Conclusive fish oil research reveals omega-3 supplements improve morning stiffness and joint tenderness for rheumatoid arthritis (RA). Well-supported scientific evidence affirms the positive effects of fish oil on RA. Further research is needed to prove that it improves symptoms of osteoarthritis (OA).
Rheumatoid arthritis patients experience a reduction in joint pain from fish oil--but not in joint damage—according to thirteen studies of 500+ RA participants who took omega-3 supplements. Other studies suggest that omega-3’s may help RA patients lower their dose of nonsteroidal anti-inflammatory drugs (NSAIDS).1
Rheumatoid arthritis is an autoimmune disease. It arises when the body’s immune system causes inflammation in the tissue that helps joints move. RA can lead to joint destruction, deformity, and loss of function. Swelling of the hands and feet is the hallmark of the disease, but most joints in the body can become affected. Frequent RA symptoms include fatigue and joint stiffness, especially in the morning and after prolonged periods of rest.2
About 1.3 million people in the United States have RA and women are three times more likely than men to be affected, according to the American College of Rheumatology. Rheumatoid arthritis causes joint damage in 80% to 85% of patients, with the brunt of the damage occurring during the first two years of the disease, according to John Hopkins Arthritis Center.3,4
Chronic pain, disability, and excess mortality are unfortunate outcomes of this disease. Appropriate treatment attempts to mitigate the symptoms.
Fish oil supplements are a good source of omega 3 oil—a fat that plays a vital role in maintaining healthy cells throughout the body, including joints. They also encourage the production of chemicals that help control inflammation in the joints, bloodstream, and tissues.
Due to its anti-inflammatory properties, substantial fish oil research has measured the effects of omega-3’s on rheumatoid arthritis, as well as osteoarthritis. Multiple studies have reported improvements in morning stiffness and joint tenderness with the regular intake of fish oil supplements for up to three months.2
The safe anti-inflammatory benefits of omega-3 fish oil were favorably compared as an alternative to the side effects of non-steroidal anti-inflammatory drugs (NSAIDs) for discogenic pain in a 2006 fish oil research study in the journal Surgical Neurology. From March to June 2004, patients with nonsurgical neck or back pain were asked to take a total of 1200 mg per day of omega-3 EFA’s (EPA and DHA) found in fish oil supplements. 5
Of the 250 patients 78% took 1200 mg and 22% 2400 mg of EFAs. Fifty-nine percent discontinued to take their prescription medications for pain. Sixty percent stated their overall pain was improved and 60% stated their joint pain had improved. Eighty percent stated they were satisfied with their improvement, and 88% stated they would continue to take the fish oil. There were no significant side effects reported.
The authors concluded, “Our results mirror other controlled studies that compared ibuprofen and omega-3 EFAs demonstrating equivalent effect in reducing arthritic pain. Omega-3 fish oil supplements appear to be a safer alternative to NSAIDS for treatment of nonsurgical neck or back pain in this selective group.”5
Increased intake of omega-3 fatty acids found in fish and fish oil supplements was associated with a decreased risk of developing rheumatoid arthritis in people at risk for the disease, according to breakthrough fish oil research. 6
The study is the first to find an association between omega-3 and the autoantibodies that lead to rheumatoid arthritis among patients who are at risk but have yet to develop the disease. Autoantibodies are immune proteins that mistakenly target the body’s tissues and organs in autoimmune diseases. 6
People with a family history of RA who consumed more omega-3 were less likely to have certain autoantibodies that precede the disease’s development, researchers found. The findings were published in 2005 in the journal Rheumatology by researchers including Michael J. Clare-Salzler, M.D., a professor and chairman of the Department of Pathology, Immunology and Laboratory Medicine in the University of Florida College of Medicine. 6
While it was a small study of 77 subjects, the results suggest that omega-3 may help protect against RA by impeding its development during the period before symptoms emerge, according to the fish oil research. Dr. Clare-Salzler commented: “If you’re consuming more omega-3 during an earlier phase of disease, you may block it from progressing to a phase where active inflammation manifests.” 6
The fish oil research was conducted from seven universities and research institutions that collaborated on the work and was supported by multiple grants from the National Institutes of Health and the Walter S. and Lucienne Driskill Foundation.
