Chronic inflammation that continues after an acute threat (such as a burn or bacterial or viral illness) has been resolved is the hallmark of chronic health conditions, including autoimmune diseases. While short-term inflammation can help the body heal from injuries, the long-term lack of immune system regulation can cause internal havoc, provoking symptoms ranging from fatigue, pain, susceptibility to illnesses, and mood instability to tissue and organ damage. As you may know, managing an autoimmune condition involves supporting a stressed mind and body. Thankfully, several dietary supplements, sometimes called nutraceuticals, can help you do just that.

In this article, we will review a few promising anti-inflammatory nutraceuticals on the market and give some pointers on how to find quality, verified supplements. As always, this article is not a substitute for individualized medical advice and you should always check in with your trusted health providers before starting something new.

What Is Autoimmune Inflammation?

As mentioned above, inflammation is a normal immune system response intended to get rid of a threat in the body. However, inflammation can become chronically activated by oxidative stress (which is also a normal part of an immune response when short-term) when the immune system is not signaled to regulate, or stop the attack. In autoimmune conditions such as systemic lupus erythematosus (SLE), multiple sclerosis, and rheumatoid arthritis, chronic inflammation and oxidative stress can affect multiple body organs. Damage can also target specific organ tissues, such as with Hashimoto’s thyroiditis and inflammatory bowel diseases. (Source, Source, Source)

Anti-Inflammatory Supplements for Autoimmune Disease

The immune system requires a lot of energy and specific nutrients to function, especially when chronically activated. In addition to a nutrient-dense eating plan, such as an anti-inflammatory diet, there may be benefits to increased amounts of some nutrients and enzymes, such as vitamin D, coenzyme Q10 (CoQ10), and omega-3 fatty acids, which tend to be lower in those with autoimmune conditions. This is due to depletion from chronic inflammation and oxidative damage. For some people, genetic variations in metabolism that are more common in those with autoimmune conditions can also influence specific nutrient needs. While genes are not your destiny, they do play a role in your individualized nutrient needs. (Source, Source, Source, Source, Source)

Prescribed medications can be important tools to support healing from your illness. However, they also present some challenges. Immunosuppressants, for example, increase vulnerability to bacterial and viral infections. This has encouraged more research on dietary supplements — sometimes referred to as nutraceuticals — to help lower chronic inflammation without harmful side effects or risks. (Source)

While vitamins are some of the best-researched anti-inflammatory supplements, others such as botanicals support immune function and address more than one inflammatory pathway. Supplements such as omega-3 fatty acids can even provide natural alternatives to NSAIDs. Following is what we know about a few nutraceuticals that can help to put inflammation in check and rebalance a body on high alert.

Coenzyme Q10

Coenzyme Q (CoQ10) is an enzyme found in the membrane of every cell and tissue in the body, including cells’ mitochondria (structures inside cells referred to as the “powerhouses of the cell”). Essentially, the mighty mitochondria require CoQ10 to function. CoQ10 facilitates mitochondrial energy production, stabilizes the cell when there is trouble, helps protect the cell from oxidative damage, and is involved in controlling inflammation-related genes. Mitochondrial dysfunction is linked to autoimmunity and the body’s ability to repair tissue, regenerate cells, and control inflammation.  (Source, Source)

Half the body’s needs of CoQ10 are provided by diet (such as in meats), while the other half is made internally in cell membranes. However, autoimmune conditions and other conditions  associated with high levels of oxidative stress are connected to lower levels of this important enzyme.

Clinical studies have shown that supplementation of 200 mg per day of ubiquinol (the most absorbable form of CoQ10) reduced markers of inflammation, oxidative stress, the expression of inflammation-causing genes, and disease activity in systemic autoimmune conditions. Additionally, CoQ10 may provide support for cardiovascular health in particular and may have a role in viral infection recovery. (Source, Source)

Curcumin

Turmeric (Curcuma longa) has been used medicinally for thousands of years. Known as a popular culinary spice in Indian and Middle Eastern cuisines, turmeric’s anti-inflammatory properties are primarily due to its biologically active polyphenolic compound curcumin. Curcumin taken by mouth has limited ability to be taken up and used in the body, though, and research is ongoing into ways to overcome this challenge. For example, the bioavailability of curcumin may be increased by as much as 2,000% when it is taken together with piperine, a bioactive compound in black pepper, although this poses a risk of toxicity with long-term use. (Source)

Curcumin can help cells adapt to stress, shift from inflammatory to anti-inflammatory states, and increase the number of regulatory immune system cells (something extra beneficial for those with autoimmune conditions). Clinical studies show that curcumin can lower levels of C-reactive protein, a marker of inflammation, as well as several inflammatory immune cells and oxidative stress markers. (Source, Source)

Studies on curcumin’s effect on inflammatory conditions have found that supplementation is associated with decreased relapses, lower disease activity, and need for fewer medications in inflammatory bowel diseases, and decreased joint pain and stiffness and disease activity scores in rheumatoid arthritis. Additionally, supplementation of 500 mg per day has been linked with a reduction of symptoms of depression and lower levels of cholesterol and triglycerides. (Source, Source)

