Fish oil and baby aspirin reduce inflammation? - JP Fitness Forums

Lisa~ · 10-20-2007, 08:06 AM

In one of Eric Cressey's newsletters (early Oct. I think) he wrote (or maybe he was quoting someone else?):

Quote:

1. During times of really heavy training when your joints are under higher than normal stresses I recommend that people take 1-2 baby aspirin with their fish oil each day (2-3g EPA/DHA). The combination of aspirin and fish oil causes the production of an extremely potent (and cutting edge) series of anti-inflammatory compounds called resolvins. Resolvins don't stop inflammation per se, but they accelerate the cleaning up of the damage caused by inflammation. This is extremely important because normally NSAIDs like Advil or aspirin (w/o fish oil) actually slow down this resolution phase of inflammation. The aspirin/fish oil combination will help clean up the inflammatory damage in your joints so you can keep lifting those heavy weights.” Of course, you should always check with your doctor before taking any medications.

I failed to save the link to the newsletter, so now this quote is all I have. Does anyone have that link?

What do you guys think of this advice? Would this fish oil/aspirin combination be effective after minor injuries that have caused inflammation?

Here's my specific situation. My son was playing pick-up tackle football with no pads after school on Thu. He took a blow to his quad (lateral aspect, about 1/3rd of the thigh up from his knee, about where his quad attaches on the femur) from the knee of the guy tackling him. He was out of the game immediately and limping, but no initial bruising. When he got home (roughly one hour later) swelling was evident just above his knee on both sides and across the front, but below the site of the hit. I had him elevate it, ice it, and take aspirin and fish oil. He saw the athletic trainer at school the next day who said it was a hematoma and told him to use a cryo cup for the next few days. At the high school football game last night, the athletic trainer called him into the field house to have the team doc take a look at it too. He said that if he'd seen it immediately he would have drained fluid with a needle, but by now (about 28 post injury) it was starting to coagulate and he'd just have to let it heal. Neither of them are all that worried about it. There still isn't any visible bruising, just the swelling, but the doc said he bet the bruising would still show up.

BUT my son tells them what I've been having him do and they both want more info on this fish oil/aspirin advice. They are skeptical. I really don't have any good information! Eric's newsletter isn't enough evidence for me to give them!

I debated on putting this in the injury forum, but I think we've gotten good advice on the injury. I'm hoping to discuss the usefulness of the fish oil/aspirin combination for this purpose.

Alan Aragon · 10-20-2007, 08:44 AM

That's just plain bad advice. Horrible advice, in fact (not directed at you but rather at the info in the newsletter). 1st off, the acute inflammatory response as a result of exercise is part of the natural cycle that leads to positive muscular adaptations over time (ie, muscular size, strength, endurance, etc). Suppressing postexercise inflammation isn't a good idea in the 1st place, and one could even argue that postexercise inflammation is a good thing when viewed from the standpoint of triggering protein synthesis. Speaking of which, there are a couple of detrimental effects of aspirin. It's well known that aspirin (& other NSAIDs) damage the lining of the stomach. Also, to add insult to injury, NSAIDs (including aspirin) have been seen to inhibit protein synthesis. In conclusion, why include aspirin when it can damage stomach lining & inhibit muscle protein synthesis -- all for the sake of initiating an unproductive process?? Good grief.

Lisa~ · 10-20-2007, 08:49 AM

OK. I agree with not using any NSAID for DOMS. But what about in the case of inflmmation from a minor injury? Wouldn't this be a time when using a NSAID is appropriate? Don't we want to suppress the inflammatory response at this time? So would using aspirin and fish oil be superior to using ibuprofen?

Alan Aragon · 10-20-2007, 08:53 AM

Quote:

Originally Posted by Lisa~

OK. I agree with not using any NSAID for DOMS. But what about in the case of inflmmation from a minor injury? Wouldn't this be a time when using a NSAID is appropriate? Don't we want to suppress the inflammatory response at this time? So would using aspirin and fish oil be superior to using ibuprofen?

