Expert: Dr. Kristina Conner - 9/28/2011

Question
Hello Dr. Conner,

I have been suffering from mild-moderate alopecia areata (AA) for about 1.5 years. I am aware that genetics plays a large role in this disease, but environmental factors such as diet also seem to be important. I have been reading literature (PubMed) and have been getting somewhat conflicting information with respect to the impact of Omega 3 polyunsaturated fatty acids (n-3 PUFA) on autoimmune diseases like AA.

AA is caused by a cell mediated (Th1) immune response.

n-3 PUFAs apparently support a Th1 immune response by competing with arachadonic acid, who's metabolites (e.g. prostaglandin E2 (PGE2)) promote a Th2 response. Therefore, one would expect n-3 PUFAs to exacerbate AA. However, there is conflicting information in the literature which argues for and against n-3 PUFA supplementation in treating Th1 autoimmune diseases.

In your opinion, should someone with AA include n-3 PUFAs in their diet?

Thanks.

Answer
Hello Jeffrey,
Thanks for your question.  You are correct, there is always more than just genetics that plays a role in autoimmune conditions.  PUFAs are common, most of us get them in our diet somehow, but certainly not everyone develops autoimmune conditions, even with some genetic background. At this point, I do not think the evidence is definitive either way for supplementation, but the other benefits of PUFAs (such as the positive impact of some on cardiovascular disease) makes me question whether taking them out of the diet or severely restricting them might not be wise for every person.  
In health,
Dr Conner