(ĐTĐ) - At 35, Chicago flight attendant Michele Mason says her bones felt like “pins and needles” were in them, and her hands were so swollen that she found it difficult to put on her infant son’s socks. Her knees ached, too. “I couldn’t even get out of the bathtub by myself,” she says.
When her doctor suspected rheumatoid arthritis, Mason worried that traditional medicines might not be good for her breastfeeding baby. So with her doctor’s blessing, she took a very low-dose steroid and turned to herbs and supplements, including boswellia (Indian frankincense) and fish oil, to help relieve the pain and inflammation.
A year later, her diagnosis of rheumatoid arthritis was confirmed. “I was happier to go with what I felt was a safer route with herbs,” she says. “While they didn’t make it go away, they did give me some relief."
Like Mason, about 30% of patients surveyed from North Carolina with rheumatoid arthritis have tried supplements, according to a study in Preventing Chronic Disease . “And use is increasing,” says study co-author Leigh Callahan, PhD, associate professor of medicine, orthopaedics and social medicine at the Thurston Arthritis Research Center at the University of North Carolina at Chapel Hill.
So what are the best herbs and supplements for RA? And, are they safe? Here's what you need to know.
Supplements and Herbs for RA: The Basics
First, know that herbs and supplements haven't been studied in the same way that prescription medicines for RA have. “There’s a tremendous disconnect between their widespread usage and people’s belief in their efficacy compared to what we’ve actually proven scientifically,” says Chaim Putterman, MD, chief of rheumatology at Montefiore Medical Center and Albert Einstein College of Medicine.
That is changing as the National Institutes of Health has a well-established center dedicated to studying complementary and alternative medicine . In the meantime, experts say that although some herbs and supplements may help relieve inflammation, don’t count on them to cure rheumatoid arthritis. “At best, they’re adjunctive therapies,” says William St. Clair, interim chief of the division of rheumatology at Duke University Medical Center. “It’s not a good reason to throw out their disease-modifying anti-rheumatic drugs.”
Always talk to your doctor first, because herbs and supplements may interfere with other medicines you are taking. Remember, too, that since they are not regulated in the same way that drugs are, you cannot always be sure what you are buying, says St. Clair.
The National Center for Complementary and Alternative Medicine (NCCAM) recommends that women who are pregnant or nursing, or those considering CAM use in children use extra caution and consult their health care provider.
With that in mind, here are the herbs and supplements some experts suggest for RA.
Supplements and Herbs for RA: The Best
Omega-3 fatty acids: Omega-3 fatty acids are anti-inflammatories found in products like fish oil, says David Leopold, MD, director of integrative medical education at the Scripps Center for Integrative Medicine. Fish oil comes from coldwater fish such as salmon and tuna. Studies of fish oil in chronic inflammatory diseases show benefits such as decreased pain and morning joint stiffness and lowered use of nonsteroidal anti-inflammatory drugs.
The downsides: Fish oil may increase risk for bleeding, especially if it is being taken with certain other medicines. It can also interact with other medications you may be taking for conditions such as high blood pressure. It can taste fishy and can cause gas, diarrhea, and bloating. Leopold recommends getting good products that don’t taste that fishy, and freezing capsules. “By the time they melt, they’ve gone past the point where they can cause a fishy burp,” he says. Check for supplements that contain mercury-free fish oils.
Borage oil: Borage oil reduces swollen and tender joints, says Robert Zurier, MD, professor of medicine in the division of rheumatology at the University of Massachusetts Medical School. With it, patients may need less prednisone, a steroid, for relief of symptoms, he says. Borage oil may cause bloating or an upset stomach. Borage oil products may hurt the liver and may also increase risk for bleeding, especially in those who are also using NSAIDs or anti-clotting medications.
Green tea extract (EGCG), curcumin (turmeric), quercetin, ginger,white willow bark, boswellia: These are potential anti-inflammatory agents. “They act very similarly to ibuprofen, but at a lesser level,” says Leopold. Curcumin, boswellia, and ginger have been used in Ayurvedic medicine for inflammatory conditions, according to the NCCAM, which is supporting research with these botanicals in the treatment of arthritis and asthma.
According to the NCCAM, ginger may increase risk for bleeding and should not be used in people with bleeding problems, heart problems, or diabetes, Curcumin may cause upset stomach and diarrhea and shouldn't be used in people with gallbladder disease or gallstones. Boswellia may also cause upset stomach. White willow bark can cause a serious allergic reaction to patients with a history of allergy to salicylates (aspirin allergy). Other side effects may include upset stomach, bleeding, rash, and kidney problems.
Avocado-soy unsaponifiables: This vegetable extract made from avocado and soybean oils “seems to help the body regenerate normal connective tissue,” says Leopold. ASUs, as they’re often called, may cause upset stomach. Even just eating avocado and soy should give people “a mild effect,” he says.
SAM-e may act as an anti-inflammatory and analgesic but may cause vomiting, diarrhea, headache, and nausea.
Cat’s claw, from the bark of an Amazon vine, may slightly reduce joint swelling and pain, but there is no conclusive evidence that it can successfully treat rheumatoid arthritis. Cat’s claw may cause nausea, headaches, and dizziness.
Supplements and Herbs for RA: The Worst
Arnica : When ingested, may be poisonous, says Leopold. Used topically, it can cause itchiness and rash.
Kombucha tea: A fungal mushroom fermented product with a high risk of contamination.
Colloidal silver: This actually contains silver, says Leopold, which can turn the whole body blue permanently. It can also cause kidney problems, fatigue, stomach upset, and neurological problems.
Thunder god vine: This may cause stomach upset, skin reactions, temporary infertility in men, and a stop to periods in women. Extended use may lead to decreased bone density. Some parts of the plant are poisonous and could cause death.
Supplements and Herbs for RA: The bottom line?
Live a healthy life. Exercise may even reduce inflammation. And most important, talk to your doctor before trying any herb or supplement. Even if your doctor doesn’t ask you point blank about any herbs and supplements you’re taking, remember to volunteer the information.