Rheumatoid arthritis (RA) is an inflammatory autoimmune disease affecting the function of previously healthy joints. This condition is characterized by joint swelling, pain, and stiffness, as well as fatigue, depression, and the breakdown of bone and cartilage. There is no cure for RA, but certain supplements are good for rheumatoid arthritis, helping target uncomfortable symptoms and manage inflammation to improve joint function and quality of life. (Source, Source)

Supplements for Rheumatoid Arthritis

Rheumatoid arthritis can cause pain along with a host of other symptoms, making the smallest of tasks difficult to achieve on a daily basis. Dietary supplements may help manage active disease by influencing how the immune system responds and reacts. The addition of natural supplements to your care plan may be beneficial for you, as their side effects are low or non-existent in comparison to prescribed antirheumatic drugs. The following is a list of natural supplements with anti-inflammatory properties to support the body and manage symptoms of rheumatoid arthritis. (Source)

Fish Oil

High in omega-3 fatty acids, fish oils have been shown to reduce inflammation in those with RA. Fatty fish such as salmon, mackerel, and tuna are high in omega-3s, but a fish oil supplement may provide a higher concentration of these fatty acids high in EPA and DHA. 

Fish oil supplements may improve pain levels while reducing the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in those with RA. If you are allergic to fish or shellfish or are prone to blood clots, fish oil may not be right for you. Side effects of liquid or gel cap fish oil supplements are usually mild as long as you’re not allergic, but may include:

• bad breath
• unpleasant taste
• heartburn
• nausea
• upset stomach
• diarrhea
• headache

(Source, Source)

Flaxseed Oil

Oil taken from the seed of the flax plant is high in  omega-3 fatty acids that may be helpful in reducing inflammation from RA. Flaxseed can be added to foods in many different forms, but is also available as a supplement in capsules, liquid, tablets, and powder. Flaxseed may interfere with other medications for blood clotting, blood pressure, oral contraceptives, and estrogen replacement therapy. Although flaxseed does not cause any side effects when taken in appropriate amounts, if consumed in excess there is a risk for:

• constipation
• intestinal blockage
• bloating
• gas
• diarrhea

(Source)

Probiotics

Research has led back to the gut microbiome as a factor in the onset and development of RA. Supplementing with probiotics can help keep your gut microbiome balanced by increasing beneficial bacteria for a more stable internal environment. Probiotics may help reduce inflammation stemming from intestinal permeability or leaky gut, to keep your immune system and overall health thriving. There are many strains of probiotics that can be helpful for managing specific conditions and improving gut health, so it’s best to talk to your provider about which strains might help keep your RA manageable. Probiotic strains that have been found to be helpful in reducing inflammation from RA include:

• Lactobacillus casei 
• Lactobacillus acidophilus
• Bifidobacterium

Most probiotics don’t cause side effects, but it is possible to experience some mild digestive upset when introducing them. (Source)

Vitamin D

Supplementing vitamin D has been shown to be effective in managing RA symptoms and improving disease indicators and prognosis. This fat soluble nutrient regulates genes in the immune system, possibly preventing onset of the disease as well as lowering occurrence.

The dosage and length of time you should take vitamin D will depend on your condition. Higher doses of vitamin D taken for a longer duration of time have been shown to reduce inflammation and produce different effects than lower doses taken for a shorter period of time. Side effects of supplementing too much Vitamin D can look like:

• nausea
• vomiting
• muscle weakness
• confusion
• pain
• loss of appetite
• dehydration
• excessive thirst and urination
• kidney stones/failure
• irregular heartbeat

 (Source, Source)

Turmeric

Curcumin is the active substance in turmeric that boosts its anti-inflammatory properties. Supplementing with turmeric may be beneficial in managing RA by reducing overall inflammation that drives RA, as well as regulating immune system response. In addition, curcumin has been shown to improve gut health as it is beneficial to healthy gut bacteria. The gut microbiome is an important piece in mediating your health with RA as gut dysbiosis has been linked to developing this autoimmune disease. Although rare, side effects of turmeric may include:

• diarrhea
• headache
• rash
• yellow stools

(Source, Source, Source)

S-Adenosyl-L-methionine (SAMe)

Not only does RA produce pain and swelling, but depression is common as well with this disease. S-adenosyl-L-methionine (SAMe) is naturally found in the body, but if you have a vitamin B12 or folate deficiency chances are high that you don’t produce enough SAMe. Lower levels of SAMe have been linked to depression and supplementation may help, as SAMe increases levels of neurotransmitters such as serotonin in the gut, which may improve your mood.

