What Do We Know About Fish Oil Supplements
Marine fish oil is rich in long-chain n-3 PUFAs which contain 18% EPA and 12% DHA.3 Fish oil supplements can take the form of capsules or liquid and the amount and relative proportion of n-3 fatty acids can vary between supplements.4
The n-3 PUFAs in fish oil have been shown to modify immunological responses involved in the pathophysiology of RA, including T-cell reactivity, reactive oxygen species reduction by leucocytes and inflammatory cytokine production by macrophages.5
EPA and DHA have been shown to suppress synthesis of eicosanoids including prostaglandin E2 and leukotriene B4, two of the most important pro-inflammatory mediators involved in RA. The omega-6 PUFA arachidonic acid is responsible for the production of these eicosanoids through the enzyme cyclooxygenase . EPA and DHA found in fish oils decrease the ARA content of immune cells and produce less inflammatory eicosanoid mediators than those produced by ARA.5
How Do You Take Fish Oil
Dont worry if you want to take fish oil, you dont have to do anything outrageous like eating mountains of fish skin. You also dont need a prescription for the supplement. There are various ways you can get more fish oil in your diet:
- Fish: You can simply eat more fish instead of a supplement. Make sure theyre cold-water oily types like tuna, salmon, sardines, cod, herring, or mackerel. Try two three-ounce servings of broiled or baked fish per week.
- Capsules: Fish oil supplements in their various forms are a more efficient way to get the oil into your body. The recommended dosage is 2 to 3 grams twice daily.
- Liquid: Liquid fish oil comes in a dropper or pump so its easy to administer. Take it with food.
- Chewable Tablets: Heads up with this one, fish oil tablets both taste and smell quite strongly of fish. Just be prepared.
- Softgels: For any fish oil supplement, look for 30% EPA/DHA.
Keep in mind that the Food and Drug Administration doesnt monitor fish oil supplements so be sure to read the label carefully of anything you plan to take. Also, make sure that you arent getting fish liver oils. They have benefits of their own but can lead to Vitamin A toxicity and pregnancy complications if you take the recommended dose for plain fish oil.
Dosage: How Much To Take
Many people take fish oilyet the typical amount they take is one or two capsules a day. Many people eat fish once or twice a week. But it turns out that is nowhere near enough for pain relief.
The studies about fish oil found that the effective amount is based on the amount of DHA and EPA contained within the fish oil. On average, 30% of fish oil is DHA and EPA, but different oils may contain different amounts.
When you get a bottle of fish oil or marine oil concentrate, read the label to find the amount of DHA and EPA contained in that particular product.
An 2006 article in Arthritis Research and Therapy, Fish Oil: What the Prescriber Needs to Know5Fish Oil: What the Prescriber Needs to KnowLeslie G. Cleland, Michael J. James, and Susanna M. ProudmanArthritis Research and Therapy 2006, 8:202PMID: 16542466 summarizes the amounts shown to be successful in studies.
- The minimum amount for pain relief is 2.7 g. of the omega-3 fatty acids DHA / EPA per day.
- No additional benefit has been shown from taking more than 6 g. of DHA / EPA per day.
The amount to take every day for pain relief is between 2.7 grams and 6 grams of DHA / EPA.
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Fact : Fish Oil Can Be Consumed In Pill Form Or Through Cold Water Fish
Feeling ready to add fish to your diet? Consider adding it to your diet in pill form, or even prepare some fish dishes.
Head to your local grocery or drug store and pick up fish oil supplements derived from real fish. Supplements should contain both DHA and EPA as opposed to pesticides, PCBs, or traces of mercury. Be sure the amount of fish oil per capsule is less than three grams.
To get your fill by adding more fish to your diet, choose cold water fish dishes. Explore salt-water fish and wild-caught fish. Some popular and tasty types of cold-water fish include:
Be sure to talk to your medical care providers to learn about safe additions to your diet. Certain groups of people, such as pregnant women, should limit their consumption of certain types of fish. Specifically, pregnant women should avoid consuming swordfish, king mackerel, and tilefish, while limiting their consumption of albacore tuna to no more than eight ounces per month.
