Activ Bundle

ActivNeeds is a blend of 55 different active ingredients. For many of the active ingredients, ActivNeeds contains higher dosing for additional benefit beyond achievable by even the healthiest of diets. This is done while maintaining generally moderate dosing at levels that are unexpected to result in side effects. Additional ingredients provide for comprehensive micronutrition, so that a multivitamin is unnecessary if you are taking ActivNeeds. Most of the 55 active ingredients in ActivNeeds are focused on improving mitochondrial metabolism and protection from oxidative damage. However, several additional ingredients act upon multiple other pathways, including cation channels, neurotransmission, inflammation, methylation, and neuroprotection.

• Vitamins (A, B1, B2, B3, B5, B6, B7, B9, B12, C, D3, E, and K1)
  • Many are in activated forms with higher efficacy and tolerability than are present in most products, including B2 (riboflavin-5-phosphate), B6 (pyridoxal-5-phosphate), B9 (methyltetrahydrofolate), and B12 (methylcobalamin).
  • Other nutrients such as choline, inositol, and vitamin K2-7 are true vitamins but uncommon in most products.
• Minerals (boron, chromium, iodine, magnesium, manganese, molybdenum, selenium, vanadium, and zinc), many of which are uncommon in most products.
• Additional nutrients critical for energy metabolism: acetyl L-carnitine, alpha ketoglutarate, alpha lipoic acid, L-carnitine, coenzyme Q10, creatine, L-malic, and D-ribose.
• Plant-based antioxidants to protect cells against oxidative toxicity: blueberry, curcumin, quercetin, and rutin.
• Amino acids that stimulate nitric oxide synthase and thus maintain open blood vessels in the brain, heart, and elsewhere: L-arginine and L-citrulline.
  • L-lysine is included to balance the effects of arginine.
• Compounds shown to slow aging: nicotinamide riboside, pomegranate (to naturally produce urolithin A), and resveratrol.
• Nootropic compounds to boost brain alertness and to reduce mental fatigue: ashwagandha, brahmi, eleuthero, phosphatidylserine, rhodiola, taurine, and L-theanine.
• Black pepper (trace amount to increase absorbance of many of the above ingredients).

ActivNeeds is intended for people of any age who want to be more active and to get more out of life. For example:

• Young adults wishing to increase their athletic performance and endurance by safe, legal, and natural means accepted by sports organizations. In particular, the focus on the mitochondria should translate to improved recovery times.
• Middle-aged adults working long hours, with active social lives, who refuse to admit that they are no longer in their 20s to 30s.
• Older people wishing to improve their activity level and endurance, such as to travel, golf, or interact with their grandchildren. Many of the ingredients have been shown in studies to slow the aging process.

Consult your physician before starting ActivNeeds, or any high-potency dietary supplement, especially if you are pregnant, nursing, or taking medication. Some of the ingredients may interact with medications, in particular related to blood sugar or pressure.   

Suggested Use: 

Healthy adults: Take three (3) scoops [12 g] in the morning.

For prolonged effect: Take two (2) scoops [8 g] in the morning and one (1) scoop [4 g] in the late afternoon. Sensitive & elderly: Start at a lower dose (e.g., 1 scoop), and increase as tolerated.

For nootropic effects: Take with caffeine for increase focus and cognition.

“Start low, go slow” is a common saying among physicians advising their patients on starting a new treatment, whether a medication or a dietary supplement. It is prudent to give the body time to adjust to the new treatment. This is particularly true for older or more sensitive people, including those on medications. However, a slower start can benefit anyone in avoiding GI (gastrointestinal) side effects such as nausea, as can taking ActivNeeds with a meal.

How “low” and how “slow” is individualized. Consider starting at one scoop [4 g] and increasing to 1½ scoops [6 g], then to 2 scoops [8 g] every other day.

30 days if used at the suggested dosing of 3 scoops [12 g] a day.

No.

All ingredients in ActivNeeds, both active and inactive, are natural, and are components found in a variety of whole foods. The dosing for all ingredients are Generally Considered As Safe (GRAS) by regulatory agencies in both the United States and the equivalent for the European Union. ActivNeeds is fully vegan except for vitamin D extracted from sheep wool.

