Fish Oil for ADHD Treatment

Fish Oil Benefits

Fish oil is one of the most studied substance in the ADHD. Studies have shown that many children with ADHD have very low blood levels of omega 3 fatty acids. This deficiency is associated with autism, ADHD, dyslexia, apraxia, depression and anxiety. It has been shown that omega 3 fatty acids supplementation improves ADHD symptoms, such as hyperactivity, inattentiveness, aggressions, anxiety, impulsiveness, and learning difficulties.

Fish oil and cod liver oil are excellent sources of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), while flaxseed oil and algal oil are excellent sources of alpha-linolenic acid (ALA), which is the precursor to DHA and EPA. ALA is an essential fatty acid, which means our body cannot produce this fatty acid. Our body makes limited DHA and EPA from ALA. However, this ability is limited. This is even more so in children with ADHD. Males, in particular, have a harder time converting ALA to DHA and EPA than females.

Furthermore, the typical American diet, which is excessive in omega 6 and deficit in omega 3 fatty acids, makes the situation even worse. This comes to no surprise as the major food sources of omega-3 fatty acids are seafood and nuts and seeds. The optimal omega-6 to omega-3 ratio is 4:1. You might think 4:1 – it seems we need more omega 6 than omega 3.

But not if I tell you the typical American diet provides a ratio of 20:1. We eat way too much omega-6 fatty acids in the form of processed foods. That means, our children will need to increase their dietary omega 3 intake by 5 times to get to the optimal 4:1 ratio. That’s a lot of fish to eat.


Both fish oil and cod liver oil contains the omega-3 fatty acids, EPA and DHA. But cod liver oil has a higher EPA content, and it also contains vitamin A and vitamin D, which help boost immunity to fight infection.

Both DHA and EPA play important roles in the brain development. DHA has a structural role and EPA has a functional role in the brain development. EPA affects hormone metabolism, dopamine (neurotransmitter that regulates mood) metabolism and immune systems. DHA is the major structural component of nerve cells. It is also a major component of the retina in the eye.

Fish oil is better choice for children struggling with dyslexia and attentiveness for its higher DHA content. And cod liver oil would be a better choice for children with frequent infection, mood swings and/or depression for its higher EPA content.


During early childhood, the brain develops rapidly. You see the rapid progression of infants transitioning from just crying, drinking, pooping and sleeping to walking, eating, and talking in merely under one year. This is also why we always say baby’s brain is like a sponge. It absorbs new knowledge and skills very quickly. In fact, the infant brain doubles in weight by 2 years of age from birth, and continues to develop rapidly until at least 5 years of age. And the brain does not stop development and reshaping until we die. Amazing…


The answer is FATS…DIETARY FATS.

As the brain develops more nerve cells, more fat, in the form of fatty acids, is needed. Omega 3 fatty acids make up about 8-10 percent of brain tissues. It is the major components of myelin sheaths on nerve cells. Myelin is the fatty coating on nerve cells. The myelin sheaths insulate nerve cells (imagine electrical wiring) to ensure smooth uninterrupted transmission of impulses, preventing misfiring of nerve impulses. The rapid myelination during early childhood is what helps brain develops.

Because of this special needs in infants and young children, fat should not be restricted. Infants and children up to 2 years old should maintain a diet of up to 50% of calories coming from fat.

Healthy fats, such as avocado, safflower oil, olive oil, organic animal fats, organic eggs, coconut oil, and organic nut oils are encouraged. Organic oils/fats are preferred because pesticides, hormones and other chemicals tend to accumulate in fatty tissues in animals and/or plants. The organic choices will help to minimize intake of these substances, which can affect brain developments and health.


Children with ADHD need more DHA and EPA than other children. They may need up to 500mg to 1,000mg DHA from fish oil or cod liver oil. Remember these children have defective fatty acid metabolism, which makes converting ALA to DHA/EPA difficult. This is even more so in males than in females. Therefore, the best route to get adequate DHA and EPA is through fish oil or cod liver oil.

Most supplement container shows the total amount of fish oil, DHA and EPA per capsule. From here, you will have to do some math to figure out how many capsules your child needs to get to 500mg. Don’t be surprised if it takes 4-6 capsules to get to 500mg. If your child prefers the gummy fish oil, the number could be double (10-12 pills).

Fish oil supplements have become very popular due to its many benefits and supporting researches. Manufacturers are coming out with new products that are flavorful for children. Look for high potency ones that deliver high dose of DHA in a more condense form. These tend to be more expensive. Therefore, when buying fish oil make sure you know what you are looking for, then price compare. It may be cheaper to buy a more expensive bottle, that your child may need only 1 pill a day versus a cheaper bottle that he/she will need 4-6 pills a day.

Cod liver oil is a good choice too. Besides providing EPA and DHA, it also provides vitamin A and vitamin D that are not in fish oil supplements.

The fish oil and cod liver oil below are 2 that I’d recommend as both provide beneficial amount of DHA and EPA in one serving. The Dr. Tobias’ brand needs only 2 pills a day and the Pipping Rock needs only 1 tsp (5ml) a day to get the right amount of DHA and EPA. Please don’t buy fish oil “gummies”. I have so many parents proclaim proudly that they give their children fish oil gummies, but was shock when I told them they have to increase to 10-15 gummies a day to get the beneficial 500mg of DHA. So don’t waste your money on “gummies”.


Improvements may be gradual. Allow at least 4 months to determine if the supplementation is helping or not. Keep a diary of behavior helps too.

Author: Anna

I'm a board-certified Pediatric Nutritionist, who takes care of medically-fragile infants and children in the US Defense System; I'm mother of a teenager and a real estate investor. I love spending time with friends and family playing tennis, golf, hiking and stand-up-paddling. And we live in Honolulu, Hawaii.