Rheumatoid arthritis (RA) is a degenerative autoimmune disease in which the joints are attacked by an abnormal immune response and slowly destroyed. RA is much less common than osteoarthritis (OA), occurring in about 1 percent of the population and affecting women two to three times more frequently than men. The first symptoms typically appear between the ages of 25 and 50, although it can occur at any age, even childhood (juvenile RA). Unlike OA, RA is a systemic disease. It can affect organ systems throughout the body, not just the joints. Problems associated with RA include inflamed blood vessels, heart attack, neuropathy, lung complications, and others.
The omega-3 fatty acids are well-known anti-inflammatories that interfere with the underlying disease progression in RA. Studies have found that fish oil supplements, which are high in the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), can reduce TNF-alpha and interleukin-6. In one human study with 60 patients, groups were randomly assigned to take fish oil supplements or placebo. No other dietary modifications were made. At the end of the study, there were significant differences in the levels of pro-inflammatory cytokines in the patients taking fish oil (Sundrarjun T et al 2004). Another study compared the value of a diet high in omega-3 fatty acids and low in pro-inflammatory arachidonic acid with a normal Western diet (which tends to be pro-inflammatory). At the end of the study, patients on the anti-inflammatory diet experienced a 14 percent decrease in the number of swollen joints, while the patients on the Western diet experienced no change (Adam O et al 2003). These results have been supported by many other human studies demonstrating profound benefits of omega-3 fatty acids, including studies showing that some people can discontinue nonsteroidal anti-inflammatory drug (NSAID) treatment after beginning therapy with fish oil supplements (Kremer JM et al 1995).
Over-the-counter NSAIDs, such as naproxen (Aleve®), ibuprofen, and others, operate by inhibiting the cyclooxygenase enzymes (COX-1 and COX-2), which convert arachidonic acid to pro-inflammatory PGE2. Side effects of over-the-counter NSAIDs include gastrointestinal upset because the COX-1 enzyme is also partly responsible for maintaining the mucosal lining of the stomach.
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