Fish oil and rheumatoid arthritis: does a herring a day keep rheumatologists away?

Article Abstract:

Increased amounts of fish in the diet have been seen to reduce the incidence of rheumatoid arthritis, a disorder characterized by inflammation of the joints, stiffness, swelling, overgrowth of cartilage, and pain. A fish diet is rich in omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA is involved in the production of certain types of prostaglandins, natural fatty acid substances, that have few inflammatory effects, whereas DHA blocks the production of other forms of prostaglandins that are strong activators of the inflammatory processes. In addition, these substances stabilize inflammatory cell membranes. One study showed that patients with rheumatoid arthritis who were given capsules containing EPA and DHA showed improvement in the number of tender joints and morning stiffness. Those results also showed that the disease worsened when the EPA treatment was withdrawn. A study in the February 1990 issue of Annals of the Rheumatic Diseases compared the effectiveness of fish oil with that of coconut oil in treating rheumatoid arthritis in 16 patients. Fish oil caused a decrease in swelling and duration of early morning stiffness, consistent with findings from the previous study. The available evidence from these studies suggests that fish oils only cause a modest improvement of rheumatoid arthritis without causing serious side effects. It is suggested that fish oils may be used as an adjunct or supplement to conventional treatment of rheumatoid arthritis with anti-inflammatory agents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Omega-3 fatty acids, Omega 3 fatty acids, editorial

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Effects of fish oil supplementation in rheumatoid arthritis

Article Abstract:

The clinical and biochemical effects of dietary fish oil supplementation were examined in 16 patients with rheumatoid arthritis, a disorder characterized by inflammation of the joints, swelling, stiffness, overgrowth of cartilage, and pain. Treatment with non-steroidal anti-inflammatory agents and other drugs was continued throughout the 12-week study. The effects of fish oils were compared to those of coconut oil, which was used as a placebo, having no known therapeutic effects. Fish oils reduced joint swelling and duration of early morning stiffness, as well as improved other clinical symptoms. Fish oil supplementation resulted in increased proportions of omega-3 fatty acids, including eicosapentaenoic acid and docosahexaenoic acid, in blood cholesterol compounds and cell membranes of neutrophils, a type of white blood cell. These changes were accompanied by a decrease in proportions of omega-6 fatty acids. The rate of production of leukotriene B4, which promotes inflammation, decreased after 12 weeks of fish oil supplementation, whereas the production of leukotriene B5, which causes less accumulation of inflammatory cells, increased during fish oil treatment. The findings show that dietary fish oil supplementation improves symptoms of joint swelling and morning stiffness associated with rheumatoid arthritis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Inflammation mediators, Leukotrienes

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Clinical significance of interleukin-6 measurement in early rheumatoid arthritis: relations with laboratory and clinical variables and radiological progression in a three year prospective study

Article Abstract:

Blood levels of in immune response protein called interleukin-6 (IL-6) may not be good indicator of early stage rheumatoid arthritis (RA) disease progression. Other immune response protein levels typically monitored during early stage RA disease are C reactive protein (CRP) and serum amyloid A (SAA) as well as hemoglobin (Hb) levels and erythrocyte sedimentation rates (ESR). Researchers measured monthly blood levels of IL-6, CRP, SAA, Hb, and ESR of 51 patients with early stage RA over a period of three years. They also examined X-rays of the patients' feet and hands every six months and monitored the number of inflamed joints. There was a significant correlation between IL-6, CRP, and SAA levels. However, there was no significant correlation between IL-6 levels and disease progression. CRP, SAA, Hb, and ESR seem to be better indicators of early RA disease progression than IL-6.

Development and progression, Interleukins

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