By presidential proclamation, we're living in the National Bone and Joint
Decade, 2002-2011, and that means we should be seeing a surge in research into
causes and treatments of arthritis and other diseases.
Meanwhile, many people with osteoarthritis (OA) and rheumatoid arthritis
(RA) seek relief by buying the latest book or nutritional supplement claiming
to relieve or cure arthritis, or they take advice from a neighbor who swore
that eating gin-soaked raisins eased her symptoms.
Symptoms of osteoarthritis may include joint pain and progressive stiffness that develops gradually.
Symptoms of rheumatoid arthritis may include painful swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in the same joints on both sides of the body, especially upon awakening.
Symptoms of infectious arthritis may include fever, chills, joint inflammation, tenderness, and sharp pain that is associated with an injury or infection elsewhere in your body.
How do you navigate this gray area of unregulated therapies to know if what
you're doing can help or harm? WebMD talked with two experts who provided
insight into the claims made for arthritis diets and supplements. Hayes Wilson,
MD, is a rheumatologist in Atlanta and medical adviser for the Arthritis
Foundation. Christine Gerbstadt, RD, MD, practices in Pittsburgh and is a
spokeswoman for the American Dietetic Association.
Here's a guide to help you sort fact from fiction:
Eliminate nightshades. One of the most common diet claims
is that eliminating nightshades, which include potatoes, tomatoes, eggplants,
and most peppers, relieves arthritis. This diet probably isn't harmful, but
there are no studies to support it.
Alkaline diet. The alkaline diet presumes both OA and RA
are caused by too much acid. Among the foods it excludes are sugar, coffee, red
meat, most grains, nuts, and citrus fruits. It's meant to be followed for just
one month. It may be that people feel better because they lose weight, reducing
stress on joints, which eases pain. There are no studies to support it.
Dong diet. This restrictive diet relies heavily on
vegetables, except tomatoes, and eliminates many of the same foods as the
alkaline diet. There's no evidence it affects arthritis.
Vegetarian diet. Some people report improvement in
symptoms, but evidence is mixed. One small study of people with RA showed
improvement in four weeks, and follow-up studies of those who stayed on the
diet showed continued improvement after one and two years.
Switching fats. One of the known correlations between food
and arthritis is that omega-6 fatty acids increase inflammation, and omega-3
fatty acids reduce it. Limit intake of meat and poultry, and increase your
intake of cold-water fish, such as sardines, mackerel, trout, and salmon. For
salad dressings and cooking, substitute olive, canola, and flaxseed oils for
corn, safflower, and sunflower oils.
Gin-soaked raisins. Lots of people claim it works, but
experts say there's no evidence. Grapes and raisins do contain
anti-inflammatory compounds, but not in amounts that would be therapeutic. The
gin might dull pain, but drinking to excess sabotages health benefits of
nutrients and vitamins, and introduces a whole new set of problems.
Green tea. Drinking three to four cups of green tea a day
could help people with RA. Studies funded by the Arthritis Foundation showed
that giving the polyphenolic compounds in green tea to mice significantly
decreased the incidence and severity of RA. Human studies have not yet
confirmed the results.
ASU (avocado-soybean unsaponifiable). French studies of
ASU, derived from avocado and soybean oils, show it can relieve OA pain,
stimulate cartilage repair, and lower a patient's need for nonsteroidal
anti-inflammatory drugs (NSAIDs) to control pain. Jason Theodosakis, MD, author
of The Arthritis Cure and champion of glucosamine chondroitin, believes ASU
will have a major impact on treatment of OA. Sold in France by prescription
under the name Piascledine 300, it's available in the U.S. without a
Black currant oil. See GLA.
Borage oil. See GLA.
Boron. Population studies show that people who have
high-boron diets have a very low incidence of arthritis, and there's evidence
that people with OA and RA can benefit. The best sources of boron are fresh
fruits and vegetables and, depending on where you live, drinking water.