In the 1950’s SAMe was first used to manage osteoarthritis pain, but it was found to also improve depression symptoms as well in those with co-morbid illnesses such as RA. Note that SAMe has been found to not be absorbed well by itself, but absorption is improved if it is taken orally with additional vitamin B12, folic acid, and the essential amino acids methionine and trimethylglycine. The side effects of SAMe are low-risk but may include:

• upset stomach
• nausea
• irritability
• anxiety

(Source, Source, Source)

Borage Seed Oil

Borage seed oil is a plant medicine that has been used traditionally to manage RA and other degenerative diseases. This oil contains gamma linolenic acid (GLA) which is responsible for its anti-inflammatory action and support of joint structure and function. Rich in fatty acids, this oil fights joint inflammation as well as helping regulate the immune system. Borage seed oil may be applied topically or taken by mouth in a capsule. Side effects of borage seed oil that have been reported include:

• nausea
• indigestion
• headache
• rash
• possible drug interactions with other anti-inflammatory or anticoagulant medications

(Source, Source)

Boswellia (Frankincense)

Boswellia, or frankincense, has been used traditionally for its anti-inflammatory and anti-arthritic effects. This natural supplement can be taken orally in a tablet or capsule, or used topically in its essential oil form to improve symptoms of RA such as joint pain and inflammation. 

There is no standardized dosage of boswellia, and because it is manufactured by many different companies and added as an ingredient to other joint health and gastrointestinal support supplements, quality, strength, and efficacy will vary. Mild side effects of boswellia may include digestive upset such as:

• nausea
• diarrhea
• constipation

(Source, Source)

Resveratrol

Resveratrol is a powerful antioxidant polyphenol that is found in grapes and grape juice, red wines, and berries, and can be taken in liquid, capsule, or powder form as well. Resveratrol may help regulate the immune system and help protect and improve cellular function in those with RA. In terms of symptom management, this antioxidant reduces inflammation and may help relieve uncomfortable RA symptoms. Short term, this supplement does not appear to have any side effects. However, the higher the dose, the greater risk there is for experiencing side effects such as:

• nausea
• vomiting
• diarrhea
• liver dysfunction

(Source, Source)

Ginger

Ginger is a safe and generally well-tolerated means to improve RA symptoms, with some exceptions. By decreasing cytokine activity and inflammatory markers of RA, ginger may help manage pain and may be a good addition to your RA treatment plan.

Ginger has traditionally been used to reduce nausea and improve digestion, but supplementation with this spicy rhizome in higher doses may cause mild digestive upset that may be reduced by taking it with food and in lower doses. There is a risk of interactions with some medications, so proceed with caution if you are taking blood thinners or are on medication for diabetes or high blood pressure. Digestive side effects may include:

• heartburn
• diarrhea
• belching

(Source, Source)

Cat’s Claw

Cat’s claw is a Peruvian vine that has been noted for its anti-inflammatory, antioxidant, and immune regulating properties. The bark and root of this vine have been used by South Americans for hundreds of years for treatment of ulcers, inflammation, dysentery, fever, and — you guessed it — arthritis. Due to its anti-inflammatory properties, this supplement has been recommended to help relieve painful and swollen joints in those with RA, although research has not shown that it inhibits joint damage.

Dosage and whether or not this supplement is right for you should be discussed with your health care practitioner. Though cat’s claw has few and mild side effects, if you have other autoimmune diseases besides RA, you may want to avoid it due to how it stimulates the immune system. There has been little research on the side effects of cat’s claw, but they may include:

• dizziness
• nausea
• diarrhea

(Source)

Evening Primrose Oil

Evening primrose oil is derived from the seeds of the evening primrose, a plant that grows in North and South America, Europe, and Asia. Like borage seed oil, evening primrose oil is high in gamma linolenic acid (GLA) as well as omega-6 fatty acids, all of which help protect against inflammation. In fact, evening primrose oil may have even greater anti-inflammatory effects than borage seed oil. Research has shown that using evening primrose oil for RA may lead to reduced use of NSAIDs to manage painful symptoms. In addition, evening primrose oil may reduce the morning joint stiffness that is common with RA. This oil is safe and mostly well tolerated, but may include digestive side effects such as:

