Omega-6 for gout – why good quality omega-6 fats are part of the fish oil treatment





This page about Omega-6 for gout was last reviewed, or updated, on 16 May 2014.

Gout diets should include omega-6 oils (fatty acids). We explained on the fish oils for gout page, (link below under Related pages you might enjoy) how EPA and DHA (both omega -3 oils), are anti inflammatory and can deliver pain relief for gout. And we explained their positive effects on heart health and other medical problems. Gout sufferers need to guard their heart because of the association between gout and heart attacks. The omega-6 fatty acids are, as well as the omega -3's, precursors of those eicosanoid prostaglandins which are anti inflammatory. This makes omega -6 oil a food to eat for gout, but you need to take them correctly in tandem with the omega 3's. 

THE IMPORTANCE OF GLA

In the case of the omega -6 oils for gout, the reason is because linoleic acid, found in for example, evening primrose oil, or borage oil, or flaxseed oil, is transformed in the body into gamma linolenic acid (GLA). Evening primrose oil and borage oil also contain GLA in its own, non transformed, form. So do oats and mothers' breast milk. Because of its importance, some brands of baby milk powder include added GLA.

GLA produces an anti inflammatory prostaglandin which may help to ease the pain and inflammation of a gout attack, just as the omega -3 fish oils may do. But too much GLA may also produce bad eicosanoids too - therefore the amount you take has to be finely adjusted.

The whole process is a little more complicated. Before GLA (in its own form, or converted from linoleic acid) can produce good eicosanoids, it's first converted into dihomo gamma linolenic acid  (DGLA). This conversion is routine. It is DGLA that either becomes arachidonic acid, or it becomes the good eicosanoids, which deliver pain relief for gout.

But don't rely on the linoleic acid in corn oil, soybean oil, sunflower oil, safflower oil or sesame oil to be converted into GLA if you fry with them.

Gamma linolenic acid can also reduce cholesterol production in the place where reducing cholesterol matters most – the liver.

The better sources mentioned above, also require the efficient functioning of an enzyme called D6D (delta 6 desaturase) to convert linoleic acid into GLA. D6D function declines as we age, and probably most people don't have enough anyway. You can augment your production of D6D by taking the following vitamins and minerals as supplements, or ensuring you have sufficient in your diet.

Vitamin C, vitamin B3 (niacin - but not too much niacin since it competes with uric acid for excretion), vitamin B6, magnesium and zinc. The amount in a once-a-day high strength multi vitamin, or vitamin B complex tablet is probably enough, including of niacin. 

Get the free USDA National Nutrient database, which is very useful in constructing gout diets, via our free gout resources page to help you get sufficient of these vitamins into your diet.

So to refresh.  You will intake better quality omega-6 fatty acids if you take supplements of evening primrose oil, or flaxseed oil, or borage oil, or blackcurrant seed oil. Better quality omega-6 for gout  will come from organic versions of the above mentioned cooking  oils, but used for this purpose without frying.

The oils should be held in dark, glass bottles, if you can find them. This is to exclude light which degrades them. That's why the better and more expensive ones usually come in these kinds of glass bottles. You'll probably find a larger choice of brands of correctly packaged oils in health food shops. 

What about Flaxseed for gout? Flaxseeds can be a way of improving both your omega -3 and omega -6 intake and balance. But there are qualifications about how well flaxseeds can produce EPA and DHA, and they do not contain gamma linolenic acid in its own from, unlike oatmeal (porridge oats). But flaxseeds can help those gout sufferers whose dietary restrictions make them unable to eat fish or take fish oils. The pros and cons of flaxseed for gout are discussed here. 

Flaxseed oil, flaxseeds and flax meal for gout.

Olive oil for gout. Olive oil is the best cooking oil for gout sufferers. But not because it's high in the EPA/DHA omega -3 fatty acids – there are none - nor because of omega -6 fatty acids, of which there are relatively few. Its health benefit comes from its high content of monounsaturated oils.

THE ROLE OF ARACHIDONIC ACID

Essentially with fish oils and omega -6 oils, you attempt to alter the balance of prostaglandins more in favour of the "good" i.e. anti inflammatory, than the "bad" i.e. pro inflammatory ones. 

You read above that linoleic acid is ultimately turned into good eicosanoid prostaglandins. But it can also be turned into bad eicosanoids. Prostaglandins are a sub class of eicosanoids, powerful hormones that don't come from glands but from cells. Whether linoleic acid is ultimately turned into a better balance in the body of good v bad eicosanoids does not just depend on D6D enzyme (delta 6 desaturase) activity.

Linoleic acid is also ultimately turned into arachidonic acid, the building block of bad eicosanoids, by the activity of the D5D - delta 5 desaturase enzyme. D5D is required in the last stage of converting linoleic acid into arachidonic acid and therefore bad eicosanoids - the step from DGLA into either good eicosanoids or arachidonic acid described above.

Two bad eicosanoids which promote pain and inflammation are the prostaglandin PGE2, and a leukotriene, LTB4.

You've read that increasing the number of good eicosanoids is beneficial, but the goal of improving the ratio of good to bad eicosanoids can be augmented in another way too. This means reducing levels of arachidonic acid in your gout diet.

Simple ways of reducing arachidonic acid (AA) in any of your diets for gout are to eat less saturated fats, avoid red meat containing large amounts of saturated fats (i.e. by eating lean red meat), and egg yolks. In addition, offal (organ meats), those high purine meats which are never good foods for gout. 

