January 31, 2025 • 9 mins
In this episode of Daily Value, we explore the potential of omega-3 fatty acids, particularly EPA and DHA, as an adjunctive therapy for reducing anxiety symptoms. A recent meta-analysis (PMID: 38890670) reviewed 23 randomized controlled trials involving over 2,100 participants, revealing that a certain amount of omega-3s per day can significantly reduce anxiety symptoms, especially when combined with traditional treatments like antidepressants.
Talking points:
- Anxiety disorders: what are they and how many people have them?
- Fish oil benefits for anxiety disorders
- Effective dosage of omega-3 fatty acids for reducing anxiety symptoms.
- Mechanisms of action: Omega-3s may reduce anxiety through 4 proposed mechanisms.
https://pubmed.ncbi.nlm.nih.gov/38890670/
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Daily Value.
I'm William Wallace, and todaywe're going to be exploring a
topic of growing interest inboth the medical and nutritional
sciences, a topic that we caneffectively put under the
umbrella of one of my favoritegeneral topics, that being
nutritional psychiatry.
Specifically, we're going to betalking about omega-3 fatty
acids and the potential theiruse in certain doses might have
(00:22):
for reducing anxiety symptoms inadults, the topic being
stimulated by a recentmeta-analysis suggesting that
omega-3 fatty acidsupplementation could be a
promising adjunctive therapy forreducing anxiety symptoms.
This episode will dissect thefindings, explore the potential
mechanisms and discuss how theseinsights might be applied in
(00:44):
clinical practice.
As always, please remember thatthis podcast is for educational
purposes only and it does notsubstitute for professional
medical advice.
Consult your healthcareprovider before making any
changes to your treatment plan,especially if you are taking
medications or have beendiagnosed with a clinical
anxiety disorder, or have beendiagnosed with a clinical
(01:06):
anxiety disorder.
Anxiety disorders are among themost prevalent mental health
issues in the world.
In fact, some data suggeststhat over 34% of people
worldwide experience an actualanxiety disorder at some point
in their lives.
Anxiety symptoms can be one ofmany things and present itself
differently across differentpeople.
(01:27):
The American PsychiatricAssociation Dictionary defines
anxiety as an emotioncharacterized by apprehension
and somatic symptoms of tension,in which an individual
anticipates impending danger,catastrophe or misfortune.
To maybe put it in a bit moresimple terms, anxiety comes with
(01:48):
two different sets of symptoms.
Those are emotional symptomslike feeling fear or
apprehension, maybe evenforeboding, and the other set of
symptoms are somatic meaning ofthe body, and those include
things like an increased heartrate, trembling and so on.
A shared characteristic acrossanxiety disorders would be an
increase in either set ofsymptoms.
(02:09):
Now, in order to be an anxietydisorder, symptoms have to be
present for up to six months andwhen the symptoms are out of
proportion to the actual threator the perceived threat.
While traditional treatmentssuch as cognitive behavioral
therapy and pharmacotherapy areeffective, they are not without
limitations and or side effects,especially the use of
(02:30):
traditional medications whenused at high doses and for long
periods of time.
Such medications includeselective serotonin reuptake
inhibitors, like paroxetine, orselective serotonin
norepinephrine reuptakeinhibitors, like venlafaxine.
These medications can beeffective, but are also
associated with side effects,such as dependency, tolerance
(02:54):
issues, as well as sexualdysfunction, which can limit
their long-term use.
The potential side effectslimiting the use of the
medications for many people hasled to interest in nutritional
factors that play a role in, orcould aid in treating symptoms
of something like anxiety.
Omega-3 polyunsaturated fattyacids, or PUFAs, particularly
(03:16):
eicosapentaenoic acid, that isEPA, and docosahexaenoic acid,
that is DHA, have been shown toregulate things like dopamine
and serotonin signaling in thebrain, making them potential
candidates for reducing anxietysymptoms.
The brain needs a sufficientamount of both of these fatty
acids to function properly, asthey act as both signaling
(03:37):
molecules and structural supportmolecules.
The central nervous systemactually has the second highest
concentration of these fattyacids, next to adipose tissue.
There are several mechanismstied to the prospect of EPA and
DHA reducing anxiety symptoms.
