Omega 3 Fatty Acids and Immune Response

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Fish oil supplements are the current choice of Omega-3 essential fatty acid supplementation, yet few patients understand why they take these supplements, and what relation they have to decrease in symptoms. Essential fatty acid balance will help you to achieve maximum potential with immune modulation, and eventually work within a holistic and comprehensive protocol to relieve symptoms and maintain proper health to minimize a number of diseases. Insuring that a balance of beneficial types of omega-3 and omega-6 essential fatty acids exists in the body will facilitate cures and benefits. Which disease mechanisms will be benefited most, and how this works is vitally important knowledge for the patient that the advertisements and standard websites do not explain clearly.

More and more patients are taking fish oils and supplements to increase the omega-3 fatty acids in their metabolism, yet have a poor understanding of just how this is supposed to help. In my practice, most patients that are taking fish oil state that their doctor told them it would help, or that they read on the internet that their symptoms would be relieved with fish oil. Like many nutritional supplement medicines, patients continue to want a response similar to a pharmaceutical chemical from nutrient supplements and herbs, and this is unrealistic. Omega-3 fatty acids will help you to achieve an improved potential for inflammatory efficiency, and help with lipid balance as well, especially if you have high triglyceride levels, but should be considered part of a larger health regimen. As time goes on, more and more scientific studies are showing benefits with essential fatty acid balance that extend to such difficult diseases as lupus, and other autoimmune disorders, such as multiple sclerosis and rheumatoid arthritis.

In response to the overwhelming data showing that improved balance of essential fatty acids incurs amazing health benefits and potential in treatment, the pharmaceutical industry has patented a drug that is a synthetic omega-3 essential fatty acid, called ethyl-eicosapantaoeic acid, or ethyl eicosapentoate, known as E-EPA, which is prescribed under a number of brand names, including Vascepa in the U.S. This synthetic EPA omega 3 essential fatty acid, though, comes with risk of adverse health effects, which are considered mild at present, and the U.S. FDA has only approved its use for more severe levels of circulating triglycerides in Metabolic Syndrome. Japanese researchers have promoted the use of E-EPA with low dose statins to improve the lipid profile, showing that we could have reduced the problematic practice of higher dose statin drugs to lower cholesterol long ago by integrating omega-3 essential fatty acid, as krill oil, into the protocol. This use of a synthetic EPA comes with an added health risk, though, in the form of imbalance of essential fatty acids in the body, which would cause indirect health problems over time, something that the short-term clinical studies would not reveal. E-EPA and synthetic resveratrol are just 2 of the many patented synthetic versions of natural herbal and nutrient medicines that are being introduced into standard medicine by the pharmaceutical industry in response to the amazing proof of efficacy of these chemicals. While standard medicine and the pharmaceutical industry continues to deride herbal and nutrient medicine as quack medicine that doesn't work, at the same time they promote synthetic versions of the key chemicals found in herbal and nutrient medicine. So far, the public has not seen the irony of this.

The reason why Omega-3 essential fatty acids are now considered important is that our modern diet is generally full of meat derived arachidonic acid, which is a type of Omega-6 essential fatty acid, and an imbalance of Omega-6 versus Omega-3 creates an excess of the type of inflammatory mediators than contribute to inflammatory pain and chronic inflammatory dysfunction. Arachidonic acid Omega-6 may contribute to excess of eicosanoids and prostaglandins that produce inflammatory discomfort and sustain chronic inflammatory conditions. Of course, if your diet is very healthy, with quality oils, fresh nuts and seeds, whole grains, and fresh vegetables, and meat consumption is limited, you may not need to supplement with Omega-3 essential fatty acids, especially if certain fish that feed on plant algaes high in Omega-3 content are eaten. The important fact to keep in mind is that our bodies need a balance of essential fatty acids, and relative excess of one type has been scientifically linked to inflammatory dysfunction. It is the balance in the body that is important, not just the quantity of Omega-3, and that a number of other health factors may also contribute to inflammatory dysfunction and should be addressed when necessary. This is why not only consumption of Omega-3 is important, but also holistic guidance and treatment by a competent Complementary Medicine physician, such as a Licensed Acupuncturist.

More and more evidence of a strong relationship between disease and essential fatty acid imbalance is being discovered. For instance, in 2012, at Western Psychiatric Institute of the University of Pittsburgh School of Medicine, in Pennsylvania, research discovered that an imbalance of arachidonic acid elevated relative to omega-3 fatty acids was a strong predictor of the development of depression as a side effect of interferon therapy, which is used mainly to treat hepatitis C (Lotrich FE et al; Brain Behav Immun. Aug 2012 - cited below in research links). The growing field of neurohormonal immunology is finding that such homeostatic imbalance is tied not only to inflammatory dysfunction, but to neurological and hormonal pathologies and symptoms. A study in 2015, at the Central Food Technology Institute, in Mysore, India, found that an imbalance between omega 6 and 3 essential fatty acids was linked to neonatal problems in pregnancy, and that laboratory animals fed a balanced array of both omega-6 and omega-3 supplements during pregnancy significantly improved body weight and decreased risk of hemmorrhoidal bleeding and overall mortality (PMID: 26246200). Understanding the basics of essential fatty acid imbalance is thus very important to a wide variety of patients and their physicians. Currently, the lack of attention to this homeostatic balance, and the simplistic treatment with omega-3 spurred by promotion of such products, may be leading to a less than satisfactory outcome for many patients.

