Published on December 17, 2021

Study shows that decreasing AA and increasing EPA through diet and supplementation improved symptoms of RA

Key Points

  • Rheumatoid Arthritis (RA) is an autoimmune disease presenting with pain and  inflammation in the joints
  • Omega-3 fatty acids (such as EPA) have anti-inflammatory effects, while omega-6 fatty acids (such as AA) can be pro-inflammatory
  • A study on RA patients showed that a diet low in AA and supplemented with fish oils (increasing EPA) resulted in the greatest, significant improvements in RA symptoms
  • Lowering the AA:EPA Ratio can be one way to help manage inflammation and improve symptoms of chronic, inflammatory diseases

Rheumatoid Arthritis (RA) is an autoimmune disease that causes inflammation and pain in the joints. RA can affect other organs in the body, increasing the risk of diseases such as cardiovascular disease, gastrointestinal disorders, infections, osteoporosis and depression.

Both vitamin D and omega-3s have been shown to benefit individuals with chronic, autoimmune diseases such as RA. A recent analysis using VITAL trial data recently reported a 25-30% decreased incidence of autoimmune diseases, including RA, among participants taking vitamin D and/or omega-3s vs only placebos.  This effect may likely be due to the anti-inflammatory actions of vitamin D and omega-3s within the body.

Study Investigates Anti-Inflammatory Diet and Omega-3 Supplementation for RA Patients

A study by Adam et al. compared the effects of an anti-inflammatory diet, fish oil supplementation, and the combination of both for patients with RA.  68 patients were divided into two groups:

Both groups were also given either fish oil capsules (30 mg/kg of body weight) or placebo for 3 months at a time. RA symptoms and blood markers for inflammation and fatty acids were measured and tracked.

What did the study find?

60 patients were included in the analysis after the 8 month study. Patients on the anti-inflammatory diet had an AA intake of approximately 30% of the amount consumed in the western diet group. Blood work showed a significant correlation between AA intake and the percent of AA in the red blood cell membranes, resulting in a significantly lower percent of AA in the blood for those on the anti-inflammatory diet.

Among those supplementing with fish oils, EPA (eicosapentaenoic acid, an anti-inflammatory fatty acid found in fatty fish) levels increased by 244% in the anti-inflammatory diet group compared to 217% in the western diet group. The anti-inflammatory diet group also saw a decrease in C-Reactive Protein (CRP) levels with fish oil supplementation, while the western diet group did not.

In terms of symptoms, the anti-inflammatory diet group saw improvements in joint swelling and tenderness, with and without the addition of fish oil supplements. Adding fish oil supplements significantly reduced the number of tender and swollen joints in both groups, by

  • 28% and 34% in the anti-inflammatory diet group
  • 11% and 22% in the western diet group

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Overall effects on joint symptoms in each group were as follows:

  • no improvement in the Western Diet group without supplements; a 17% overall improvement when fish oil supplements were added
  • a 14% improvement with the anti-inflammatory diet alone, and a 31% overall improvement with an anti-inflammatory diet plus fish oil supplements

This study indicates that lower intake of AA and/or increased intake of EPA may lead to improvement in RA, with the greatest benefit seen with a combination of lower AA and higher EPA.

Using the AA:EPA Ratio to Measure Inflammation Levels

Omega-3s and omega-6s play different roles in inflammation. Omega-6s (such as AA) are essential for initiating and sustaining the inflammatory response – a physiologic function necessary for healing from injuries and infection. Having too much of these omega-6s can suppress the immune system, promote blood clotting, and increase inflammation and inflammatory disease. On the other hand, omega-3s (such as DHA and EPA) are anti-inflammatory and promote the resolution of the inflammatory process.