Any product can cause nausea on ingestion, and occasional cases of nausea with ActivNeeds ® are mitigated by taking lower dosing at first and working up, and/or ingesting with a meal.

If the product gives you too much energy, lower the dose taken.

This question is best asked to your health care provider, but some general guidance is provided herein for you and your provider.

If the amount of the nutrient currently taken is less or about the same as that provided by ActivNeeds, consider stopping the supplement at the time you start ActivNeeds. For example, if you currently are taking 250 mg a day of vitamin C a day, since the amount of vitamin C in ActivNeeds ® is 500 mg a day, you can stop the vitamin C supplement.

If the amount of the nutrient currently taken is more than that provided by ActivNeeds, consider reducing the amount of the supplement you are taking. For example, if you currently are taking 125 mg a day of magnesium, since the amount of ActivNeeds is 75 mg a day, you can reduce the magnesium supplement to 50 mg a day. This maintains the same dosage.

Most standard multivitamin tablets have quite low dosing of every nutrient, and can be discontinued when you start ActivNeeds without additional supplementation. Compare the amounts of each nutrient before making a decision.

Yes, ActivNeeds capsules can be mixed in with formula for tube feedings, especially if that tube goes to the stomach. Most of the ingredients are absorbed in the small intestine, and may or may not be adequately absorbed with jejunal (intestinal) feedings.

No, ActivNeeds does not include omega-3 fatty acids (“omega 3s”. Omega-3s are critical for overall health, including that of the brain and heart. Unless your diet is heavy on wild-caught seafoods, it is likely highly deficient in omega-3s, and it is highly recommended that an omega-3 source be supplemented as well. As fish oil-derived omega-3s do not directly cross into brain, but krill oil-derived omega-3s do, a product that includes krill oil is recommended by Dr. Boles for brain health, including for reducing mental fatigue. NeuroNeeds® has an omega-3 product, OmegaNeeds®, derived from both krill (for brain) and fish (for heart), as well as phosphatidylserine from sunflower seed (for brain). To learn more about why fish oil products do not directly enter brain, click here.

Your physician may wish to add additional dietary supplementation beyond ActivNeeds, tailored to each unique person.

In particular, additional coenzyme Q10 (CoQ10) in the form of ubiquinol is highly recommended. CoQ10 plays a pivotal role in energy metabolism, and the dosing in ActivNeeds alone is insufficient to reach a therapeutic blood level in Dr. Boles’ opinion. CoQ10 comes in two different forms, ubiquinone (the form present in most products) and ubiquinol (a highly bioavailable form). ActivNeeds is best if taken with additional ubiquinol. Dr. Boles generally recommends adding a ubiquinol supplement on top of ActivNeeds at 200 mg twice daily (400 mg a day) for anyone age 12 years or older. NeuroNeeds® markets our own brand of ubiquinol, QNeeds®, which has excellent bioavailability, even above most other ubiquinol products.

QNeeds® is a highly bioavailable form of coenzyme Q10 (coQ10). CoQ10 is an essential electron carrier in the respiratory chain, where almost all of the energy for the body is produced. It also functions as an antioxidant, which protects the body from damage caused by harmful molecules. Many chronic conditions, especially those involving mitochondrial function, can increase the demand for CoQ10 in the body, leading to deficiency. Having been a mainstay of the mito-cocktail in the treatment of mitochondrial disease for decades, many physicians now recommend CoQ10 supplementation for a variety of different medical conditions.

Some chronic conditions, especially those involving mitochondrial function, can increase the demand for coQ10 in the body, leading to deficiency. CoQ10 is generally present in only small amounts in foods, which leads many physicians to recommend supplementation. CoQ10 is sometimes recommended for treating a wide range of conditions, especially those associated with mitochondrial dysfunction, including functional, neurodevelopmental, and cardiac conditions. Functional conditions involve anomalous symptomatology from disease of the nervous system, and include migraine, fibromyalgia, other pain conditions, cyclic vomiting, irritable bowel, gastroparesis, chronic fatigue, and dysautonomia. Studies have demonstrated benefits of coQ10 in migraine (multiple), cyclic vomiting, fibromyalgia, and chronic fatigue syndrome, among others. Anxiety, depression, and panic disorder are also considered functional, and sometimes improve as well with coQ10. Neurodevelopmental disorders include autism, ADHD, intellectual disability, and epilepsy). In one study in autism, significant improvements were noted in communication skills, playing with friends, sleeping, and food acceptance with coQ10 supplementation to plasma levels above 2.2 mg/L

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953391/pdf/OMCL2014-798957.pdf).