The best sources for the various essential fatty acids, omega-3 and omega-6 types

If you do decide to take a supplement, the choice of Omega-3 essential fatty acid is very important. The term essential means that the body does not produce it and we need to get it from our diet. Of course, getting these long-chain fatty acids from the diet is best, and so an improved diet along with supplement consumption when necessary is the smart course. Omega-3 fatty acids are found in a variety of fresh whole foods, but the fresh nuts and seeds, and especially the nut and seed oils, if cold-pressed, unrefined, and fairly fresh, contain a high amount. Oily fish also contain a high amount, especially oily seafood. The problem with seafood is freshness and quality. Salmon used to be a wild fish, but now most of the salmon on the market is from fish farms. Some studies have also found that many suppliers are selling farmed fish as wild. Farmed salmon have been found to have a high level of disease microbes and are sometimes fed a lot of chemicals to keep them healthy and give their flesh a wild pink tone. Fish oil capsules are probably derived from these fish. Fish oil in capsules will also oxidize and go rancid fairly quickly, despite production tricks to preserve it. The customer rarely notes whether the fish oil in capsule is fresh or oxidized. Oxidized fats produce chemicals that are not good for you, namely oxidant free radicals that put stress on the immune system. This was also a problem with flax oil. Flax oil used to be the most popular form of Omega-3 fatty acids, until studies found that these supplements contained chemicals that weren't good for you along with the fatty acids that were. Flax seed in limited consumption is a healthy addition to a dietary regimen that supplies that right balance of essential fatty acids. Depending completely on flax oil for these oils is not the smartest regimen.

A 2012 study by Ascenta Health of Canada, published in the Journal of Science of Food and Agriculture, November 16, 2012 (PMID: 2355124), found that in a study of a broad sample of fish oil supplements that over half of these supplements did not meet their label claims for DHA and EPA (the most important essential omega-3 fatty acids), and a quarter of these samples of commercial fish oil supplements exceeded the recommended limits for peroxide value (oxidized fatty acids, or rancidity). In the United States, the FDA has refused to effectively regulate the food supplement industry, and there is virtually no penalty for such blatant fraud and misinformation. This hurts public health, and the majority of patients that purchase these fish oil supplements are not only ignoring the issue of essential fatty acid balance, which is the essential health concern, but are wasting money on ineffective and sometimes potentially harmful products. The way to insure that essential fatty acid balance is improved is to purchase professional nutrient medicine with assured quality, take a proactive approach to understanding the health issues, as well as working with a knowledgeable Complementary Medicine Physician to receive a professional assessment and prescription. The knowledgeable Licensed Acupuncturist and herbalist, or a good Naturopathic Physician, could be essential to reestablishing a healthy essential fatty acid homeostasis.

Krill oil is one form of seafood oil that has concentrated amounts of the key Omega-3 fatty acids, EPA and DHA, in balance, and also contains a natural preservative made by the krill. Krill are also gifted with a genetic trait to increase reproductive rates when fished, because they are eaten by whales, which come along seasonally and eat huge amounts of krill. Krill oil is a little expensive since it requires deep ocean harvest. Hopefully, the supplier is conscious of the ecology of krill. With the heavy prescription and advertising surrounding omega-3 supplements, there is of course now many product claims with misinformation. Pharmaceutical grade omega-3 is the new catchword, and while this is an admirable idea on the surface, namely improving the quality and dependability of the supplement, there is some glaring problems uncovered with simple research. Large companies are producing pharmaceutical grade omega-3, which is actually just highly refined oil and has nothing to do with pharmaceutical manufacture, and obtaining it from sources such as the New Zealand deep ocean hoki fish. While the advertisements imply that the hoki is a fish that is particular to a clean area of the ocean and thus pure, the actual fact is that this little fish is now the main commercial source for processed fish products, including fast food fish, frozen fish filets, fish sticks etc. This is just the next species that is being overfished, and already in 2007 the World Wildlife Fund voiced objections to the massive depletion and unsustainability of this source. Instead of relying on large commercial corporations, and believing anything you see in expensive advertising, the thoughtful patient may want to research a little, improve their diet, correct their fatty acid imbalance with help from a professional Complementary Medicine physician, and not just blindly consume lots of expensive so-called pharmaceutical grade omega-3.

Another source of Omega-3 fatty acids that is often overlooked is spirulina, blue-green algae, and chlorella. Fish, like animals, do not manufacture their own Omega-3 fatty acids, and obtain them from a diet that is rich in plant algaes, and other marine plants, such as seaweeds. These primitive algae are packed with nutrition and good for you in a number of ways. These fish produce the EPA and DHA in their metabolism from smaller chain fatty acids, like we do, and so humans benefit from a diet of foods high in Omega-3 fatty acids other than EPA and DHA, such as alph-linolenic acid. Other oils than fish are also high in these Omega-3 fatty acids, such as toasted walnut, toasted hazelnut, pumpkin seed, almond, etc. Some oils high in Omega-3 are now not as popular as they once were because commercial oil making was found to create unhealthy chemicals, such as safflower, soy and others. Quality olive oil is moderately high in Omega-3, but not the best concentrated source. One book that explains this in detail is Paul Pritchford's dietary healing guide, Healing with Whole Foods, which has undergone a number of editions, which differ in content, but are all good.

Since the conversions of long-chain fatty acids from shorter chain fatty acids occur competitively in our bodies, we do need to decrease consumption of Omega-6 fatty acids such as arachidonic acid to insure balance. Since arachidonic acid is primarily obtained from red meat, the percentage of red meat in our diet should be decreased if we want to achieve a healthy balance. Also, since the accumulation of Omega-3 fatty acids in our tissues is the desired end result, the effects of fatty acid balance will occur over time, and generally will not produce immediate results. If you have stopped eating much red meat, or are vegetarian, it is important to consume a variety of essential fatty acids, Omega-6 included. Therefore, some knowledge of foods and fatty acids is important to achieve the desired balance over time. Gamma-linolenic acid is the most studied of the plant derived Omega-6 fatty acids, and is found in higher concentration in sprirulina, black currant seed oil, and hemp seeds. Gamma-linolenic acid can also be converted from linoleic acid, which can be obtained from grape seed oil, poppy seeds, cold-pressed corn unrefined corn oil, toasted walnut oil etc. and in lesser concentration in olive oil. Enzymes control the rate of fatty acid conversion, so a health liver function is also a necessity.

