This page about fish oils for gout was last reviewed, or updated, on 16 June 2014.
This is a first of a series of linked pages which takes you through a method of getting pain relief for gout. The other pages you need to read are listed at the bottom of this page.
If you would like a simpler explanation for why you take fish and fish oils for gout, visit this page on seafood and gout. It discusses a study that supports this recommendation.
Fish oils' supplements contain two omega-3 fatty acids, known in abbreviated form as, EPA and DHA. Fish such as sardines, anchovies, and cod (cod liver oil) are used to prepare these supplements.
You also get omega-3 from the fish themselves of course but not as much as many of the dietary supplements concentrated to provide more omega-3, unless you eat a lot of fish. Which is not a good idea, although some fish probably is.
FIGHT FLARES WITH FISH OILS
Omega-3 for gout Omega-3 fatty acids have well researched, anti inflammatory properties because they help to build anti inflammatory prostaglandins. Prostaglandins are a class of eicosanoids, a powerful class of hormones. Other kinds of prostaglandins – the Cox -1 and Cox -2 ones – send pain and inflammation signals. These are the ones that require blocking by medications such as NSAIDs, and maybe up to a point, by the anthocyanidins in cherries, or by the curcumin in turmeric.
Although the pain and inflammation of gout attacks is caused by the immune system's attack on the MSU crystals, the anti inflammatory properties of fish oils make them a good idea for gout sufferers – they ought to deliver pain relief for gout, because they help to build anti inflammatory prostaglandins and decrease production of pro inflammatory ones.
Omega-6 for gout Omega -6 oils, used in tandem with the omega -3's are also turned into anti inflammatory prostaglandins if it is done correctly. But fish oils won't work as quickly as NSAIDs. They will however, over time, help to produce more anti inflammatory prostaglandins, and inhibit pro pain and inflammation eicosanoids.
THE OMEGA-3: OMEGA-6 BALANCE
There’s another good reason for taking fish oils for gout. It's generally agreed now by nutritionists that better health is promoted by a better dietary balance of omega-3 and omega-6. What's better? When there is around three times
They don't really need them
more omega -3 than omega -6 in your diet. From cooking oils, you get sufficient omega-6 if you use (for frying and salad oils) corn oil, soy oil, sunflower oil, safflower oil or sesame oil. But for much better anti-inflammatory action you need better quality omega-6.
You probably need more omega-3
Most people do not intake sufficient omega-3 fatty acids to ensure this better balance of the two in the body. So unless you’ve paid attention to this in the past it’s very likely you need an omega-3 dietary boost. Gout sufferers cannot afford to overlook this. These oils are good foods for gout.
Other food sources of omega -3
Apart from some fish, there aren't many food sources of omega -3 oils. Walnuts are a good source of the third omega -3 fatty acid, alpha-linolenic acid. (ALA). But ALA has to be converted in the body into EPA and DHA, and the conversion is not very efficient. English walnuts are a much richer source, about four times, than black walnuts.
Flaxseeds are also a good source of ALA. However, this website does not believe flaxseed oil and flaxseeds, contrary to what is touted in lots of places, are a particularly good food for gout. And flaxseeds themselves are only marginally helpful - fish oils can do the same job much better. However, if you are a vegetarian with gout and you don't take fish oils, flaxseeds are an option.
Eggs have a little omega -3 (and omega -6) but a better source are eggs from hens that have been fed with chicken feed which has added cod liver oil, or flax meal. When you see "added omega -3" on eggs' packaging, or any product packaging, consider a purchase. The best will be EPA and DHA, not ALA. Eggs are low purine. But, and this is a "but," egg yolks, not the whites, contain arachidonic acid which leads to the production of bad eicosanoids. See the Omega -6 page.
Cod liver oil also has direct EPA and DHA, but less than in fish oil. i.e. there's no conversion from ALA.
You also get ALA by consuming canola oil (aka rapeseed oil), walnut oil, flaxseed oil, hemp oil, and soy bean oil. But fish and fish oil supplements are best.
Fish oils and coping with gout
There is one more good reason why you should take fish oils for gout. They are known to have a generally positive effect on mental health and possibly are of some help against depression. They may help to lift bad moods, and raise general optimism, cheerfulness and positive thinking. It's very understandable that gout causes bad moods, irritability and depression. So if you sufferer from gout's depression, they may help somewhat. Look for mental changes over time, not an immediate uplift.
Can you take fish oil supplements made from high purine fish on a low purine diet?
