Arthritis and Fish Oil

TL;DR – Fish oil supplements have been shown to be effective in reducing pain from chronic arthritis.

Fish oil supplements are very popular and for good reason, but a lot of people still don’t know why. We will explore some of the better known aspects of fish oil, and touch on some of the less well established claims as well. To be clear this is not intended to be a comprehensive review of all the benefits of fish oil, but rather we will focus on why arthritis sufferers should care about fish oil.

In order to get started we need to know what exactly is arthritis. Arthritis as a term can be broken down into two parts: 1) Arthro – a prefix that simply means joint. So anywhere two bones come together, and 2) Itis – a suffix that mean inflammation. Arthritis is a major problem in the US. In fact over 8 million working age adults report restricted work abilities due to arthritis. Unfortunately, arthritis is also on the rise – the CDC predicts that by 2030 the number of adults diagnosed with arthritis will rise to 67 million people.

So, why do we even care about fish oil? The answer is long chain omega-3 fatty acids – specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) help reduce inflammation – the “itis” part of arthritis. This is achieved in two major ways – by blocking inflammatory substances called cytokines and prostaglandins, and by converting into anti-inflammatory chemicals called resolvins. If we reduce the amount of inflammation in the joint we reduce the amount of pain caused by arthritis.

So why supplement, why not just eat fish? I am actually a major supporter of trying to get our appropriate nutrition from the source rather than supplementation, but I also know that most of us fail to eat a diet that fully satisfies our all of our nutritional needs. Therefore, I am also a supporter of supplements. In order to get the 2.6 grams of omega-3 fatty acids per day that have been shown to have therapeutic effects, we would need to eat between 6 oz of fish like wild caught mackerel or salmon and 2.4 pounds of fish like tilapia, crab, lobster, shrimp – keep in mind that 3 oz is a standard serving of fish. Basically, you need fish at nearly every meal to do that, and that is a lot of fish to have everyday. Most people aren’t going to do that. A word of warning though – not all supplements are created equally. Higher quality supplements which have at least 30% EPA and DHA by volume and utilize better processing are more effective than other lower quality (and unfortunately lower priced) supplements.

But wait I heard… Like I mentioned at the beginning there is a lot of information out there, and some recent studies have shown some possible negative effects of elevated EPA/DHA levels in the blood. At this point more research needs to be conducted. The current studies have limited use because they did not do a great job of eliminating confounding factors (other reasons people might have had the negative effect). This among a few other problems with the studies leave us with our best science showing that fish oils benefits are real and the risk nearly non-existent. The most common side effect of fish oil is fishy tasting burps.

The bottom line. Research indicates that fish oil can actually replace the use of non-steroidal anti-inflammatory drugs (things like acetaminophen and ibuprofen) for chronic arthritis pain suffers.