So fish oil capsules are just one source of Omega-3 fatty acids, and food sources are always best. Other dietary sources of the Omega-3 essential fatty acids EPA and DHA, in order of highest concentration to lowest, are: tuna, mackerel, trout, anchovy, salmon, sardine, herring, redfish, halibut, whitefish, egg yolk, mussel, flounder, and pork. Eggs from chickens that are fed a natural diet of seeds and grains and are allowed to free graze and peck at soil growths contain a high concentration of Omega-3 fatty acids, while cheaper commercial eggs, from chickens confined to small cages and fed standard chicken feed are low in Omega-3 content. Studies show that grass-fed cattle also produce beef that is rich in essential fatty acids, Omega-3 EPA and DHA, as well as CLA and its precursor, vaccenic acid, and has a healthier ratio of omega-6 to omega-3 essential fatty acids than feedlot beef. Omega-3 fatty acids may be produced in our body from a shorter-chain polyunsaturated fatty acid, such as alpha-linolenic acid, and so a diet with fresh whole foods containing this fatty acid will also produce the necessary levels of EPA and DHA.

Foods that contain alpha-linolenic acid, from highest to lowest concentration are flax seed, butternut squash seed, white mustard seed, hardy lettuces, soybean, and a variety of beans, such as black bean, flageolet, kidney bean, navy bean, haricot, and even green beans. Spinach and dark leafy greens, such as bok-choy and mustard greens also contain a high amount. Strawberry, cucumber, thyme, brussel sprouts, cabbage, guava, pineapple, marjoram, black currant, asparagus, almond, ginger, kohlrabi, and pistachio also contain considerable amounts. Alpha-linoleic acid is also a viable source for the precursors of EPA amd DHA. Various beans and legumes will contain fairly high concentrations, such as lima bean, or butter bean. Other types of linoleic acid are found in a variety of foods, with highest to lowest concentration found in avocado, cucumber seed, sunflower seed (fresh in the shell, not rancid), squash seeds, poppyseeds, brazil nuts, peanut, strawberry, and apricot seed, as well as cumin and coriander. A varied healthy diet incorporating many of these foods will insure better fatty acid balance and help cure and prevent a number of diseases.

Various herbs contain alpha-linoleic acid at very high concentrations, such as seeds of evening primrose. Various common Chinese herbs contain linoleic acid, such as Nu zhen zi, Gou qi zi, Che qian zi, Di gu pi, Sang shen zi, Xuan shen, Hong hua, and Yin chen hao, and further reading will show how linoleic acid, the precursor to Gamma-linolenic acid is a potent medicinal chemical. Chinese herbs that are rich in linolenic acid, the precursor to Omega-3 EPA and DHA, include aged garlic, Cong bai, Chai hu, Xuan shen, Di gu pi, Du huo, Che qian zi, Nu zhen zi, and Sang shen zi, This is one way that various Chinese herbs work to cure inflammatory disorders. Of course, each Chinese herb has a number of symbiotic chemicals in it to achieve its medicinal purpose. Besides these now famous fatty acids, such as linoleic and linolenic, there are a variety of fatty acids found in herbs that are known to exert beneficial medicinal effects. So far, the scientific investigation of these fatty acids in foods is lacking. The future will produce more information.

In addition to EPA and DHA, and the shorter chain alpha-linolenic acid, there are also a number of other known Omega-3 acids available in our diet. Stearidonic acid is obtained from spirulina, hemp seed, black currant oil, and oil from a slightly toxic herb called Echium plantagineum, which would need to be prepared properly to take in quantity. This prepared herb oil has been studied by the NIH, though, and found to significantly reduce triglyceride levels in animal studies. Other Omega-3 fatty acids are currently being investigated.

All of these healthy essential fatty acids are from polyunsaturated fats. A variety of seeds, grains, legumes and fruits contain unsaturated fats, with the best sources being almonds, flax seeds, hazelnuts, pecans, pine nuts, pumpkin and squash seeds, sesame seeds, sunflower seeds, and walnuts. Since these seeds and nuts contain some toxin, toasting them lightly first and eating small amounts in one sitting are recommended. Avocodo is very rich in unsaturated fat as well, as are olives. Quinoa, soybean, garbanzo beans, steel cut oats, millet, corn, and brown or sticky rice are also good sources. Miso contains a high amount of unsaturated fat as well. The best oils to incorporate into the diet for polyunsaturated fats are toasted walnut, sesame, natural corn oil unrefined, almond oil, and peanut oil. Some of these oils break down too easily with high heat and should be used as dressing, such as walnut and almond. Others are ideal for cooking with higher heat, such as peanut, which should be organic to avoid the toxic pesticides commonly used on this crop. Some are ideal for adding to baked products, which heat the oil moderately, such as corn. Sesame oil has a natural preservative and is used in moderate heat cooking in a refined state, and as a dressing in an unrefined state. Safflower oil is high in polyunsaturated fats, as is soy oil, but the typical commercial production damages these oils, and preservation is a problem. Even cold-pressed oils are often heated and exposed to air in the production process, creating an unhealthy oil. In addition, chemical solvents often are used in so-called natural cold-pressed oils, and worse, hydrogenation is sometimes used in commercial oils, producing very unhealthy trans-fats. Quality olive oil is a very healthy product, but contains only 8% polyunsaturated fats, making it only a mild source of these healthy essential fatty acids.

Gamma-Linolenic Acid and healthy immune modulating Prostaglandins

Besides the current pop star Omega-3, and its chief plant-derived precursor, Alpha-linolenic acid (ALA), other fatty acids do have important health benefits that are important. Gamma-linolenic acid (GLA) is an omega-6 essential fatty acid synthesized in your body from linoleic acid, another omega-6 essential fatty acid. GLA converts into the class of healthy immune modulators called prostaglandin E1 (PGE1). The Omega-3 DHA and EPA fatty acids convert to PGE3. PGE1 has been found to be medically effective in many scientific studies in activation of T-cells, inhibiting cancer, modulating inflammatory conditions such as eczema and arthritis, as well as most auto-immune disorders, and controlling excess release of stored arachidonic acid. GLA has also been found to be effective in decreasing risk of stroke and cardiovascular disease, and reversing kidney damage in diabetes. PGE1 is a potent vasodilator and may inhibit excess blood clotting. Therefore GLA may contribute to lowered blood pressure and decreased atherosclerosis. GLA has also been shown to improve brain function and often alleviates dry eye syndrome in Sjogren's disease. Increased PGE1 appears to regulate insulin metabolism as well. In addition, GLA stimulated PGE1 appears to potentially help with PMS, breast cysts, hyperactivity disorders, obesity, and alcohol craving. Multiple sclerosis is thought to result in part because of poor conversion of linolenic acid to PGE1. We see the great potential for correcting fatty acid imbalance with GLA as well as Omega-3.

