The earliest signs of rheumatoid arthritis (RA) are tiny injuries to the synovial membrane and an increase in the number of synovial cells. At this point, long before symptoms are experienced, there is evidence of immune cell penetration into the synovial membrane. Over time, the immune response continues to gain momentum and inflict damage on the synovial membrane.
Rheumatoid arthritis symptoms are caused by chemical messengers called cytokines. It is thought that the release of interleukin-1, TNF-alpha, and interleukin-6 into the circulation system may account for systemic symptoms such as malaise and fatigue. In fact, these symptoms, along with weakness and vague musculoskeletal symptoms, are often the first indication of any disease. They may last for weeks or months, during which time a diagnosis may be difficult to make. It is not until specific, joint-related symptoms appear that RA is diagnosed.
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).
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