Probably the most common usage of coQ10 is in cardiac conditions, including recovery from post cardiac surgery. CoQ10 is often recommended in individuals taking statin drugs to lower cholesterol. CoQ10 is also said to boost energy and speed recovery from exercise, and to slow down some effects of aging. Essentially, anyone who is interested in excellent health might consider taking coQ10.

CoQ10 comes in two forms, ubiquinone, the oxidized form, and ubiquinol, the reduced antioxidant form. Both forms can easily be processed into the other by the body through either the loss or gain of electrons. Ubiquinone is the original and more clinically tested form, as well as the form that is in most dietary supplements. Many people claim that ubiquinol has better gut absorption and that a much lower dose is required. Additionally, ubiquinol likely has better penetration into brain, which is a good argument for the use of this form in the nutritional supplementation of individuals with any condition involving the brain.

Bioavailability is a measure of how much of the dosage taken is available for use by the body. The higher the bioavailability, the less product needed to achieve the same blood level and clinical effects.  One study demonstrated that a specific ubiquinol product was absorbed five times better than a standard ubiquinone product (https://www.neuroneeds.com/wp-content/uploads/2019/08/CoQH_JFF-2009_KGK-STUDY.pdf). QNeeds® is a private label of exactly the same ubiquinol product used in the above study.

NeuroNeeds cannot determine what dosage level of QNeeds®, or any product, is appropriate in any individual.  It is recommended to discuss any dietary supplement, including QNeeds®, with your physician especially in the context of chronic disease and/or medications.  Many medical doctors practice therapeutic dosing coQ10 supplementation based on blood levels, adjusting the dose until the blood level is between 4.0 and 7.0 mg/L, which is substantially above the normal range.  Again, it is recommended to discuss any dietary supplement, including QNeeds®, with your physician especially in the context of chronic disease and/or medications. 

Yes, many medical doctors recommend attaining coQ10 blood levels for their patients.  CoQ10 may be measured in blood (serum or plasma), and this measurement reflects dietary intake and gut absorption rather than tissue status. It is thus useful to determine whether coQ10 supplementation is adequate. When supplementing with coQ10, note that the amount is usually quite low (100 mg) in most commercially-available supplements, and much higher dosages are generally required to arrive at a therapeutic level. Dosing should be discussed with your physician. 

Blood (serum or plasma) coQ10 level is a medical test offered by many laboratories, including Quest and LabCorp. Testing is best done two weeks after starting supplementation, in the morning before taking anything with coQ10 in it (food, QNeeds®, SpectrumNeeds®, EnergyNeeds®, etc.). Contact the laboratory well before arriving as there are special precautions and not all draw centers can correctly process this test. Some specialized centers measure coQ10 levels in cultured skin fibroblasts, muscle biopsies, and/or blood mononuclear cells, which are better indications of coQ10 deficiency states, but not necessarily of substantial routine help in patient management.

QNeeds® contains 60 softgels with the suggested daily dose of 1 softgel twice daily.  One container of QNeeds® would allow for a 30 day supply.  Note that much higher dosages are generally required to arrive at a therapeutic level. Dosing should be discussed with your physician. 

QNeeds® has a “shelf life” or expiration date of 2 years and is located on the bottom of each container.  Once opened, store QNeeds® in a cool dry place and keep QNeeds® away from warm, humid environments to help ensure effectiveness for longer periods after opening. 

If QNeeds® is exposed to heated environments, you may experience clumping of the softgels.  For example, our Research & Development (R&D) trials tested QNeeds® softgels overnight in a equatherm oven at 90° F.  The next day the softgels were somewhat soft and sticky but not leaking or completely clumped together.  We conducted the same trial but set the temperature for 100 ° F for 2 days and found that the softgels bricked up together and were unbreakable.

Yes, there are many relatively-inexpensive soy-based ubiquinol products on the market, as well as some high-priced limonene-based ubiquinol products, although the latter are more difficult to find. As QNeeds® has superior bioavailability (meaning less product need be purchased) and a low price, QNeeds® is actually competitively priced along with the bulk of the soy-based ubiquinol products. While ubiquinone products may be less expensive, the need for several times the dosage to achieve the same blood levels generally makes these products more expensive.