Vitamin D

Vitamin D acts both as a hormone and as a nutrient in the body. It has an important role in facilitating and directing the immune system, including anti-inflammatory responses. In fact, vitamin D regulates over 200 genes in the body, including those related to immune function and response to stress, both of which have roles in inflammation. Vitamin D deficiency is common in those with autoimmune conditions, and a low level of vitamin D is considered a risk factor for development of autoimmunity. (Source, Source, Source)

We know that vitamin D deficiency in winter months is common due to decreased exposure to sunlight. Less commonly known is that there can be genetic differences in how vitamin D is absorbed in the body. Activation of vitamin D requires specific enzymes and receptors that can be altered in some individuals. Additionally, vitamin D is fat-soluble, meaning its absorption is enhanced when consumed with dietary fat; too little fat in the diet could limit vitamin D absorption. (Source, Source, Source)

It is reported that most people in the United States consume significantly less than the recommended amounts of vitamin D from fortified foods and fatty fish. Given that deficiencies are higher in those with autoimmune conditions, vitamin D supplements are likely beneficial. The general recommended dietary allowance (RDA) of vitamin D for most adults is 15 mcg, or 600 IUs (international units) per day. However, these recommendations do not consider genetic differences or deficiency levels. Individual needs vary, and you should check in with your health provider before supplementing with high doses of any nutrient. (Source, Source, Source)

Lemon Balm

Lemon balm, or Melissa officinalis, may not be an expected anti-inflammatory choice, but the multiple benefits of lemon balm make this a wise addition to any autoimmune medicine cabinet.

Botanicals like lemon balm have dynamic plant properties with different actions in the body that make them challenging to study or isolate; however, research is slowly increasing. Lemon balm has been used for thousands of years around the world for gastrointestinal symptoms, pain relief, wound healing, and bacterial and viral infections. Studies have shown it’s particularly useful for neurological disorders, including anxiety and memory impairment. (Source, Source)

A closer look reveals that lemon balm does indeed carry anti-microbial, anti-tumor, anti-oxidant, anti-inflammatory, antispasmodic, and anti-viral properties in its essential oil, polyphenols, flavonoids, and terpenes. Of note, lemon balm’s antiviral properties can inhibit virus attachment to human cells in COVID-19 and treatment-resistant herpes viruses. This may be of particular importance to autoimmune conditions since viral triggers can initiate chronic immune activation and inflammation responses. (Source, Source, Source)

N-Acetylcysteine

N-acetylcysteine (NAC) is an essential drug according to the World Health Organization, especially for the treatment of acetaminophen toxicity and associated liver failure. However, NAC has the potential to support a much wider gamut of imbalances. (Source)

Glutathione is the most important antioxidant needed for normal detoxification processes, including neutralizing free radicals that can cause oxidative damage in the body. Glutathione can be commonly depleted in autoimmune conditions, and low levels are associated with lower innate immune responses to viral infection and inflammation. The unique chemical makeup of NAC can address oxidative stress and also help regulate inflammation. The most recent research with NAC shows it may be of benefit in reducing symptoms of viral infections, including COVID-19. (Source, Source)

Depleted glutathione levels and mitochondrial oxidative stress have been found in those with SLE, a systemic autoimmune condition. Several small human studies show that NAC can improve fatigue and lower disease activity in those with SLE, which is proposed to be related to the ability of NAC to activate the synthesis of glutathione in the body and protect the microbiome and organs from ongoing oxidative stress and damage. (Source)

Another small placebo-controlled study with people with rheumatoid arthritis also showed lower disease activity and lower erythrocyte sedimentation rate, a lab used to evaluate inflammation, in those who supplemented with NAC. These studies are promising and indicate the benefit of NAC for inflammatory autoimmune conditions; however, larger-scale studies are needed. (Source)

How to Tell if a Supplement Is High Quality

Dietary supplements are not regulated by the FDA, which means there is a certain amount of consumer risk when buying and taking them (as may be true with other things that are FDA-approved). It is possible, for example, for a supplement to not be what it says it is, or to make false claims about its potency. We recommend verifying the quality of supplements before purchasing them. Here are a few quick tips for doing this:

• Look for a seal that indicates the product was produced following World Health Organization (WHO) current Good Manufacturing Practice (cGMP).
• Look for a seal or statement about third-party testing or verification, such as NSF. For herbal products, look for a US Pharmacopeia (USP) seal. These are independent scientific nonprofits that set quality assurance standards and verify ingredients and claims of natural supplements.
• Purchase supplements from a distributor that verifies their products or only sells cGMP products. For example, only buy directly from a supplement company that indicates this, or from a distributor such as FullScript.

For more information on supplement verification, check out these third-party testing groups for searchable tools. Keep in mind that even when a product is third-party tested, you should still run changes by your health provider to ensure that it is the right supplement for you.

• NSF Supplement and Vitamin Certification Tool
• Consumer Lab

The Bottom Line

The nutraceutical toolbox is plentiful, so we encourage you to explore not just these options, but also those outside this list. Many botanical herbs have been found to support lower inflammation levels, as have essential nutrients that haven’t been covered in this article. Just as with medication, supplements can be important in your recovery process, but they are not the only tools — lifestyle changes such as diet and stress reduction are foundational changes you can make. One step at a time, WellTheory can help get you there.