You may have heard that fish oil can be anti-inflammatory and could be used in place of NSAIDs (non-steroidal anti-inflammatory drugs). Yes, this is true, but please read through this entire article as there are some very important points to consider.
First, why stop using NSAIDs (Vioxx, Naproxen, aspirin, ibuprofen and others) if they are working for you?
- NSAIDs are the most common cause of drug-related morbidity and mortality reported world-wide. In the USA, at least 16,500 deaths each year are reported.
- NSAIDs use is related to higher rates of Alzheimer’s, atrial fibrillation, erectile dysfunction, gastrointestinal bleeding, stroke, liver/kidney damage and heart attacks.
- Tylenol, while not a NSAID, still has an accummulation affect through a person’s lifetime and causes liver/kidney damage.
So, to get some pain relief, you place yourself at greater risk for some nasty illnesses – and the NSAIDs do not address the cause of the inflammation/pain.
I prefer to focus on causes and not just the symptoms.
The most common cause of inflammation? The diet, which leads to an over-abundance of omega-6 oils (n-6) and a deficiency of omega-3 oils (n-3). While we need some n-6 oils, the Western diet provides too much n-6 and little n-3 oils. Too many grains that we eat, that the cows, pigs, chickens, and farm raised fish eat; plus all the seed oils like corn, safflower, sunflower and soybean. Sugar doesn’t add n-6 oils but still fuels inflammation.
This is where adding omega-3 oil into the diet can bring the n-6 to n-3 ratio into better balance. But how much n-3 is needed for the anti-inflammation effect? 2.7 gm/day minimum. (That’s 2700 mg!) But wait, there’s more: it is not 2.7 gm of omega-3 oil, it’s 2.7 gm of EPA and DHA combined. So, check your labels and it will tell you the amounts of total omega-3 and the individual amounts of EPA and DHA.
Let’s say your fish oil is 1000 mg/capsule with 400 mg EPA and 100 mg DHA. To get the 2.7 gm per day, you’d take 6 capsules each day for a total of 3 gm EPA & DHA. (It’s okay to take more, but 2.7 gm is the minimum.)
But wait! there’s more! Omega-3 oils are polyunsaturated fatty acids (PUFAs) and are susceptible to oxidation (going rancid). The body uses them in the cell membranes for structure, not for fuel. This means you need more fat soluble anti-oxidants, vitamins A & E, to protect the PUFAs and cell membranes from breaking down prematurely.
But wait! (again!?!) Simply taking more vitamins A & E (which 90% of the stuff on the market is synthetic) can have dangers too: liver damage, bone loss and stroke risks. (Funny, studies find when people eat diets high in vitamins A & E, they do not have those risks. But performing trials and supplementing synthetic A & E – natural and synthetic are the same thing, right? – produce those risks. However, even natural vitamin A can produce acute toxicity at 1.7 million IU for a 150lb. adult in a day.) This is why focusing on a symptom and doing one thing, even a natural thing, can get complicated.
What to do then? Remember that I said I like to focus on causes? Well, taking 2.7 gm of omega-3 oils addresses the inflammation symptoms from the omega-3 deficiency. What about the omega-6 excess, the toxicity component? You had better address that issue because the inflammatory effects of n-6 are greater than the anti-inflammation effects of n-3. Dowsing a house fire that keeps flaring up still produces damage. The n-6 to n-3 ratio could be more important than the absolute amounts of these fatty acids.
As usual, God and nature have a solution. Those researchers studying low carbohydrate high fat diets have found that all of the above issues are addressed. Since most of the inflammation is from the diet, the low carb diet reduces the n-6 oils from grains. Seed oils are eliminated or greatly reduced. Interestingly, when this diet is followed, the PUFAs in the cell membranes don’t get oxidized much, meaning there is less need for greater amounts of the vitamin A & E anti-oxidants. This also means that instead of 2.7 gm/day of EPA and DHA, you’d only need 1 gm/day.
Using omega-3/fish oil as anti-inflammation and pain relief for the short term (6 – 9 months) rather than NSAIDs would be my recommendation, AS THE DIET IS CHANGED! I would then drop the dosage to the 1 gm/day. Remember: omega-3’s are essential nutrients and must be in the diet or supplemented or you will have illnesses.
Caution: Research shows 2 – 3 months usage before significant drop in pain levels was common.
WARNING: While omega-3 oils have demonstrated excellent benefits for heart health, omega-3 oils thin the blood. Taking high levels of n-3 with blood thinner medications would be contra-indicated.
Ask us about your course of action. Be Well!
Dr. Tom