Sudden, severe pain in the big toe hardly sounds disabling, but those who suffer from gout know all too well the misery that can emanate from this condition. Your physician might have told you to avoid foods that contain purines, which includes anchovies, herring sardines or trout -- foods that contain fish oil and are used to produce fish oil supplements. That doesn't mean, however, that you should avoid fish oil altogether.
Gout is a particular form of arthritis that suddenly causes severe pain, swelling, tenderness and redness, usually in the big toe, but also in other joints including your feet, ankles, knees, hands and wrists. The pain strikes suddenly, becomes more severe and typically reaches an apex after 12 to 24 hours. The pain wanes, but lingering pain can persist for a few days to a few weeks. Ensuing attacks tend to last longer and afflict more joints.
The primary source of gout pain comes from needle-like urate crystals that form in your blood and then lodge into membranes around joints. The urate crystals form when you accumulate high amounts of uric acid in your blood. Uric acid is produced by the breakdown of purines, compounds which are found naturally in your body but which you also ingest in foods such as anchovies, herring, asparagus, organ meats and mushrooms.
A significant portion of the pain you experience in gout occurs because of inflammation. Your body's immune system responds to the urate crystals by sending white blood cells and fluids into the afflicted area. The swelling and inflammation causes further damage to surrounding tissue and triggers greater pain and discomfort.
Fish Oil and Inflammation
While the flesh of certain fish contains purines, fish oil doesn't. Fish oil won't eliminate urate crystals -- you'll need to take medications and alter your diet to do that -- but fish oil can help with gout pain. Fish oil contains potent antioxidants that promote anti-inflammatory immune system processes. Fish oil functions like nonsteroidal anti-inflammatory medications, reducing swelling and inflammation, according to "Arthritis Today."
To obtain the anti-inflammatory effects of fish oil, you must take relatively high doses. A clinical review article published in the December 2005 "Arthritis Research & Therapy" indicates that a daily intake of 2.7 g of EPA and DHA, the active ingredients in fish oil, provides therapeutic anti-inflammatory effects. Standard fish oil capsules typically contain 300 mg of EPA and DHA, while concentrated and pharmaceutical grade capsules usually contain about 600 mg of EPA and DHA. You must therefore take nine standard grade fish capsules or five concentrated or pharmaceutical grade capsules to effectively treat arthritis and gout. Check the supplement label to confirm dosage of EPA and DHA.
Always consult your physician before taking fish oil supplements, especially when you are taking them at a high dosage level. Fish oil thins your blood, so your doctor may advise against it if you are already on blood thinning medications. The doses necessary to effectively treat inflammation associated with arthritis and gout can potentially cause side effects. Side effects can include stomach distress, bloated full feeling, acid reflux, belching, diarrhea, headaches, muscle aches and pains, chills and hoarseness. Minor side effects typically improve after a few weeks. Call your physician immediately if side effects include chest, arm, back or jaw pain, difficulty breathing, nausea, sweating, wheezing, shortness of breath or irregular heart beats.
Minimizing Side Effects
Start taking fish oil at a lower dose -- a pill or two a day -- and slowly work up to the target dose. Take them on an empty stomach just before you eat a meal. Don't eat or drink too much when taking fish oil, and avoid carbonated beverages. MedLinePlus, a medical website sponsored by the National Institutes of Health, recommends that you freeze fish oil capsules before eating them to minimize gastrointestinal side effects.
- "Arthritis Research & Therapy; Fish Oil: What the Prescriber Needs to Know; Leslie Cleland, et al.; 2006
- Arthritis Today; Safety of Fish Oil Supplements with gout; James McKay, M.D.
- Highlands Orthopaedics and Sports Medicine: Gout
- MayoClinic.com: Gout
- MayoClinic.com: Omega-3-Acid Ethyl Esters (Oral Route)
- MedLinePlus: Fish Oil