Can Omega-3 Help Reduce Inflammation in Ankylosing Spondylitis? - Internal Medicine

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Can omega-3 improve the inflammatory condition of ankylosing spondylitis?


Hello, Doctor.
I am a patient with ankylosing spondylitis and have been experiencing symptoms for three and a half years.
Currently, I take two capsules of Celebrex and two capsules of Humira daily to manage my condition.
I have come across several reports online stating that omega-3 can effectively combat inflammation, but I am unsure if the inflammation mentioned in these reports includes that associated with ankylosing spondylitis.
Therefore, I would like to ask you: 1) Can omega-3 improve the inflammatory condition of ankylosing spondylitis? 2) If it can improve the condition, would taking an appropriate amount of over-the-counter omega-3 supplements allow me to reduce my Humira dosage (for example, from two capsules daily to one capsule daily)? Thank you, Doctor.

Hao, 20~29 year old female. Ask Date: 2023/02/14

Dr. Gao Jiankai reply Internal Medicine


Hello, thank you for your question.
Here are my responses:
1) Can omega-3 improve the inflammatory condition of ankylosing spondylitis? --> Currently, there is no clear evidence.
Omega-3 is a food supplement, not a medication, and its anti-inflammatory effects are limited.
Additionally, it is not inexpensive and requires a large intake, so from a cost-effectiveness perspective, it may not be worth it.
2) If it can improve the condition, could taking an appropriate amount of commercially available omega-3 supplements reduce the dosage of Celebrex (from currently 2 capsules a day to 1 capsule a day, for example)? --> As mentioned above, I believe it can be used in conjunction with current medication treatments, but I remain cautious about whether it can replace anti-inflammatory pain relievers, including Celebrex.
Department of Allergy, Immunology, and Rheumatology, Changhua Hospital, Ministry of Health and Welfare.
We care about you.

Reply Date: 2023/02/14

More Info


Omega-3 fatty acids, primarily found in fish oil and flaxseed oil, have been widely studied for their anti-inflammatory properties. However, when it comes to specific inflammatory conditions like Ankylosing Spondylitis (AS), the evidence remains somewhat inconclusive.

1) Can Omega-3 Improve Inflammation in Ankylosing Spondylitis?
Current research suggests that Omega-3 fatty acids may have a modest effect on reducing inflammation in various inflammatory conditions, including rheumatoid arthritis and other autoimmune diseases. However, the direct evidence supporting the use of Omega-3 specifically for Ankylosing Spondylitis is limited. While some studies indicate that Omega-3 supplementation can lead to a reduction in inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), these findings are not universally accepted or robust enough to establish Omega-3 as a primary treatment for AS.

The anti-inflammatory effects of Omega-3 are thought to stem from their ability to compete with Omega-6 fatty acids, which are pro-inflammatory. By increasing the intake of Omega-3, it is hypothesized that the balance between these fatty acids can shift, potentially leading to reduced inflammation. However, the extent of this effect can vary significantly among individuals, and it is not a substitute for conventional treatments.

2) If Omega-3 Can Improve Inflammation, Can It Reduce the Dosage of Medications Like Celebrex?
While incorporating Omega-3 supplements into your diet may provide some benefits, it is crucial to approach this with caution. Omega-3 fatty acids should be viewed as a complementary therapy rather than a replacement for prescribed medications such as Celebrex (celecoxib) or other anti-inflammatory drugs. These medications are specifically designed to manage pain and inflammation associated with Ankylosing Spondylitis and have a well-established efficacy profile.

Reducing the dosage of your prescribed medication without consulting your healthcare provider is not advisable. While Omega-3 may help in managing inflammation, it is unlikely to provide the same level of relief as your current medication regimen. Moreover, the interaction between Omega-3 supplements and your existing medications should be evaluated by your healthcare provider to avoid any potential adverse effects.

In conclusion, while Omega-3 fatty acids may offer some anti-inflammatory benefits, their role in managing Ankylosing Spondylitis specifically is not well-defined. It is essential to maintain open communication with your healthcare provider regarding any changes to your treatment plan, including the addition of Omega-3 supplements. They can help you assess the potential benefits and risks, ensuring that your overall management strategy for AS remains effective and safe. Additionally, a balanced diet rich in various nutrients, regular physical activity, and adherence to prescribed medications are critical components in managing Ankylosing Spondylitis effectively.

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