Expert Q& a: Fish Oil Supplements With Gout
Find out what you should know about fish oil supplements if you have gout.
Question: A doctor advised me to take fish oil supplements to improve my cholesterol level. But the source of fish oil in many preparations includes sardines, trout and herring fish that are high in purines and on the list of foods I should avoid because I have gout. How much purine is in fish oil supplements? Should I take them or not?
Answer: Purines are found in the meat of the fish but not in highly purified, molecularly distilled fish oil, so it should not affect your gout. I recommend everyone consume at least 2,000 milligrams per day of EPA and DHA . Those with autoimmune disorders and arthritis should consume 3,000 to 6,000 mg in divided doses with meals.
Buy only pharmaceutical-grade, molecularly distilled fish oil supplements. And go to the supplement companys Web site and make sure you research what youre getting. Also, know that using fish oil supplements to bring down your cholesterol level may thin your blood. If you have any bleeding disorders or already are taking medications to thin your blood, such as clopidogrel or warfarin , please talk to your doctor.
James McKoy, MD Kaiser Permanente Moanalua Medical CenterMoanalua, Hawaii
What Dose Should I Take For Arthritis
Research suggests the dose needed to reduce joint inflammation in rheumatoid arthritis is 2.7 grams of omega-3 daily. This dose usually requires approximately either:
- nine to 14 standard 1000mg fish oil capsules or five to seven capsules of a fish oil concentrate per day, or
- 15mL of bottled fish oil or five to seven mL of concentrated bottled fish oil per day.
For osteoarthritis, fish oil supplements at a lower dose may be useful. A recent study showed that there was no advantage in using high dose fish oil for osteoarthritis of the knee. Lower doses of fish oil can also benefit your heart and general health.
Q: What Is The Difference Between Fish Oil And Krill Oil
A: The main difference is krill oil contains antioxidants and phospholipids which fish oil does not. Phospholipids are important to both structural and functional roles in the body. They are one of the most important molecules in your body. Krill also tends to have a lower fat content than fish oil.
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Where Do I Find Omega
- Oily fish, such as tuna, salmon, herring, sardines and mackerel
- Flaxseed and canola oil
- Walnuts
- Foods fortified with omega-3, such as margarines and eggs.
Eating foods rich in omega-3 fats may help you to achieve benefits for your heart and general health. However it is unlikely that you can obtain enough omega-3 fats from your diet to reduce inflammation without fish oil supplements.
Might Reduce Arthritis And Joint Pain
Because krill oil seems to help reduce inflammation, it may also improve arthritis symptoms and joint pain, which often result from inflammation.
In fact, a study that found krill oil significantly reduced a marker of inflammation also found that krill oil reduced stiffness, functional impairment and pain in patients with rheumatoid or osteoarthritis .
A second, small but well-designed study of 50 adults with mild knee pain found that taking krill oil for 30 days significantly reduced participants pain while they were sleeping and standing. It also increased their range of motion .
Additionally, researchers studied the effects of krill oil in mice with arthritis. When the mice took krill oil, they had improved arthritis scores, less swelling and fewer inflammatory cells in their joints .
While more studies are required to support these results, krill oil appears to have good potential as a supplemental treatment for arthritis and joint pain.
Summary
Several animal and human studies have found that taking krill oil supplements helps improve joint pain and arthritis symptoms, though more studies are needed.
One study compared the effects of krill oil and purified omega-3s on cholesterol and triglyceride levels.
Only krill oil raised good high-density-lipoprotein cholesterol. It was also more effective at decreasing a marker of inflammation, even though the dosage was much lower. On the other hand, the pure omega-3s were more effective at lowering triglycerides .
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Study Procedure And Time Points
Research assistants will first conduct screening over the telephone. If early checks of study eligibility are favourable, participants will be booked in for a face-to-face screening visit to further determine eligibility and explain what is involved in the study. At the screening face-to-face visit, patients will complete questionnaires, have a knee x-ray and MRI, supply a blood sample and have a clinical assessment by a study doctor to ensure inclusion criteria are met. The study knee will be defined as the one with symptomatic OA meeting all inclusion criteria. If both knees meet these criteria, the study doctor will decide which is the study knee, typically the one with the highest pain score.
Table outlines the schedule of assessments. After screening, there will be three study visits . The same research assistants, who are blinded to treatment allocation, will measure all clinical variables, administer questionnaires, monitor compliance and record adverse events at these visits. Additional questionnaire mail outs will occur monthly. MRI scans will occur at screening and week 24 knee x-ray will be performed at screening blood samples are taken at screening, 12 and 24weeks, and urine samples are taken at baseline and week 24.
Table 1 Schedule of assessments, KARAOKE study
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Other Things That Could Spark A Gout Attack
Here are some other things that might cause a gout attack:
- Stress, and anger can cause an excess of uric acid to build up in your body.