Fish oil research carried out by Duke University in North Carolina has determined that omega-3 consumption could help to improve joint health patients with osteoarthritis. The study published July 2014 in the Annals of the Rheumatic Diseases has shed further light on the established relationship between obesity and arthritis, suggesting that unhealthy dietary fats may exacerbate osteoarthritis symptoms. 9
Researchers examined a sample of mice with osteoarthritis of the knee caused by injury to the joint, all of whom were fed one of three high-fat diets—one rich in saturated fat, one high on omega-6 fatty acids, and one that supplemented a high omega-6 intake with a small amount of omega-3 fatty acids.9
It was found that arthritis was significantly associated with the mice’s diets, but not with body weight—a noteworthy development, given that it is often understood that the impact of obesity on arthritis is caused by the additional pressure on load-bearing joints.
The mice that ate diets high in saturated fat or omega-6 fatty acids experienced significant worsening of their arthritis, while mice consuming supplements of omega-3 had healthier joints. Moreover, those receiving omega-3 had enhanced capability to heal wounds, further underlining the health benefits of this form of fatty acid. Omega-3 is found in fish or fish oil supplements and is recognized for offering heart health and anti-inflammatory benefits.9
About 30 million adults in the United States have osteoarthritis (OA), the most common form of arthritis, according to the Centers for Disease Control & Prevention (CDC). It is sometimes called degenerative joint disease or “wear and tear” arthritis. The symptoms include pain, aching, swelling, stiffness and decreased range of motion in joints such as the knees, hands, and hips. The cartilage and bones within the joints begin to break down, developing slowly and get worse over time.7
A July 2015 fish oil research study in the American Journal of Orthopedics reviewed literature to address claims that fish oil supplementation can prevent or decrease severity of osteoarthritis. An extensive search of databases covered all relevant terms related to omega-3 supplements and their effects on OA. They hypothesized there would be insufficient clinical studies to justify recommending supplementation to patients.8
Laboratory studies have shown that EPA and DHA reduce pro-inflammatory mediators and increase joint lubrication in vitro. In addition, animal trials have shown clinically significant reductions in various symptom parameters. Results of human clinical trials, however, have not been consistently significant.8
The authors concluded that well-designed clinical trials are needed to substantiate or refute the potential benefit of fish oils in osteoarthritis treatment. Long-term studies are needed to assess the possibility of prevention. In addition, standardization of the fish oil industry is needed for consistency of therapy.8
Omega-3 fatty acids help reduce inflammation throughout the body and some studies have shown benefits for heart health, brain function and diabetes, according to the online Arthritis Foundation blog, “Living with Arthritis”.1
Omega-3 fish oil is the most commonly used dietary supplement in the United States, according to the National Institutes of Health.
A fish oil research trial published in the Annals of Rheumatic Disease in 2013 found that when a high-dose fish oil supplement is added to so-called triple therapy for rheumatoid arthritis (methotrexate, sulfasalazine and hydroxychloroquine), patients achieved better outcomes; were far less likely to “fail” treatment and twice as likely to reach remission than those who did not take a supplement.1
Fish oil research authors believe they have uncovered the secret behind why omega-3’s are so beneficial, according to the Arthritis Foundation blog. A study at Brigham and Women’s Hospital in Boston revealed that omega-3’s convert into compounds that are 10,000 times more powerful than original fatty acids.1
These compounds include resolvins, which help bring an inflammatory response in the body to an end, according to the study’s lead researcher, Charles Serhan, PhD, director, Center for Experimental Therapeutics and Reperfusion Injury at Harvard Medical School, Boston.1
The body’s normal inflammatory process repairs damage and protects the body from infections in a healthy immune system. But in inflammatory types of arthritis and related diseases, an overactive immune response leads to tissue destruction. Serhan’s fish oil research showed that the same pathway that signals the start of inflammation also includes an off switch. Omega-3’s convert into these more powerful compounds, putting the brakes on this active process and causing it to screech to a half, says Serhan. What is not yet known is how much omega-3s are needed to optimize the body’s conversion from omega-3s into resolvins, the blog quotes Serhan as saying.1
Lack of quality in fish oil supplements has resulted in intervention by the Food & Drug Administration (FDA) and has created numerous issues with fish oil safety.
