Dietary Supplements for Treating Arthritis

Many people take dietary supplements to try to reduce or prevent arthritis inflammation and degeneration.

See Inflammatory Arthritis and Degenerative Arthritis

Dietary supplements include vitamins, minerals, herbs, and many other products, such as probiotics. They are typically sold over the counter in pill form, but may also be sold as powders or liquids.

Watch: Video: Salt & Pepper Roasted Cauliflower for Arthritis Pain Relief

Proponents say that certain dietary supplements:

• Help alleviate existing joint pain in some patients
• Have very few side effects
• Are a relatively affordable treatment option

Before taking supplements, patients are advised to talk to their doctors and make sure that the supplements are appropriate and will not interact negatively with existing medical conditions, prescription medications, or dietary restrictions.

Some of the most common and well-researched supplements for arthritis are turmeric and/or curcumin; ginger; fish oil; and glucosamine and chondroitin sulfate.

Turmeric and/or curcumin. Evidence suggests curcumin, found in the spice turmeric, has antioxidant properties that can potentially decrease inflammation and inhibit arthritis pain.¹Yang Y, Wu X, Wei Z, Dou Y, Zhao D, Wang T, Bian D, Tong B, Xia Y, Xia Y, Dai Y. Oral curcumin has anti-arthritic efficacy through somatostatin generation via cAMP/PKA and Ca(2+)/CaMKII signaling pathways in the small intestine. Pharmacol Res. 2015 May-Jun;95-96:71-81. doi: 10.1016/j.phrs.2015.03.016. Epub 2015 Mar 30. PubMed PMID: 25836921.^,2Funk JL, Oyarzo JN, Frye JB, Chen G, Lantz RC, Jolad SD, Sólyom AM, Timmermann BN. Turmeric extracts containing curcuminoids prevent experimental rheumatoid arthritis. J Nat Prod. 2006 Mar;69(3):351-5. PubMed PMID: 16562833; PubMed Central PMCID: PMC2533857.^,3Nakagawa Y, Mukai S, Yamada S, Matsuoka M, Tarumi E, Hashimoto T, Tamura C, Imaizumi A, Nishihira J, Nakamura T. Short-term effects of highly-bioavailable curcumin for treating knee osteoarthritis: a randomized, double-blind, placebo-controlled prospective study. J Orthop Sci. 2014 Nov;19(6):933-9. doi: 10.1007/s00776-014-0633-0. Epub 2014 Oct 13. PubMed PMID: 25308211; PubMed Central PMCID: PMC4244558.^,4G. Huang, Z. Xu, Y. Huang, X. Duan, W. Gong, Y. Zhang, et al. Curcumin protects against collagen-induced arthritis via suppression of BAFF production. J. Clin. Immunol., 33 (3) (2013), pp. 550–557 Researchers estimate that curcumin accounts for only about 3% of turmeric,⁵Tayyem RF, Heath DD, Al-Delaimy WK, Rock CL. Curcumin content of turmeric and curry powders. Nutr Cancer. 2006;55(2):126-31. PubMed PMID: 17044766. so a curcumin supplement is often recommended. Advocates suggest a daily dose of 200 to 1000mg of curcumin labeled as containing 95% curcuminoids.