A systematic review that waspublished in 2020 suggested four
(03:58):
potential mechanisms.
Those include reducing theinflammatory response associated
with anxiety, increasingbrain-derived neurotrophic
factor, or BDNF, loweringcortisol and supporting
cardiovascular health.
Research has demonstrated thatan anti-inflammatory response in
the form of inflammatoryprotein release are associated
(04:18):
with anxiety.
Data in animals and humansshows a decrease in these
inflammatory proteins whentaking insufficient amounts of
omega-3 fatty acids.
Likewise, circulating BDNFlevels are higher in people with
a higher omega-3 index.
Higher omega-3 index.
Now, whether that's meaningfulfor the brain or not is up for
(04:38):
debate, since peripheral BDNF isprimarily platelet-derived, but
that's a totally separatediscussion.
It's those two particularmechanisms which have been tied
to omega-3 supplementation,specifically two grams per day
of EPA, being useful forreducing depressive symptoms.
Now a meta-analysis publishedin 2018 did find that 2 grams of
total omega-3 supplementationdid improve anxiety symptoms in
(05:01):
adults, but there are alsoplenty of studies that have
found no relation to omega-3supplementation and reduced
anxiety as such.
The optimal dosage and efficacyof omega-3 supplementation in
anxiety management has beenunclear, prompting the recent
publication that brought on thistopic.
The meta-analysis published byBafkar et al and published in
(05:24):
BMC Psychiatry reviewed 23randomized controlled trials
with a total of 2,189participants to evaluate the
dose-dependent effects ofomega-3 supplementation on
anxiety symptoms.
The results indicated thatsupplementation with one gram
per day of omega-3 fatty acids,that's, dha and EPA, led to a
(05:45):
moderate reduction in anxietysymptoms, with the most
significant improvement observedat a dosage of two grams per
day.
Importantly, doses above twograms per day did not confer
additional benefits.
Now there are two importantnuances in the findings to point
out.
Firstly, there did not seem tobe an effect when looking at a
subgroup of people who had avery high baseline risk for
(06:07):
anxiety or depressive symptoms,people who may need treatment
the most.
However, for people who werebeing treated with
antidepressants or anxiolyticmedications, there was a
significant improvement inanxiety symptoms in people using
omega-3 in conjunction withtheir medication, compared to
people not using medication orusing medication but no
(06:30):
additional omega-3s.
This suggests that omega-3s maybe more effective as an adjunct
treatment in combination withmedication that people may
already be using, prescribed fortheir anxiety.
Now there is research showingthat omega-3s can be effective
at enhancing the antidepressiveeffects of antidepressant
medication.
(06:50):
The last noteworthy finding ofthis study was that this study
was unable to find a differencein effectiveness of EPA versus
DHA, mostly because the studiesthey looked at were often
combining DHA and EPA, like isoften the case in real-world
supplement settings.
As I mentioned previously,there are studies suggesting
(07:13):
that EPA-dominant formulas doreduce depressive symptoms more
strongly than DHA-dominantformulas do reduce depressive
symptoms more strongly thanDHA-dominant formulas, but for
the purpose of anxiety-relatedsymptoms, the best we can say
right now is 2 grams of combinedDHA and EPA may provide an
effect, even if small, so that'sa good starting point.
It is worth noting that studieswith a high risk of bias in the
(07:34):
AMET analyses reported thelargest effect sizes compared to
the studies, with less risk ofbias, meaning that the overall
quality of evidence available onthis topic right now is quite
low.
So what do these findings meanfor actual real-world practice?
Well, the evidence suggests thatomega-3 supplementation,
particularly at a dosage ofaround 2 grams per day, could be
(07:57):
an effective adjunctive therapyfor individuals with anxiety
disorders.
This is especially relevant forpeople who experience side
effects from conventionalmedications or those who are
seeking complementary therapiesto what they're already doing.
For practitioners, it'simportant to consider the type
of omega-3 supplement being used.
A balanced supplementcontaining EPA and DHA with a
(08:21):
dosage of approximately 2 gramsper day may support intended
outcomes, but when it comes tothings like depressive symptoms,
epa-dominant formulas may farebest.
Overall, 2 grams a day ofcombined EPA and DHA are a
suitable suggestion for mostpeople for general health
purposes.
