Osteoarthritis and Cetylated Fatty Acids

In 2004, a special mixture of fats called cetylated fatty acids began to be widely marketed as a treatment for osteoarthritis. Although the claims associated with this product appear to exceed what has actually been proven, it is fair to say that cetylated fatty acids have shown definite promise in preliminary trials.

A type of naturally occurring fatty acid called cetylated fatty acids have shown growing promise for osteoarthritis. It is used both as a topical cream and as an oral supplement.

It's not known how cetylated fatty acids might help osteoarthritis. Proponents cite the known benefits of fish oil for rheumatoid arthritis, but since the fatty acids in fish oil are rather different from those in cetylated fatty acids, and the origin of rheumatoid arthritis is quite unlike that of osteoarthritis, there is little relevance to these observations. Proponents also make multiple specific claims, including that cetylated fatty acids reduce inflammation, protect cartilage from damage, lubricate cell membranes, and increase fluid in joints. However, none of these explanations have more than speculative scientific support. At present, if in fact cetylated fatty acids help osteoarthritis, we do not know how they might do so.

Read more details about Cetylated Fatty Acids.

Three double-blind placebo-controlled studies have found cetylated fatty acids helpful for osteoarthritis. Two involved a topical product, and one used an oral formulation.

In one of the studies using the cream, 40 people with osteoarthritis of the knee applied either cetylated fatty acid or placebo to the affected joint.¹²⁸ The results over 30 days showed greater improvements in range of motion and functional ability among people using the real cream than those using the placebo cream.

In another 30-day study, also enrolling 40 people with knee arthritis, use of cetylated fatty acid cream improved postural stability, presumably due to decreased pain levels.¹⁴⁵

In addition, a 68-day, double-blind, placebo-controlled study of 64 people with knee arthritis tested an oral cetylated fatty acid supplement (the supplement also contained lesser amounts of lecithin and fish oil.)¹⁴⁷ Participants in the treatment group experienced improvements in swelling, mobility and pain level as compared to those in the placebo group. Inexplicably, the study report does not discuss whether or not side effects occurred. While this is a promising body of research, it is far from definitive. Current advertising claims for cetylated fatty acids go far beyond the existing evidence. For example, a number of websites claim that cetylated fatty acids are more effective than glucosamine or chondroitin. However, no comparison studies have been performed upon which such a claim could be rationally based.

Cetylated fatty acids are used both orally and as a topical cream.

A typical oral dose of cetylated fatty acids is 1,000 to 2,000 mg daily. Cetylated fatty acid creams are applied two to four times daily to the affected area.

Safety Issues

Cetylated fatty acids appear to have a low level of toxicity, according to safety studies conducted by the primary manufacturer. ^{1 2} However, maximum safe doses in young children, pregnant or nursing women, or people with severe liver or kidney disease have not been established.

1. Bacterial reverse mutation Ames test screening. (2002) MDS Pharma, Les Oncins, France.
2. The acute toxicology of oral cetylated fatty acid gavage CD-1 mouse model (2001). Perry Scientific, Inc., Study No. 00-1075.

128. Kraemer WJ, Ratamess NA, Anderson JM et al. Effect of a cetylated fatty acid topical cream on functional mobility and quality of life of patients with osteoarthritis. J Rheumatol. 2004;31:767-74.
145. Kraemer WJ, Ratamess NA, Maresh CM et al. Effects of treatment with a cetylated fatty acid topical cream on static postural stability and plantar pressure distribution in patients with knee osteoarthritis. J Strength Cond Res. 2005;19:115-121.
146. Kraemer, WJ, et al. One week of treatment with a cetylated fatty acid topical cream with menthol reduces pain and improves functional performance in patients with arthritis of the knee, elbow, and wrist. J Strength and Cond Res. 2005;19: in press.
147. Hesslink R Jr, Armstrong D 3rd, Nagendran MV, et al. Cetylated fatty acids improve knee function in patients with osteoarthritis. J Rheumatol. 2002;29:1708-1712.
148. Berman BM, Lao L, Langenberg P, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2004;141:901-910.