Should you turn to herbs, supplements, and vitamins?
Before your rheumatoid arthritis (RA) prescription medication reaches your hands, it’s gone through medical research. It’s also gone through clinical trials, and its effectiveness and safety have been approved.
The Food and Drug Administration (FDA) doesn’t approve dietary supplements like herbs, minerals, and vitamins. But some people do report temporary relief from their RA symptoms when using complementary therapies.
Healthline put together a guide on herbs, supplements, and vitamins for RA symptoms that includes information on the most scientifically researched remedies and up-and-coming treatments. There is also information about:
- what symptoms these treatments help manage
- what research says about their effectiveness
- any potential side effects
The alternative treatments covered in this guide shouldn’t replace your current medications. Always talk to a doctor before trying any herbs, supplements, or vitamins. Some remedies can cause serious side effects or mix with your current medications.
Also be sure to check you are purchasing these products from reputable sources. Since the FDA doesn’t regulate herbs, supplements, and vitamins, contamination is possible.
These supplements have proven
Borage oil (Borago officinalis)
What does it do? Borago officinalis, also known as starflower, is an herb that has gamma-linolenic acid (GLA). GLA is an omega-6 fatty acid that is essential for joint structure and function.
Does it work? Some older studies show that borage seed oil can help RA symptoms. A 2001 study found that borage oil reduces RA activity. A 2014 study looked at reduction of disease activity in people who took six borage seed oil capsules and seven sunflower or fish oil capsules per day.
Dosage: Taken in capsule form, borage oil may reduce joint tenderness and inflammation. The Arthritis Foundation recommends 1,300 milligrams of oil daily. Side effects include headache and constipation. Talk to your doctor before taking the supplement.
Cayenne pepper (Capsicum spp.)
What does it do? Cayenne pepper has a long history of medicinal use as a digestive aid. Today it’s used more widely to treat pain. The active substance, capsaicin, blocks your nerve cells against a chemical that sends pain messages.
Does it work? This herb is a known topical treatment for reducing pain. A review of capsaicin recognizes that higher concentrations (8 percent) can help with pain management.
Dosage: You can find capsaicin in topical creams for minor aches and pains. The Mayo Clinic recommends using capsaicin creams several times a day. You may need to wait two to three weeks before you feel the effects. The Arthritis Foundation also recommends cayenne peppers as part of your anti-inflammatory diet.
Cat’s claw (Uncaria tomentosa)
What does it do? Cat’s claw originates in the South American rainforests. Scientists have investigated the plant’s anti-inflammatory properties for its effectiveness in relieving joint pain, swelling, and morning stiffness.
Does it work? One human trial on the effectiveness of cat’s claw and RA found that 53 percent of participants taking the supplements reported decreased pain compared to 24 percent of the placebo group. The participants took cat’s claw alongside their medications. Larger studies are still needed to confirm the benefits of cat’s claw.
Dosage: The Arthritis Foundation recommends 250-350 mg every day for immune support. Cat’s claw produces very few side effects. Some people report upset digestion.
Evening primrose (Onagraceae)
What does it do? Evening primrose is a common herbal medicine for many conditions, from RA to menstrual concerns. This wildflower has 7 to 10 percent GLA, the same fatty acid that makes borage oil effective. It’s also known for its protective and anti-inflammatory properties.
Does it work? Arthritis Research UK ranks evening primrose as effective. Evening primrose oil is rich in GLA, which helps your immune system and joints function. But studies on evening primrose and RA are older, and research isn’t conclusive.
Dosage: You can take 540 mg of this oil twice per day, every day. It may take six months to feel the effects. Evening primrose oil may cause side effects like nausea, diarrhea, and rashes. Don’t take this oil if you have epilepsy.
What does it do? Omega-3 fatty acids, the primary component in fish oil, are healthy fats that your body needs. Omega-3 may help prevent chronic inflammation and ease symptoms associated with arthritis pain. Fish high in omega-3 include herring, mackerel, and tuna.
Does it work? A 2013 study found taking fish oil resulted in greater remission rates of RA symptoms than in a control group that didn’t take fish oil. There are many other health benefits of omega-3 fatty acids. But it’s hard to get enough fish oil from food alone.