The AA:EPA Ratio test measures the ratio of the amount of pro-inflammatory AA and anti-inflammatory EPA in the red blood cells, and can be an indication of the amount of cellular inflammation in the body. Desirable ranges for health are generally between 2.5 and 11, however, some experts recommend an even lower AA:EPA Ratio of 1 to 3 for the resolution of cellular inflammation. Measuring the ratio can help individuals take more specific steps to achieve an ideal ratio and lower overall inflammation levels, mainly by increasing omega-3s (EPA and DHA) intake and decreasing pro-inflammatory omega-6 intake (such as AA).

Add the AA:EPA Ratio to Your Custom Home Test Kit

Having and maintaining healthy vitamin D, omega-3s, and other nutrient levels can help improve your health now and for your future. Choose which to measure, such as your vitamin D, omega-3s with the AA:EPA Ratio, and essential minerals including magnesium and zinc, by creating your custom home test kit today. Take steps to improve the status of each of these measurements to benefit your overall health. You can also track your own intakes, symptoms and results to see what works best for YOU.

Enroll and test your levels today, learn what steps to take to improve your status of vitamin D (see below) and other nutrients and blood markers, and take action! By enrolling in the GrassrootsHealth projects, you are not only contributing valuable information to everyone, you are also gaining knowledge about how you could improve your own health through measuring and tracking your nutrient status, and educating yourself on how to improve it.

What Does it Take YOU to Get Your D to 40 ng/ml (100 nmol/L)?

Did you know your health could be greatly affected by making sure you have a vitamin D level of at least 40 ng/ml (100 nmol/L)? Help us help you.

STEP 1 - Do you know what your vitamin D level is? If not, be sure to test today to find out.

STEP 2 – Determine your target level. Are you at your target level? Experts recommend a level of at least 40-60 ng/ml (100-150 nmol/L).

STEP 3 – Need to boost your level? Use the D*calculator to see how much vitamin D it may take to reach your target. Opt for the Loading Dose for a quicker boost.

STEP 4 – Optimize how your body absorbs and utilizes vitamin D with co-nutrients and these simple steps.

STEP 5 – Re-Test! This is an important step to make sure you have reached your target level, and to ensure you are not taking too much! Re-testing after 3-4 months is recommended.

STEP 6 – Adjust, Repeat…

Give your immune system the nutrients it needs to support a healthy you and protect yourself from unnecessary diseases, especially COVID-19.


The first Randomized Controlled Trial on vitamin D and COVID-19 has shown a 96% lower risk of ICU admission for those receiving vitamin D (as 25(OH)D to quickly boost vitamin D blood levels) along with the standard treatment, compared to those receiving standard treatment alone.

These results support many previous observational studies showing a relationship between vitamin D levels and intake and COVID-19 severity.

Review the Latest Nutrient Research for COVID-19

GrassrootsHealth Nutrient Research Institute has launched the new Immune Boost project with the use of our myData-myAnswers nutrient health system that nearly 15,000 people are already using for their health. Specific markers that influence immune health are suggested for testing as part of this project including:

  • Vitamin D
  • Omega-3 Index
  • Essential elements magnesium, selenium, and zinc
  • hsCRP

Our goal is to demonstrate how one can use the Nutrient Research Model established by Dr. Robert Heaney to show the effect of vitamin D serum levels of at least 40 ng/ml (100 nmol/L) on risk reduction for all ethnicities in the population. Status and intake of other nutrients will also be analyzed for any type of relationship to immune status and symptom severity. Join the project today!

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Through GrassrootsHealth Nutrient Research Institute, you can also test your essential elements magnesium, copper, zinc and selenium, toxins such as lead, mercury and cadmium, as well as your omega-3 levels, inflammation levels and thyroid stimulating hormone (TSH) level. Find out your levels today! Log on to the test selection page (click the link below) to get your tests and see for yourself if your levels can be improved.

Make sure you track your results before and after, about every 6 months!

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For each specific supplement, you can track what days you take it, how much, and many other details.  This will help you know your true supplemental intake and what patterns of use work for you to reach and maintain optimum nutrient levels. Check it out today!