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Rheumatoid Arthritis and Omega-3, Latest Studies

Rheumatoid arthritis and omega-3

Along with a variety of medications people can take to treat symptoms of rheumatoid arthritis, nutritional changes may also have a significant, positive impact. One such option involves the addition of omega-3 fatty acids to the diet or as a supplement, as three recent studies report on the effectiveness of this nutritional step.

Can omega-3s help rheumatoid arthritis symptoms?

Millions of people around the world suffer the painful, often debilitating symptoms of rheumatoid arthritis, an autoimmune disease that attacks the joints and is characterized by swollen, tender joints, morning stiffness that can last for hours, fatigue, nodules under the skin, fever, and weight loss. Over time, rheumatoid arthritis can worsen and result in deformed joints and limited ability to perform routine activities.

Omega-3 fatty acids are a nutrient found primarily in certain fish (e.g., tuna, salmon, herring, sardines, mackerel, lake trout), krill, algae, nut oils, walnuts, pumpkin seeds, and soybeans. Fish oil supplements are another source. Also known as polyunsaturated fatty acids, omega-3 fatty acids are critical for brain function and normal growth and development.

Researchers have explored omega-3s extensively, and many studies have shown these essential fatty acids to be helpful in reducing inflammation and pain associated with arthritis, inflammatory bowel disease, heart disease, and other inflammatory conditions. Here are some of the latest research findings on the use of omega-3s for rheumatoid arthritis.

The most recent (November 2012) study, published in Nutrition, involved 37 individuals with rheumatoid arthritis. All the volunteers completed a food frequency questionnaire and kept a daily diary of their food intake for three days.

Researchers analyzed levels of adipokines and oxidative stress markers in serum and saliva and came to the following conclusion: consuming omega-3s, fish oil, and monounsaturated fatty acid had a beneficial effect on rheumatoid arthritis and reduced inflammation.

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In July 2012, the results of a meta-analysis were published in the Archives of Medical Research. The meta-analysis involved 10 trials that included 183 patients with rheumatoid arthritis and 187 patients who were treated with placebo.

Overall, evaluation of the studies showed that patients who took omega-3 fatty acids (more than 2.7 grams daily for more than 3 months) needed to take less nonsteroidal anti-inflammatory drugs to treat their symptoms. The number of tender and swollen joints, level of morning stiffness, and physical function also showed a trend toward improvement among patients who took omega-3s when compared with controls.

A June 2012 systematic review of 23 trials was conducted in England and reported in the British Journal of Nutrition. The authors pointed out that the two main omega-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) found in oily fish and fish oil reduce the level of arachidonic acid in cells involved in immune response and thus reduce the production of inflammatory substances.

This explanation prefaced their conclusion, which was that "evidence is seen for a fairly consistent, but modest, benefit" of omega-3s from fish on symptoms of rheumatoid arthritis. Use of the essential fatty acids also had a beneficial impact on the use of nonsteroidal anti-inflammatory drugs.

With all that said, how much omega-3 fatty acids should people with rheumatoid arthritis consume? First, anyone who wants to take omega-3 supplements should discuss it with their healthcare provider before starting supplementation. Omega-3s may interact with other medications or supplements you are taking, and the fatty acids do increase the risk of bleeding.

Typical doses of omega-3s and fish oil are 1,000 to 2,000 mg daily, and it's generally recommended not to take more than 3,000 mg without a doctor's consent. Be sure to talk to your healthcare provider before taking omega-3 for rheumatoid arthritis.

Hayashi H et al. Nutritional status in relation to adipokines and oxidative stress is associated with disease activity in patients with rheumatoid arthritis. Nutrition 2012 Nov; 28(11-12):1109-14.
Lee YH et al. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Archives of Medical Research 2012 Jul; 43(5): 356-62
Miles EA, Calder PC. Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. British Journal of Nutrition 2012 Jun; 107 Suppl 2:S171-84

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