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Health & Nutrition

Omega-3 Fatty Acids (fish oil) as an Anti-Inflammatory: An Alternative to Nonsteroidal Anti-Inflammatory Drugs For Discogenic Pain

Source: Surgical Neurology
65 (April 2006) 326-331
Joseph Charles Maroon, MD, Jeffrey W. Bost, PAC
These authors are from the Department of Neurological Surgery, University of Pittsburgh Medical Center


  1. The use of NSAIDs (non-steroidal anti-inflammatory drugs) is associated with extreme complications, including gastric ulcers, bleeding, myocardial infarction (heart attack), stroke, and even death.
  2. In this study, after 75 days on fish oil, 59% of patients who were taking NSAIDs for chronic spinal pain and who had degenerative spine disease, were able to discontinue their prescription NSAIDs, and 88% stated they were satisfied with their improvement and that they would continue to take the fish oil.
  3. In this study, fish oil supplementation was not associated with any significant side effects.
  4. “Omega-3 EFA fish oil supplements appear to be a safer alternative to NSAIDs for treatment of non-surgical neck or back pain.”
  5. “More than 70 million NSAID prescriptions are written each year, and 30 billion over-the-counter NSAID tablets are sold annually.”
  6. “5% to 10% of the adult US population and approximately 14% of the elderly routinely use NSAIDs for pain control.”
  7. Selling NSAIDs is a 9 billion dollar per year US industry.
  8. Prescription NSAIDs for rheumatoid and osteoarthritis alone conservatively cause 16,500 deaths per year.
  9. “NSAIDs are the most common cause of drug-related morbidity and mortality reported to the FDA and other regulatory agencies around the world.”
  10. “The agent best documented by hundreds of references in the literature for its anti-inflammatory effects is omega-3 EFAs [essential fatty acids] found in fish and in pharmaceutical-grade fish oil supplements.”
  11. The beneficial anti-inflammatory effects of high-dose fish oil include the reduction of joint pain from rheumatoid and osteoarthritis, improvement in dry eyes and macular degeneration, reduced plaque formation, reduced arrhythmias, and reduced infarction from coronary atherosclerosis.
  12. Both natural and synthetic corticosteroids decreased healing capabilities, decreased the normal immune response, and have significant bone and gastric side effects.
  13. COX-2 inhibitors significantly increase gastric and cardiovascular side effects.
  14. Omega-3 DHA and EPA are used to make the anti-inflammatory eicosanoids (PGE3; prostaglandin E3), whereas excess omega-6 EFAs form inflammatory arachidonic acid based eicosanoids (PGE2; prostaglandin E2).
  15. “Animal proteins, especially red meat, also contain an abundant amount of arachidonic acid.” COMMENT FROM KIMBERLY HEINRICH: This is true of animals fed an abundance of omega-6 grains, most notably corn and soy. It is not true of cows that are grass-fed.
  16. A deficiency in omega-3 fatty acids, especially EPA and DHA, will result in a deficiency of anti-inflammatory prostaglandins.
  17. The delta-5 desaturase enzyme is the gatekeeper to inflammation and is increased from elevated levels of insulin (as a consequence of being diabetic, consuming refined carbohydrates, or consuming any high fructose corn syrup).
  18. “To encourage the production of anti-inflammatory prostaglandins (PGs) and to discourage the production of inflammatory PGs, saturated fats, trans-fatty acids, and arachidonic acid should be reduced in the diet; blood glucose should be controlled; and appropriate amounts of omega-3 fatty acids found in fish oils should be consumed.”
  19. Omega-3 supplementation is safe and effective for many inflammation-related conditions and has a low incidence of side effects.
  20. NSAIDs inhibit the effectiveness of fish oil in producing anti-inflammatory prostaglandins.
  21. “The US Department of Agriculture has limited fish consumption to 1 fish serving per week in adults and even less in children and pregnant women because of the concern of toxic contaminants such as mercury, polychlorinated biphenyls, and dioxin in our fish population.”
  22. These authors did not recommend fish oil for those on anticoagulants or those with fish-related allergies, but noted “aspirin use was not a contraindication.”

Credit given to Dan Murphy, DC for this review.