Question: Do Vitamin tablets/fish oil tablets, fish/tuna in general help strengthen our joints, which may or may not help our joints in regards to getting bleeds and injuries?
The answer to this question depends on who is asking it! There is not one correct answer as everybody is different. You would need to discuss vitamin and supplement use with your doctor before you start taking them to see if they are suitable for you. In general, people who have a healthy nutritious diet do not need to supplement their intake.
Vitamin D is a common exception – due to our sun smart programs to prevent skin cancer, many people do not get enough vitamin D. We get vitamin D from sunlight, not from food and it is important for bone strength rather than joints. You can have a blood test ordered by your doctor to test your vitamin D level and see if you need a supplement.
As for fish oil, there is no clear cut evidence that it will be useful for inflammation. Essentially if there is a target joint, we as your Haemophilia Centre team would want to treat this far more effectively than fish oil! For common injuries in young people such as tendonitis, there is no evidence fish oil is useful. Fish oil can be useful in preventing cardiovascular disease (as can fish).
Some people with bleeding disorders take fish oil for arthritis type pain, but high doses can cause an increase in bleeding in some people. Some people cannot tolerate fish oil at all! More than one serving of tuna per week should be avoided as these large ocean fish contain large quantities of mercury. Like in most things, avoiding excesses is a good idea.
If there is a particular concern in a joint, then a clear diagnosis needs to be found. For example, is this osteoarthritis, a target joint or a tendonitis or something else? If there is no joint pain, and if I were you, I wouldn’t bother taking any supplements! If your doctor diagnoses arthritis, then a 3 month trial of the supplements is not unreasonable, while you are looking out for an increase in bleeding episodes. We tend to avoid using chondroitin (a supplement for joints) in people with bleeding disorders due to a reported increase in soft tissue and joint bleeds.
The best thing to do to ensure less bleeds and less injuries is a proper conditioning program which can be suggested by your Haemophilia Centre physiotherapist or nurse rather than supplements.
Answered by: Doctors – haematologist and rheumatologist (an arthritis specialist)