That's a question best left for a doc. Although your doc might not have a clue... I would take the conservative route & not "mix drinks". Again, hit up the doc. EDIT: I saw that the docs are skeptical & want more info. Well, I'd hit up another doc, but I bet you they'd all tell you not to do it.

OldGuy · 10-20-2007, 08:54 AM

This may be the study Eric is citing.

http://www.jem.org/cgi/content/full/196/8/1025

Lisa~ · 10-20-2007, 09:30 AM

OG, thanks so much for finding that study. I'm attempting to read it but it is seriously over my head!

They seem to be discussing chronic disease related to inflammatory conditions, like cardiovascular disease, rather than DOMS or swelling from minor injuries. I don't know how far we can extrapolate this information to other situations.

Alan, I'm really hoping you're going to read this study and tell us what you think!

OldGuy · 10-20-2007, 09:39 AM

My eyes glazed over when I started reading it.

Quote:

I don't know how far we can extrapolate this information to other situations.

Exactly. Also you don't know how fast these resolvins form. In your sons case he may be healed by the time the magic starts.

Leigh P. · 10-20-2007, 10:18 AM

The argument point here (in my mind) is more should this be used often in a post workout situation. In the case of your son though I see that it has purpose and promise to help. To use in training regularly I am not sold based on some things Alan stated as well as some others. As for the research here is the short of it.

Fish oil/EFA supplements has been shown in multiple studies to reduce inflammation due to prostaglandins. Prostaglandins are derived from the arachidonic acid in Omega 6 fatty acids. In this study they are showing that from eicosapentaenoic acid (from omega 3's) resolvens also give an anti-inflammatory effect.

In short what the study is saying that Resolvens stop the movement of inflammatory cells to sites of inflammation, and the turning on of other inflammatory cells. Taking a low dose of aspirin has the ability to facilitate the generation of antiinflammatory lipids from eicosapentaenoic acid and arachidonic acid. Mainly it speeds up this process through strong extraction.

You can also look at these two studies...

Serhan, C.N., and N. Chiang. 2002. Lipid-derived mediators in endogenous anti-inflammation and resolution: lipoxins and aspirin-triggered 15-epi-lipoxins. ScientificWorldJournal. 2:169–204.[Medline]

Paul-Clark, M.J., T. Van Cao, N. Moradi-Bidhendi, D. Cooper, and D.W. Gilroy. 2004. 15-epi-lipoxin A4-mediated induction of nitric oxide explains how aspirin inhibits acute inflammation. J. Exp. Med. 200:69–78

LisaS · 10-20-2007, 11:05 AM

years ago I had an interesting discussion with my immun. prof about the role of histamine in response to acute injury and that maybe if you could get a fast acting anti-hist into your system around the time of an injury you might have a benefit - but you'd almost have to do it prophylactically because of the speed of the injury cascade & time needed for metab of the anti-hist. But it still would be an interesting area of research - addressing a different actor in the inflamm response. But those mast cells are fast you'd have to be right on it.

PowerManDL · 10-20-2007, 11:07 AM

The take-away I got from that was that yes aspirin does nifty things to the COX pathways which can create some freaky DHA voodoo, but really they were just saying that EPA and DHA were pretty widely relied on by the body's inflammatory processes, and it was cool to see some novel modifications come out of it.

In general sense I agree with Alan....not something to be relied on, but in the case of acute injury...hell honestly I don't know enough to say for sure. I'd have to dig around more before I'd be able to form a more clear opinion.

ETA: I will say that aspirin (or rather acetylsalicylic acid) is somewhat different from most commonly used NSAIDS because it does seem to be one of those naturally-occurring compounds that just sorta "fits" our particular biochemistry. Not sure if that's even relevant, but yeah.

Ian Kay · 10-20-2007, 11:11 AM

For the record, it was Mike Roussell who provided the tip for Eric's newsletter.

Lisa~ · 10-20-2007, 11:30 AM

Quote:

Originally Posted by Ian Kay

For the record, it was Mike Roussell who provided the tip for Eric's newsletter.

