Fish Oil, Arthritis and Resolvins

Does fish oil containing omega-3 fatty acids have any beneficial effect on arthritis pain? With all the other benefits being claimed for it, fish oil seems like it would help. But is there any scientific evidence? And is so, why does it confer these benefits?

One study, published in Feb 21, 2005 in Nutrition, found that taking fish oil omega-3 fatty acids

“relieved several clinical parameters used in the present study. However, patients showed a more precocious and accentuated improvement when fish oil supplements were used in combination with olive oil.”

The study tracked improvements in joint pain intensity, handgrip strength, duration of morning stiffness, ability to bend down to pick up clothing from the floor, and other clinical indicators after both 12 and 24 weeks, and compared them to a control group receiving a placebo.

Rheumatoid Arthritisand Omega 3

Another study, appearing in Oct 27, 2000 in the Journal of Rheumatology, looked at 50 rheumatoid arthritis subjects who were given fish oil supplements containing omega 3 fatty acids at 40 mg per kg body weight for 15 weeks.

The researchers, at the University of Newcastle in Australia, concluded that that

“fish oil supplementation that delivers (n-3) fatty acids at a dose of 40 mg/kg body weight/day, with dietary (n-6) fatty acid intake < 10 g/day in the background diet, results in substantial cellular incorporation of (n-3) fatty acids and improvements in clinical status in patients with RA.”

A similar study done in 1990 at Albany Medical College, looked at olive oil vs. low-dose fish oil vs. high-dose fish oil supplementation for 49 patients with active rheumatoid arthritis.

They found that 5 of 45 clinical measures were significantly improved from a baseline in the olive oil supplemented group, 8 of 45 measures improved in the low-dose fish oil group, and 21 of 45 in the high-dose fish oil group were improved during the 24 week study.

The high dose supplementation was 54 mg of eicosapentaenoic acid, or EPA, per kg body weight and 36 mg/kg docosahexaenoic acid (DHA). This suggests that anyone taking fish oil for arthritis needs to take higher amounts than what is usually recommended, if they want to get any relief.

Anti-inflammatory Effects

There have been numerous other studies along the same lines, all showing some benefits. The improvements in symptoms are due to some kind of anti-inflammatory mechanism.

We know that both omega-3 and omega-6 are converted in the body to molecules called prostaglandins, which have numerous beneficial effects, such as reducing inflammation, inhibition of blood clotting, and maintaining various regulatory states in the body.

A class of fatty compounds discovered in 2002, that our bodies make from eicosapentaenoic acid, called resolvins, may make clear how omega-3 gives its anti-inflammatory effects.

  • See the study: Resolvins : A Family of Bioactive Products of Omega-3 Fatty Acid Transformation Circuits Initiated by Aspirin Treatment that Counter Proinflammation Signals

Resolvins have been shown to reduce cellular inflammation by inhibiting the production and transportation of inflammatory cells and chemicals to the sites of inflammation. They are produced by the COX-2 pathway especially in the presence of aspirin. This suggests that diet supplementation with fish oil may work better when combined with low aspirin doses.

Of course, more evidence is needed, but as far as a replacement for Vioxx, fish oil and omega-3 could be a serious contender.

Related Studies

1. Kremer JM, Lawrence DA, Jubiz W, DiGiacomo R, Rynes R, Bartholomew LE, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects. Arthritis Rheum 1990;33:810-20.

2. Cleland LG, French JK, Betts WH, Murphy GA, Elliott MJ. Clinical and biochemical effects of dietary fish oil supplements in rheumatoid arthritis. J Rheumatol 1988;15:1471-5.

3. Volker D, Fitzgerald P, Major G, Garg M. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. J Rheumatol 2000;27:2343-6.

4. Lau CS, Morley KD, Belch JJ. Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis-a double-blind placebo controlled study. Br J Rheumatol 1993;32:982-9.

5. James MJ, Cleland LG. Dietary n-3 fatty acids and therapy for rheumatoid arthritis. Semin Arthritis Rheum 1997;27:85-97.

6. Vargova V, Vesely R, Sasinka M, Torok C. Will administration of omega-3 unsaturated fatty acids reduce the use of nonsteroidal antirheumatic agents in children with chronic juvenile arthritis? [Slovak] Cas Lek Cesk 1998;137:651-3.

7. Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr 1997;65:1645S-54S.

8. Clària, J., and C.N. Serhan. 1995. Aspirin triggers previously undescribed bioactive eicosanoids by human endothelial cell-leukocyte interactions. Proc. Natl. Acad. Sci. USA. 92:94759479

9. Calder, P. C (2006). n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am. J. Clin. Nutr. 83: S1505-1519S

10. Arita, M., Bianchini, F., Aliberti, J., Sher, A., Chiang, N., Hong, S., Yang, R., Petasis, N. A., Serhan, C. N. (2005). Stereochemical assignment, antiinflammatory properties, and receptor for the omega-3 lipid mediator resolvin E1. J. Exp. Med. 201: 713-722