Adverse (side) effects are rare with coQ10. When they do occur, adverse effects are mild and reversible upon stopping/lowering the dose:

• A minority of individuals have sleep difficulty if coQ10 is provided at bedtime, which generally responds to moving the last dose earlier in the day.
• A minority of individuals are “hyper-energized”, which generally responds to dose reduction, and/or the addition of “calming” supplements (for one suggestion, see https://www.neuroneeds.com/product/calmneeds). Note that normal children often misbehave, and that increased mischief may be a reflection of a child with more energy and mental clarity trying new things.

Yes! While there is quite a lot of coQ10 in both products, it is in the ubiquinone form since ubiquinol is not stable and bioavailable in a powder form.  CoQ10 blood monitoring suggests that additional coQ10 may be recommended for many individuals taking SpectrumNeeds® or EnergyNeeds®.  Please note that it is recommended to discuss any dietary supplement, including QNeeds®, with your physician especially in the context of chronic disease and/or medications. 

Many people, especially small children, have difficulty swallowing medications. QNeeds® comes in sleek submarine-shaped flexible gel capsules, so swallowing is relatively easy. However, some people need a liquid preparation as they are unable to swallow.  One option is to cut the end off of QNeeds® with scissors, and squeeze out the contents into a teaspoon of your favorite cooking oil, such as olive oil. Next, flavor per taste, with some suggestions being adding to concentrated chocolate syrup or concentrated fruit juice. Smoothies are great ways to hide medication as well as to promote health.

Yes, coQ10 can be added to a G (gastrostomy) tube for direct administration into the stomach. Direct administration into the small intestine/jejunum (J or GJ tube) may decrease absorption, but is done by many families. There are liquid ubiquinol products on the market from a few other companies. Another option, which is often less expensive than liquid coQ10 products, is to cut the end off of QNeeds® with scissors, and squeeze out the contents into a teaspoon of your favorite cooking oil, such as olive oil.

Yes, purchase 12 or more containers of QNeeds® at neuroneeds.com, and watch the price per container drop substantially.

Many medical practitioners recommend genetic testing in patients with multiple functional or neurodevelopmental disorders, as many times such testing can be helpful in determining the underlying factors leading for disease in that individual, be it mitochondrial dysfunction, neurotransmitter disorders, channelopathy, axonal transport, and/or other mechanisms. Understanding these underlying factors often allows for targeting therapies. Even in patients with known mitochondrial disease, genetic testing can often identify factors leading to this disease that suggest specific therapies. For more information, see Dr. Boles’ private practice website at molecularmitomd.com.

OmegaNeeds® is a blend of fish and krill oil. This provides the benefits of both phospholipids (for the promotion of brain health) AND high dosing (for the promotion of heart and general health). No major brands on the market combine these important oils together, until now. OmegaNeeds® also contains phosphatidylserine (PS), another important component of brain health found in few supplements.

OmegaNeeds® is a source of omega-3 fatty acids (omega-3s). Omega-3s are critical for life, including for the proper function of brain and heart. Humans cannot make omega-3s and they must come from the diet. However, while historical diets were often loaded in these essential nutrients, most modern diets are quite low. Oils from certain cold-water fishes (especially herring, sardines, anchovies, and mackerel) have high concentration of omega-3s, which facilitates entrance into heart and other organs, and thus these oils are often recommended for heart and general health. Krill oil has omega-3s bound into phospholipids, which greatly facilitates entrance into brain, and thus krill oil is often recommended for brain health. OmegaNeeds® is a blend of the above listed cold-water fishes AND krill oil. OmegaNeeds® also contains phosphatidylserine (PS), an important component of brain health added in few supplements. Thus, OmegaNeeds® is an excellent supplement for people interested in both physical and mental/brain health.

To learn more about the science and health of omega-3 fatty acids, see additional FAQs below.