Thank you! I thought he was quoting someone, I just couldn't remember who and I didn't save it. Do you still have the link to the newsletter?

And Matt, thanks for adding your comments.

smoddelm · 10-20-2007, 12:12 PM

Quote:

Originally Posted by Alan Aragon

That's just plain bad advice. Horrible advice, in fact (not directed at you but rather at the info in the newsletter). 1st off, the acute inflammatory response as a result of exercise is part of the natural cycle that leads to positive muscular adaptations over time (ie, muscular size, strength, endurance, etc). Suppressing postexercise inflammation isn't a good idea in the 1st place, and one could even argue that postexercise inflammation is a good thing when viewed from the standpoint of triggering protein synthesis. Speaking of which, there are a couple of detrimental effects of aspirin. It's well known that aspirin (& other NSAIDs) damage the lining of the stomach. Also, to add insult to injury, NSAIDs (including aspirin) have been seen to inhibit protein synthesis. In conclusion, why include aspirin when it can damage stomach lining & inhibit muscle protein synthesis -- all for the sake of initiating an unproductive process?? Good grief.

I have been contending with a persistent case of tendinitis in my elbow since March. My doctor prescribed 15 days of naproxen. After 3 days I thought it was actually "curing" me, but the "cure" started tapering off after that. It has waxed and waned now for 8 months. My doctor referred me to an orthopedic surgeon who concluded that it wasn't really serious enough to treat with anything other than anti-inflammatories.

So I have been popping Aleve and Advil like m&m's for about 7 months -- not just for the elbow but also for arthritis in my neck, shoulder pain that I have had for over 25 years, knee pain, etc. No stomach problems except occasionally when I have taken on an empty stomach. But I do feel like my workout gains have been minimal over this period. Could the drugs possibly be an issue? And if so, do I have to make a choice between pain relief and my workout goals?

PowerManDL · 10-20-2007, 01:25 PM

There's definitely been shown to be a negative correlation between protein synthesis and NSAIDS, due to the fact that they impair steps in the inflammation process.

I don't remember enough about glucocorticoid activity off-hand to say if they'd inhibit or assist in joint problems, but IIRC they do help subtly by modifying the COX pathway.

In any event, not something I'd want to use routinely while trying to make progress, no.

However, if it's the trade-off between chronic pain and making gains, I know which I'd likely pick (barring moments of masochism).

Slightly OT to address your tendinitis issue: it's been shown that performing eccentric actions has therapeutic effects over the short term for tendinitis. It may be worth looking into.

Mohr Results · 10-21-2007, 10:53 AM

The problem with the blurb in Eric's newsletter is that it is extrapolating data and making it sound like any injury, inflammation, etc should turn to fish oil and aspirin. Your sons injury (acute trauma) is not the same as joint pain/inflammation...therefore, from the little information we have from this thread, I wouldn't combine the two. Alan did a good job explaining the basic mechanisms between the fish oil and aspirin, so I won't delve into that too far. Unfortunately email makes it impossible to "diagnose" someone/something, so it would really be wise to seek out another MD (sports med MD) who can actually look at this and determine the best approach.

Good luck!

Frank.S · 10-21-2007, 12:47 PM

Quote:

Originally Posted by smoddelm

I have been contending with a persistent case of tendinitis in my elbow since March. My doctor prescribed 15 days of naproxen. After 3 days I thought it was actually "curing" me, but the "cure" started tapering off after that. It has waxed and waned now for 8 months. My doctor referred me to an orthopedic surgeon who concluded that it wasn't really serious enough to treat with anything other than anti-inflammatories.

So I have been popping Aleve and Advil like m&m's for about 7 months -- not just for the elbow but also for arthritis in my neck, shoulder pain that I have had for over 25 years, knee pain, etc. No stomach problems except occasionally when I have taken on an empty stomach. But I do feel like my workout gains have been minimal over this period. Could the drugs possibly be an issue? And if so, do I have to make a choice between pain relief and my workout goals?

Get bloodwork dude.. You kidneys/liver must hate you by now.