Fish/Omega 3 supplements

[C Noonan]

Are Fish/Omega 3 supplements OK with gout, since they contain anchove, sardine and mackeral oils (refined).

Thank you.

Candace

[nobody]

The pure oil shuold be fine but I don’t expect fish oil supplements to contain pure oil since people might also want to get vitamins and such from them. Still, if it’s mostly oil and small amounts at that, the purine content should be minimal so it shouldn’t be a significant problem gout-wise (just make sure it’s indeed oil you’re consuming and not some mystery compound).
I’d be more concerned about quality and cost. It used to be that bad fish oil was commonplace (at least if you didn’t leave anywhere near the fish) and the supplement industry is generally untrustworthy. Prices can also be crazy. On the other hand, you should be able to get decent quality vegetable omega3 pretty cheap. I’m aware the composition is different but you could easily put enough linseed oil in salads and such that you’ll metabolize a sufficient amount of the compounds which are more easily obtained from fish oil supplements. You only need to be willing to approach it from a food/cooking perspective rather than a supplement perspective and you’ll end up consuming way more omega3 than you’d get from fish oil.
That’s the main reason I don’t consume fish or fish oil.

[Elizabeth]

Absolutely do not take fish oil. Get your omegas from plant sources like flax oil and other seed/nut oils. Caused my husband alot of pain with fish oil.

[Keith Taylor]

Thanks for sharing your husband’s experience of gout pain after taking fish oil supplements, Elizabeth. But might I add a note of caution?

Because gout pain is a complicated beast. That has very different states for most gout sufferers. The most common state is where gout pain results from years of excess uric acid. Resulting in uric acid crystals forming. Then our immune system attacks these crystals just as it attacks viruses, bacteria, etc when they invade our bodies. But uric acid crystals cannot be killed. So our white blood cells smother them.

This can continue for months and years. Slowly increasing the “uric acid burden”. But if uric acid falls below the crystallization point, those old crystals start to dissolve. So you get a painful gout state that is common in allopurinol therapy. Where partially dissolved crystals are again exposed to the immune system. Causing gout attacks during falling uric acid levels.

Now to get a true picture, your husband needs to consult his doctor for uric acid testing during periods with and without fish oil supplementation. Then during those consultations, he might like to discuss the 2015 investigation that showed “Plasma concentrations of triacylglycerol, uric acid, C-reactive protein, and ferritin were significantly decreased after 4 and 8 week supplementation of fish oil, and vitamin B- 12 + fish oil. ”
Huang, Tao, Kelei Li, Sailimuhan Asimi, Qi Chen, and Duo Li. 2015. “Effect of Vitamin B-12 and n-3 Polyunsaturated Fatty Acids on Plasma Homocysteine, Ferritin, C-Reactive Protein, and Other Cardiovascular Risk Factors: A Randomized Controlled Trial.” Asia Pacific Journal of Clinical Nutrition 24 (3): 403–11.
Ideally, that discussion would prompt a thorough review of treatment, including diet. Because other factors might effect the benefits of fish oil.

The key points for all gout sufferers to be aware of are:
1. Sometimes gout attacks are an inevitable part of recovery. So they need to be managed as part of the recovery plan.
2. The recovery plan must be a joint effort between patient and physician.
3. Fish oil supplements are an optional, minor part of any viable gout treatment package. So patients and physicians have to develop a comprehensive mix of therapies that suit the patient’s individual circumstances.

So fish oil supplements might be good for gout sufferers. But only if they understand their treatment needs. And manage those needs in the framework of a patient-physician plan. (in my opinion)

[Author]

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