Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Dose-related effects of eicosapentaenoic acid on innate immune function in healthy humans: a comparison of young and older men. West Melbourne: Therapeutic Guidelines Ltd, 2017 (accessed 29 January 2018). Therapeutic guidelines: Principles of nonsteroidal anti-inflammatory drug use for musculoskeletal conditions in adults. Modifiable lifestyle factors associated with response to treatment in early rheumatoid arthritis. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Smolen JS, Landewe RBM, Bijlsma JWJ, et al.A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic reviw of their effects on clincal outcomes in rheumatoid arthritis. Fish oil supplements for rheumatoid arthritis. Whittle S, Richards B, Ramiro S, et al.Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. New therapies for treatment of rheumatoid arthritis. Smolen J, Aletaha D, Koeller M, et al.
Therapetic Guidelines: Rheumatoid arthritis. For this reason, take omega-3 supplements from fish body oil rather than fish liver oil. High intake of vitamin A in the diet can be toxic. Taking the capsules with food or keeping them in the freezer can help reduce this aftertaste.Įxtra caution should be taken with fish liver oils such as cod liver oil as they contain high levels of vitamin A. Gastrointestinal adverse effects of fish oil include heartburn, diarrhoea and a fishy aftertaste. Serious side effects from fish oil supplements are rare at these doses but minor side effects may include nausea and a rash. This is the same as taking between 6 and 9 capsules or 1–3 teaspoons of liquid per day. If you have rheumatoid arthritis the recommended daily intake of omega-3 in fish oil is at least 2.7 g. Supplements vary in the amount of omega-3 they contain. However, it is important that you do not stop taking your other medicines or reduce the doses without speaking to your doctor first.
These include non-steroidal anti-inflammatory drugs (eg, aspirin, ibuprofen, diclofenac) and steroids (eg, prednisone). Fish oil supplements may take up to 3 months for maximal effectiveness, so you may need to take other pain relief medicines in the meantime. Having less severe symptoms may allow you to reduce the doses of other medicines you take for rheumatoid arthritis. Omega-3 fatty acids found in marine fish oil may help to reduce inflammation in the joints and improve the symptoms of rheumatoid arthritis for some people. With this evidence in mind, a threshold intake of at least 2.7 g (n-3) daily is recommended in clinical guidelines in order to achieve a mild anti-inflammatory effect for patients with RA.
5, 11 Studies using low intakes of EPA and DHA ( 1.5, suggesting that EPA is more beneficial than DHA. To elicit an anti-inflammatory effect, a threshold intake of 2.7 g per day EPA has been suggested. Studies suggest that there may be a dose response relationship between marine n-3 PUFAs and the reduction of ARA-derived eicosanoids associated with inflammation. Taking a fish oil supplement did not impact doctor-assessed pain (SMD −0.14, 95% CI −0.49 to 0.22, p = 0.45).
Although significant, these differences are very small. 6īeneficial outcomes have also been reported in a meta-analysis of randomised controlled trials where supplementation with n-3 PUFAs for 3–4 months reduced patient reported joint pain intensity (SMD −0.26, 95% CI −0.49 to −0.03, p = 0.03), the amount of morning stiffness (measured in minutes) (SMD −0.43, 95% CI −0.72 to −0.15, p = 0.003) and the number of painful and/or tender joints (SMD −0.29, 95% CI −0.48 to −0.10, p = 0.003). Fish oil may take up to 3 months to exert a maximal effect, so it may be necessary to prescribe fish oil supplements alongside NSAIDs initially.Ī systematic review evaluating the effect of marine fish oil on pain in arthritic disease concluded that patients with RA experienced a reduction in pain (standard mean difference –0.21, 95% confidence interval –0.42 to –0.00) with low heterogeneity observed between studies (I 2 = 32%). Positive effects of fish oil supplementation on various disease outcomes, including joint pain and stiffness, have been reported for patients with RA.
0 kommentar(er)
