Rheumatoid Arthritis and the Benefits of Fish Oil
June 13th marks the beginning of Rheumatoid Arthritis Awareness Week, a campaign run by the National Rheumatoid Arthritis Society. One of the main goals of the campaign is to heighten awareness of the early warning symptoms of this condition, and to support those who have been recently diagnosed.
Many people do not recognise the early warning signs of rheumatoid arthritis. This is because the symptoms can be blamed on ‘overdoing things’. By recognising the three key symptoms – swelling, stiffness and fatigue – sufferers can take early action to seek help and find the right treatment. Because the disease is progressive, if sufferers are able to recognise and address the condition early, they are more likely to find treatment effective.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease. Normally the body’s immune system produces an inflammatory response as part of the healing process. If a joint is injured, special chemicals are released that cause short-term pain and swelling, immobilising the joint to give it opportunity to heal. However, sometimes this process can go awry and the immune system creates long-term chronic, painful inflammation that damages the joint tissues.
How is it Treated?
Medications for rheumatoid arthritis tend to work by suppressing inflammation. Examples are corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-inflammatory drugs (DMARDs).
However, recent studies have also highlighted the success of natural agents in modifying the inflammatory response. One of the most promising natural supplements linked to treatment of rheumatoid arthritis is fish oil.
The Benefits of Fish Oil
A study published just last year tested the effects of fish oil versus placebo on 144 patients with recent onset rheumatoid arthritis. Most of the patients were women in their 50s, and were already taking conventional arthritis medication. The group was given either placebo capsules or supplements of high-dose fish oil (5.5g per day).
Those taking the fish oil showed greater improvement in daily function in the first three months. After a year, the women given the high dose fish oil showed double the rate of remission compared with those on placebo.
It makes sense that fish oil should relieve inflammatory diseases such as rheumatoid arthritis. Fish oil is a rich source of the omega-3 fatty acids, EPA and DHA. The body uses both omega-3 and omega-6 fatty acids to make chemicals called prostaglandins and leukotrienes. The right balance of these chemicals help to control inflammation, and EPA and DHA promote the anti-inflammatory chemicals.
These omega-3 fatty acids actually have a similar action to medications used in rheumatoid arthritis: they help to block production of several inflammatory chemicals involved in arthritis, including prostaglandin E2 and leukotriene B4, and peptide mediators, tumor necrosis factor (TNF)α and IL-1β (2).
Plant foods such as flaxseed and hempseed are sources are a type of omega-3 fat called ALA. However, the long chain omega-3 fats used in this study are only found in fish and seafood, such as salmon, herring and mackerel, and in algal oil which represents a vegan source.
The study authors concluded that fish oil led to ‘increased rates of remission and decreased drug use’ in those with recent onset rheumatoid arthritis. This study certainly indicates that fish oil supplementation would be a sensible supplement to consider for anyone recently diagnosed with rheumatoid arthritis.
1. Proudman Sm et al (2015) Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Ann Rheum Dis 2015;74:89-95
2. Proudman SM et al (2008) Dietary omega-3 fats for treatment of inflammatory joint disease: efficacy and utility. Rheum Dis Clin North Am. 34:469–79.