In conclusion, while omega-3fatty acids hold promise as a
(08:43):
safe and potentially effectiveintervention for reducing
anxiety symptoms, they should beconsidered as part of a broader
, individualized treatment plan.
Thank you for tuning in toDaily Value.
If you found this episodeinsightful, please subscribe and
share it with others who mightbenefit from this information.
Until next time, stay informedand stay mentally healthy.
Welcome to Daily Value.
I'm William Wallace, and todaywe're going to be exploring a
topic of growing interest inboth the medical and nutritional
sciences, a topic that we caneffectively put under the
umbrella of one of my favoritegeneral topics, that being
nutritional psychiatry.
Specifically, we're going to betalking about omega-3 fatty
acids and the potential theiruse in certain doses might have
(00:22):
for reducing anxiety symptoms inadults, the topic being
stimulated by a recentmeta-analysis suggesting that
omega-3 fatty acidsupplementation could be a
promising adjunctive therapy forreducing anxiety symptoms.
This episode will dissect thefindings, explore the potential
mechanisms and discuss how theseinsights might be applied in
(00:44):
clinical practice.
As always, please remember thatthis podcast is for educational
purposes only and it does notsubstitute for professional
medical advice.
Consult your healthcareprovider before making any
changes to your treatment plan,especially if you are taking
medications or have beendiagnosed with a clinical
anxiety disorder, or have beendiagnosed with a clinical
(01:06):
anxiety disorder.
Anxiety disorders are among themost prevalent mental health
issues in the world.
In fact, some data suggeststhat over 34% of people
worldwide experience an actualanxiety disorder at some point
in their lives.
Anxiety symptoms can be one ofmany things and present itself
differently across differentpeople.
(01:27):
The American PsychiatricAssociation Dictionary defines
anxiety as an emotioncharacterized by apprehension
and somatic symptoms of tension,in which an individual
anticipates impending danger,catastrophe or misfortune.
To maybe put it in a bit moresimple terms, anxiety comes with
(01:48):
two different sets of symptoms.
Those are emotional symptomslike feeling fear or
apprehension, maybe evenforeboding, and the other set of
symptoms are somatic meaning ofthe body, and those include
things like an increased heartrate, trembling and so on.
A shared characteristic acrossanxiety disorders would be an
increase in either set ofsymptoms.
(02:09):
Now, in order to be an anxietydisorder, symptoms have to be
present for up to six months andwhen the symptoms are out of
proportion to the actual threator the perceived threat.
While traditional treatmentssuch as cognitive behavioral
therapy and pharmacotherapy areeffective, they are not without
limitations and or side effects,especially the use of
(02:30):
traditional medications whenused at high doses and for long
periods of time.
Such medications includeselective serotonin reuptake
inhibitors, like paroxetine, orselective serotonin
norepinephrine reuptakeinhibitors, like venlafaxine.
These medications can beeffective, but are also
associated with side effects,such as dependency, tolerance
(02:54):
issues, as well as sexualdysfunction, which can limit
their long-term use.
The potential side effectslimiting the use of the
medications for many people hasled to interest in nutritional
factors that play a role in, orcould aid in treating symptoms
of something like anxiety.
Omega-3 polyunsaturated fattyacids, or PUFAs, particularly
(03:16):
eicosapentaenoic acid, that isEPA, and docosahexaenoic acid,
that is DHA, have been shown toregulate things like dopamine
and serotonin signaling in thebrain, making them potential
candidates for reducing anxietysymptoms.
The brain needs a sufficientamount of both of these fatty
acids to function properly, asthey act as both signaling
(03:37):
molecules and structural supportmolecules.
The central nervous systemactually has the second highest
concentration of these fattyacids, next to adipose tissue.
There are several mechanismstied to the prospect of EPA and
DHA reducing anxiety symptoms.
A systematic review that waspublished in 2020 suggested four
(03:58):
potential mechanisms.
Those include reducing theinflammatory response associated
with anxiety, increasingbrain-derived neurotrophic
factor, or BDNF, loweringcortisol and supporting
cardiovascular health.
Research has demonstrated thatan anti-inflammatory response in
the form of inflammatoryprotein release are associated
(04:18):
with anxiety.