As stated, the balance of essential fatty acids is more important than the amount of just one type. A modern diet and lifestyle, with an excess of meats and butter fat, as well as simple carbohydrates, eventually may lead to a relative deficiency of key omega-3 essential fatty acids, but a diet that is switched to a predominantly vegetarian diet, without the right healthy fats and oils, may create a relative deficiency of healthy omega-6 essential fatty acids. One of the best sources for GLA (Gamma-linolenic acid) is spirulina, blue-green algae, and chlorella. The oils of evening primrose, black currant seed, and borage seed are also used as supplements. Food sources include cold-pressed walnut oil, pumpkin seed oil, fresh flax oil, steel cut oats, barley and other whole grains, legumes, legume sprouts, fresh nuts and seeds, especially hemp seeds, as well as dark leafy green fresh vegetables. GLA supplements are often made from black currant seed oil, and Vitamin Research Products is recommended. Increasing GLA if there is a relative deficiency may help treat chronic inflammatory and autoimmune diseases, eczema, and even premenstrual syndrome, but since this effect would be for patients with relative omega-6 deficiency in relation to omega-3, studies produce varied results so far. Scientific studies need to identify patients with this relative deficiency to produce reliable results of proof of benefit, and this is difficult to assess.

Conjugated Linoleic Acid and its proven benefits

As stated, a balance of essential fatty acids are needed in the body to maintain healthy homeostasis, not just a lot of a particular fatty acid. The omega-3 essential fatty acids, EPA and DHA are highly studied and touted, as both modern dietary habits and environmental stressors may commonly create imbalances that are in favor of such omega-6 essential fatty acids as arachidonic acid. For instance, modern dietary habits often involve a much greater emphasis on the percentage of meat and simple carbohydrates in the diet, producing an excess of arachidonic acid. When a person shifts to a predominantly vegetarian diet, and does not consume enough healthy fats, the opposite imbalance may occur over time, and supplementation with the omega-6 GLA may be more beneficial, as well as consumption of GLA-rich foods, such as walnut oil, steel cut oats, barley, hemp seeds, and spirulina. Linoleic acid sources also include fresh walnuts, avocado, pumpkin seeds, young leaves of cantaloupe, cucumber and melons plants, poppy seeds, butternut squash seeds, brazilnuts, hemp seeds, sesame seeds, evening primrose oil, and caraway, cumin, fennel and coriander seeds.

Conjugated linoleic acid (CLA) is another omega-6 supplement that is found in many herbs, especially alcohol glycerite tinctures, that is much studied and used to treat various disorders. CLA is an isomer of linoleic acid, or mirror image, and is polyunsaturated. Linoleic acid helps form all cell membranes in our bodies, and deficiency can appear as dry hair, hair loss, and poor wound healing, while excess may contribute to weight gain, obesity, poor sleep patterns, attention deficit disorder, depression, arthritis, and cancers. CLA, or conjugated linoleic acid, has a totally different mechanism from linoleic acid, though. Studies have shown that CLA may help one burn fat, especially in the midsection and organs, normalize leptin and resistin hormonal activity, which are often imbalanced in Metabolic Syndrome and obesity, aid in muscle building, serve as an anti-cancer agent, increase metabolic rate, and serve as an antioxidant. It may be useful to treat insulin resistance, food-induced allergic reactions, and cardiovascular disease, if an essential fatty acid imbalance had occurred. Once again, if studies do not identify patients with a relative omega-6 essential fatty acid deficiency, results will vary in the studied population.

The history of fatty acids and inflammatory modulation

Aspirin is a composed of a chemical that was used for centuries to control excess fever and inflammation, salicylic acid from the bark of the willow tree. When we take aspirin, which was perhaps the first modern chemical pharmaceutical highly marketed, we see a quick temporary relief of the symptoms of pain. This is because aspirin inhibits inflammatory mediators called prostaglandins, as well as exerting other modulatory effects on the inflammatory processes. Aspirin is a chemical extracted from herbs, salicylic acid, or a synthetic analoque, which is enhanced chemically to work fast in the body by compounding with an acetyl molecule. The synthetic analoque is biosynthesized from the amino acid phenylalanine, as it is in the plants, or more frequently, from phenolate. The term salicylic comes from the latin for willow bark, which was the original source of salicylic acid extract in Europe. This organic acid was discovered to be a common phenolic plant hormone involved in plant immune defenses against pathogens, modulating the inflammatory response in plants, which is remarkarbly similar to animal immune response. This understanding of an aromatic acid and immune modulation has led to a century of research concerning fatty acids and their role in our bodies to enhance our natural immune responses. Although it was noted by the Greek physicians in 500 BC that the bark of the willow tree relieved pain and inflammation, especially unwanted high fevers in relation to infection, it was not until 1826 that chemists started to piece together the chemical puzzle.

In the twentieth century, dietary fatty acids were thoroughly explored to understand the role that diet played in optimizing inflammatory modulation. It was found that key fatty acids from the diet, which are termed essential, meaning that we must get these chemicals essentially from food, and that our bodies do not manufacture enough for our uses, play an important part in chronic and acute inflammatory dysfunction. This inflammatory dysfunction produces pain, swelling, stiffness, and degeneration of joint tissues. Essential fatty acids are needed to produce the array of inflammatory mediators that stimulate the inflammatory processes, and when we have a balance of these essential fatty acids in the diet, inflammatory dysfunction is less likely to occur. Healthy inflammatory function produces quick clearing of damaged and old tissues and healthy restoration, or replacement with new tissue growth. Thus we find that a few key essential fatty acids play a big role in our health and comfort. Arachidonic acid (AA) is a plentiful essential amino acid that is, of course, also plentiful in other animal tissues, or meats. The human metabolism is apparently not built to eat too much meat, for the modern diet has appeared to create an imbalance of fatty acids where the combination of acidity and excess arachidonic acid contributes to chronic inflammatory dysfunction. Thus science has found that other essential fatty acids will help right the ship and restore balance when a typical modern diet has created inflammatory dysfunction.