Dosage: The Arthritis Foundation recommends 2.6 grams of fish oil twice per day. But more than 3 g of fish oil per day can increase your risk for bleeding. Talk to your doctor if you are taking anticoagulants. Pregnant women should also avoid eating too much fish as it could contain dangerous levels of mercury.
Turmeric (Curcuma longa)
What does it do? Turmeric has been used in Ayurvedic and Chinese herbal medicine for over four thousand years. The active ingredient in turmeric is curcumin. It’s been shown to be anti-inflammatory, which can help with decreasing RA swelling and tenderness.
Does it work? A small study published in the AAPS Journal found that a product made from turmeric, called BCM-95, was more effective in reducing pain and swelling in patients with RA than taking the RA medication diclofenac. Larger-scale studies are needed to confirm this benefit.
Dosage: You can introduce turmeric into your diet through teas, curries, and as a spice. It’s also available as a supplement called curcumin. The recommend dose is 500 mg twice per day. Curcumin is generally safe and low in toxicity.
Ginger (Zingiber officinale)
What does it do? Ginger is a common herb people use to treat everything from colds and digestion to migraines and hypertension. It’s known for its anti-inflammatory effects that are similar to ibuprofen. If you experience nausea or vomiting due to current medication, ginger may also help alleviate those side effects.
Does it work? Evidence for ginger as a medication for RA continues to be researched. A recent study suggests that ginger has the potential to help RA symptoms as well as the condition itself. It may also have additional protective effects on the joints.
Dosage: The fresh root is available in grocery stores and can be brewed into tea. You can drink up to four cups of ginger tea per day. It can also be easily found in supplement form. People who take blood thinners or who have gallstones should not take ginger due to risk of unwanted side effects.
Green tea extract
What does it do? Beyond being a tasty beverage, green tea is a centuries-old herbal remedy high in antioxidants. It’s traditionally been used as a diuretic to promote digestion and improve heart health.
A recent study on rats found that green tea may have an active compound that reduces inflammation and swelling. Green tea is high in catechins, a compound with antirheumatic activity.
Does it work? Another recent study looked at people with RA who drank green tea for six months. The participants also took part in a moderately intensive exercise program where they walked on a treadmill for 45-60 minutes three times a day. The study found that green tea and exercise were effective in decreasing RA symptoms.
Dosage: Drink four to six cups of green tea per day. But always check with a doctor before introducing green tea into your diet. Green tea is known to interact with some medications negatively.
These supplements show promise
Celery seed (Apium graveolens)
What does it do? Celery seed has been used for thousands of years to treat everything from colds, digestion, and arthritis, to conditions related to the liver and spleen. Today it’s used mainly as a diuretic.
Does it work? It has gained some support as an effective treatment for arthritis and gout, but there haven’t been any human trials conducted. Researchers have conducted rat studies that show celery seed extracts have an anti-inflammatory effect. A dose of 100 mg per kilogram of celery seed extract has an effect similar to 300 mg/kg of aspirin.
Dosage: Ask your doctor about the dosage for celery seed oil. It’s possible for it to interact with medications you’re taking. You’ll also want to keep celery seed oil out of a child’s reach.
King of bitters (Andrographis paniculata)
What does it do? The king of bitters plant is native to Asia and is widely cultivated. It is known for its anti-inflammatory, anti-viral, antioxidant, and antibacterial properties. It’s been used in traditional medicine to treat upper respiratory infections, infectious diseases, and fevers.
Does it work? Research shows that this herb has potential to treat RA symptoms. One study found that people who took the herb reported some improvement in swollen joints and mobility. But compared to the placebo, there was no statistical difference. Larger-scale and longer studies are needed to confirm this herb’s effectiveness.
Dosage: The herbal remedy can be found most readily in tablet form. The study above had people take 30 mg three times per day. Potential side effects include headaches, fatigue, and nausea.
What does it do? This plant-based flavonoid is responsible for giving many flowers, fruits, and vegetables their color. Quercetin has potent antioxidant and anti-inflammatory properties, and may benefit those with RA.