The answer is yes, as long as it's good quality, ultra-refined, and molecularly distilled fish oil. Fish oils are often made from high purine fish such as anchovies, and sardines, or medium purine fish such as cod (cod liver oil) and mackerel (which is either high or medium in purines' content). Less refined, cheaper, fish oils may have some purines left in the oil. Your low purine diet may not be as low as you think, if you use cheaper fish oil.
Dietary supplement dosage for Omega-3
High omega -3 fish themselves are better, but most have purine drawbacks. You can take fish oil supplements 1.0 – 3.0 grams (1,000 mg – 3,000 mg) daily, taken in divided doses. Consult a doctor about whether it should be more than 3.0 grams.(3000 mg). Some gout sufferers have taken 9 - 10 grams, but for high doses you must consult a doctor. Go for brands with the highest amount of EPA/DHA per capsule. And note the points below about the best fish oils for gout.
Pherols not Pheryls Vitamin E (400 IU) should be taken with fish oil supplements but in good preparations it will already be included. Vitamin E helps to maintain fish oils quality during storage and it enhances fish oil activity. The best form is d-alpha-tocopherol (natural). Or the packaging may say natural tocopherols. This is a better form than dl-alpha-tocopheryl-acetate (synthetic).
If you buy fish oil supplements also ensure the fish oil supplement you purchase has been manufactured with at least a molecular distillation process. This process removes mercury, PCBs and dioxins. Many are, some are not. Check product labels.
Just how pure are fish oils' dietary supplements?
High dose fish oils must be high quality otherwise you will intake too many contaminants. At this dosage they must be very refined. Dr. Sears of the Zone diet, a fish oils expert, calls high quality fish oils - ultra-refined fish oils.
Remember to consult a doctor or health care professional about an anti -inflammatory dosage of fish oils, especially if you are taking blood thinners and aspirin. Excessive fish oil and vitamin E, as noted above, may thin the blood too much. Cheap fish oils may have too many impurities to be taken at high dose levels. And you can eat some fish, but certainly not those fish high in purines such as sardines, anchovies, herrings, trout and tuna. See the purines/uric acid page and the fish and gout page.
It's usually recommended that you should eat fish at least twice a week, and really your fish for gout should be fish high in EPA/DHA – the two omega -3 fatty acids that matter for anti inflammation purposes. So see the page on fish and gout, where we explain the value of fish, and its cautions for gout sufferers.
The best fish for gout are those that have the most omega -3 (or EPA) oils per purine, or amount of uric acid created. Here's our ranking tables.
GOUT, INSULIN RESISTANCE AND HEART DISEASE
associated with three other major medical problems – heart disease,
insulin resistance (aka the metabolic syndrome) which leads to type 2
diabetes and kidney stones from uric acid. Fish oils can help with the
first two of these three, but not kidney stones.
In addition to their anti inflammatory action, fish oils deliver many other health benefits, including for arthritis, but we'll focus on fish oils for gout. One assist is against insulin resistance (aka the metabolic syndrome, which studies have shown is a cause of gout and which can also lead to type 2 diabetes). The second is heart health, which is also associated with insulin resistance. Heart health, including high blood pressure, may well deteriorate if you suffer from gout. If you have gout, you must do as much as you can to protect your heart.
So how can fish oils for gout help, in addition to their effect on pain and inflammation? They lower triglycerides (blood fats), and they inhibit platelet clumping (aggregation) which forms clots, another cause of heart attacks. They help to lower blood pressure. Additionally, they improve heart beat regularity, irregularities of which are called arrhythmias.
RELATED FISH OILS FOR GOUT PAGES
www.zonediet.com is the website of Dr.Barry Sears, author of the best selling diet books "The Zone," "The Anti-Inflammation Zone," "The Omega RX Zone" and others. Dr. Sears has developed a range of high quality supplements based on his 30 years' research into omega-3 fatty acids and other nutrients.
One point about his OmegaRX range is not the size of the capsule - 1,000mg (1 gram) per capsule is common. It's the amount of EPA and DHA in the 1,000mg capsule preparation. They contain high amount of EPA and DHA, much higher than the standard 300 mg (combined) amount in 1,000 mg capsule.
The other major point about fish oil supplements is that they should also contain an ingredient to combat degradation of the oil, both in the container and in the body. Fish oil supplements should contain vitamin E to do this, as noted above.
These omega-3 products are definitely among the strongest fish and most refined oil concentrations available anywhere.
www.zonediet.com also sells the EicoRX fish oil range. This range contains GLA (gamma linolenic acid) as well as the omega-3 fatty acids, EPA/DHA. EicoRX uses a patented toasted sesame seed oil concentrate as well as vitamin E (tocopherols), to help avoid degradation.
www.zonediet.com ship within the U.S. and internationally.