Data in animals and humansshows a decrease in these
inflammatory proteins whentaking insufficient amounts of
omega-3 fatty acids.
Likewise, circulating BDNFlevels are higher in people with
a higher omega-3 index.
Higher omega-3 index.
Now, whether that's meaningfulfor the brain or not is up for
(04:38):
debate, since peripheral BDNF isprimarily platelet-derived, but
that's a totally separatediscussion.
It's those two particularmechanisms which have been tied
to omega-3 supplementation,specifically two grams per day
of EPA, being useful forreducing depressive symptoms.
Now a meta-analysis publishedin 2018 did find that 2 grams of
total omega-3 supplementationdid improve anxiety symptoms in
(05:01):
adults, but there are alsoplenty of studies that have
found no relation to omega-3supplementation and reduced
anxiety as such.
The optimal dosage and efficacyof omega-3 supplementation in
anxiety management has beenunclear, prompting the recent
publication that brought on thistopic.
The meta-analysis published byBafkar et al and published in
(05:24):
BMC Psychiatry reviewed 23randomized controlled trials
with a total of 2,189participants to evaluate the
dose-dependent effects ofomega-3 supplementation on
anxiety symptoms.
The results indicated thatsupplementation with one gram
per day of omega-3 fatty acids,that's, dha and EPA, led to a
(05:45):
moderate reduction in anxietysymptoms, with the most
significant improvement observedat a dosage of two grams per
day.
Importantly, doses above twograms per day did not confer
additional benefits.
Now there are two importantnuances in the findings to point
out.
Firstly, there did not seem tobe an effect when looking at a
subgroup of people who had avery high baseline risk for
(06:07):
anxiety or depressive symptoms,people who may need treatment
the most.
However, for people who werebeing treated with
antidepressants or anxiolyticmedications, there was a
significant improvement inanxiety symptoms in people using
omega-3 in conjunction withtheir medication, compared to
people not using medication orusing medication but no
(06:30):
additional omega-3s.
This suggests that omega-3s maybe more effective as an adjunct
treatment in combination withmedication that people may
already be using, prescribed fortheir anxiety.
Now there is research showingthat omega-3s can be effective
at enhancing the antidepressiveeffects of antidepressant
medication.
(06:50):
The last noteworthy finding ofthis study was that this study
was unable to find a differencein effectiveness of EPA versus
DHA, mostly because the studiesthey looked at were often
combining DHA and EPA, like isoften the case in real-world
supplement settings.
As I mentioned previously,there are studies suggesting
(07:13):
that EPA-dominant formulas doreduce depressive symptoms more
strongly than DHA-dominantformulas do reduce depressive
symptoms more strongly thanDHA-dominant formulas, but for
the purpose of anxiety-relatedsymptoms, the best we can say
right now is 2 grams of combinedDHA and EPA may provide an
effect, even if small, so that'sa good starting point.
It is worth noting that studieswith a high risk of bias in the
(07:34):
AMET analyses reported thelargest effect sizes compared to
the studies, with less risk ofbias, meaning that the overall
quality of evidence available onthis topic right now is quite
low.
So what do these findings meanfor actual real-world practice?
Well, the evidence suggests thatomega-3 supplementation,
particularly at a dosage ofaround 2 grams per day, could be
(07:57):
an effective adjunctive therapyfor individuals with anxiety
disorders.
This is especially relevant forpeople who experience side
effects from conventionalmedications or those who are
seeking complementary therapiesto what they're already doing.
For practitioners, it'simportant to consider the type
of omega-3 supplement being used.
A balanced supplementcontaining EPA and DHA with a
(08:21):
dosage of approximately 2 gramsper day may support intended
outcomes, but when it comes tothings like depressive symptoms,
epa-dominant formulas may farebest.
Overall, 2 grams a day ofcombined EPA and DHA are a
suitable suggestion for mostpeople for general health
purposes.
In conclusion, while omega-3fatty acids hold promise as a
(08:43):
safe and potentially effectiveintervention for reducing
anxiety symptoms, they should beconsidered as part of a broader
, individualized treatment plan.
Thank you for tuning in toDaily Value.
If you found this episodeinsightful, please subscribe and
share it with others who mightbenefit from this information.
Until next time, stay informedand stay mentally healthy.
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