by BERKELEY WELLNESS
For 20 years research has been accumulating about omega-3
(fish oil) supplements as a treatment for rheumatoid arthritis (RA), with
mostly promising results. RA is an autoimmune disease that causes inflammation
in joints and various organs. For instance, a 2007 analysis of 17 small
clinical trials (lasting three to six months) concluded that the supplements
may help modestly reduce joint pain and tenderness, morning stiffness, and use
of pain relievers. Late last year perhaps the best study yet on the subject
appeared in the Annals of Rheumatic Diseases.
Promising, but not a slam-dunk
The Australian study involved 140 people who had RA for
less than a year and were not taking the standard drugs for the disease. The
treatment group was given a high dose of omega-3s (5.5 grams a day, though they
ended up averaging 3.7 grams a day). The rest took a low dose (0.4 grams); all
started taking standard RA drugs as well. After a year, those taking high-dose
omega-3s were 76 percent less likely to need an additional, newer—and very
expensive—anti-rheumatic drug than the low-dose group. They were also twice as
likely to go into remission, the goal of drug treatment, and more likely to
stop taking pain relievers.
This suggests that omega-3s could be a useful adjunct to
the standard medications and may help slow the progression of RA in some
people. That is no minor matter when dealing with a hard-to-manage progressive
disease like RA. Keep in mind, however, that while the study was larger and
longer than earlier trials, it was still relatively small and short, and not
all previous research on this has had positive results. So these findings will
need to be confirmed, especially since the dose of omega-3s is so large.
How might omega-3s help? Lab research shows that these
fats have quite a few anti-inflammatory effects. Notably, they inhibit
pro-inflammatory chemical mediators (including certain cytokines,
prostaglandins and leukotrienes) that play a role in rheumatoid arthritis and
other inflammatory diseases. They also boost levels of anti-inflammatory
chemicals such as resolvins, which have been the focus of recent research.
What about osteoarthritis?
Far more people have osteoarthritis (OA), characterized
by the breakdown of cartilage, than RA. It used to be believed that only RA
involved inflammation, which was the rationale for trying omega-3s as a
treatment. It’s now known, however, that inflammation also plays a role in OA,
though to a lesser degree.
Much less research has been done on omega-3s for OA than
for RA. Lab studies have shown that omega-3s can improve various biomarkers for
osteoarthritis and reduce enzymes that degrade cartilage. But there have been
no good clinical trials showing that omega-3s reduce OA symptoms or actually
reduce cartilage breakdown, as seen in X-rays or MRIs.
Bottom line: If you have RA, talk with your doctor about
omega-3 supplements. Keep in mind that the longer-term safety of the high doses
used in this and other studies is unknown, especially if you are
immunocompromised or are taking drugs that affect your immune system. Expecting
omega-3 capsules to ease osteoarthritis is just wishful thinking, at this
point. Instead, we advise eating fatty fish at least twice a week.
Dr. Frank Talamantes, Ph.D,
Professor of Endocrinology (Emeritus)University of California
Santa Cruz, California, 95064
Residence: 83 Sierra Crest Dr.
El Paso, Texas 79902~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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