See Turmeric and Curcumin for Arthritis

Ginger (Zingiber officinale). Recent research shows that ginger may work as an anti-inflammatory and help relieve symptoms in people with rheumatoid arthritis or osteoarthritis.⁶Ribel-Madsen S, Bartels EM, Stockmarr A, Borgwardt A, Cornett C, Danneskiold-Samsøe B, Bliddal H. A synoviocyte model for osteoarthritis and rheumatoid arthritis: response to Ibuprofen, betamethasone, and ginger extract-a cross-sectional in vitro study. Arthritis. 2012;2012:505842. doi: 10.1155/2012/505842. Epub 2012 Dec 31. PubMed PMID: 23365744; PubMed Central PMCID: PMC3546442.^,7Al-Nahain A, Jahan R, Rahmatullah M. Zingiber officinale: A Potential Plant against Rheumatoid Arthritis. Arthritis. 2014;2014:159089. doi: 10.1155/2014/159089. Epub 2014 May 27. Review. PubMed PMID: 24982806; PubMed Central PMCID: PMC4058601.^,8Bartels EM, Folmer VN, Bliddal H, Altman RD, Juhl C, Tarp S, Zhang W, Christensen R. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015 Jan;23(1):13-21. doi: 10.1016/j.joca.2014.09.024. Epub 2014 Oct 7. PubMed PMID: 25300574. A 100 to 225mg ginger capsule can be taken daily. For people who prefer not to take capsules, integrating a few tablespoons of fresh grated ginger into meals may also have an effect. People who take blood-thinning medication, such as warfarin (Coumadin), should avoid ginger because it can counteract the medication’s effects.

Watch: Video: The Best-Tasting Anti-Inflammatory Cocktail You've Never Tried

Fish Oil (Omega-3 fatty acids EPA and DHA). Fish oil contains Omega-3 fatty acids that have anti-inflammatory effects in people with rheumatoid arthritis as well as osteoarthritis and Sjogren’s syndrome. Many experts recommend eating seafood, such as salmon, mackerel, cod and mussels, which contain EPA and DHA. Smaller amounts of EPA and DHA are found in eggs, particularly Omega-3 fortified eggs. People who do not regularly eat fish or fortified eggs can take a daily fish oil capsule.

It is important to distinguish EPA and DHA Omega-3 fatty acids, which are found in most seafood, from ALA Omega-3 fatty acid, which is found in plant-based foods such as flax seeds and nuts. The body can convert ALA into EPA and DHA; however, eating foods containing ALA does not seem to be as effective as eating foods with EPA and DHA.⁹Talahalli RR, Vallikannan B, Sambaiah K, Lokesh BR. Lower efficacy in the utilization of dietary ALA as compared to preformed EPA + DHA on long chain n-3 PUFA levels in rats. Lipids. 2010 Sep;45(9):799-808. doi: 10.1007/s11745-010-3464-6. Epub 2010 Aug 24. PubMed PMID: 20734237.

See What Are Anti-Inflammatory Foods?

Glucosamine and chondroitin sulfate. Advocates believe glucosamine and chondroitin sulfate supplements promote cartilage formation and repair and reduce or prevent inflammation.

See Glucosamine and Chondroitin Sulfate Supplements for Osteoarthritis

Research regarding these supplements is mixed.¹⁰Sawitzke AD, Shi H, Finco MF, et al. The Effect of Glucosamine and/or Chondroitin Sulfate on the Progression of Knee Osteoarthritis: A Report from the Glucosamine/Chondroitin Arthritis Intervention Trial. Arthritis & Rheumatism, 2008; 58(10):3183–3191.^,11McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014 Mar;22(3):363-88. doi: 10.1016/j.joca.2014.01.003. Epub 2014 Jan 24. PubMed PMID: 24462672. Positive clinical studies show glucosamine and chondroitin sulfate supplements providing modest pain relief. It may be that these supplements work for some but not all people. Experts recommend people stop taking glucosamine and chondroitin supplements if they do not experience any benefit within 6 months. Glucosamine should be avoided by anyone allergic to shellfish, since it is derived from shrimp, crab and other shellfish.

The US Food and Drug Administration does not regulate supplements, so potency may vary from brand to brand and even batch to batch during manufacturing. (In addition to confounding consumers, this variability makes it difficult for researchers to evaluate supplements effectiveness in treating arthritis.)

People interested in taking a supplement to treat arthritis pain are advised to consult their doctors about specific types and brands. Consumers can also find out which brands are tested by independent laboratories to verify their purity. For example, manufacturers that list Good Manufacturing Practice or GMP on their labels attest that the products are pure and that they have made efforts to minimize or eliminate contamination and errors.

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