In the 1950s, a German biochemist named Johanna Budwig and a German cancer researcher named Max Gershon, both discovered that Omega-3 fatty acids provided much medical benefit in treatment of a variety of inflammatory diseases, such as cancer, arthritis, kidney disease, ulcerative colitis, asthma, skin disorders such as eczema and psoriasis, prostatitis, and migraine. They also found that immune deficiency disorders and depression could be helped, and set in motion much study of neurodegenerative disorders related to immune dysfuncion and fatty acid imbalance. Of course, these scientists were labeled quacks by the medical establishment for decades. Now we finally see a broad adoption of this research into standard medicine. These scientists heralded a golden age of naturopathic medicine.

Omega-3 and Omega-6 fatty acids are catchy names for some of these essential fatty acids, whose scientific names are long-chain polyunsaturated fatty acids. In the 1970s, researchers exploring why some small populations around the world seem to have less of a problem with cardiovascular disease, which is primarily linked to chronic inflammatory dysfunction, consumed less arachidonic acid in a relative sense, and a high amount of these Omega-3 and Omega-6 fatty acids. These essential fatty acids, in a study of Eskimo peoples in Alaska, came from a diet high in seafood, especially seafood rich in fish oils. The key Omega-3 fatty acids were EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid), which were found to be the most effective of these essential fatty acids in production of key inflammatory mediators, or cytokines. EPA and DHA are the chemicals in the fish oils. Unfortunately, our bodies are not like our lawn mowers. We can't just add a quality oil and have the engine run better. The efficiency of our bodies is a little more complicated, and this article is intended to help you understand your body a little bit better, so that you can understand why you take Omega-3 fatty acids for your symptoms.

The term Omega was used for these long chain polyunsaturated fatty acids EPA and DHA because they were the longest chain molecules, and the word omega is the 24th and last letter of the Greek alphabet, which is often still used in scientific terminology. Alpha is the first letter and omega is the last. This term is used because these fatty acids are identified chemically by the carbon bonds at the end of the long chains, namely the n-3 and n-6 positions. Our bodies try to maintain a balance of essential fatty acids to achieve optimum performance of our enormously complex immune system. Our organs and cells cannot directly produce EPA and DHA, although if we take a smaller Omega-3 fatty acid, such as alpha-linoleic acid, our bodies can synthesize the larger EPA and DHA from this essential fatty acid. The conversion of smaller essential fatty acids to larger ones, though, competes in our bodies with the production, or conversions, of certain Omega-6 fatty acids. The Omega-6 fatty acids include linolenic acid, linoleic acid, and arachidonic acid. There are a number of Omega-6 fatty acids in this chemical family, but we do focus on these few in much of our research. Alpha-linolenic and linoleic acids are found in a number of effective plant medicinals used in China to regulate inflammatory processes.

These essential fatty acids may be viewed in terms of their effect on blood clotting. Some omega-6 fatty acids may encourage blood clot formation, while Omega-3 fatty acids, such as alpha-linolenic acid, reduce excess blood clotting. This demonstrates how a balance of these fatty acids helps maintain health. This is not only important in inflammatory processes and tissue healing, but in cardovascular health. Even chronic pain from fibromyalgia is linked to dysfunction in clotting mechanisms creating excess fibrins in the muscle tissues. Vegetarians avoid the excess arachidonic acids that typical red meat eaters accumulate. In this case, arachidonic acid deficiency may occur, a differnt type of fatty acid imbalance. Vegetarians that eat no dairy, or vegans, can snack on toasted nori seaweed and organic peanuts to replenish arachidonic acid.

There is thus a balance, or homeostasis, of these Omega-3 and Omega-6 fatty acids in our bodies that is important to maintain so that we produce the right balance of inflammatory mediators. Whenever our bodies need to replace damaged tissues there is a complex inflammatory process that occurs, with many chemical mediators involved, some of which stimulate tissue swelling and breakdown, which unfortunagely causes pain, and some of which moderate these processes to achieve the best results. Omega-6 fatty acids convert to Omega-6 eicosanoids, which are chemicals that hormonally bind to immune receptors in virtually any tissue in our body, and convert to the inflammatory mediators prostaglandin and leukotriene hormones. Of course, these prostaglandins and leukotrienes have been the focus of many non-steroidal anti-inflammatory pharmaceuticals, such as aspirin. These various pharmaceuticals, such as Ibuprofen, block production or conversion of prostaglandins et al. This is what decreases your pain and swelling, and sometimes your fever. Unfortunately, this also comes with serious side effects if we take these medications for a long time, or in too high of a dosage. We take these medications for granted, but they do, in effect, kill a large number of people each year from gastrointestinal bleeding and cardiovascular strokes and heart attacks, etc. Thus, we look for more natural ways to help our bodies maintain healthy homeostasis and regulate inflammatory processes naturally. This is why we take Omega-3 fatty acid.

Do Omega-6 fatty acids, such as arachadonic acid, then produce the unwanted inflammatory effects of pain and swelling? The answer in our body is never that simple. Our bodies evolved with a complex mix of chemicals that are kept in a tight balance in order for our complex physiology to function properly. When millions of years of evolution produce an orgnism this complex, there is no simple way to add one ingredient and have such a direct effect. Omega-6 fatty acids play a part in excess and chronic inflammatory symptoms but are part of a whole array of factors that lead to these unwanted inflammatory diseases, or immune dysfunctions. They are also part of a balancing, or modulating, mechanism that our bodies use to keep us free of these unwanted inflammatory problems and healthy. Omega-3 fatty acids are needed in our diet in a balance with Omega-6. To be most effective, we need to take a sufficient daily dose of these fatty acids for a long time. Omega-3 fatty acids are essential components of cell membranes and play important roles in regulation of cell functions, especially regarding immune responses. Taking these essential fatty acids for a long time insures that normal immune cellular responses will be normal. Taking them when an inflammatory disease produces more severe symptoms will not produce the most optimal effects, which are preventative effects.

