Omega-3 Fatty Acids for Rheumatoid Arthritis

Omega-3 fatty acids are well known for their ability to reduce inflammation, and those with rheumatoid arthritis (RA) may want to consider incorporating them into their management plan. Increased intake of omega-3 may help alleviate pain and stiffness, as well as protect joints from damage—cornerstone goals of every RA treatment regimen.

The most common sources of omega-3 fatty acids are fish oil and flaxseed, which contain different types of omega-3s. While you can get them through food, omega-3s are also available in supplement form.

Effects of Omega-3

Omega-3s are power fatty acids that get well-deserved attention for their application in helping address a number of health concerns.

For RA, omega-3s may:

• Lower inflammation: Inflammation in the lining of the joints—a type of tissue called the synovium—is a hallmark of RA. Because omega-3 fatty acids may lower your body's production of inflammatory chemicals, it's theorized that intake of omega-3s can help inhibit this inflammation and thwart joint damage.
• Influence immune activity: Classified as an autoimmune disorder, RA occurs when the immune system mistakenly attacks the synovium. Omega-3 fatty acids may help regulate the immune response and prevent the attacks.
• Help lower comorbidity risk: Some research indicates that omega-3 fatty acids may improve heart health. RA is associated with an increased risk of heart disease, so careful management of cardiovascular risk factors is important.

A 2020 review of literature on omega-3s for RA concluded that these fatty acids may be beneficial to people with the disease because they modulate the immune system and block inflammatory actions. Researchers said adding supplements to participants' treatment regimens reduced the number of painful, swollen joints.

A 2017 paper also stated that fish-oil supplements appear to be a beneficial part of the RA regimen and pointed to numerous effects on the immune system and the inflammation cycle.

A 2012 report found that people with RA who took omega-3 supplements tended to see small improvements in symptoms, such as swelling and stiffness, and in overall physical function. These participants also were less likely to take nonsteroidal anti-inflammatories (NSAIDs), a class of drugs often used to alleviate the pain of rheumatoid arthritis yet which have many potential side effects.

Risks of Taking Omega-3 If You Have RA

While studies suggest that omega-3 fatty acids are likely safe for most people when taken in doses of between 2.5 and 5 grams, there's some concern that higher doses may interfere with blood clotting and increase your risk of bleeding.

RA can cause problems with blood clotting due to abnormal platelet levels, so you may want to ask your healthcare provider if you should have blood tests before starting omega-3s or while you're taking them.

Omega-3 supplements also pose other risks—as well as minor, generally tolerable side effects like nausea—unrelated to RA that you should consider. One important one is a potential for medication interaction at high doses, which is worth noting if you are working to manage RA and another condition, like diabetes.

Omega-3 in Foods

Omega-3 fatty acids come in several forms, depending on the source.

Fish oil is abundant in two forms of omega-3:

• Docosahexaenoic acid (DHA)
• Eicosapentaenoic acid (EPA)

Flaxseed, meanwhile, is rich in a third type called alpha-linolenic acid (ALA).

You probably get some omega-3 fatty acids via your diet without trying. The National Institutes of Health's Office of Dietary Supplements says most people in the United States get enough ALA through food, in addition to small amounts of EPA and DHA. (No recommended daily amounts have been established for EPA and DHA.)

Foods that provide omega-3s include:

• Fish and other seafood, especially cold-water fatty fish (salmon, tuna, sardines, mackerel, herring)
• Nuts and seeds, especially flaxseed, chia seeds, and walnuts
• Plant oils, including flaxseed oil and soybean oil
• Fortified foods, including some yogurts, juices, milk, soy beverages, and eggs

Omega-3 Supplements

If you want to make sure you get a consistent amount of omega-3s, supplements are a good way to accomplish that.

You can find many different formulations on the market, including some with just fish oil, just flaxseed, or a mix of the two. Some supplements also include omega-6 and omega-9 fatty acids.

Some people find that fish oil supplements leave them with fishy-tasting breath, heartburn, or nausea. If those are a problem for you, it may help to switch to flaxseed-based supplements or concentrate on dietary sources.

Rheumatoid Arthritis Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

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Other Health Benefits

In addition to being helpful in treating rheumatoid arthritis and protecting against cardiovascular disease, omega-3 fatty acids appear to have several other health benefits, including:

• Lowering triglyceride levels
• Reducing symptoms of irritable bowel disease
• Alleviating symptoms of multiple sclerosis

Omega-3s have been studied as a treatment for numerous other illnesses, including depression, attention deficit hyperactivity disorder (ADHD), and Alzheimer's disease. Thus far, results are mixed for these conditions.

A Word From Verywell

While omega-3s are generally considered a healthy addition to your diet, don't start using them medicinally without talking to your healthcare provider. That can help you avoid potential negative interactions with medications and ensure your dosage and sources are safe.

Since rheumatoid arthritis can lead to serious health problems, including major joint damage and disability, it's important to work closely with your practitioner in managing this condition rather than attempting to self-treat the disease with omega-3 fatty acids or any other form of alternative medicine.