Rheumatologist, West Hills

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Nov 1

Herbal and natural supplements for arthritis

Not infrequently, once I have explained the diagnosis of arthritis, its manifestations and treatment options, a patient will ask me “what herbal or natural supplements can I use to help my condition?  Although not heavily emphasized in Western medicine, there have been several studies on the effects of herbal and natural supplements for arthritis pain. So I decided to make a comprehensive review of what has been proven to work.

 Things to consider

First, let me start by making a couple of points about natural supplements in general:

  • Just because something is “natural” it does not mean it is harmless. Read carefully about potential side effects.
  • Natural remedies are not regulated by the FDA, so their composition may be variable and their claims may be untrue. (see blog on Reumofan)
  • The ingredients in some herbal supplements are the same as those found in FDA-approved drugs
  • The supplements may interfere with your other medications, so please review them with your doctor
  • They may help with mild arthritis, but chances are you may need stronger drugs if your arthritis is severe!
  • Herbal supplements may not be safe in pregnancy or breastfeeding

Herbal and natural supplements for arthritis:

 

Where is comes from

What it claims to do

Dose

Potential side effects

Glucosamine Sulfate

Derived from the shells of shellfish

Reduce osteoarthritis pain and slow progression. Lubricates joints

1500mg/day

-people with shellfish allergy may be allergic

-may interact with blood thinners

-can increase blood sugar

-can increase cholesterol

Chondroitin Sulfate

Usually from bovine trachea or pork by-products

Reduce osteoarthritis pain and slow progression

800-1200 mg/day, usually with Glucosamine

-remote possibility of mad cow disease if contaminated

-may cause blood thinning

-use with caution if sulfa allergy

-diarrhea, constipation

Omega-3 fatty acids

Found in fish oil (salmon and tuna), Canola oil

Decrease joint inflammation and pain

1-4 grams

EPA/DHA

-may have a fishy taste

-can increase risk of bleeding

-may contain high levels of mercury

-can cause gout flare

-gas, diarrhea, bloating

DHEA

(dehydro-epiandrosterone)

A natural hormone produced by the adrenal glands

Reduce disease flare in lupus and perhaps rheumatoid arthritis

10-25 mg/day

-acne, facial hair, menstrual irregularities

-abdominal upset

-may worsen liver function

-contraindicated in prostate cancer and uterine fibroids

S-adenosylmethionine (SAMe)

Naturally occurring chemical in the body.

Sold as a drug in Europe

Reduce pain and stiffness from osteoarthritis, fibromyalgia,  rebuild cartilage, help depression

400mg twice per day

-expensive

-avoid if bipolar disorder

-nausea, vomiting, diarrhea, headache

Borage oil

From Borage plant seed

Anti-inflammatory and anti-thrombotic properties

1300mg/day

-increased risk of bleeding

-liver damage

-bloating, upset stomach

Turmeric

(Curcumin)

From turmeric plant root

Reduce joint pain and inflammation

0.5-2 g/day

(capsule or spice)

-can thin the blood

-stomach upset

-contraindicated in people with gallstones (causes flares)

Ginger

From ginger plant root

Reduce joint pain and inflammation, helps circulation in Raynaud’s, also motion sickness

30-500 g

Any form

-can interfere with Coumadin (warfarin)

-can increase bleeding risk

-contraindicated in people with gallstones

-considered safe by the FDA

Green tea extract

Concentrated from green tea

Anti-oxidant effects, help RA and Sjogren Syndrome

Capsule, liquid extracts

-liver inflammation

-insomnia (it has caffeine)

Arnica

From Arnica flower

Help muscle aches, sprains, bruises, joint pain

Topical cream or ointment

-should not be taken by mouth without medical supervision

-skin irritation, eczema

Avocado soybean unsaponifiables

Made from avocado and soybean oils

Slow breakdown of cartilage

300mg/day

-upset stomach

Cat’s claw

From the bark of an Amazon vine

Anti-inflammatory properties (mild)

250-1000 mg/day

-can lower blood pressure

-nausea, headache, dizziness

Boswellia

From the bark of the Boswellia tree in India

Reduce inflammation and pain in RA and OA

100-250 mg/day

-stomachache, diarrhea

-skin rash

Evening primrose oil

From the evening primrose seed

Contains gamma- lineloid acid (GLA)

Reduce arthritis pain

 

-increased bleeding risk

-may cause seizures

-may interact with medications

-nausea, diarrhea, headache

Black current oil

From black current seeds

 

 

Insufficient data

DMSO

 

Decrease joint pain and inflammation

 

Conflicting data in clinical studies

Thunder god vine

 

Helps symptoms of rheumatoid arthritis

 

Severe side effects including:

-temporary infertility in men, amenorrhea (lack of periods) in women, decreased bone density, suppressed immune system.

-Some parts of the plant are poisonous and can cause death.

 

 

Reference:

http://www.arthritistoday.org/treatments/supplement-guide/supplements/index.php

http://www.healthnews.com/en/news/Choosing-Natural-Supplements-for-Arthritis-Pain-Relief/3KLokZr8H7SPvXriP7RZUd/

http://www.rd.com/health/wellness/6-supplements-for-arthritis-sufferers/

http://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-best-worst-supplements-herbs

http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/herbal.asp

http://www.arthritis.org/natural-depression-fighters.php

http://www.mayoclinic.com/health/osteoarthritis/DS00019/DSECTION=alternative-medicine

http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=alternative-medicine

 

Firooz, Dr. Nazanin

Dr. Firooz is board-certified in Rheumatology and Internal Medicine. She is an active member of the American College of Rheumatology, and is affiliated with the Department of Rheumatology at Cedars Sinai Medical Center.

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