Diet and Supplements for Polymyalgia Rheumatica (PMR)

Inflammatory joint pain from conditions such as polymyalgia rheumatica (PMR) may be aggravated or suppressed by certain foods. ¹ Sarris, J. & Wardle, J. Musculoskeletal system. In: Sarris, J. & Wardle, J. Clinical naturopathy : In Practice. Chatswood, NSW: Elsevier; 2017. Making the right food choices can help you reduce joint pain and curb serious medication-related side effects, such as osteoporosis.

It is important to note that dietary changes and supplements are not quick-fixes or stand-alone treatments for PMR. Talk with your doctor before trying a new diet, home remedy, or supplement to make sure it does not adversely interfere with your health or current medications.

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Here are a few diet and supplement considerations for PMR.

• Anti-inflammatory foods. Anti-inflammatory foods contain certain chemical compounds that are known to reduce joint inflammation and pain. ² Kohatsu W, Karpowicz S. Antiinflammatory diet. In: Rakel D, ed. Integrative Medicine 4th ed. Philadelphia, PA: Elsevier; 2018: 869-877. Foods with anti-inflammatory properties include nuts, fruits, leafy greens, cold water fish, tofu, whole grains, and green tea. The Mediterranean diet ¹ Sarris, J. & Wardle, J. Musculoskeletal system. In: Sarris, J. & Wardle, J. Clinical naturopathy : In Practice. Chatswood, NSW: Elsevier; 2017. and DASH diet ³ DASH eating plan. U.S. Department of Health & Human Services, National Institutes of Health Web site. Accessed November 16, 2018. are two examples of diets that encourage consuming several anti-inflammatory foods.

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• Omega-3 fatty acids. Omega-3 fatty acids can help reverse immune system responses to inflammation and protect against a recurrence of PMR. ¹ Sarris, J. & Wardle, J. Musculoskeletal system. In: Sarris, J. & Wardle, J. Clinical naturopathy : In Practice. Chatswood, NSW: Elsevier; 2017. ^{, 4} Macejová Z, Singh RB. Association of High w-6/w-3 Ratio Diet with an Ophthalmic Emergency in Patient with Polymyalgia Rheumatica and Giant Cell Arteritis. The Open Nutraceuticals Journal (2009), 2, 136-139. You can obtain these healthy fats from fish, walnuts, flax seeds, chia seeds, and leafy greens.

  See Dietary Supplements for Treating Arthritis

• Calcium and Vitamin D. When you are on steroid treatment for PMR, you are at an increased risk of osteoporosis, fractures, and bone damage. ⁵ Emamifar A, Gildberg-Mortensen R, Andreas Just S, Lomborg N, Asmussen Andreasen R, and Jensen Hansen IM, "Level of Adherence to Prophylactic Osteoporosis Medication amongst Patients with Polymyalgia Rheumatica and Giant Cell Arteritis: A Cross-Sectional Study," International Journal of Rheumatology, vol. 2015, Article ID 783709, 5 pages, 2015. Getting an adequate amount of calcium and vitamin D are especially important.

  Spinach, broccoli, soybeans, chickpeas, almonds, calcium-fortified juices, sardines with bones, and several types of non-dairy milk (including soy, almond, hemp, and rice) are examples of foods rich in calcium. Vitamin D can be obtained from tuna, egg yolk, salmon, beef liver, non-dairy milk, and direct exposure to sunlight (preferably at noon). Alternatively, you can also take calcium and vitamin D supplements.

  Although dairy products are rich in calcium, full-fat dairy products and cheeses may increase joint inflammation in some people. ⁶ Dairy: Arthritis Friend or Foe? Arthritis Foundation website. https://www.arthritis.org/living-with-arthritis/arthritis-diet/healthy-eating/dairy-and-inflammation.php Accessed November 19, 2018. ^{, 7} Fitzgerald K. A case report of a 53-year-old female with rheumatoid arthritis and osteoporosis: focus on lab testing and CAM therapies. Altern Med Rev. 2011 Sep;16(3):250-62. PubMed PMID: 21951026. In such cases, avoiding dairy foods, consuming dairy sparingly, or opting for low-fat dairy products may help you avoid triggering inflammation.

• Boost your body’s own steroid production and regulation. Natural steroids can help fight inflammation, control the body’s metabolism, and also promote good sleep. ⁸ Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335(1):2-13. ^{, 9} Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015;8(3):143-52. Supplements of vitamins C ¹⁰ Padayatty SJ, Doppman JL, Chang R, et al. Human adrenal glands secrete vitamin C in response to adrenocorticotrophic hormone. Am J Clin Nutr. 2007;86(1):145-9. and B6 ¹¹ Parra M, Stahl S, Hellmann H. Vitamin B₆ and Its Role in Cell Metabolism and Physiology. Cells. 2018;7(7). are known to help the body produce and regulate steroid hormones.

Other foods, such as curcumin (turmeric) and devil’s claw, or supplements of methyl-sulfonyl-methane, Boswellia (frankincense), and willow bark have shown pain-relieving properties in arthritis and fibromyalgia ¹² Smithson, J., Kellick, K. A., & Mergenhagen, K. Nutritional Modulators of Pain in the Aging Population. Nutritional Modulators of Pain in the Aging Population (2017), 191–198. doi:10.1016/b978-0-12-805186-3.00016-3. —conditions with joint pains similar to PMR. Although there is no direct evidence of the effects of these foods and supplements on PMR, they may be worth a try.

See Turmeric and Curcumin for Arthritis

When you decide to follow a healthy diet, it is important to abstain from foods that may promote inflammation. A few examples of such foods are deep-fried foods, red meat, and refined and/or processed foods, including meats, oils, and grains. When shopping for processed foods, such as cereals, prepackaged meals, and condiments, read the food labels. Avoid buying foods that contain refined sugar, corn syrup, refined flour, and/or corn oil.

Learn more:

Foods for a Healthier Gut and Less Arthritis Pain

3 Strategies for Coping with Polymyalgia Rheumatica (PMR)