Does it work? Researchers suggest in a study, published in the African Journal of Traditional, Complementary, and Alternative Medicines, that quercetin can help regulate inflammation reactions and may be a potential drug for RA. A 2015 study designed to measure the effects of quercetin dosages found that quercetin reduced molecules involved with inflammation.
Dosage: People with RA found benefits when they took 1,500 mg of quercetin with 100 mg of azathioprine. Talk to your doctor before mixing supplements with mediation. Quercetin has few side effects, although it may interact with some medications.
Rosemary (Rosmarinus officinalis)
What does it do? This Mediterranean shrub has been widely used as a food spice and fragrance in cosmetics. Rosemary has also been praised for its medicinal benefits like relieving muscle pain and treating indigestion. Rosemary also contains antioxidants, which can help to reduce inflammation in the body.
Does it work? There are no studies on rosemary as a remedy. A 2005 pilot trial looked at the effects of a treatment that had rosemary extract. People with RA took 440 mg of the drug three times per day for four weeks. Results found a 40-50 percent decrease in pain.
Dosage: You can try applying rosemary oil topically. But you should talk to your doctor before trying rosemary as a supplement.
Thunder god vine (Tripterygium wilfordii)
What does it do? Thunder god vine is native to China, Japan, and Korea. The extract, which comes from the root of this plant, is supposed to reduce pain and inflammation.
Does it work? The National Center for Complementary and Integrative Health notes that thunder god vine may help RA symptoms. A 2014 study done in China found that taking thunder god vine with the medication methotrexate was better than taking the medication alone.
Dosage: Thunder god vine can be toxic if taken incorrectly. Talk to your doctor about the dosage. This herb can cause serious side effects, including diarrhea, upper respiratory infections, and skin rash.
White willow bark (Salix alba)
What does it do? The bark of white willow has been used to treat inflammation for thousands of years. Salix species are credited as the natural source of aspirin.
Does it work? There is evidence that the active ingredient in willow, salicin, reduces the production of pain-inducing chemicals in nerves. According to the journal Phytotherapy Research, laboratory trials showed willow bark was more effective than chamomile and meadowsweet in reducing inflammatory compounds associated with RA.
Dosage: As with aspirin, willow bark can interact with certain drugs, including anti-inflammatories and anticoagulants. Willow bark can cause stomach upset and allergic reactions. Always talk to your doctor before taking willow bark.
These supplements need more
research and trials
Boswellia (Boswellia serrata)
What does it do? The scrubby tree Boswellia serrata is native to India and Pakistan. It has a long history of medicinal use. The bark, also known as Indian frankincense, produces a sticky resin that has anti-inflammatory properties. Boswellic acids are thought to interfere with leukotrienes, which cause inflammation in the body.
Does it work? There is little scientific evidence to show boswellia is effective for people with RA. There have been no human trials yet. Researchers have only conducted laboratory and animal studies. But The British Medical Journal reviewed relevant studies and noted the herb shows promise for RA.
Dosage: You can take boswellia as a capsule or tablet. The Arthritis Foundation recommends 300-400 mg three times per day. Talk to your doctor before trying this supplement.
Green lipped mussel (Perna canaliculus)
What does it do? Green-lipped mussel is native to New Zealand. It can be used as a nutritional supplement. It contains omega-3 fatty acids, which may help reduce inflammation associated with arthritis.
Does it work? Study results are mixed on its effectiveness. Arthritis Research UK claims the supplement has no effect on relieving RA pain. The Arthritis Foundation highlighted several trials where taking green lipped mussel reduced pain.
Dosage: The Arthritis Foundation recommends taking 300-350 mg three times per day. Green lipped mussel may be healing to the stomach. So, it can be an alternative for those who can’t take NSAIDS because of ulcer-causing effects. People with seafood allergies should also avoid this supplement.
Pau d’Arco (Tabebuia avellanedae)
What does it do? The bark of the South American evergreen tree has been traditionally used to treat arthritis, fever, and different cancers. Anecdotal reports have identified anti-inflammatory, antifungal, antiviral, and antibacterial properties.
