Cod liver oil may reduce the need for NSAIDs in rheumatoid arthritis

There Will Be Oil

“Anything that can help to reduce NSAID use is going to be safer for patients.”

Amen!

That quote comes from Dr. Andrew Bamji, and he knows what he’s talking about – he’s the president of the British Society for Rheumatology.

Dr. Bamji recently offered that quote to the BBC regarding a new UK study that shows how some rheumatoid arthritis patients might reduce their use of non-steroidal anti- inflammatory drugs by supplementing with a safe, natural agent that has been shown to supply many other healthy benefits as well.

Cutting back

As I’ve noted in many e-Alerts, NSAID use puts a severe strain on the digestive system. How severe does it get? According to the American Gastroenterological Association, long-term NSAIDs use is responsible for well over 100,000 hospitalizations each year due to upper gastrointestinal adverse events, and may contribute to an astonishing 16,500 deaths per year.

But many patients with rheumatoid arthritis would find life unbearable without NSAIDs to relieve their pain.

In rheumatoid arthritis (RA), chronic inflammation of the joints and soft tissue around the joints is prompted by an autoimmune reaction. The key word in that sentence is “inflammation” – exactly the problem that NSAID use addresses, but at a potentially high cost.

Based on research that shows omega-3 fatty acids reduce inflammation, researchers at the University of Dundee and the University of Edinburgh recruited nearly 100 RA patients for a cod liver oil intervention study.

STUDY PROFILE

• Half the subjects were given 10 grams of cod liver oil daily (delivering 2.2 grams of omega-3 fatty acids), and half were given a placebo
• At baseline, and again at weeks 4, 12, 24, and 36, researchers checked each subject’s daily use of NSAIDs and RA activity
• At week 12 each subject was instructed to gradually reduce or even stop NSAID use if possible
• Nearly 40 percent of subjects in the cod liver oil group were able to reduce NSAID use by at least 30 percent
• Only 10 percent of subjects in the placebo group were able to reduce NSAID use to the same level

The BBC reports that this is the third study conducted by the Dundee/Edinburgh team in which patients were able to cut down on NSAID use with the help of cod liver oil supplements.

Too much or just enough?

Of course, many RA patients who use cod liver oil daily will enjoy other healthy benefits because this type of fish oil is an excellent source of vitamin D and omega-3 fatty acids – two of the most important nutrients in the prevention of cancer and heart disease.

But what about that dosage? 10 grams per day? Isn’t that pretty high?

I put that question to HSI Panelist Allan Spreen, M.D., and he told me that it’s actually about right when you’re treating a major challenge like RA.

Dr. Spreen: “Like vitamin C, to really get a ‘drug-like’ effect, you have to get pretty heavy on the dosage. That means lots of capsules (or nasty tasting oil), which upsets some people’s stomachs and leaves them ‘fish-tasting’.

“Similar doses can be used on depression, bipolar disorder, high triglycerides, and other issues tied to inflammation besides arthritis. But it also requires (in my opinion) 400 iu of vitamin E mixed tocopherols twice/day, to stop the free radical formation that comes from even the ‘good’ polyunsaturated oils.”

Talk to your doctor before adding cod liver oil to your supplement regimen.

Sources:
“Cod Liver Oil (n-3 Fatty Acids) as an Non-Steroidal Anti-Inflammatory Drug Sparing Agent in Rheumatoid Arthritis” Rheumatology, Published online ahead of print 3/24/08, rheumatology.oxfordjournals.org
“Cod Oil ‘Cuts Arthritis Drug Use'” BBC News, 3/25/08, news.bbc.co.uk