Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that causes pain, swelling, and damage to the joints. It occurs when the immune system mistakenly attacks healthy tissue in the joints. RA is a progressive disease that can cause permanent joint damage and disability if left untreated. Recent research shows that fish oil supplements containing omega-3 fatty acids can safely improve various symptoms and outcomes in RA patients. This article will discuss 10 Science-Backed health benefits of fish oil for Rheumatoid Arthritis.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is the most common type of inflammatory arthritis. It affects over 1.3 million Americans, mostly middle-aged and older women [1].
In RA, the immune system produces antibodies that attack healthy tissue in the joints, especially the synovial membrane lining the joints. This causes inflammation, swelling, pain, and joint damage over time.
Common symptoms of RA include [2]:
- Joint pain, tenderness, swelling, or stiffness, especially in the smaller joints of hands and feet
- Fatigue, fever, and weight loss
- Firm bumps under the skin (rheumatoid nodules)
- Joint deformity or loss of function over time
While there is no cure for rheumatoid arthritis, early treatment is crucial to prevent irreversible joint damage. Standard treatments include NSAIDs, corticosteroids, DMARDs, and biologics to suppress inflammation and slow disease progression.
Anti-Inflammatory Effects of Omega-3s in Fish Oil
Fish oil, rich in omega-3 fatty acids, has been shown to have anti-inflammatory properties. Omega-3 fatty acids like EPA and DHA found abundantly in fish oil have potent anti-inflammatory properties. They can beneficially modulate nearly all aspects of immune function that drive inappropriate inflammation in RA.
Some ways omega-3s reduce inflammation:
1. Cytokine Inhibition
Cytokines are small proteins that allow immune cells to signal each other to perpetuate chronic inflammation. Omega-3s block cytokines like TNF-alpha, IL-1beta, IL-6, and others.
2. Inflammatory Gene Expression
EPA/DHA supplementation changes what genes are expressed inside immune cells, suppressing pro-inflammatory genes. This includes genes encoding inflammatory cytokines.
3. Altered Cell Signaling
Omega-3s become incorporated into immune cell membranes, disrupting inflammatory signaling cascades so they can’t perpetuate joint inflammation.
4. Inflammatory Mediator Production
Omega-3s block immune cell production of inflammatory eicosanoids like leukotrienes, prostaglandins, proteases, and adhesion molecules that drive tissue damage in joints.
10 Science-Backed Health Benefits of Fish Oil for Rheumatoid Arthritis
1. Alleviates Morning Stiffness and Joint Pain
Morning stiffness and chronic inflammatory joint pain are hallmark symptoms that negatively impact the quality of life in RA. Multiple double-blind randomized controlled trials demonstrate fish oil supplementation reliably reduces the duration of morning stiffness and severity of painful joints compared to placebo.
For example, one study provided RA patients either fish oil capsules containing a total of 1.8 grams of EPA and DHA daily or placebo capsules of corn oil. After just 3 months, the fish oil group reported approximately 1 hour less morning stiffness duration and 28% less joint tenderness compared to placebo.
The anti-inflammatory and joint lubricating properties of EPA and DHA likely alleviate stiffness and pain symptoms.
2. Reduces Systemic Inflammation
The root cause of RA joint symptoms and destruction is uncontrolled inflammation. Markers like C-reactive protein (CRP) quantify levels of bodily inflammation. Multiple studies find fish oil supplementation significantly reduces CRP and other inflammatory markers in RA patients compared to placebo.
For example, one trial had RA patients take ≥2.6 grams/day combined EPA and DHA – or placebo – along with their standard medications. After 3 months, the fish oil group decreased CRP levels by 49% on average versus no change in placebo.
By lowering bodily inflammation, fish oil likely also lowers flare risk.
3. Enhances Efficacy of Pharmaceutical Treatments
Research shows adding supplemental fish oil to standard RA medication regimens enhances their efficacy.
One study added ≥2.6 grams/day EPA+DHA or placebo to RA patients’ disease-modifying antirheumatic drug (DMARD) regimens. After 3 months, 68% of the fish oil group met the criteria for major clinical improvement versus only 33% of placebo patients.
Presumably by augmenting their anti-inflammatory effects, fish oil may help DMARDs and biologics better control RA disease activity.
4. Improves Physical Functioning and Mobility
Uncontrolled inflammation and progressive joint damage contribute to mobility issues and impaired physical functioning in RA patients. Multiple studies demonstrate fish oil supplementation leads to significant improvements in walking distances and times, mobility task completion times, and self-reported physical function scores compared to placebo.
For example, one study found RA patients taking 1.8 grams/day EPA+DHA could walk 62 meters further without pain after 3 months compared to placebo. Benefits increased at 12 months.
By lubricating joints and reducing inflammation, fish oil likely alleviates pain and stiffness to improve mobility.
5. Protects Cardiovascular Health
Chronic inflammation in rheumatoid arthritis accelerates atherosclerosis, significantly heightening the risk for cardiovascular events like heart attacks and strokes.