• Anyone interested in good brain health. The omega-3 fatty acids present in OmegaNeeds® have been shown in studies to be helpful in people with multiple disorders of the brain, including autism, ADHD, migraine, depression, anxiety, chronic pain, and dementia.
• Anyone interested in good heart health. The omega-3 fatty acids present in OmegaNeeds® have been shown in studies to be helpful in people with multiple disorders of the heart and blood vessels, including reduction of blood pressure, improved lipid (cholesterol, triglyceride) levels, weight control, and protection against cardiovascular disease (e.g., heart attack).
• Anyone interested in good general health. The omega-3 fatty acids present in OmegaNeeds® have been shown in studies to be helpful with inflammation, autoimmune disease, diabetes/blood sugar, macular degeneration (age-related blindness), and in many other conditions, see list below.

Selected studies and reviews demonstrating relationships between omega-3 fatty acids in various conditions (Library of Congress PMID listings shown):

• ADHD 11817499, 14669965, 17435458, 21807480, 21961774, 26966583, 27555775 28741625, 29207548, 32759851
• Anxiety 21784145, 30646157, 34959972
• Autism 11487301, 16920077, 18072818, 22370992, 24839884, 28218722, 29490101, 30744880, 32759851
• Autoimmune disease 12480795, 15290734 (lupus), 15723739 (RA), 26362904 (MS)
• Cardiovascular disease/blood lipids 11997274, 18774613, 19487105, 22113870, 22180524, 22317966, 25458786
• Depression/bipolar 12888186, 15907142 (multiple psychiatric disorders), 17685742, 18247193, 21721919, 22910528, 24757497, 26188642
• Dementia 19262590, 19523795, 25592004, 28466678
• Diabetes (especially autoimmune-related) 14668274, 25329601, 30684965
• Inflammation 12480795, 20727522, 21784145, 24505395
• Macular degeneration 24557349, 34749130, 34829613
• Metabolic syndrome 19593941, 20727522, 23456976
• Pain 7588501, 8623866, 24049587, 28495596
• Skin disorders 20620762, 21760742, 34681353
• Sleep disorders 21897776, 24605819, 24812543

• Adults and adolescents over 40 kg (> 88 lbs): Two gel capsules daily, to be taken at one time or one gel capsule twice daily.
• Adolescents and children 20-40 kg (44-88 lbs): One gel capsule daily.
• Children under 20 kg (< 44 lbs): Consult your physician.

We recommend taking this product with meals, at least at first, as gastrointestinal side effects, might occur, including nausea, diarrhea, and/or reflux (GERD).

Fatty acids are an unbranched hydrocarbon chain with an acid group (COOH) at one end. Humans and other animal species require several different fatty acids of different chain lengths and saturation levels. Chain length refers to the number of carbon atoms linked together, end to end, in the fatty acid. Humans can add and subtract carbons to alter the chain length. Saturation refers to the number of double bonds. Fatty acids without any double bonds are referred to as “unsaturated”, and these constitute most of the main fatty acids made by humans and present in the animal products that we consume. Double bonds can add kinks (bends) to the fatty acid and provide substantial changes to their properties. Humans have very limited abilities to add double bonds to fatty acids. Thus, there are many fatty acids that are essential for life that humans cannot make, and we need to obtain from our diet. As other animals cannot make these unsaturated fatty acids either, we obtain them from plants in our diet (e.g., vegetables), or from certain animals that themselves obtain them from plants or algae.

In designating fatty acids, the length of the carbon chain and position of the double bonds are listed. The position of the double bond is counted starting with the acid group of the fatty acid. For example, oleic acid, common in olive oil, is designated as C18:1 cis-9. This translates to 18 carbons, one double bond at position 9 (between carbons 9 and 10), and the double bond is in the cis position. “Cis” means that the chains are both on the same side of the double bond, bending the molecule. “Trans” fatty acids rarely occur in nature but are induced in some food processing; they are generally considered to be detrimental to human health.

Some highly unsaturated fatty acids (containing multiple double bonds) are very important in health. Many of these are called omega-3 fatty acids. Omega is the last letter of the Greek alphabet, and in fatty acid designation, “omega” refers to the last carbon in the chain (the end opposite the acid group). A double bond 3 carbons from the far end of the chain is referred to in speaking as “omega three” and in writing as “omega-3”. Two common and important omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA is C22:6, cis-4, 7, 10, 13, 16, 19, but often designated simply as 22:6n3 (22 carbon chain, six double bonds in total, the last double bond at the omega-3 position; cis orientation of all the double bonds is assumed). EPA is C20:5, cis-5, 8, 11, 14, 17, but often designated simply as 20:5n3.

