplements with Some Evidence

Melatonin

• Recommended by the American Academy of Sleep Medicine for post-concussion sleep disorders 3
• Advantages include minimal side effects
• Helps regulate sleep-wake cycles commonly disrupted after concussion

Omega-3 Fatty Acids

• Strong preclinical evidence but limited clinical trial data 4, 5
• May help with neuroinflammation and neuroprotection
• Food sources: fatty fish (salmon, mackerel), flaxseeds, walnuts
• Optimal timing and dosing remain unclear
• Caution: One human trial showed higher dosages pre-injury were associated with more concussions 2

Branched Chain Amino Acids (BCAAs)

• Recent pilot RCT (2024) showed dose-response effect in reducing concussion symptoms 6
• Higher doses associated with faster return to baseline physical activity
• Generally well-tolerated with minimal gastrointestinal side effects
• Food sources: meat, dairy products, legumes

Vitamin Considerations

• Low serum levels of vitamins D, C, and E associated with worse outcomes in animal studies 2
• Consider testing and correcting deficiencies
• Multivitamins may be beneficial as part of overall nutritional support

Sleep Management

• Sleep disturbances are common after concussion
• Cognitive Behavioral Therapy for Insomnia (CBT-I) recommended as first-line treatment 3
• Establish consistent sleep schedule and practice good sleep hygiene
• Create quiet, dark, and cool sleeping environment
• Avoid screens before bedtime and limit caffeine

Important Considerations and Monitoring

• Monitor symptoms throughout recovery
• Avoid driving until cleared by healthcare provider
• Avoid alcohol and recreational drugs during recovery
• Never return to high-risk activities while still symptomatic
• Consider referral for specialized evaluation if symptoms persist beyond 4 weeks

Supplements to Avoid

• Caffeine may be detrimental if taken after concussion 2
• Diphenhydramine, benzodiazepines, and antipsychotic drugs have weak evidence or potential risks 3

While several supplements show promise in preclinical studies, the evidence for most remains limited in human clinical trials. The strongest current evidence supports nonpharmacological interventions like graded exercise, vestibular rehabilitation, and proper sleep management, with melatonin, omega-3s, and BCAAs as potential supplemental approaches.