• abdominal pain
• fullness
• nausea

(Source, Source)

Rosehip

Rosehip, the fruit that remains after a rose bloom dies, is an herbal supplement that has anti-inflammatory properties. High in vitamin C and unsaturated fatty acids, this supplement may reduce inflammation, inhibit joint damage, and reduce morning joint stiffness and pain. Due to its high antioxidant content, rosehip may reduce not only damage to the joints but the breakdown of cartilage from RA as well. This supplement comes in capsule form and may include mild side effects such as:

• constipation
• diarrhea
• heartburn

(Source, Source)

Folic Acid

Disease modifying antirheumatic drugs (DMARDs) such as methotrexate are used to manage RA. Methotrexate’s adverse effects include depletion of folic acid (vitamin B9) from the body, which may cause nausea, vomiting, or pain in the abdomen, as well as blood and liver issues. If you are taking methotrexate to manage your RA, supplementing with folic acid may help reduce the risk and improve the negative symptoms associated with this drug. Though it is normal for patients with RA to be depleted in folic acid anyway, supplementing with folic acid will not reduce actual symptoms of RA. Side effects of supplementing with folic acid are usually mild and may include:

• nausea
• loss of appetite
• bad taste in the mouth

(Source, Source)

Iron

Iron is a mineral stored in your body and used to carry out many different functions such as carrying oxygen from the lungs to the rest of the body and providing energy to your muscles. Some diseases, including RA, may interfere with your body’s ability to store and utilize iron, which could result in anemia and require iron supplementation. Side effects of taking too much iron (especially without food) may include:

• constipation
• nausea
• abdominal pain
• vomiting
• diarrhea

• ulcers
• decreased absorption of zinc

 (Source)

Coenzyme Q10

Coenzyme Q10 is a substance naturally found in the body, though you may be lower in it than others if you have a disease such as RA. Due to its unique anti-inflammatory, anti-arthritic, and antioxidant properties, this supplement may help manage symptoms of muscle weakness and atrophy from RA. Coenzyme Q10 may interact with blood thinners, diabetes medication, and some cancer treatments, but otherwise, risk of side effects are low and may include: 

• insomnia
• digestive upset

(Source, Source)

Green Tea

Though green tea isn’t technically a supplement, it can be used medicinally due to the health benefits of its active component, epigallocatechin-3-gallate (EGCG). Therapeutic benefits for those with RA may include reduced inflammation and destruction of cartilage and bone, and protection from oxidative damage to cells. More research needs to be done regarding whether a cup of green tea is as potent as a capsule of concentrated EGCG would be, but findings are promising that joint functionality can be improved with the addition of EGCG. Green tea has not been found to be unsafe, but high doses of EGCG may be hard on your liver. (Source, Source)

Supplement Safety

When using supplements, it’s important to know that even though they are natural substances, they can interfere with medications and other supplements you may be taking. Working with a health care practitioner can be helpful in reducing or eliminating the risk of drug interactions, avoiding possible negative side effects, and dosing supplements appropriately for your condition. Introducing supplementation into your RA management plan can be helpful in reducing symptoms of active disease, but doing so safely with a skilled practitioner from the get-go is best. (Source)

Alternative Methods for Managing RA Symptoms

There are many different ways to manage RA symptoms. In addition to supplementation, you may also want to focus on anti-inflammatory foods such as those recommended in the autoimmune protocol (AIP) diet protocol. Supporting your body with therapeutic nutrition may be beneficial in managing systemic inflammation. Besides diet, other complementary additions to your RA treatment plan may include:

• meditation and mindfulness
• gentle movement such as tai chi or yoga 
• massage
• acupuncture

(Source, Source)

The Bottom Line on Supplements for Rheumatoid Arthritis

Rheumatoid arthritis can be painful and come with a slew of symptoms, but fortunately taking natural supplements may be one effective means to manage this disease among many other alternative methods. There is no cure for RA, but supplements may be a good fit to your care plan to reduce painful joint swelling and inflammation, fatigue, depression, and wear and tear on joints to improve quality of life. If you are considering making some changes to experience a reduction in symptoms, the WellTheory 1-1 coaching membership can help take the guesswork out of it. Working with a Nutritional Therapy Practitioner can provide hands-on guidance so you can identify a dietary approach to support your condition. If you’re ready to make some nutrition changes WellTheory can help with a personalized nutrition and lifestyle plan that supports the healing process.