Does it work? There have been no human studies on its effect on arthritis pain. How it works is only starting to be understood. A recent study found this bark has significant effects on inflammation responses. It may be an alternative for people who can’t take Tylenol.
Dosage: Pau d'arco can be taken as a supplement pill, dried bark tea, or a tincture made with alcohol. Taken in large amounts, Pau d'arco can be toxic. Talk with your doctor before taking Pau d'arco. There have not been enough studies to understand its toxicity and effects.
Rehmannia or Chinese foxglove (Rehmannia glutinosa)
What does it do? Chinese foxglove is an ingredient in traditional Chinese medicine (TCM). It’s used to treat conditions including asthma and RA. Chinese foxglove is rich in amino acids and vitamins A, B, and C. Its anti-inflammatory properties may also be effective in reducing joint pain and swelling.
Does it work? There aren’t any major studies to support whether it works. Because it’s often added to other herbs, researchers have difficulty pinpointing Chinese foxglove as effective.
Dosage: There have been very few human studies showing Chinese foxglove is a safe and effective treatment. You should talk to your doctor before trying this herb. The FDA has not given Chinese foxglove a safe rating.
Supplements to avoid
The Arthritis Foundation also recommends avoiding these supplements due to their side effects:
- autumn crocus
- kombucha tea
Other treatments for common RA symptoms and complications
The following remedies aren’t directly meant for RA symptoms. But they may still benefit your health.
What does it do? Bromelain is an active enzyme found in pineapples. This enzyme has anti-inflammatory effects that can help with indigestion and pain relief. Bromelain’s primary use is to reduce inflammation caused by infection. It may also help arthritis pain, swelling, and mobility.
Does it work? A recent study on rats shows pineapple juice can decrease inflammation. But there are no new studies on bromelain and its effect on RA in humans.
Dosage: Researchers suggest pineapple juice can be a good dietary addition, but read the label before purchasing. Most pineapple juices have a lot of added sugar. The Arthritis Foundation recommends 500-2000 mg of bromelain supplements three times per day between meals. Avoid bromelain supplements if you have pineapple allergies or are taking blood thinners.
What does it do? Many RA medications contribute to bone loss (osteoporosis) or increase your risk of bone loss. Inactivity from inflammation and pain can also cause bone health to deteriorate. A calcium-rich diet and a supplement are important parts of RA management.
Does it work? Calcium supplements aren’t meant to treat pain. They help your body maintain bone density and reduce the likelihood of having a bone break. Dark green leafy vegetables, low-fat dairy products, and calcium-fortified beverages should all be part of a daily diet.
Dosage: The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Institute of Health (NIH) recommend a 1,000 mg supplement for all adults under the age of 50, and 1,200 mg for women over 50 and men over 70. Talk to your doctor before taking calcium supplements, especially if you have excess calcium in your blood. Some side effects include gas, constipation, and bloating.
Chamomile (Chamomilla recutita)
What does it do? Chamomile tea is praised for its anti-inflammatory properties and sedative effects. Taken internally, chamomile may be effective at healing sore or irritated skin. It may also improve:
- rheumatic pain
- gastrointestinal disorders
Does it work? There are only lab studies about chamomile tea and RA. One lab study found that chamomile has an inflammatory effect on tumor necrosis factor and interleukin. These two compounds are associated with RA inflammation. A 2013 lab study on chamomile tea and RA suggests that it has potential as a pain reliever.
Dosage: It’s recommended to drink seven to eight cups of tea throughout the day to prevent against infections. Chamomile has low toxicity. People who are allergic to ragweed and chrysanthemums may want to avoid chamomile.
What does it do? Vitamin D significantly contributes to joint and bone health. It also helps to regulate calcium metabolism in the body.
Does it work? According to the journal Therapeutic Advances in Endocrinology and Metabolism, low levels of vitamin D can contribute to the onset and progressive symptoms of RA. The more significant the deficiency, the more severe RA symptoms could be.
Dosage: Making sure you get outside in the sunshine may help. But being outdoors isn’t enough to provide the body with its daily vitamin D requirement. Food sources of vitamin D include salmon, canned tuna fish, and fortified milk.