However, omega-3s beneficially impact several cardiovascular risk factors. Meta-analyses associate fish oil supplementation with improvements in:
- Blood pressure
- Triglycerides
- Endothelial function
- Arterial plaque stability
- Heart rate
- Blood clotting
By optimizing numerous risk factors, fish oil offers cardioprotective effects that may help counteract RA’s cardiovascular consequences.
6. May Help Slow Joint Destruction Progression
The inflammatory onslaught of RA slowly but progressively destroys joint structures over time if left uncontrolled. Some research indicates fish oil’s anti-inflammatory effects may help slow this joint damage progression.
In one 6-month trial, RA patients took fish oil capsules containing 2.6 grams/day combined EPA+DHA – or placebo capsules. The fish oil group had significantly less progression of joint space narrowing and bone erosions compared to placebo, as quantified by x-ray imaging and MRI scans.
By suppressing inflammatory chemicals driving joint damage, omega-3s may help preserve joint integrity. More research is still needed.
7. Boosts Mood and Mental Health
RA’s mix of chronic pain, fatigue, disability, and medication side effects predispose patients to struggles with mood disorders like depression and anxiety. Up to 42% of RA patients deal with clinically significant depression.
However, some studies demonstrate fish oil supplementation reliably improves self-reported mood, well-being, and depression severity in RA populations compared to control groups. Anti-inflammatory effects and neurotransmitter benefits likely underlie these mental health improvements.
8. Combats Fatigue
Debilitating fatigue afflicts up to 80% of RA patients, exacerbating disability and corroding quality of life. Some research suggests fish oil may counteract RA fatigue.
One 12-week study had RA patients with severe fatigue take capsules providing 540mg EPA and 360mg DHA daily or placebo. On fatigue severity assessments, the fish oil group improved by 40% while the placebo group worsened by 4%.
Omega-3s likely fight fatigue by suppressing inflammatory chemicals closely linked to RA exhaustion. Larger trials are still needed.
9. Supports Weight Loss Efforts
Excess adiposity worsens RA disease activity by secreting inflammatory chemicals. Losing weight often improves RA symptoms and joint functionality if inflammation can be controlled.
Some evidence suggests fish oil supplementation enhances weight loss efforts. Meta-analyses associate omega-3 intake with:
- Increased satiety/fullness
- Heightened fat oxidation
- Preserved lean mass during energy restriction
- Increased weight/fat lost during energy restriction
By optimizing body composition and accelerating fat loss, fish oil helps lighten the load on RA joints.
10. Safe and Well-Tolerated
Current research overwhelmingly supports fish oil supplements as safe for most adults at moderate doses (≤3 grams combined EPA+DHA daily), especially when fish oil purity and freshness are verified by third-party testing.
Unlike many RA medications, fish oil rarely causes significant side effects beyond minor GI upset in sensitive individuals. However, high doses may interact with other medications like blood thinners.
How Much Fish Oil Should be Consumed for Rheumatoid Arthritis?
Most studies showing RA symptom improvements use fairly high doses of 2-5 grams EPA+DHA daily from fish oil capsules Lower doses around 1 gram per day don’t reduce inflammation as effectively. So RA patients should take at least 2 grams of combined EPA/DHA from fish oil daily for best results.
Some patients may benefit from slightly higher doses nearly 4 grams per day. However, high fish oil doses may increase digestive side effects. It’s best to start with 2 grams per day and increase the dose slowly if needed.
Always choose reputable “pharmaceutical grade” fish oil capsules verified for EPA/DHA content and purity. Over-the-counter supplements often contain less omega-3s than stated on the label.
Safety Considerations With Fish Oil
Multiple clinical trials found no significant difference in adverse events between fish oil supplementation and placebo control groups in RA patients.
Fish oil is very safe for most people at recommended anti-inflammatory doses for RA. Potential side effects are usually mild like :
- Fishy aftertaste or belching
- Heartburn or nausea
- Stomach pain or diarrhea
- Easy bruising or prolonged bleeding
Taking fish oil capsules with meals can prevent most digestive issues. Freezing capsules before use may also help sensitive individuals.
It remains important to consult your doctor before starting fish oil, especially if taking blood thinners or NSAID pain relievers which can interact. Stop fish oil if any unusual bleeding, rash, or swelling develops.
For most RA patients, moderate-dose fish oil is very safe and well tolerated, especially under medical supervision. But perform some due diligence selecting quality encapsulated omega-3 supplements verified for purity.
FAQs
1. Can fish oil replace other treatments for rheumatoid arthritis?
Fish oil should not be used as a substitute for prescribed medications or other treatments for rheumatoid arthritis. It is most effective when used as a complementary therapy alongside conventional treatments, as recommended by a healthcare professional.
2. Are there any dietary restrictions when taking fish oil for rheumatoid arthritis?
There are no specific dietary restrictions when taking fish oil for rheumatoid arthritis. However, it is important to follow a balanced diet that includes a variety of nutritious foods to support overall health and well-being.
3. How long does it take to see the benefits of fish oil for rheumatoid arthritis?
The time it takes to see the benefits of fish oil for rheumatoid arthritis can vary from person to person. Some individuals may experience improvements in symptoms within a few weeks, while others may require several months of consistent use. It is important to be patient and continue taking fish oil as directed by a healthcare professional.
