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Fish oils

This sheet provides general information about the use of fish oil supplements as a treatment for arthritis. It includes information about who may benefit from taking fish oils, how much to take and where to find more information.

What are fish oils?

Fish oils are oils found in the tissues of fish. They contain a certain type of fat called omega-3.

What are omega-3 fats?

Omega-3 fats are a type of fat that may be important for good general health. Our bodies cannot produce omega-3 fats so they must be obtained from food. Omega-3 fats are mostly found in oily fish and certain nut and seed oils.

How do omega-3 fats work for arthritis?

Certain types of omega-3 fats can reduce inflammation from arthritis. This may help to relieve joint pain and stiff nests in a similar way to non-steroidal anti-inflammatory drugs (NSAIDs).

What types of arthritis benefit from omega-3 fats?

Omega-3 fats have not been studied in all forms of arthritis. Current research suggests omega-3 fats are helpful for people with inflammatory arthritis, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. There is also evidence that fish oils can help control symptoms of lupus (systemic lupus erythematosus). Fish oils have not been thoroughly tested in other forms of arthritis, such as osteoarthritis, so it is unclear whether they are useful for these conditions.

Other benefits

Long-term intake of fish oil has been shown to reduce the reliance on NSAIDs in some cases of arthritis. This can help decrease the risk of side effects from these medicines. Fish oils can also help reduce the risk of heart disease and heart attack. There is some evidence that they may also play a role in preventing and treating depression.

Where do I find omega-3 fats?

Oily fish, such as tuna, salmon, herring, sardines and mackerel
Flaxseed (linseed) and canola oil (however these oils are not as active against inflammation as fish oils)
Walnuts
Foods fortified with omega-3, such as margarines and eggs.

Eating foods rich in omega-3 fats may help you to achieve benefits for your heart and general health. However it is unlikely that you can obtain enough omega-3 fats from your diet to reduce inflammation without fish oil supplements.

Where do I find fish oil supplements?

There are many different brands of fish oils supplements available at health food shops and pharmacies.

What type of supplement should I choose?

Fish oil supplements are available as capsules or as a liquid. Different brands of capsules vary in the amount of omega-3 fats they contain so it is worthwhile to compare brands. Check the label to see the amount of omega-3 contained in each capsule (it may be listed as a total omega-3 or as EPA and DHA, which are two forms of omega-3). Bottled fish oil is generally the most convenient and least expensive way to take the dose needed to reduce inflammation (see below). Capsules are preferred by some people and are more portable when travelling.

What dose should I take for arthritis?

Research suggests the dose needed to reduce inflammation is 2.7 grams of omega-3 (EPA plus DHA) daily. This dose usually requires approximately either:

nine to 14 standard 1000mg fish oil capsules or five to seven capsules of a fish oil concentrate per day, or
15mL of bottled fish oil or five to seven mL of concentrated bottled fish oil per day.

(Note, fish oil can benefit your heart and general health at lower doses. However these doses, generally, will not control symptoms of arthritis).

How long will it take to notice an effect?

You may need to take fish oil supplements regularly at the recommended arthritis dose for two to three months before you notice improvements in your arthritis symptoms. If there is no change by then, the supplements are probably not effective for your arthritis.

Are there any side effects?

Fish oil is usually well tolerated. A possible side effect from fish oil supplements is an upset stomach (for example, heartburn, nausea, diarrhoea). Taking high doses of more than seven grams of omega-3 fats per day may increase the risk of bleeding. Fish oils do not seem to interact with medicines that affect bleeding, such as aspirin or warfarin. However it is recommended that you check with your doctor before taking fish oil if you are taking these types of medicines.

Caution with fish liver oils

It is important not to confuse fish oils with fish liver oils (such as cod liver oil and halibut liver oil). 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.

Let your doctor know

Always let your doctor and pharmacist know if you are taking any treatments, including fish oils and other natural medicines. Do not stop any current treatments without first discussing it with your doctor.

Contact your local Arthritis Office for more information sheets on arthritis.

Omega-3 fats may help reduce inflammation in some forms of arthritis. Make sure you take the right dose to affect inflammation.

For more information:

Fish oil: what the prescriber needs to know written by Professor Cleland, Associate Professor James and Dr Proudman (Rheumatology Unit, Royal Adelaide Hospital). Available on request from rheuma@mail.rah.sa.gov.au or (08) 8222 5219.

Library

Foltz-Gray, Dorothy 2005, Alternative treatments for arthritis: An A-Z guide, Arthritis Foundation of America, Atlanta.

Borrowing from the library is available for members of Arthritis Victoria. If you would like to find out more about becoming a member call: (03) 8531 8000, or click here.

Websites

National Center for Complementary and Alternative Medicine (US) www.nccam.nih.gov
Complementary Medical Association (UK) www.the-cma.org.uk

Copyright

Source

A full list of the references used to compile this sheet is available from your local Arthritis Office.

The Australian General Practice Network, Australian Physiotherapy Association, Australian Practice Nurses Association, Pharmaceutical Society of Australia and Royal Australian College of General Practitioners contributed to the development of this information sheet. The Australian Government has provided funding to support this project.

Disclaimer

This sheet is published by Arthritis Australia for information purposes only and should not be used in place of medical advice.

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