If you have joint pain that will not subside with natural remedies or over-the-counter medications, it may be a sign of a more serious condition. Visit the orthopaedic specialists at UPMC online or call 1-877-471-0935 to schedule an appointment.
Influence Of Background Diet
Increased ingestion of n3 PUFAs from vegetable sources yields modest changes in LC n3 PUFAs in most tissues compared with fish oils taken in anti-inflammatory doses. However, avoidance of n6 PUFAs in visible fats can increase LC n3 PUFA levels achieved with a given dose of fish oil . Reduction in n6 PUFA intake can be achieved simply by choosing options that are rich in MUFAs, such as olive oil or canola oil based products, or that are rich in n3 PUFAs, such as flaxseed oil or fresh ground flaxseed. Patients should be advised to avoid products labelled as containing polyunsaturated oils because this generally means an n6-rich oil. Canola and olive oil based products generally are so marked. The substitutes suggested above are inexpensive and contain little undesirable saturated fat. A suggested guide to background diet is given in Table .
Table 2 Fatty acid information for food choices
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Does Fish Oil Help Your Joints
Living withjoint pain can make everyday activities difficult. Over-the-counter medications can help ease some ofthe discomfort associated with joint pain, but there is a natural alternativeworth trying.
Fish oil supplements are a popular alternative for those looking to relieve joint pain. It is made up of omega-3 fatty acids which contain anti-inflammatory properties. These fatty acids play a role in providing pain relief to many of your bodys joints.
Some Scientists Question The Safety And Efficacy Of Fish Oil In Osteoarthritis
Chen et. al report that 2-year supplementation with fish oil does not have any effect on bone loss in osteoarthritis. Mild side effects such as headache and gastric symptoms were reported.
Animal study shows that supplementation with omega 3 fatty acids does not prevent the onset of osteoarthritis.
In a study reviewing the efficacy of dietary supplements for osteoarthritis, researchers have mentioned that there is no concrete evidence to recommend omega 3 fatty acids to replace NSAIDs in osteoarthritis.
What does this mean? Few studies show that fish oil supplementation does not have pronounced effect in osteoarthritis in terms of reducing progression of the disease.
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Does Cod Liver Oil Help Relieve Arthritis Knee Pain And If So How
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It is a rich source of Omega 3 fatty acids , and studies have shown that these are helpful in treating arthritis. Cod liver Oil is also rich in Vitamins A and D. It has also been widely used for arthritis pain for generations. In fact a UK study of home remedies found it to be one of the most common. Although eschewed in the past, it now is usually found to be true that remedies that are in longstanding popular use do have value. Ultimately you can only tell by trying it if you are so inclined and it may well be that there is another nutrient that we are not aware of that is partially responsible for its beneficial effects. It is clear however that a fish oil supplement and a Vitamin D supplement are useful for virtually everyone, and this regimen probably provides what the Cod Liver Oil does. But if you want to give it a try, it certainly will not be harmful, and you can gauge the results for yourself.
How To Use Fish Oil For Pain Relief
Using fish oil for pain relief is well documented, and, unlike drugs, fish oil increases in effectiveness with consistent use. However, it might surprise you to learn that pain relief requires at least six times the dose that most people would take!
Since prehistoric times and until very recently, people ate large amounts of seafood to stay healthy.
Today, to relieve pain, its necessary to get seafood in concentrated form: fish oil or other marine oils , or, even more practical, concentrated omega-3 fatty acids from marine oils.
Well show you the how-to and the documentation in this article.
But first, just a little bit about healthy fat.