An article Are your omega-3 supplements bogus? in Prevention Magazine January 27, 2014 by Markham Heid commented on a report from LabDoor, a private company that tests consumer health products, that showed many fish oil supplements skimp when it comes to their omega-3 content—meaning you’re not getting what you pay for.23
Five of the 30 fish oil products tested fell 10% or more short of their advertised quantity of docosahexaenoic acid (DHA)—a type of omega-3 fatty acid that several studies have linked to improved heart and brain health, among other benefits. Whether too high or too low, the average supplement label was off by 24% when it came to both DHA and eicosapentaenoic acid (EPA) content, according to the report.
The article commented that another private laboratory, ConsumerLab.com, has conducted multiple tests of omega-3 supplements since 2001, with similar results. Eleven of 35 supplements they examined in 2012 did not contain their labeled quantities of omega-3. They also found that two products exceeded international limits for PCB safety.23
The industry is regulated by the current Good Manufacturing Practices (cGMP) safety guidelines for supplement makers, which critics complain are far too lax and basically leave manufacturers on the honor system.
My strategy was to find the best natural nutrition manufacturer first. After preparing a list of 30 questions, my inquiries led me to the science-based industry leader since 1956. They are the only dietary supplement company that clinically tests all its products for efficacy, even though there’s no industry requirement to prove effectiveness in the human body.
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Fish oil is also heart healthy. While we don’t have rheumatoid arthritis, my husband and I recommend this product from personal use for many years for osteoarthritis..
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1 Arthritis Blog Home; Living with Arthritis blog, post The Benefits of Omega-3 Fatty Acids for Arthritis, published Arthritis Today Magazine, July 29, 2015. http://blog.arthritis.org/living-with-arthritis/omega-3-fatty-acids-arthritis/
2 Davis, Jeanie Lerche, Article, Alternatives and Supplements for Arthritis Joint Pain, Omega-3 (Fish Oil) for Joint Health, published WebMD Archives, December 13, 2010 www.webmd.com/diet/features/alternatives-and-supplements-for-arthritis-joint-pain#5
3 Learning Center Statistics, Article Prevalence Statistics published American College of Rheumatology, Rheumatology.org Accessed July 10, 2018 https://www.rheumatology.org/Learning-Center/Statistics/Prevalence-Statistics
4 Koch, Cheryl, CNSD, updated by Manno, Rebecca, MD, MHS, Nutrition & Rheumatoid Arthritis, published John Hopkins Arthritis Center, May 11, 2015 https://www.hopkinsarthritis.org/patient-corner/disease-management/rheumatoid-arthrtis-nutrition/
5 Maroon, JC, Bost, JW, Study, Omega-3 fatty acids as anti-inflammatory; an alternative to NSAIDs for discogenic pain, Journal Surgical Neurology, April 2006 65(4):326-31 (PubMed) https://www.ncbi.nlm.nih.gov/pubmed/16531187
6 Clare-Salzler, MJ, M.D., Study, Fish, omega-3 supplements may lower rheumatoid arthritis risk for some people, published journal Rheumatology 2015. Summary study article, Doug Bennett, December 21, 2015, University of Florida Health Newsroom https://ufhealth.org/news/2015/fish-omega-3-supplements-may-lower-rheumatoid-arthritis-risk-some-people
7 Webpage, Arthritis Basics, Arthritis Types, Osteoarthritis, published Centers for Disease Control & Prevention (CDC), accessed July 10, 2018 https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
8 Boe, C; Vangsness, CT; study Fish Oil and Osteoarthritis: Current Evidence, published American Journal of Orthopedics, 44(7):302-305. July 2015 Abstract Research Gate https://www.researchgate.net/publication/279966343_Fish_Oil_and_Osteoarthritis_Current_Evidence
9 Guilak, F., Ph.D., et al; study, Omega 3 Fatty Acids Lessen Severity of Osteorthritis in Mice, published in journal Annals of the Rheumatic Diseases (10.1136-2014-205601), July 11, 2014, summary article, News & Media Front Page, Duke Health https://corporate.dukehealth.org/news-listing/omega-3-fatty-acids-lessen-severity-osteoarthritis-mice
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