Bovine cartilage. Taken from the windpipe and trachea of
cows, it's supposed to act as an anti-inflammatory agent in the treatment of OA
and RA. A few animal and laboratory studies are promising, but there are no
human studies to support claims. Researchers also think it may promote regrowth
Bromelain. This substance found in pineapple is supposed
to relieve pain and swelling in OA and RA and improve mobility. There are no
studies that show it's effective by itself, but one study of a bromelain
supplement containing the enzymes rutin and trypsin relieved pain and improved
function in 73 people with knee OA. The effect was similar to taking an
CMO. It's touted as an "arthritis cure," but
there's no human clinical evidence to support it.
Chondroitin sulfate. Used for many years in Europe to
relieve OA pain, it's been shown to stop joint degeneration, improve function,
and ease pain. One study followed patients with OA in finger joints for three
years, and showed fewer patients developed further cartilage damage. It can
take two months or more to realize the effects of chondroitin.
DMSO. Once widely used to relieve joint and tissue
inflammation, it fell out of favor when animal studies showed high doses
damaged the lens of the eye. Don't use it without consulting your doctor.
Evening primrose oil. See GLA.
Fish oil. Studies show it relieves the pain of RA.
Flaxseed. There are many good nutritional reasons to add
it to your diet, but studies of its effect on arthritis have shown mixed
results. Its anti-inflammatory properties work best if other vegetable-based
oils are restricted.
GLA. Gamma linolenic acid (GLA) is an omega-6 fatty acid
the body uses to make anti-inflammatory agents, unlike other omega-6 fatty
acids that actually increase inflammation. It's found in evening primrose oil,
black currant oil, and borage oil supplements. Several studies show it relieves
the stiffness and pain of RA. In one study, some patients were able to quit
Ginger. It's known to have painkilling and
anti-inflammatory agents. Ginger is believed to reduce joint pain and
inflammation in people with OA and RA, and protect the stomach from
gastrointestinal effects of NSAIDs. A clinical study showed ginger reduced knee
Glucosamine. As glucosamine hydrochloride or glucosamine
sulfate, this supplement relieves symptoms for many, but not all, people with
OA. It helps the body build and repair cartilage. In a double-blind study,
glucosamine sulfate was as effective in relieving symptoms in patients with
knee OA as ibuprofen and had fewer side effects. It takes about two months to
realize the effectiveness of this supplement. And it's derived from crab,
lobster, or shrimp shells, so check with your doctor before taking any kind of
glucosamine if you are allergic to shellfish.
Glucosamine chondroitin. Many OA patients get relief by
taking glucosamine and chondroitin together, but it's not known whether the
combination is more effective than taking them alone. That's the subject of a
National Institutes of Health (NIH) study called GAIT (glucosamine/chondroitin
arthritis intervention trial) now under way. The research shows how effective
the supplements are in terms of improving functional ability and reducing pain
in people with knee OA. Results are expected to be published in 2005.
MSM. It's widely touted for relief of pain and
inflammation. Its safety and effectiveness have yet to be determined.
SAM-e. Many European studies over the last 20 years show
SAM-e is as effective as anti-inflammatory painkillers in treating OA but with
fewer side effects. It works in conjunction with vitamin B-12, B-6, and folate.
Claims that SAM-e repairs and rebuilds cartilage lack evidence, as studies have
been done only in the lab and in animals.
Shark cartilage. Ground-up cartilage from Pacific Ocean
sharks is supposed to relieve the inflammation and pain of arthritis. Animal
and lab studies are promising, but there are no human studies to support
claims. Researchers also think it may promote regrowth of cartilage.
Stinging nettle. Taken orally or applied to the skin,
stinging nettle is supposed to reduce the pain and inflammation of OA. Some
studies show that patients can lower their dosages of NSAIDs by taking stinging
nettle in extract form. Two small studies showed stinging nettle applied
topically reduced pain for people with hip OA and thumb joint pain.
Turmeric. This supplement is used in traditional Chinese
and Indian Aruyvedic medicine to relieve pain, stiffness, and inflammation of
OA and RA. A small study that combined turmeric, boswellia, and zinc showed
decreased pain in OA. Two studies using a combination of turmeric, boswellia,
ginger, and aswangandha relieved pain and inflammation in RA. Its effectiveness
alone is unknown.
Wild yam. Although it contains natural anti-inflammatory
steroids, it is likely they're not in a form the body can use.