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Study Procedures And Outcome Measures
A detailed description of the study procedures has been published . Briefly, participants attended the research facility a total of four times , having refrained from medication, food and beverages other than water for 2h before the visit. During the first visit, anthropometric measures were taken, and participants were screened for suspected dementia . Then, participants were seated down for 10min before measurement of arterial compliance . Arterial pulse waveform analysis was used to assess the artery elasticity index of the small arteries, an indicator for endothelial dysfunction. Three consecutive measurements were taken and averaged for analysis. During the second visit, a venous blood sample was collected by a commercial pathology centre after an overnight fast to measure the inflammatory biomarker high-sensitivity CRP. Then, participants were asked to complete questionnaires regarding their chronic pain and OA burden, in addition to their general well-being. All assessments were repeated in the same order at the end of the 16-week trial.
Chronic pain measures
The participants perception of physical and mental well-being during the last 4weeks before their scheduled visit was assessed with the 36-Item Short Form Survey , which includes nine subscales . Each subscale has a maximum score of 100, indicating no disability, and the overall perception of quality of life was calculated by taking an average of all subscale scores.
About Upmc Orthopaedic Care
As a national leader in advanced orthopaedic care, UPMC treats a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. Whether you have bone, muscle, or joint pain, we provide access to UPMCs vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. As leaders in research and clinical trials with cutting-edge tools and techniques, UPMC Presbyterian Shadyside appears on U.S. News & World Reports rankings of the top hospitals in the country for orthopaedics.
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Pain Relief In Rheumatoid Arthritis
Much clinical research about fish oil has focused on advanced rheumatoid arthritis.
Fish oil has been tested in patients with rheumatoid arthritis using randomized controlled trials. Thats the same protocol used in drug testing.
A 2003 review article in the medical journal Drugs1The Role of Fish Oils in the Treatment of Rheumatoid ArthritisLeslie C. Cleland, Michael J. James, and Susanna M. ProudmanDrugs 2003 63: 845-853PMID: 126787 described 13 of these trials. Reduced morning stiffness and fewer painful joints were consistent results.
A few studies asked whether patients were able to reduce medication. An article in the medical journal American Journal of Clinical Nutrition summarized in 20002n-3 Fatty Acid Supplements in Rheumatoid ArthritisJoel M. KremerAmerican Journal of Clinical Nutrition 2000 71:349S-51SPMID: 10617995, Several investigators have reported that rheumatoid arthritis patients consuming dietary supplements were able to lower or discontinue their background doses of nonsteroidal antiinflammatory drugs or disease-modifying antirheumatic drugs.
Caution With Fish Liver Oils
It is important not to confuse fish oils with fish liver oils . Fish liver oils also contain vitamin A. Large amounts of vitamin A can cause serious side effects, particularly during pregnancy. If you take fish liver oils in the doses recommended for arthritis you may exceed the recommended daily intake of vitamin A. Only take the dose of fish liver oil recommended on the label. To increase your intake of omega-3 fats, you should do so by taking pure fish oils, not fish liver oils.
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Does Fish Oil Help To Relieve Arthritis
Arthritis a disease where the joints of our bones swell and they become too painful to touch. For relief your doctor will prescribe you various medicines and some more to fight the side effects of the medicines. An easier way would be to include an anti inflammatory diet in your food. Some reasons why you can depend on fish oil for treating your arthritis is given below.
- Fish oil contains two types of omega-3 fatty acids they are DHA and EPA . EPA and DHA can reduce inflammation, which is the basic cause of swelling and pain in patients.
- Fish oil is used for treating rheumatoid arthritis.
- When you consume fish oil regularly you are less likely to develop arthritis.
Fact : The Fats Found In Fish Oil Are Important In Maintaining Healthy Cells
The fats present in fish oil are healthy fats including natural chemicals. These fats play a role in keeping your joints healthy by restoring and supplementing joint tissues. Natural chemicals provide the joints with proper lubrication. This reduces the rubbing together of joints and helps minimizes pain and strains.
