Fat is an essential nutrient for the body. While some fats are deemed “bad,” others, such as polyunsaturated fats, actually help lower cholesterol and the risk of heart disease. These polyunsaturated fats — and the omega-3 fatty acids they contain — have been the focus of MS studies with some evidence pointing to benefits for relapsing-remitting MS.
Two placebo-controlled clinical trials studied supplementation with omega-3 fatty acids. A large, two-year study followed 312 people with MS. The group taking 10 grams of fish oil (which contains omega-3 fatty acids) daily had less disability progression and fewer relapses than those taking the “dummy pill.” The difference was not “statistically significant,” but there was a trend favoring the fish oil group.
Getting a dose
- Omega-3 fatty acids are found in certain fatty fish, such as salmon, mackerel, herring and sardines, and in fish oil products.
- Smaller amounts are found in a few other sources, such as canola oil, flaxseed and walnuts.
- Fish oil supplements, in pill or liquid form, are the richest sources of omega-3 fatty acids. A daily intake of up to 3 grams is usually considered safe.
- The safety and effectiveness of omega-3 supplementation in combination with Copaxone®, Avonex®, Betaseron®, or Rebif® have received only limited study. It is possible, though unlikely based on current evidence, that omega-3 fatty acid supplements could decrease their effectiveness. Omega-3 fatty acids have not been studied with Novantrone® or Tysabri®.
- Drug interactions may occur with anticoagulant medications such as warfarin (Coumadin®), enoxaparin (Lovenox®), heparin, aspirin, and other drugs with aspirin-like effects such as clopidine (Ticlid®) and clopidogrel (Plavix®).
- Omega-3 fatty acids may also decrease the effectiveness of insulin, oral diabetes medicine, and high blood pressure medications.
To take or not to take?
Reasonable doses of fish oil supplements are generally safe as long as there are no medical issues restricting its use (see cautions above). While there is a scientific rationale for taking omega-3 fatty acids and some hints of effectiveness, omega-3 fatty acids should never be used instead of the conventional MS medications or treatments. If one is considering taking omega-3 fatty acids, this decision should be discussed with a health professional.
Allen C. Bowling, MD, PhD, neurologist, and Tom Stewart, JD, PA-C, are both at the Rocky Mountain MS Center in Englewood, Colorado, which emphasizes a comprehensive approach to MS care.
Originally published in December 2006–January 2007 InsideMS