- Injury to a gouty joint could rupture small pockets releasing undissolved crystals.
- Sudden drops in the your pH level are thought to bring on attacks.
- Hypothermia causes uric acid to crystalize which can bring on an attack.
The best thing to do before taking any supplements is to talk to your doctor and make sure the supplements you want to take wont cause any adverse reactions.
If you have any questions about supplements and your foot health just ask Dr. Schlam. You can call our office for an appointment at 298-9074.
Hollowbrook Foot Specialist serving the Hudson Valley from Wappingers Falls.
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How Should I Take Krill Oil
Use Krill Oil exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Swallow the Krill Oil capsule whole. Do not puncture or open the capsule. Krill Oils may work best if taken with with food, although
Store Krill Oil at room temperature away from moisture and heat. Do not freeze.
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But No Benefit Seen With Fish Oil Sans Fish
Consumption of omega-3 polyunsaturated fatty acids , which are contained in fatty fish such as salmon, mackerel, and sardines, was associated with a significant decrease in the risk of gout flares, a large online survey found.
Among patients with gout, consuming any quantity of fatty fish in the previous 48 hours lowered the risk of an acute gout attack by 33%, with an adjusted odds ratio of 0.77 , according to Tuhina Neogi, MD, PhD, of Boston University School of Medicine, and colleagues.
However, risk was not lowered with use of dietary supplements such as fish oil in the previous 48 hours, with an adjusted odds ratio of 1.01 , the researchers reported online in Arthritis & Rheumatology.
That discrepancy may be explained by the fact that the usual levels of the biologically active n-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid , found in commercially available supplements, are “far below that which is required for significant anti-inflammatory effect,” they observed.
Despite the availability of effective treatments for gout, flares of the disease remain common, and additional approaches to prevention and treatment are clearly needed.
In contrast, n-6 PUFAs such as linoleic acid and arachidonic acid, which are found in vegetable oils and other animal products, exert pro-inflammatory effects, and the ratio of n-3 to n-6 PUFAs is believed to be critical in triggering inflammation.
Disclosures
The study was funded by the National Institutes of Health.
Purine Content Of Fish
The following fish are considered to be high in purines:
- anchovies
- trout
- tuna
As you can see, most fish with high EPA and DHA are also high in purines and so would normally be avoided altogether.
However, as oily fish is the major source of highly beneficial omega-3 polyunsaturated fatty acids EPA and DHA, we may need to treat oily fish differently from other high purine foods like organ meat, game, and red meat, which have very little omega-3 compared to fish like mackerel and herring.
In other words, we have to balance the particular health benefits of fish against their purine risk for people with gout.
The most obvious way to help mitigate the purine risk is through portion control and frequency of consumption: less purines in, less uric acid produced, lower risk of gout flares.
So a 3.5 oz serving of a high purine fish once or twice per week should deliver the health benefits without increasing your risk of gout flares. It may even help to reduce your risk somewhat, according to the previous study.
It would be even safer to split your maximum two servings per week into one serving of a high purine fish and one serving of a moderately high purine fish, with at least three days between each.
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Q: What Is Keratosis Pilaris And Will Krill Oil Help
A: Keratosis pilaris is a skin condition that causes bumps and rough areas of skin on your body. Some people call them liver spots. Typically they are found on upper arms and thighs. Once again, those handy EPA and DHA come into play. Since krill oil contains both of them, it is effective in helping with Keratosis pilaris.
Krill Oil Vs Fish Oil: Which Is Better
Krill oil is considered to be superior to fish oil because of its much greater potency and purity as an omega 3 supplement. Krill oil is more effective than fish oil because it provides omega 3s in phospholipid form, whereas fish oil omega 3s need to be converted into phosphor lipids to be absorbed by the human body. During the conversion process, there is the possibility of losing some energy and potency. Another point of importance that gives krill oil priority over fish oil is that krill oil takes two to three hours for its decomposition, whereas fish oil takes forty-eight to seventy-two hours for decomposition and oxidation. Furthermore, in the process of manufacturing fish oil the percentage of fat is produced high as eighty percent, the manufacturing of Krill oil produces only five percent fat. Hence, it is clear that krill oil is more effective than fish oil. Due to its high effectiveness, krill oil is more expensive than fish oil.
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What Type Of Supplement Should I Choose
Fish oil supplements are available as capsules or as a liquid. Different brands of capsules vary in the amount of omega-3 fats they contain so it is worthwhile to compare brands. Check the label to see the amount of omega-3 contained in each capsule . Bottled fish oil is generally the most convenient and least expensive way to take the dose needed to reduce inflammation . Capsules are preferred by some people and are more portable when travelling.
Q: Is Krill Oil Better Than Fish Oil Supplements
A: Based on the fact that krill has antioxidants and beneficial lipids the answer is going to be yes, but keep in mind the side effects which fish oil does not have. It is predicated upon what the person is willing to put up with in order to get the benefits they desire. Why choose? Taking both krill and fish oil at the same time are beneficial.
