Popular Supplements for Arthritis: What You Need to Know
Learn which supplements and vitamins might help with arthritis symptoms, and what risks some can pose.
Severalnutritional supplementshave shown promisefor relieving pain, stiffnessand other arthritis symptoms. Glucosamine and chondroitin, omega-3 fatty acids,SAM-eandcurcuminarejustsome of thenatural productsresearchers have studied for osteoarthritis (OA) and rheumatoid arthritis (RA).
Some of thesenatural remedies mayoffer arthritis symptom relief, especially whenyou use themin conjunction with traditional treatments.Here’s the evidence onsome of the most popular supplementsused to treat arthritis, and how they work.
Glucosamine and Chondroitin
Glucosamine and chondroitinare two ofthe most commonly usedsupplementsforarthritis.They’re components of cartilage—the substance that cushions the joints.
Research on these supplements has been mixed, in part because studies have used varying designs and supplement types.AlargeNational Institutes of Healthstudy called the GAIT trial compared glucosamine and chondroitin,alone ortogether,with an NSAID and inactive treatment (placebo)in people withknee osteoarthritis (OA). Glucosamine improved symptoms like pain and function,but not much better thanaplacebo.Yet a 2016 international trial found the combinationto beas effective as the NSAID celecoxib at reducing pain, stiffness and swelling in knee OA.
Studies have also differed on whichform of the supplements is most effective. Some evidence suggests glucosamine sulfate is best.Others find glucosamine hydrochloride to be more effective. One study that compared the two forms head to head showed they offered equivalent pain relief.Mayo Clinic researchers say evidence supports trying glucosamine sulfate – not hydrochloride – with or without chondroitin sulfate for knee OA.
Fish oil
The polyunsaturated omega-3 fatty acids found in fish havepotentanti-inflammatory properties.“Omega-3 fats seem to work better for rheumatoid arthritis than for osteoarthritis,most likelybecause rheumatoid arthritis is mainly driven by inflammation,” says ChrisD’Adamo, PhD, director of Research & Education at the University of Maryland School of Medicine Center for Integrative Medicine.
A 2017systematic reviewof studiesfoundthatomega-3 supplementsreduced joint pain, stiffness and swelling in RA.Taking these supplements might help some people cut down on their use of pain relievers-- and avoid theirside effects.“For mild cases of arthritis, it may be better to reach for the supplements before you go for the ibuprofen,” says FarshadFaniMarvasti, MD, MPH, director ofPublicHealth,Prevention, and Health Promotion at The University of Arizona. Omega-3s have the added benefit of protecting against heart disease and dementia, hesays.
Plant-based sources such as flax and chia seeds also contain omega-3s, but in the form of short-chain alpha-linolenic acid (ALA). “It’s the long-chain omega-3 fatty acids --eicosapentaenoicacid (EPA) and docosahexaenoic acid (DHA)--that have themajority of thehealth benefits,”D’Adamosays. When you buy fish oil, make sure the supplementlists the EPA and DHA content, and that you takeat least one gram each of EPA and DHA, he adds. Vegans can get these omega-3s from an algae-based supplement.
SAM-e
S-adenosyl-methionine (SAM-e) is a natural compound in the body that has anti-inflammatory, cartilage-protectingand pain-relieving effects.In studies, it was about asgoodat relieving OA pain as NSAIDs like ibuprofen and celecoxib, without theirside effects.
SAM-e has a bonusbenefit, too.“Thesupplement is most useful when you also have depression, because it has a mild to moderate antidepressant effect,”Marvastisays.
The typicalSAM-edose is 1,200 mg daily.If you plan to try this supplement, be patient. “It’s going to take a few weeks to see the full effects,”D’Adamosays.
Curcumin
Curcumin is the active compound in the yellow-hued spice, turmeric, which is a staple of Indian curries. In the body,it acts as a powerfulanti-inflammatory agent, blocking the sameinflammation-promotingenzyme asthe COX-2 inhibitor drug,celecoxib.
In astudy of 367 people with knee OA,a 1,500 mg daily dose of curcumin extract was as effective as 1,200 mg a day of ibuprofen, without the gastrointestinal side effects.Thissupplement alsoappears to relieve RA swelling and tenderness.
One downside to curcumin isthatit’s hard for the body to absorb. “You want to take it with a source of fat. Some of the supplements will be in an oil base, which is really important,”D’Adamosays.
Black pepper also increasesthe absorption. Some supplements addthe black pepper extract,piperine. However,piperinecould potentially cause liver damage,anditcan increase the absorption of medications like carbamazepine (Tegretol) and phenytoin (Dilantin), making them more potent.
Vitamins
Several vitamins have been studied for their effects on arthritis, including the antioxidant vitamins A, C, and E, and vitamins D and K.So far there’s no evidence that taking antioxidant vitaminsimproves arthritis symptoms, although eating a diet rich in these nutrients is healthy overall. Vitamins D and K are both important for bone strength, and vitamin K is involved in cartilage structure. Supplementing these two nutrients may be helpful if you’re deficient in them.
Supplement Risks
When you take supplements as directed and under your doctor’s supervision, they’re generally safe.Yet even though they’re labeled “natural,” supplements can sometimescause side effects or interact with the medicines you take.For example, high-dose fish oil supplements can thin the blood and may interact with anticoagulant medicines such as warfarin (Coumadin).
Sometimes you can overdo it and take too much, especially when it comes to vitamins. Some vitamins -- like B and C -- are water soluble. That means if you take too much of them, your body will flush out the extra. Yet fat-soluble vitamins such as A, D, E and K can build up in your body to the point where they become harmful, so check with your doctorabout safe amounts.
Finally, supplements don’t go throughthesame rigorous approvalprocess from theFood and Drug Administration (FDA)as medicines. TheFDAhas toreview and approve every medication to make sure it works and that it’s safe. With supplements,the ingredients listed on the label may not be the same ones thatarein the bottle.
How toTakeSupplementsSafely
If you do want to try supplements, use them as anadd-on to arthritis drugs, notasa replacement. Theyshould never take the place ofmedications, whichare the onlyprovenway to slow joint damage.
Always check withyour doctor before you try any new supplement to make surethatit’srightfor you, and that you’re taking a safe dose.“I do recommend for the consumer who’s anticipating using a lot of supplementseithertofind an integrative physician who can help themor invest in a[subscription with an]independent testing company like Consumer Labs and check with their physician,”Marvastiadvises.Also go through yourentire supplement andmedication list withyour pharmacistto check for possible interactions.