In humans and other vertebrates, most fatty acids are part of triglycerides, often referred to simply as “fat”. A triglyceride consists of three fatty acids, which can be of the same or different types, bound to glycerol (a 3-carbon alcohol). Phospholipid are another type of fat in which one of the end carbons of glycerol is bound to a compounded phosphate and the other two carbons are bound to fatty acids. Usually, the phosphate is compounded with choline, serine, inositol, or ethanolamine, and these fats are referred to as phosphatidylcholine (often abbreviated as PC), phosphatidylserine (PS), phosphatidylinositol (PI), or phosphatidylethanolamine (PE), respectively. The two fatty acids can be the same of different types and can be omega-3 fatty acids. Phospholipids are critical in many processes, including in mitochondrial energy metabolism, and in many aspects of health, especially in the brain and heart.

Alpha-linolenic acid (ALA, C18:3n3) is an important omega-3, essential fatty acid. Humans can convert ALA to EPA. Humans can then convert EPA to DHA. However, brain has very limited capacity to synthesize DHA and ≤ 0.2% of the ALA entering the brain is converted to DHA. Almost all DHA and EPA in the brain is imported from the blood. While human liver has the ability to convert ALA to EPA to DHA, a major limitation is that all these omega-3s are essential. We cannot make ALA (except from other omega-3s such as EPA), and ALA is one of the main essential fatty acids that we obtain from plants. Humans can interconvert ALA, EPA, and DHA, but cannot put the double bond into the omega-3 position. These fatty acids must come from the diet. For people whose diet is low in fruits, vegetables, and seafoods, all these omega-3 fatty acids can be deficient. Thus, while we can interconvert these fatty acids, the omega-3s in general must come from the diet.

The main sources for EPA and DHA are from algae, either directly or indirectly. Western diets usually are low on algae. Since algae is the main base of the oceanic food chain, seafood is high in omega-3 fatty acids from algae. Cold-water oceanic animals are particularly rich in omega-3 fatty acids, which become increasingly concentrated in organisms the further they are up the food chain. Some fish can also source omega-3s from their own gut flora. Thus, the main dietary source of omega-3s in most Western populations is from seafood.

Thus, a diet rich in seafood is an excellent source of omega-3s. However, seafood can be contaminated by mercury and other heavy metals, in which concentrations also accumulate up the food chain. Additionally, seafood is expensive, not available everywhere, and not preferred by many people. Also, there are issues regarding the sustainability of massive fishing on natural marine populations. For these reasons, seafood-derived oils, either from small oily fishes (mackerel, anchovies, herring, sardine) or crustaceans (krill), is preferred. Good sources are high in omega-3 fatty acids, very low in mercury and other heavy metals, and sustainably fished. OmegaNeeds® is one such source.

Phospholipids are particularly abundant in krill, in which most of the EPA and DHA are complexed as part of phospholipids.

There are two major mechanisms in which most omega-3 fatty acids enter brain. This has been studied more extensively for DHA.

1. Passive diffusion across the cell membrane
2. MFSD2A-mediated transport

Cell membranes are composed mostly of lipids, for which fatty acids are a major component. DHA from the blood can directly enter the outside side of a cell membrane, “flip” over to the inner side of the membrane, then disassociate from the membrane to enter the cell. This transport by “passive diffusion” occurs from areas of high concentration to areas of low concentration. By passive diffusion, the tissue concentration in brain, heart, or other organs cannot exceed that of the blood by this mechanism. Thus, to increase tissue concentrations beyond usual levels, very high blood levels are needed. This is exactly the mechanism by which many of the premium, high-potency omega-3 fatty acid products on the market work. These products contain very high amounts of omega-3 fatty acids in order to substantially raise the concentration in the blood, and thus to raise the concentration in the tissues.