Nevertheless, numerous studies have noted limited benefits to taking Omega-3 fatty acids to relieve symptoms. Studies have shown positive effects with rheumatoid arthritis, irritable bowel disease, and dysmenorrhea (Goldberg and Katz, 2007), as well as depression, bipolar disorder, and various dementias, or neurological degenerative disorders. Sufficient dosage is needed for relief of symptoms. A daily small dosage can be used for preventative purposes, but a larger dosage should be tried for symptom relief, in the realm of 3000 to 5000 IU per day. Alpha-linolenic acid (ALA), EPA and DHA all have significant benefits, although in some cases they act differently in the body. EPA exerts greater and more rapid effects in blood plasma, but effects are not as lasting as DHA, which acts slower. DHA exerts more neuroprotective effects by helping to create various key cytokines that help repair and maintain brain cells.

A more complete list of inflammatory diseases and conditions that scientists have identified as appropriate for Omega-3 fatty acid therapy, either preventative or symptom relieving, includes allergies, asthma, COPD, atherosclerosis, acute cardiovascular events, Crohn's disease, diabetes, psoriasis, neurodegenerative disease, lupus, multiple sclerosis, obesity, cystic fibrosis, cancer cachexia, rheumatoid arthritis, and inflammatory responses to trauma, surgery or critical illness (Calder 2006). In addition, as mentioned, GLA, another essential fatty acid, has been found useful to treat a number of inflammatory disorders as well. Once again, restoration of homeostatic balance of the omega-3 and omega-6 essential fatty acids is the key.

Sources of Omega-3 fatty acids and alpha-linoleic acid are important. Any oil based fatty acid may oxidize over time, especially when exposed to air and sunlight. Oxidized fatty acids, which we eventually would call rancid, may exert negative effects on the health. The best source for a concentrated dose of EPA and DHA is krill oil. These deep ocean shrimp-like creatures are very rich and balanced in these essential fatty acids, and they have a natural preservative in the oil that prevents oxidative deterioration. krill also have a naturally evolved way of avoiding extinction from overfishing. Since they are the natural food of whales, who eat great quantities in their migratory patterns, krill have evolved mechanisms that greatly speed their reproductive cycle when they are harvested. They are thus ecologically sound sources of Omega-3 fatty acids. Fish oils may have gone rancid, or oxidized, in the capsules and you may not notice this, except if they make you a little queasy after taking them. You also have to take quite a lot of fish oil to get sufficient dose. The same is true for flax oil, which also goes rancid quickly.

Digestion and assimilation of Omega-3 and Omega-6 fatty acids

Long-chain polyunsaturated fatty acids are not as easy to digest and absorb as smaller chain fatty acids. These fat molecules are too large to be absorbed directly into the small capillaries that carry most of our nutrients to the liver and the rest of the body. These larger fat molecules are partially broken down and reassembled into triglycerides in the cells of the intestinal lining, where they are coated with protein and carried via the lymphatic vessels to larger veins, such as the subclavian, and then transported as triglycerides to the liver, or other target cells. Thus, health of our digestive system is important, as well as the liver function in relation to triglyceride metabolism. We always get back to this same point when trying to understand how to improve our health. Our bodies are a complex integrated system of various organs and tissues that need to work together to function well. We are not a machine, and simply putting one nutrient into the body will not insure restoration of function. We need to take a holistic and comprehensive look at dysfunction in our bodies and work over time to correct these dysfunctions with patient holistic therapeutic protocol. If you have digestive problems, or if liver function is not optimal, and your blood tests reveal a high triglyceride level in circulation, you need to work on these problems to utilize the Omega-3 essential fatty acid supplements.

Also, there needs to be a balance of fatty acids in the body. One form of fatty acid that is important are the lipoproteins that circulate in our blood, mainly carrying metabolic products to and from the liver, that we have long referred to, mistakenly, as cholesterols. These are called low-density lipoproteins (LDL), very low-density lipoproteins (VLDL) and high-density lipoproteins (HDL). If the ratio of HDL to LDL is not good, something is not right in your metabolism, and you should take a number of steps to improve the HDL ratio. This will benefit the overall fatty acid balance. A number of studies now demonstrate that improved fatty acid balance and increased Omega-3 where necessary lowers high triglyceride levels and is cardioprotective. It is not a coincidence that metabolic syndrome, obesity, and insulin resistance are related to inflammatory dysfunction. An overall imbalance in your fatty acid metabolism is related to a number of health problems that are themselves interrelated. This is another reason why a holistic and comprehensive approach to health is important to both curing and preventing inflammatory diseases. Improving the digestion and lipid balance in the body may be a key to utilization of Omega-3 fatty acids.

Immune function and the role of essential fatty acids in the diet

Understanding of our immune system allows us to understand why we need to improve the fats in our diet and take Omega-3 fatty acid supplements balanced with Omega-6. Our immune systems are very complex and utilize a large number of complementary molecules to achieve the many functions of the system. Some of these chemicals our bodies produce, or metabolize, as needed, and other we need to keep supplying in our diet. Omega-3 and Omega-6 essential fatty acids are chemicals that we need to supply in our diet, and that need to be supplied in a balance to achieve optimum modulation of inflammatory mechanisms.

Our immune systems are composed of soluble chemicals that need to be constantly replenished, as well as immune mediating cells. These soluble chemicals are largely called the complement system, meaning that these various chemicals complement each other to produce a complex response. Immune cells are largely produced with the blood in our bone marrow, and stored throughout the body, in the spleen, thymus, lymph nodes and lymphoid tissues. These cells have lipoprotein, or fatty mebranes, that are specialized, and contain various levels of fatty acids. Long-chain polyunsaturated fatty acids (LC PUFA), especially the Omega-3 and Omega-6 types (n-3 and N-6 LC PUFA), have been well studied and identified as important in the part of the immune system that chiefly regulates and modulates inflammatory mechanisms. Our immune systems are divided into distinct systems called the innate and acquired immunity systems. The innate system, meaning that we were born with genetic coding that creates these immune cells, is the first line of defense against infection, and is a generalized protection for our bodies. The acquired immunity is adaptive to need, is antigen-specific, and produces white blood cells (T-cells and B-cells) with a sort of memory, or acquired programmed response to specific threats.

