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Supplements

Many people take supplements to help relieve pain and other symptoms. But talk with your doctor first -- some can cause side effects or interfere with other meds. Track any supplements you take and note which help your symptoms.

Do Your Homework

Supplements may help some people ease pain or other symptoms. However, they are not regulated by the FDA in the same way drugs are; manufacturers are not required to show their products are safe or effective. So it's important to learn all you can about a supplement before you decide to take it. Also, be sure you talk with your doctor before starting a new supplement -- some supplements can cause side effects and interact with medications.

Select USP or NSF

The FDA does not regulate supplements in the same way as medications. But a few nonprofit organizations review supplements for overall quality of the ingredients and brand credibility. Before you buy a supplement, look for a seal from the United States Pharmacopeia (USP) or NSF International, or check on the ConsumerLab Web site for proof of quality.

 

Track Supplements

If you decide to try a supplement, only use one at a time. That will make it easier to tell whether it helps ease your symptoms and if you have any side effects. Remember, you may need to give supplements some time to take effect. Track the brand name and dose in your Journal and compare it to your pain level.

Take the Right Dose

It's important to take supplements according to the label instructions. If you have any questions about how much you should take, ask your doctor. Don't take more than directed on the label unless your doctor tells you to.

Include Supplements

Don't forget to include supplements in your master list of medications. List the brand name and dosage. Supplements can interact with other medications and treatments, so it's important to include them on any list you give to your doctor, pharmacist, or any other health care provider.

Fish Oil

The omega-3s in fish oil can help reduce inflammation, morning stiffness, and overall pain, especially if taken in adequate doses. Small studies show it may also ease migraine symptoms. Good sources include fatty fish such as salmon and herring. You can also get it from fish oil supplements. Fish oil may increase the risk for bleeding in some people, but usually just in very high doses. Don't take it if you take aspirin or blood thinners such as warfarin unless under the supervision of a doctor.

Borage Seed Oil

Borage seed oil contains gamma-linolenic acid (GLA), an omega-6 fatty acid that may help relieve swollen and tender joints. Some people find they need less prednisone for RA symptoms while using the supplement. But borage seed can cause some side effects, including upset stomach, diarrhea, or bloating. It can affect the liver and may make liver problems worse. It may also increase your risk for bleeding, especially if you are taking aspirin or blood thinners.

Cat's Claw

Some small studies show that cat's claw, made from the bark of an Amazon vine, may slightly reduce swollen joints and pain. Rarely, it may cause dizziness, nausea, and headaches. It also may interfere with managing blood pressure during or after surgery, so tell your doctor if you are taking it. Pregnant women and women trying to get pregnant should not take cat's claw.

Folic Acid

Folic acid is a type of B vitamin found in food. It helps build red blood cells in your body. Your doctor may recommend taking folic acid supplements if you're taking Folex, Rheumatrex, or Trexall (methotrexate). Studies have shown that in patients taking methotrexate for rheumatoid arthritis, folic acid may help reduce the side effects of the drug.

Build Your Bones

People with arthritis who take prednisone have a higher risk for bone loss. Getting enough vitamin D and calcium can help protect you from bone loss. These nutrients are found in some foods. Plus, your body can make vitamin D from sunlight. But if you don't get enough from these sources, ask your doctor if you need to take supplements.

Natural Substances

Glucosamine and chondroitin sulfate are two substances found in normal cartilage. Many people with OA take these supplements together to help reduce pain. However, studies are conflicting about whether these supplements work, so more research is needed. In the meantime, ask your doctor if you should give glucosamine and chondroitin sulfate a try.

MSM

MSM (methylsulfonylmethane) is a sulfur compound found in living things, including fruits, vegetables, and humans. No large studies of MSM have been done, but one small study of people with knee OA found it reduced pain and improved function. MSM can cause diarrhea, headache, rash, and tiredness. You should not use MSM if you are taking blood thinners, such as aspirin or warfarin.

SAM-e

SAM-e is a chemical found naturally in the body. Studies show it can help treat the pain, stiffness, and swelling of OA. Some small studies show it may also help fibromyalgia symptoms. SAM-e can cause an upset stomach and headache. It can also interact with some meds and make Parkinson's disease worse.

Slow OA with ASU

Avocado soybean unsaponifiables (ASU) is a vegetable extract produced from the oils of avocado and soybeans. Studies show that it may help prevent cartilage from breaking down and provide relief from the pain of OA.

Fruit for Fibro

Eat a bowl of red and blue fruit. Cherries, blueberries, and raspberries are all packed with a colorful compound called anthocyanin. In one study, this substance helped people with fibromyalgia sleep more soundly. Don't like berries? You can take anthocyanin in supplement form, but ask your doctor about side effects like nausea and indigestion.

St. John's Wort

Feeling blue? The popular supplement St. John's wort may help treat mild to moderate depression as well as some prescription antidepressants, and it may help you sleep better, too. St. John's wort can interfere with other drugs, so see your doctor before taking it. Don't take St. John's wort if you also take SSRIs such as Celexa (citalopram), Lexapro (escitalopram oxalate), or Prozac (fluoxetine), because it can cause potentially serious side effects.

Try Melatonin

For fewer sleepless nights, consider taking a melatonin supplement before bed. This natural hormone helps regulate your body's sleep-wake cycle, and it may help you fall asleep faster and snooze more soundly. Melatonin can sometimes have side effects, including headaches and dizziness, and can interact with certain medications. Also, make sure you're not still drowsy before you drive the next morning.

Vitamin B12

Did you know that having very low levels of vitamin B12 -- found in many animal products and fortified foods -- can worsen or even cause some types of nerve pain? Older adults, strict vegetarians, and people with certain health conditions are more at risk for B12 deficiency. Also, some medicines can interfere with the absorption of the vitamin. Ask your doctor if you should be tested for a B12 deficiency -- and whether supplements could help your symptoms.

Alpha-Lipoic Acid

The antioxidant alpha-lipoic acid -- found in foods such as yeast, broccoli, potatoes, and spinach -- may help with some types of nerve pain. Some people with nerve pain take alpha-lipoic acid supplements daily, but ask your doctor before you start using it. People with diabetes or low blood sugar should use alpha-lipoic acid supplements with caution because they can lower blood sugar levels.

Carnitine

Carnitine is derived from amino acids that occur naturally in the body. Studies have found that carnitine supplements may help relieve diabetic neuropathy and other types of nerve pain.  Some animal products such as meat, fish, and milk are good sources of carnitine.

Inositol

Inositol is a vitamin-like substance found in some plants and animals. Studies have found that inositol supplements may help with nerve damage caused by diabetes. Ask your doctor if it could help you.

Excess Vitamin B6

Don't assume that all supplements are safe if you have nerve pain. Getting enough vitamin B6 in your diet is essential to healthy nerve function. However, taking very high doses of vitamin B6 have been shown to cause nerve pain. Talk with your doctor to make sure you're not accidentally getting too much from fortified foods and vitamin supplements.

Vitamin D

Ask your doctor if you should have your vitamin D levels tested. While many people have low vitamin D levels, some research has shown that vitamin D supplements may help ease pain in people with nerve damage caused by diabetes.

Be Patient

If your doctor suggests supplements for nerve pain, give them time to work. Studies have found that after starting vitamin B12 for nerve pain due to B12 deficiency, it can take several weeks or longer to obtain a normal vitamin B12 level. It's not easy, but try to be patient. The same is true for omega-3s, or some of the herbal medicines.

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