65 (April 2006) 326-331
Omega-3 Fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain
Joesph Charles Maroon, M.D. (Neurosurgeon for the Pittsburgh Steelers)
Jeffrey W. Bost, PAC-Both of these authors are from the Department of Neurological Surgery, University of Pittsburgh Medical Center
Side note before the article: SPM’s. Specialized Pro-Resolving Mediators Inflammation fighters. The SPMs (lipoxins, resolvins, protectins and maresins) are derived from arachidonic acid and omega-3 fatty acids. SPMs play a unique role in helping the body finally shut down the immune response, inhibit additional inflammation, clear away the damaging byproducts of the inflammatory process, and aid tissue remodeling. For decades, we thought EPA and DHA from fish oil helped relieve inflammation by competing with pro-inflammatory omega-6 fatty-acid metabolites. This isn’t the whole story.Read More: Specialized Pro-Resolving Mediators Inflammation fighters.
Okay on with Dr. Maroon’s article…
1. The use of NSAIDS is associated with extreme complications, including gastric ulcers, bleeding, myocardial infarction, stroke, and even death.
2. In this study, after 75 days on fish oil, 59% of patients who were taking NSAIDS for chronic spinal pain and who had degenerative spine disease, were able to discontinue their prescription NSAIDs, and 88% stated they were satisfied with their improvement and that they would continue to take the fish oil.
3. In this study, fish oil supplementation was not associated with any significant side effects.
4. “Omega-3 EFA fish oil supplements appear to be safer alternative to NSAIDs for treatment of nonsurgical neck or back pain.”
5. “More than 70 million NSAID prescriptions are written each year, and 30 billion over-the-counter NSAID tablets are sold annually.”
6. “5% to 10% of the adult US population and approximately 14% of the elderly rountinely use NSAIDs for pain control.”
7. Selling NSAIDs is a 9 billion dollar per year US industry.
8. Prescription NSAIDs for rheumatoid and osteoarthritis alone conservatively cause 16,500 deaths per year.
9. “NSAIDs are the most common cause of drug related morbidity and mortality reported to the FDA and other regulatory agencies around the world”
10. “The agent best documented by hundreds of references in the literature for its anti-inflammatory effects is omega-3 EFA’s found in fish and in pharmaceutical-grade fish oil supplements”
11. The beneficial anti-inflammatory affects of high-dose fish oil include the reduction of joint pain from rheumatoid and osteoarthritis, improvement in dry eyes and macular degeneration, reduced plague formation, reduced arrhythmias, and reduced infarction from coronary athrosclerosis.
12. Both natural and synthetic corticosteroids decreased healing capabilities, decreased the normal immune response, and have significant bone and gastric side effects.
13. COX-2 inhibitors significantly increase gastric and cardiovascular side effects.
14. Omega-3 DHA and EPA are used to make the anti-inflammatory eicosanoids (PGE3), where as excess omega-6 EFAs form inflammatory arachidonic acid based eicosanoids (PGE2).
15. “Animal proteins, especially red meat, also contain an abundant amount of arachidonic acid.”
16. A deficiency in omega-3 fatty acids, especially EPA and DHA, will result in a deficiency of anti-imflammatory prostaglandins.
17. The delta-5 desaturase enzyme is the gatekeeper to inflammation and is increased from elevated levels of insulin….from being diabetic, consuming refined carbs, or consuming any high fructose corn syrup.
18. “To encourage the production of anti-inflammatory PGs and to discourage the production of inflammatory PGs, saturated fats, trans-fatty acids, and arachidonic acid should be reduced in the diet; blood glucose should be controlled; and appropriate amounts of omega-3 fatty acids found in fish oils should be consumed.”
19. Omega 3 supplementation is safe and effective for many inflammation-related conditions and has a low incidence of side effects.
20. NSAIDs inhibit the effectiveness of fish oil producing anti-inflammatory prostaglandins.
21. “The US Department of Agriculture has limited fish consumption to 1 fish serving per week in adults and even less in children and pregnant women because of the concern of toxic contaminants such as mercury, polychlorinated biphenyls, and dioxin in our fish population.”
22. These authors did not recommend the fish oil for those on anticoagulants or fish related allergies, but noted “aspirin use was not a contraindication”.
Side Note: Buy from reputable companies! It doesn’t pay to find the cheapest fish oil products. You wouldn’t shop for cheapest heart surgeon for a loved one would you? Read this link on fish oil lawsuit in 2010.
Other good article links below:
Omega-3 books-(These are also good books on overall health!)
1. Omega-3 Connection by Andrew Stoll, Simon & Schuster, 2001
2. Medicinal Fatty Acids in Inflammation, edited by Joel Kremer (Professor of Medicine and Head of Rheumatology at Albany Medical College, New York), (Birkhauswer Verlag), 1998 (Technical Biochemical reference book $131.00)
3. Fats that Heal, Fats that Kill, by Udo Erasmus, Alive books, 1993
4. The Omega Zone, by Barry Sears, Regan Books, 2002
5. Fish oil, The Natural Anti-inflammatory, Joseph Maroon, M.D., Basic Health, 2006
6. Eat, Drink, and Be Healthy by Walter Willett and The Harvard School of Public Health, Simon & Schuster, 2001
7. Healthy Fats For Life, by Lorna Vanderhaeghe and Karlene Karst, Wiley, 2004
8. The Ultimate Omega-3 Diet, Evelyn Tribole, McGraw Hill, 2007
9. The Queen of Fats, Why omega-3s Were Removed From the Western Diet and What We Can Do to Replace Them, Susan Allport, University of Calif. Press, 2006
10. Your Miracle Brain by Jean Carper, Harper Collins, 2000
11. The Better Brain Book, by David Perlmutter, M.D., Riverhead Books, 2004
12. Brain Lipids and Disorders in Biological Psychiatry, ER Skinnner (Ed.), Elsevier Science, 2002
13. Phospholipid Spectrum Disorders In Psychiatry and Neurology, edited by Malcolm Peet, Iain Glenn, David Horrobin, Marlus Press, 2003
14. The Anti-Inflammation Zone, by Barry Sears, Ph.D, Reagan books, 2004
15. Inflammation Nation, by Floyd Chilton, Fireside Books, 2005
16. The Antioxidant Miracle by Lester Packer, Wiley, 1999
17. The Schwartzbein Principle, by Diana Schwartzbein, M.D., 1999
18. The LCP Solution, by B. Jacqueline Stordy, Ballantine Books, 2000
19. The Paleo Diet, by Loren Cordain, Wiley 2002