Reducing AA also means completely avoiding trans fats, that is, anything you find in the supermarket which has the words "hydrogenated", or "partially hydrogenated, vegetable oil(s)" on the nutrition panel. Moreover, too much linoleic acid (omega -6) from the vegetable oils mentioned at the beginning of this page (corn oil etc.) leads to over-production of arachidonic acid.

Over-consumption of ALA (alpha linolenic acid, an omega -3), found in high quantity in flaxseeds for example, also reduces GLA production by inhibiting the D6D enzyme.

ANOTHER ROLE FOR FISH OIL

At the same time you take fish oils for their EPA, one of the omega -3 fatty acids, because EPA inhibits the activity of the D5D enzyme, and therefore fewer bad eicosanoids are produced. EPA also inhibits the arachidonic-acid-originated leukotriene LTB4. (Leukotrienes are another class of eicosanoid involved in pain). Hence fish oils' ability to lower pain and inflammation with the help of GLA. Eating some fish helps, but read our fish for gout page because you must consider the purines in fish.

Finally, lower your insulin level, which should accompany the other methods. discussed here. You probably won't achieve pain relief for gout from fish oils and GLA alone. Lowering the insulin level also inhibits D5D activity. This means using the Zone Diet, or perhaps you simply restrict carbohydrates and/or eat carbohydrates lower on the Glycemic Index. Or better still, the Glycemic Load. But not necessarily down to the carbohydrates amounts of the initial stages of the Atkins diet. 

READING FURTHER 

The ideas on this page and on the fish oils for gout page have been distilled from The Zone Diet and the Omega RX Zone both by Barry Sears PhD and from Dr.Atkins' Vita-Nutrient Solution by Robert Atkins M.D. 

Both agree that fish oils and  correctly taken omega oils, are important for heart health, type 2 diabetes control, inflammation and hypertension, but reach different conclusions about the amounts of these fats that should be taken. Arachidonic acid is central to Dr.Sears' argument, but is not central to Dr.Atkins' argument. Use trial and error to discover your best amounts of these oils, both omega -3 and omega -6.

The Atkins formula does not require fish oils in excess of 1,200 mg (1.2 grams)of EPA and DHA, (combined figure), daily and pharmaceutical grade fish oils are probably not needed at this amount. But make sure you use molecularly distilled fish oils purified for mercury, dioxins and PCBs.

To get a better understanding of these ideas we recommend thoroughly reading these books. Your ultimate prize will be to understand how well these oils can help against the medical conditions listed above, all of which are associated with gout, and in better controllingpain and inflammation. Pain and inflammation are more specifically and rigorously dealt with in Dr. Sears' books - The Omega RX Zone, and The Anti-Inflammation Zone.

TESTIMONIALS

Especially recommended is the chapter on pain and inflammation in the Omega RX Zone. In the Omega RX Zone there are three references to dealing with gout using what Dr.Sears describes as pharmaceutical grade (i.e. very high quality, highly refined) fish oils – one is listed in the index, but in fact there is one more, plus an indirect reference. One of the references describes a successful case of gout treatment with fish oils.

And in the appendix on eicosanoids other pro inflammatory eicosanoids, which are inhibited by substances originally derived from the linoleic and gamma linolenic omega -6 fatty acids, are explained.

The books are available from his website. The Zone diet is one of the few diets for gout that has been studied in gout treatment. Click on the banner advertisement for Autoship at the Zone Diet.com at the bottom of this article. When the home page arrives, click on the books tab to go to the books page. It's not a commercial link.

MORE TESTIMONIALS FOR FISH OILS USE IN GOUT

To read another testimonial for Dr. Sears' fish oils in gout treatment.... this is on the Amazon.com book reviews page for the Omega RX Zone book. Click here to read the one entitled "Dr. Sears reveals the health miracles of high dose Omega 3" from "A Customer."

And visit this page for more links to this treatment's testimonials

AA:EPA RATIO TEST

Click here to read about the blood test that will tell you the balance of the "good" and "bad" eicosanoids in your body. Both now and after a period on the fish oils, GLA and insulin reduction course.

DIETARY DIAGRAM FOR GOUT PAIN RELIEF 

To help you understand this relief from gout treatment visit this page which shows our dietary diagram for relief from gout


Related pages 

Whether fish are a good food for gout is discussed here.

Read about PORRIDGE OATS (OATMEAL) for gout - one of the very few foods that contain GLA.


TIPS - LEARNING ALL THIS With all these somewhat similar names, and the number of inter-actions to learn, this is complicated to grasp. Just study the recommendations, or learn about these substances, the processes, and their gout and diet effects. These processes are well researched. You can return to this page and the fish oils page at any time and you can print them. Bookmarking these pages is also a good idea. The books mentioned are highly recommended.

CAUTION 

You will need to work with a doctor who is familiar with these ideas. Do NOT attempt to do-it-yourself. For just one reason you may have a medical condition which precludes the use of high dose fish oil. For example, it may thin the blood too much and it may cause a rise in blood glucose. It may be contraindicated with a medicine you are already taking. And cheap fish oils may have too many impurities at the amounts Dr.Sears talks about





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If you decide on the high omega -3/low GLA approach, click on the Zone Diet banner below, and view the EicoRx  range of fish oils which also contain added amounts of GLA. To do this, when the Zone Diet's home page arrives, click on the Omega -3 tab at the top. This is an editorial link, not a commercial one.



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