If I were asked to pick just one supplement for optimal joint health, I would have to go with fish oil.

Why fish oil? Well, fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), long-chain polyunsaturated fatty acids (PUFAs), commonly referred to as omega-3 fatty acids or just omega-3’s. These omega-3 PUFAs have a number of beneficial effects on the body, including the joints.

In any type of arthritis, pain comes from two main sources:

1. Exposed and irritated nerves in the bone which are vulnerable to friction and chemical irritants when the protective cartilage layer is destroyed.
2. Inflammation which causes the synovial membrane of the joint to swell, grow, and produce excessive amounts of joint fluid (”water on the knee”).

Omega-3 fatty acids have been shown to reduce inflammation by interfering with the production of inflammation-producing chemicals which stimulate pain nerves in the tissues.

While it is true that there are some vegetarian sources of omega-3’s like walnuts, flaxseed (linseed) oil, canola oil, soybean oil, etc., all of these are short chain polyunsaturated acids which must be converted by the body into longer chain PUFAs to be useful.   Since fish oil already contains long chain PUFAs, it’s the best dietary source.

In fact, fish oil is so effective, that some studies have shown that it can relieve pain symptoms even in cases of rheumatoid arthritis (RA).   RA is a serious autoimmune condition that can affect joints and soft tissues throughout the entire body.

One study showed that fish oil reduced morning stiffness and joint tenderness and increased the effectiveness of NSAIDs in patients with RA.1 Another study suggested that the long-term use of fish oil (over 12 weeks at 6 grams a day) may decrease the need for NSAIDs and other RA medications.2,3

Finally, a recent Australian study showed that fish oil reduced the use of NSAIDs by 75% in RA patients and reduced inflammation-causing chemicals by up to 41%.4

When you add these benefits to the others known to be associated with fish oil like lowering triglycerides, “thinning” the blood (reducing the risk of clots), and benefitting both the heart and brain (60% of the brain is fat and half of that is DHA), there is no doubt that it’s the king of joint supplements.

When taking fish oil supplements, it is also a good idea to take vitamin E (3 mg for every 1 gram of fish oil) to protect against oxidation.5 A garlic supplement can also be taken to prevent increased levels of LDL cholesterol.

References

1. Mayo Clinic, National Standard Patient Monograph 2008.
2. Geusens, P et al. Arthritis & Rheumatism, 37:824-829, 1994.
3. Kremer, JM et al. Ann Int Med. 106:497-503, 1987.
4. Darlington, LG and Stone, TW, Brit J Nutr. 85:251-269, 2001.
5. Cleland, LG et al. J Rheum. on-line, 2006.

[Ed. Note: Dr. Bill is William Thomas Stillwell, MD, FACS, FICS, FAAOS, FAANAOS, FAAPGS, a board certified orthopaedic surgical specialist, President and CEO of Dr. Bill's Clinic, Inc. and author of the new healing program, How to Avoid  Knee  Surgery. To learn more, click here.]

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