However, most of the DHA in the brain enters by way of the MFSD2A system [PMID: 24828044]. MFSD2A is expressed exclusively on the endothelium of the blood-brain barrier, whereas it is found at high concentration. The blood-brain barrier consists of the cells lining the blood vessels within the brain, which fit tightly together limiting transport into brain in order to protect this vital organ. Mice lacking MFSD2A have markedly reduced levels of DHA in brain and loss of neurons (nerve cells) in important brain areas such as the hippocampus and cerebellum. These mice have cognitive deficits (mental retardation), severe anxiety, and small heads. Humans born with genetic mutations in MFSD2A have cognitive deficits, small heads, spasticity, seizures, and early death [PMID: 26005865, PMID: 26005868]. Brain imaging usually shows abnormalities related to a loss of neurons, and cellular studies showed much reduced DHA transport rates [PMID: 26005868]. Additionally, mice with genetic mutations that remove MFSD2A function have 50% lower brain DHA levels when compared to littermates without the mutation, attributed to significantly reduced brain DHA uptake [PMID: 24828044].

Studies demonstrate that over 80% of DHA in the body is esterified (a form of chemical bond) in phospholipids [PMID: 24036166]. MFSD2A transports DHA into brain only if esterified in phospholipid, in particular phosphatidylcholine (PC), but also phosphatidylserine (PS) and phosphatidylethanolamine. However, MFSD2A transports very little DHA into brain if esterified in triglycerides or unesterified (by itself, free fatty acids) [PMID: 24828044]. Omega-3 fatty acids, including DHA, are naturally esterified with PC in products derived from krill. Thus, krill-based products have a substantial advantage in terms of promoting brain uptake of DHA. On the other hand, brain DHA uptake is more difficult when present in triglycerides, as is the case with products derived from fish. Blood DHA levels must be highly elevated in order to facilitate brain uptake from passive diffusion

EPA esterified in PC (PC-EPA) was shown to increase brain EPA levels over 100-fold, while free EPA had little effect. “Furthermore, LPC-EPA, but not free EPA, increased brain DHA 2-fold” [PMID: 30530735]. Krill oil, and OmegaNeeds®, contain high amounts of PC-EPA.

Supplementation with the omega-3 fatty acids DHA and/or EPA has shown modest success in controlling symptoms related to ADHD. While not all studies have demonstrated a benefit, most did, including the randomized, placebo-controlled trials summarized here:

• Improved attention, reduced hyperactive and defiant behaviors, and improvement in cognition and emotion in ADHD children on DHA 480 mg/day, EPA 186 mg/day, and additional nutrients (gamma-linolenic acid 96 mg, vitamin E 60 IU, cis-linoleic acid 864 mg, arachidonic acid 42 mg, and thyme oil 8 mg) [PMID: 11817499].
• Improved attention and oppositional behaviors in children on DHA 480 mg, EPA 80 mg, arachidonic acid 40 mg, gamma-linolenic acid 96 mg, and vitamin E 24 mg [PMID: 14669965].
• Marked improvement in ADHD symptoms, including improved attention control, and vocabulary performance in children supplemented for 15 weeks with EPA as opposed to those receiving placebo [PMID: 17435458].
• Improvement of ADHD symptoms (impulsivity, inattention), mood and behavioral problems on phosphatidylserine (PS) containing 120 mg total EPA and DHA [PMID: 21807480].

Additional references discussing omega-3 therapy in ADHD:

• A meta-analysis (an in-depth evaluation comparing multiple studies together) from 2018 [PMID: 28741625] stated “there is evidence that n-3 PUFAs (omega-3) supplementation monotherapy improves clinical symptoms and cognitive performances in children and adolescents with ADHD, and that these youth have a deficiency in n-3 PUFAs levels. Our findings provide further support to the rationale for using n-3 PUFAs as a treatment option for ADHD.”
• An earlier meta-analysis from 2011 [PMID: 21961774] revealed moderate efficacy in comparison to standard drug treatments, yet “given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacologic interventions or for families who decline other psychopharmacologic options.”
• A review article from 2016 [PMID: 27555775] stated “(i)n conclusion, there is evidence that a ω-3 PUFA (omega-3) treatment has a positive effect on ADHD. It should be added that treatment could be more effective in patients with mild forms of ADHD. Moreover, the dosage of stimulant medication could be reduced when used in combination with ω-3 PUFA supplements.”
• Omega-3 and other natural supplements in ADHD are also summarized in PMID 26966583, 29207548, and recently (2020) 32759851.

