Can Fish Oil Reduce Sjogren's Syndrome Activity and Symptoms?

Many doctors now agree that omega-3 fatty acids (typically found in fish oil or flaxseed oil) can help reduce eye dryness associated with Sjogren's Syndrome. But can they do more? Omega-3s are often referred to as having anti-inflammatory properties, which makes many people who have autoiummune conditions like Sjogren's Syndrome wonder if omega-3s can reduce the "inflammation" behind autoimmune diseases.

Research has been spotty at best (a literature review from the Agency for Healthcare Research and Quality done in 2004 showed mixed or no results for use of omega-3s to treat rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease), although the medical field is finally catching up to this idea. For example, Dr. Michelle Petri, a lupus specialist at Johns Hopkins University, is about to begin a clinical trial asessing the efficacy of fish oil in lupus patients; and the National Center for Complementary and Alternative Medicine is currently running a study focusing on fish oil and borage oil in treatment of rheumatoid arthritis. However, I know many autoimmune patients who aren't waiting for research to confirm that omega-3s help reduce symptoms... they are on fish oil or flaxseed oil already.

I have considered fish oil or flaxseed oil for my eyes, and wondered about whether it would do anything for my Sjogren's. I tried fish oil pills briefly, but the nasty fish burps afterwards really turned me off. When my allergist recently told me there is anecdotal evidence that fish oil helps alleviate the symptoms of exercise-induced asthma, I decided it might be time to try it again.

I consulted with my rheumatologist about whether omega-3s might help my Sjogren's, and if so, what the proper dose would be. She referred me to a study in the Annals of the Rheumatic Diseases 2008;67:841–848 showing that low-dose omega-3s have beneficial effects on disease activity in patients with SLE and help protect them against the atherosclerosis typical in lupus patients. You can read a project abstract in PubMed, here: "A randomised interventional trial of omega-3- polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus". Of course, there is no comparable study for Sjogren's patients yet.

The magic dose in the study was 1.8 g eicosapentanoic acid (EPA) and 1.2 g docosahexanoic acid (DHA) per day. Now I need to run to the store and see if I can get that more easily in pill form or liquid form. My initial research shows that you have to take a lot of pills each day to reach those totals. I'm hoping fish oil in liquid form will provide a more concentrated dose. A fair warning: the study showed that lower doses were not as effective in reducing the "oxidative stress" that contributes to heart and vascular disease in lupus patients.

Comments

[Mary]

I have had Sjogren's for several years, and started taking fish oil after Vioxx was banned. At the time my hands hurt so bad I could not use them, and wanted to just hold them still and cry! I started taking them (Nature Made brand, because I read they dissolve well) and messed around with the dose until I found what works for me - 3 in the morning and 3 in the evening.

The change in my life has been INCREDIBLE! If I travel, or otherwise get off schedule, with taking the entire dose, first my hands start hurting immediately (a very big problem for me - I'm a professor, right now teaching online and spending all my time typing). I have the overall body aches and if I miss a couple days of pills, I starting to feel the beginning of that darn fatigue. When I take only 4 in a day, I feel the stirrings of the inflammation again and I hurry up and pop a couple more.

When I am taking it regularly, I feel like a "regular" person! Sjogren's has gone from being one of the top things I thought about every single day, to being something that comes up on a much more occasional basis. I really think it was the fish oil that made all the difference for me! Granted, I was doing other things as well: Restasis has been fantastic for my eyes, and I started riding my bike a lot which I think has been really helpful for me.

But, fish oil has been a huge part of how good I feel, and I tell everyone how great it is whenever I get a chance!

(I tried telling this to my dr, but was completely ignored. I then moved to a new state, and am moving again this summer to a different state, which is discouraging when I need to collect an entire range of doctors. And, my insurance company (BCBS - HATE you guys!) is very discouraging by routinely denying payment for every test. I was getting so stressed out by the dr visits and subsequent billing difficulties that I just quit going to the dr and have not been to one in...wow, nearly 3 years. That does seem bad; I'm moving again to a more permanent location and will start up with trying to locate some decent doctors again. Sigh!)