Rheumatoid Arthritis
and Omega-3 Fatty Acids

This section was compiled by Frank M. Painter, D.C.
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Rheumatoid Arthritis & EFA Articles

Omega-3s May Help Rheumatoid Arthritis
Omega-3 fatty acid-rich fish oil supplements may provide modest improvement in rheumatoid arthritis (RA), according to a double-blind, placebo-controlled study conducted at the University of Newcastle in Australia. In this study, 50 people with RA were randomly assigned to take either 40 mg/kg body weight of fish oil (containing 60 percent omega-3 fatty acids) or placebo daily for 15 weeks. The fish oil group had an average age of 54 and an average disease duration of 12 years, whereas the placebo group was 60 years old on average and had RA for an average of 15 years. Because omega-6 fatty acids, found in most vegetable oils, compete with omega-3 fatty acids, the researchers included only subjects who generally ate less than 10 g/day of omega-6 fatty acids.

Rheumatoid Arthritis & EFA Abstracts

Treatment of Rheumatoid Arthritis with Marine and Botanical Oils:
An 18-month, Randomized, and Double-blind Trial

Evid Based Complement Alternat Med. 2014 (Mar 19);   2014:   857456

Although the combination of oils did not prove superior to either oil alone, patients in each group did improve significantly, so that most patients had incentive to continue the trial. In addition, these oils can substitute for NSAIDs, and the combination of both oils allows reduction of more toxic DMARDs by patients treated with agents that block TNFa. Newer formulations which provide appropriate fatty acids in smaller capsules would encourage more patients to use them rather than NSAIDs. Further studies of the combination of marine and botanical oils might provide data to persuade physicians to use them in treatment of patients on DMARDs and biologic agents, in an effort to reduce treatment with the more toxic DMARDs.

Influence of Marine n-3 Polyunsaturated Fatty Acids on Immune Function and a
Systematic Review of Their Effects on Clinical Outcomes in Rheumatoid Arthritis

Br J Nutr. 2012 (Jun);   107 Suppl 2:   S171-84

Marine n-3 PUFAs can affect other aspects of immunity and inflammation relevant to RA, including dendritic cell and T cell function and production of inflammatory cytokines and reactive oxygen species, although findings for these outcomes are not consistent. Fish oil has been shown to slow the development of arthritis in animal models and to reduce disease severity.

N-3 Fatty Acid Supplements in Rheumatoid Arthritis
Am J Clin Nutr 2000 (Jan);   71 (1 Suppl):   349S351S

Ingestion of dietary supplements of n-3 fatty acids has been consistently shown to reduce both the number of tender joints on physical examination and the amount of morning stiffness in patients with rheumatoid arthritis. In these cases, supplements were consumed daily in addition to background medications and the clinical benefits of the n-3 fatty acids were not apparent until they were consumed for > or =12 wk. It appears that a minimum daily dose of 3 g eicosapentaenoic (EPA) and docosahexaenoic acids is necessary to derive the expected benefits.

Validation of a Meta-analysis:
The Effects of Fish Oil in Rheumatoid Arthritis

J Clin Epidemiol 1995 (Nov);   48 (11):   13791390

The purpose of this study was to validate the results of a meta-analysis showing the efficacy of fish oil in rheumatoid arthritis with the results of a re-analysis of the complete primary data set.

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 (Nov);   32 (11):   982989

These patients were able to reduce their NSAID requirement without experiencing any deterioration in the clinical and laboratory parameters of RA activity.

Fish-oil Fatty Acid Supplementation in Active Rheumatoid Arthritis:
A Double-blinded, Controlled, Crossover Study

Ann Intern Med 1987 (Apr);   106 (4):   497503

Fish-oil ingestion results in subjective alleviation of active rheumatoid arthritis and reduction in neutrophil leukotriene B4 production. Further studies are needed to elucidate mechanisms of action and optimal dose and duration of fish-oil supplementation.

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