Besides attacking and destroying pathogens such as infectious bacteria, viruses, fungi and parasites, the immune system also destroys infected and old tissues, and clears this tissue debris away, and produces the responses that help regenerate these tissues with new healthy tissue. This is the inflammatory response, which is responsible for a lot of discomfort, as well as producing new healthy tissues and clearing away infection. The pain and discomfort in the inflammatory process comes from the increased and decreased blood flow, tissue perfusion of fluids, changes in tissue temperature, and breakdown of the tissue, as well as the uncomfortable accumulation of tissue debris and irritating chemicals that excite the nerve receptors. All of these immune responses need to be elaborately modulated to achieve their purpose without overacting. Even the immune attack on bacteria and viruses needs to be modulated, as a large number of bacteria are producing healthy and necessary symbiotic activities in our bodies, and even viruses play a beneficial role in genetic evolution. This modulating activity on the inflammatory process is largely achieved with the help of complement chemicals derived from Omega-3 and Omega-6 fatty acids.

The membranes on our cells are composed of lipoproteins, or fatty molecules, which contain a number of important inflammatory mediators to help the immune system. Since we are living organisms we need to keep supplying these cells with new fatty molecules that work well in the complement immune cascade. Many of these immune mediators are derived from fat cells and fatty acids when signaled. This signalling comes from our hormonal system, our antibodies, our white blood cells, and depends on proper enzyme activity. Many of our enzymes are created in our liver from proteins and amino acids. Omega-3 fatty acids are able to produce specific immune mediators when stimulated, and these immune mediators, or cytokines, are responsible for controlling excessive inflammatory processes. This is why they potentially help to decrease harsh inflammatory processes that cause pain and discomfort. When we take Omega-3 fatty acids we are not stimulating specific processes, but we are giving our bodies a greater chance to respond properly to modulate inflammatory processes. In addition to Omega-3 fatty acids, we need to promote healthy immune and liver functions, and provide the body with a number of healthy nutrients with good diet, if we want to guarantee a successful outcome.

Cell membranes contain phospholipids, or phosphate and fatty acid molecules, which are composed of a variety of fatty acids that convert to immune modulating cytokines. Arachidonic acid, an Omega-6 fatty acid, which experts agree has become overabundant in our cells because of the typical American diet, promotes certain immune mediators over others when our bodies are stressed with chronic inflammatory dysfunction. When our bodies respond with inflammatory reactions, it needs a complete array and balance of accumulated long-chain polyunsaturated fatty acids to produce the right balance of immune mediators. When there is imbalance, there is a greater chance that our bodies will respond poorly, causing unwanted inflammatory processes that are linked to many common diseases. Excess accumulation of arachidonic acid in the cell membranes produces excess cytokines called prostaglandins, thromboxanes, and leukotrienes. Arachidonic acid produced prostaglandins E2 and I2 inhibit platelet platelet adhesion and leukocytes, delaying tissue repair and contributing to chronic inflammation. Arachidonic acid may convert to an eicosanoid 5-HPETE (5-hydroperoxyeicosantetraenoic acid), on the other hand, which converts to leukotriene A4 through a lipoxygenase driven reaction, and if there is sufficient glutathione production in our bodies, converts into other beneficial leukotrienes (C4, D4, E4). If there is problem with the enzyme or glutathione metabolism, the arachidonic acid conversions may go to the alternate pathway, which is regulated by the COX1, COX2 (cycloxygenases) and peroxidase enzymes. This pathway is the one blocked by aspirin, NSAIDS (ibuprofen), and COX2 inhibitors (Vioxx), and is obviously producing immune mediators that cause pain. Most common pain medications were designed to inhibit this pathway. By promoting a better fatty acid balance, and a better glutathione bioavailability, as well as better liver enzyme production, you decrease the need to block this pathway with pain medication.

While these biochemical reactions are complicated to a person not familiar with this science, the basic facts are not complicated. If you want to promote natural healthy balance in inflammatory regulation in your body, and decrease dependancy on pharmaceutical pain relievers, you take a number of steps that will give your body the ability to deal with tissue inflammation and other processes in an optimal fashion. This is accomplished over time, and is best accomplished with a holistic protocol. Omega-3 fatty acids in the diet are just one of the steps in this holistic health regimen. You may read about glutathione balance on another article on this website. The effects are not immediate and dramatic, yet they are dramatic in the long run in a less obvious way. Your body is able to repair damaged, infected, and aging tissues better, and many horrible diseases will be prevented. Of course, when a disease is prevented, most people take this for granted. This benefit is unseen, invisible. Yet this type of health benefit is the best. Improving the quality of fats and oils in the daily diet, reducing red meat consumption, taking krill oil, spirulina, GLA supplement derived from black currant oil as needed, and other healthy habits, will insure a healthier future.

We do know that a variety of variables and factors participate in the inflammatory modulation exerted by Omega-3 fatty acids, and these factors and variables make measurement of specific levels of inflammatory modulation impossible. The key to effective use of these essential fatty acids is to try to provide the body with the bioavailability of these chemicals in order to insure proper function, but only when we also try to provide optimum overall healthy function. Maintaining a proper Omega-6 to Omega-3 fatty acid balance is important, expecially over time, and these essential fatty acids are derived completely from the diet. Understanding how the optimal diet helps our bodies modulate inflammation allows us to change our dietary habits when necessary, to correct inflammatory dysfunction. Upsetting this balance will contribute heavily to the possibility of dysfunction, and give our bodies less of a chance to perform as it needs to in regard to immune modulation. Each individual must understand their own conditions, as well as their own dietary habits, and improve this aspect of health maintenance as needed. If the dietary balance of Omega-6 and Omega-3 fatty acids is poor, and has been for some time, supplementation with Omega-3 fatty acid capsules may be important for your health, and the best source of these Omega-3 fatty acids are in krill oil, spirulina and blue-green algaes, and an increase of the foods listed above that supply the precursors for the longer-chain fatty acids EPA and DHA.