Medications are often effective and appropriate in the treatment of behavioral over-activity, and in particular in ADHD can sometimes help get a failing student back on track again. NeuroNeeds® does not advocate nutrition over medication in all or most cases. However, appropriate nutritional therapies can often be an effective complementary approach along with appropriate medical therapies. OmegaNeeds® can be an important part of nutritional therapy in people with ADHD. Also, consider adding mitochondrial support in the form of SpectrumNeeds® (capsules, 40 active ingredients) or EnergyNeeds® (powder, 2 flavors, 33 active ingredients), in addition to QNeeds® (gel capsules, highly bioavailable ubiquinol form of coenzyme Q10). In Dr. Boles’ experience, nutritional therapies can sometimes reduce the amount of dosage of medication needed, and occasionally eliminate the needs for medications altogether. In addition, medications are not appropriate in all affected individuals.

Supplementation with the omega-3 fatty acids DHA and/or EPA has shown modest success in controlling symptoms related to autism/ASD. While not all studies showed benefit, most did, including the following trials summarized here:

• Significant improvements in the omega-3 group versus placebo were noted in the stereotypy and lethargy subscales of the Aberrant Behavior Checklist Children as well as a non-significant reduction in hyperactivity on 1.3 g of total omega-3 fatty acids per day [PMID: 24839884].
• Significantly improved Aberrant Behavior Checklist for social withdrawal and communication on 240 mg of arachidonic acid (AA)-enriched triglyceride (40 mg/capsule each of AA and DHA, and 0.16 mg/capsule of astaxanthin) [PMID: 22370992].
• Reduction in ASD symptoms per the Brief Infant Toddler Social Emotional Assessment ASD versus placebo on DHA 225 mg, EPA 338 mg, and gamma-linolenic acid 83 mg [PMID: 29490101].
• Reduced irritability symptoms in children with ASD per the Aberrant Behaviour Checklist on DHA 722 mg and vitamin D 2000 IU [PMID: 30744880].
• Benefit on hyperactivity and stereotypy (persistent repetition) in a double-blind randomized controlled trial in children with ASD on DHA 700 mg and EPA 840 mg [PMID: 16920077].

Additional references discussing omega-3 therapy in autism:

• In a meta-analysis (an in-depth evaluation comparing multiple studies together), compared with placebo, omega-3 fatty acids improved social interaction and repetitive and restricted interests and behaviors [PMID 28218722].
• Low blood DHA and/or total omega-3 fatty acid levels have been documented in children with ASD [PMID: 11487301, 28218722], including in nearly 100% of cases [PMID: 18072818], while about 90% of patients with pervasive developmental disorders (PDD) have been found to have low EPA/DHA levels in red blood cell membranes [PMID: 18072818].
• A review paper concluded, “In double-blind, randomized, controlled trials, DHA and EPA combinations have been shown to benefit…autism, dyspraxia, dyslexia, and aggression...” [PMID: 18072818, 32759851].
• Omega-3 and other natural supplements in autism are also summarized in PMID 32759851.

• 30 days at recommended dosing of two gel capsules daily for adults and children over 40 kg (> 88 lbs)
• 60 days at recommended dosing of one gel capsule daily for adolescents and children 20-40 kg (44-88 lbs):

Absolutely! In fact, OmegaNeeds® is designed to add an important niche to optimized nutrition that is not met by SpectrumNeeds® (powder) or EnergyNeeds® (capsules). QNeeds® is another such product designed to add another important niche. Together, these 3 products (OmegaNeeds + QNeeds + either SpectrumNeeds or EnergyNeeds) provide excellent comprehensive supplementation for mitochondrial function, brain health, and general health. However, OmegaNeeds® can also be taken alone (without SpectrumNeeds®, EnergyNeeds®, or QNeeds®).

Yes, especially in a G (gastrostomy) tube. Absorption in a J (jejunal) tube or GJ-tube may be reduced.

Dr. Boles recommends genetic testing in patients with autism and other neurodevelopmental disorders, as many times such testing can be helpful in determining the underlying factors leading for disease in that individual, be it mitochondrial dysfunction, neurotransmitter disorders, channelopathy, axonal transport, and/or other mechanisms. Understanding these underlying factors often allows for targeting therapies. Even in patients with known mitochondrial disease, genetic testing can often identify factors leading to this disease that suggest specific therapies. For more information, see https://neurabilities.com/neurogenomics.