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Were Starving For Healthy Fats
Our standard dietwith its white bread, hamburger buns, frozen pizzas, french fries, pastries, candy barsis chock full of unhealthy, substandard fats. Its low in healthy fats, and almost completely lacking in the fats that are the basis for healthy cell membranes.
When we crave junk food, its our bodys desperate attempt to locate healthy fats. We Americans are starving for healthy fats!
Reduced Joint Pain Isnt The Only Benefit Of Fish Oil
While fish oil supplements are strongly recommended for many people with rheumatoid arthritis, the supplement can improve other areas of health as well. Research has shown that omega-3s can improve immune function, lower blood pressure, and improve heart disease symptoms.Many patients with arthritis also have other health conditions. Nearly half of all adults with heart disease also suffer from some form of arthritis. For many people, a fish oil supplement can offer a huge bang for the buck in improving health.
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What About The Microbiome
There is enormous interest now in the role of the microbiome the vast numbers of microorganisms living within us in health and disease. And we know that diet affects the microbiome within the intestinal tract. It could turn out that what you eat may cause certain populations of bacteria in the intestinal tract to rise or fall. Since these bacteria may affect immune function, and since rheumatoid arthritis is an autoimmune condition, its possible that changes in the microbiome will affect the activity and severity of rheumatoid arthritis. Researchers are working hard to understand how the microbiome might affect autoimmune diseases, and how this new perspective could lead to better control of conditions such as rheumatoid arthritis.
Fact : Consuming One To Three Grams Of Fish Oil Per Day Can Decrease Joint Pain
One-to-three grams of fish oil each day can help reduce the intensity of joint symptoms like morning stiffness, tenderness, swelling, and discomfort. The omega-3 fatty acids present in this amount can also increase blood flow throughout the body during exercise, which can help reduce joint pain and swelling.
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Pain Relief In Other Conditions
Does it work on pain other than rheumatoid arthritis? Yes.
In 2010, The Clinical Journal of Pain3Omega-3 Fatty Acids for Neuropathic Pain: Case SeriesG.D. Ko, N.B. Nowacki, L. Arseneau, M. Eitel, A. HumClinical Journal of Pain 2010 Feb 26:168-72PMID: 20090445 published a case series: five patients with other types of pain. The diagnoses included cervical radiculopathy, thoracic outlet syndrome, fibromyalgia, carpal tunnel syndrome, and burn injury. The doctors reported significant improvementnot just on the patients pain scales and reports, but on objective measures such as grip strength and EMG nerve conduction studies.
Homemade Smoothies Salad Dressings
In addition to the foods above, it helps to slip fish oil drops into a green or fruit smoothie, yogurt, or homemade salad dressing. You may be surprised how concentrated fish oil liquid can blend into foods that have a strong flavor, notes Bonci, author of The Active Calorie Diet. Try adding fish oil to a smoothie with grated orange peel, yogurt with ginger or cinnamon or even garlic-based or ginger-based salad dressing. Plus, using liquid fish oil concentrates may be more cost effective than using capsules.
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Icipants And Baseline Pain Measures
Between June 2017 and August 2018, 152 participants were enrolled, of whom 134 completed the intervention, and after setting the compliance to 80%, 126 participants remained . Side effects were reported in four participants , but no serious adverse events were reported. Two participants were excluded from the pain analysis , owing to unrelated pain that was non-existent at baseline , leaving 124 participants for analysis .
The baseline characteristics of participants are described in . Chronic pain measures were not significantly different between groups except for OA burden, which was significantly lower in the FO group compared with the CUR group . One hundred and thirty-one participants reported chronic pain at baseline. For the majority , however, pain symptoms were mild, as determined by VAS, averaging 3.5±0.2/10cm . The pain was mostly OA specific, because it was predominantly reported in the knees , lower back and shoulders , with aching being the most common pain descriptor . Furthermore, overall pain and pain subscales were correlated strongly with OA burden, with most participants reporting physical deconditioning/limitation , sleep disturbance and physical distress .