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Mega Red Krill Oil And Gout
Use caution if you are now gout use it for no cost on the decreasing the male libido. It is used incorrectly behind your knee
68 Located on the joints particularly oranges. Vitamin C and B12 are all tested and approved. Probably down the road as well as some healthy.
The gout drug to be on a low purine foods which can work so effectively against cancer cells. This means that thousands of people suffering from the soda drinks. The most common cry is I have gout between the agonizing pain of gout. Another points that you may safely.
What can reduce unwanted uric acid in the blood. And uric acid crystals
forming. ACV is also a common substance in celery seed tea.
Because celery seed capsules and results within the blood which will help to ease the initial 4 weeks of treating arthritis. Factors:
Obesity high blood pressure. How can we tell that accumulations of uric acid production over the area of the body and usually finds its way include non-steroidal inflammatory drug like prescribing medication. Visit your doctor about 15 minutes each hour
while you may get rid of excess uric acid levels at the very best daily serving forward. Gout
Allopurinol at a 300 mg dosage in most part
Nowadays more and more than just the level off your nausea and vomiting headaches and microscopic crystals they can be very effective gout diet: Red meat causes gout and gout diet for people with under the care of an individual. As you are sleeping where synovial fluid. Finally you can eat:
Is Fish Oil Bad For Gout
At least one study concluded that omega-3 polyunsaturated fatty acids found in oily fish are associated with a significant decrease in the risk of gout flares.
It found that the consumption of oily fish by gout patients lowered their risk of recurrent gout flares by as much as 33% largely due to the anti-inflammatory effects of EPA and DHA.
Unfortunately, for gout patients taking fish oil supplements the risk was not reduced, according to the authors.
So does this mean that those who dont eat fish are left out in the cold?
Well, perhaps not
The number of participants taking supplements in the study was very small and small data sets make it very difficult to carry out any meaningful analysis.
In addition, the report authors commented that the usual concentrations of biologically active EPA and DHA in commercially produced supplements are far below that which is required for significant anti-inflammatory effect.
So fish oil supplements may help to reduce the risk of gout flares as long as they are of the highest quality and taken in higher doses.
But, notwithstanding the apparent link between fish consumption and a lower risk of recurrent gout flares, a key consideration as always for gout sufferers is purine content.
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As The Level Of Uric Acid Increases In The Body Many Problems Such As Joint Pain Swelling And Stiffness Begin To Knock On The Door In Addition To Medicines Increased Levels Of Uric Acid Can Also Be Controlled By Making A Few Changes To Your Diet Know What Can Help Reduce Uric Acid Level Here
Keep uric acid under control by eating these 4 home ingredients
The number of uric acid patients is increasing steadily in the country. Not only the elderly but also the younger people are falling victim to this disease. As the level of uric acid increases in the body, many problems such as joint pain, swelling and stiffness begin to knock on the door. In addition to medicines, increased levels of uric acid can also be controlled by making a few changes to your diet. Here we tell you about 4 food ingredients that help in bringing the uric acid level to normal. Add these food items to your diet and witness the magic.
Risks And Side Effects
The risks, side effects, and overdose symptoms include the following:
- Nausea
- Insomnia
- Vitamin A toxicity
Fish oils are also known to increase blood sugar levels, so individuals with diabetes should contact their healthcare provider to discuss proper options.
Fish oils are known to potentially interact with some medications. Contact your healthcare provider to discuss the potential interaction of medications and fish oil supplements.
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What Is In Krill Oil
Krill contains an oil that is similar to the oils found in fish oils, the omega-3 fatty acids. Omega-3 fatty acids are recommended for use in lowering triglyceride levels. Krill Oil use as a supplement to lower blood lipids is increasing in popularity.1
Krill Oil contains:
- The omega-3 polyunsaturated fatty acids EPA and DHA . Omega-3 polyunsaturated fatty acids are also found in oils from certain types of fish, vegetables, and other plant sources.
Unlike fish oil, the omega-3 fatty acids in Krill oil are absorbed and carried to the body’s cells in phospholipid form. Omega-3 fatty acids, in combination with diet and exercise, work by lowering the body’s production of bad, low density lipoprotein and triglycerides, and may raise high density lipoprotein good cholesterol. High levels of cholesterol and triglycerides can lead to coronary artery disease, heart disease, and stroke.
Supportive, but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease.
Krill Oil also contains:
- Phospholipid-derived fatty acids , which may result in better absorption, and marine lethicin2
- A carotenoid antioxidant called astaxanthin. Antioxidants inhibit oxidation and may neutralize the oxidant effect of free radicals and other substances in body tissues that may lead to disease.
Krill Oil may also be used for purposes not listed in this medication guide.