A comprehensive course of therapy that best utilizes Omega-3

Hopefully, the patient that reads this article has begun to understand that a comprehensive approach to health is essential. Taking a supplement and wondering if it is going to help your specific health condition, without understanding how it works, and how it fits into a larger treatment protocol that is specific for your needs, is not the smartest approach. Too often, we take specific supplements and pharmaceuticals, and then ignore the health problem, with a mentality that taking this pill will solve all problems. The truth is that maintaining health and resolving health problems takes a comprehensive approach. Your symptoms may be somewhat relieved by specific medications, but the underlying health problem still needs to be addressed. A supplement like Omega 3 can help with health problems and sometimes even symptom relief, but it does not address the whole problem. Seeking professional help from the experts in preventative medicine and comprehensive holistic approaches integral to Complementary and Integrative medicine is the smart approach.

Additional Information and information resources

  1. A 2012 review of scientific study of the omega-3 essential fatty acids EPA and DHA (eicosapentaenoic and docosahexaenoic acids), by the University of the Sunshine Coast, in Maroochydore, Queensland, Australia, found that standard treatment guidelines now recommend these supplements, or increased intake in diet, for a variety of chronic disease states, including, but not limited to, coronary heart disease, rheumatoid arthritis, dementia, and depression. This medical school and university is exploring the many factors that could effect results of this therapy, including cell membrane health, genetic expression, other signaling pathways, and of course, healthy metabolite formation, especially with nutrient cofactors and liver health:
  2. A 2012 study at the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, in Pennsylvania, US, found that the imbalance between omega-6 and omega-3 essential fatty acids, with a relative excess of arachidonic acid (derived mainly from meat in the diet), was a significant predictor of depression as a side effect of interferon therapy (e.g. treatment of Hepatitis C). It is hypothesized that a balance of essential fatty acids could improve neurohormonal health and aid homeostatic mechanisms to improve a majority of cases of depressive mood disorder:
  3. A 2013 review of scientific study of essential fatty acids, or long-chain polyunsaturated fatty acids (PUFAs), noted that it is the imbalance of the omega-3 and omega-6 fatty acids in the diet (essential) that is important, with much proof that an imbalance that favors the overconsumption of omega-6 PUFAs is highly linked to the pathogenesis of obesity and osteoporosis by promoting low-grade chronic inflammation:
  4. A 2015 study at the University of Padova Via Giustiniani School of Medicine, in Padova, Italy, found that excess arachidonic acid metabolites are highly linked to cardiovascular disease and high blood pressure. This excess arachidonic acid condition is promoted by a meat dominant diet, and is the reason for so many studies of the supplementation with omega-3 essential fatty acids to regain balance. Of course, these standard medical experts favor the creation of pharmaceuticals that manipulate these arachidonic acid metabolites rather than just promoting an essential fatty balance in public dietary recommendations. Such thinking leads to an excess of adverse side effects from medications that could be avoided easily:
  5. A 2012 study at the Klinika Psychiatrii Doroslych, in Poland, found that integrating omega-3 essential fatty acids with standard medications for treatment-resistant recurrent depression or bipolar affective disorder resulted in marked improvement in depression symptoms:
  6. A 2012 study at the Institute of Psychiatry and Clinical Psychology at the Catholic University of the Sacred Heart, in Rome, Italy, found that the omega-3 essential fatty acid DHA as consistently deficient in the blood plasma of patients with bipolar affective mood disorder, and that supplementation with DHA (krill oil) may provide a significant therapeutic effect, improving neurohormonal second messengers linked to the membrane phosphatidylinositol cycle. Of course, other aids, such as phosphatidylcholine and inositol hexacotinate, could be effective to achieve these goals as well:
  7. A 2004 study at Philipps University of Marburg, Marburg, Germany, Molecular Cardiology Department, found that a relative deficiency of omega-3 fatty acids, EPA plus DHA, presents a significant relative risk of sudden cardiac death in patients with coronary artery disease, especially following a myocardial infarction:
  8. In 2012, a study at Yonsei University College of Medicine, in Seoul, South Korea, found that the omega-6 gamma linolenic acid (GLA) aided kidney function, inhibited key inflammatory mediators MCP-1 and ICAM-1, and decreased the fibrosis of extracellular matrix, to significantly inhibit or reverse kidney damage in diabetes. GLA is readily available in foods and herbs, or as a supplement derived from black currant seed oil:
  9. In 2012, a study at Hadassah-Hebrew University Medical Center, The Agnes Ginges Center for Human Neurogenetics, in Jerusalem, Israel, found that alpha linolenic acid (ALA) may serve as a potent anti-inflammatory agent to treat dry eye syndrome in Sjogen's and other ocular inflammatory diseases. These researchers found that the simple ALA supplement was comparable to using corticosteroids:
  10. In 2015, a study at the Central Food and Technological Research Institute, in Mysore, India, found that the imbalance of Omega 3 and 6 essential fatty acids was the key factor in many inflammatory dysfunctions, and showed that a balanced supplementation with both Omega-6 and Omega-3 EFAs significantly improved weight, hemmorhoidal bleeding, and reduced overall mortality in studies of laboratory animals during pregnancy. Such studies are finally being conducted that study the subject of EFA imbalance, not just the effects of supplementation with one family of essential fatty acids:
  11. The March, 2010 withdrawal assessment report by the European Union for approval of synthetic omega-3 essential fatty acid in the form of ethyl eicosapentaoeic acid, or ethy eicosapent, E-EPA, here applied for approval for treatment of Huntingtons' Chorea, but also applied for approval for a wide variety of inflammatory and neurohormonal immune diseases. We see that this synthetic version of a natural omega-3 essential fatty acid presents some adverse effects, whereas the natural form does not, and that "major problems" were found in the presentation of the pharmokinetics of this synthetic drug by the manufacturer. E-EPA was approved in the U.S. for extremely high triglycerides, but not for other uses, for these same reasons, namely lack of proof of real efficacy, and lack of data presented concerning potential adverse risks. In 2015, a federal judge in New York ruled that the U.S. FDA could not impede the marketing of this drug for unapproved uses if they did not have proof of public harm, as this violated the free speech of the manufacturer! This ruling may open the floodgates for even less public protection from new drugs: