RA: Best and Worst Supplements and Herbs

Medically Reviewed by David Kiefer, MD on December 28, 2015

People in some parts of the world have used herbal remedies to treat diseases for centuries. But in the United States, we tend to rely heavily on traditional Western medicine.

Still, the use of dietary supplements has taken off in the last few decades. A 2011 survey from the CDC found that more than half of all adults in the U.S. take one of these products.

And in general, over half of people with rheumatoid arthritis take them, too, says Eric Matteson, MD, a rheumatologist at the Mayo Clinic in Rochester, MN.

But they can have side effects, and they don't always work well with traditional medicines. That’s why you should always talk to your doctor before you try them to make sure they’re safe for you, Matteson says.

Although more research needs to be done on most dietary supplements used to treat rheumatoid arthritis, some can help ease both pain and inflammation.

Fish oil. Omega-3 fatty acids are found most often in fish, says Kim Larson, RD, a dietitian in Seattle. She suggests eating fish and seafood two to three times a week. “Good nutrition through food is the best avenue to health with RA,” she says.

If fish isn’t on your menu, try fish oil. The omega-3 fatty acids in these supplements have some of the same effects as nonsteroidal anti-inflammatory drugs, or NSAIDs. But they aren’t as hard on your stomach.

Fish oil comes from cold-water fish like salmon and tuna. Some of these can have high levels of mercury, so do your research before you pick a supplement. Omega-3 fatty acids can also slow blood clotting, so talk to your doctor about taking them if you’re already on blood thinners or blood pressure medications.

Borage oil. The seeds of certain plants, including borage, evening primrose, and black currant, contain an omega-6 fatty acid called gamma-linolenic acid (GLA). It can also ease joint inflammation and stiffness, says Paula Mendelsohn, RD, a dietitian and nutritionist in Boca Raton, FL. Though results from studies of GLA and rheumatoid arthritis vary, some do show less of a need for NSAIDs among people taking supplements with GLA.

Borage oil supplements can cause side effects like gas pains, constipation, or soft stools. Some products contain substances called pyrrolizidine alkaloids, which can cause liver damage.

Turmeric. Thiskey ingredient in Indian and Middle Eastern food contains the chemical curcumin, which may fight joint inflammation. A 2006 study even suggested that certain turmeric extracts were better at preventing it than easing it. Like fish oil, turmeric can act as a blood thinner if you take high doses of it, so be careful if you’re taking warfarin or other blood thinner meds.

Boswellia. It's also known as Indian frankincense, and it appears to have similar anti-inflammatory properties as NSAIDs without the stomach problems.

Like turmeric, boswellia is used in a form of holistic medicine from India. While study findings are mixed, it remains one of the most researched and promising supplements for RA.

Ginger and green tea extract also are said to have anti-inflammatory effects, but they need to be studied more.

Probiotics. There’s a lot of buzz around these good bacteria. A 2014 study found that they helped lower signs of inflammation.

Probiotics support and enhance digestion and absorption, as well as support the immune system,” Mendelsohn says. “In addition, probiotics help ‘push out’ bad bacteria.”

Certain products are best left on the shelves.

Some supplements can be bad for your liver, Matteson says. “These include arnica, chaparral and Kombucha tea -- especially if homemade.”

Studies have shown that chaparral causes liver toxicity. That means it isn’t a good choice if you take methotrexate, a commonly prescribed drug that also can affect your liver.

Other products might ease your RA symptoms, but the side effects aren’t worth the risk. Thunder god vine, for example, has shown promise as an anti-inflammatory in lab tests. But it can bring on severe nausea, diarrhea, and respiratory infections. That "high side-effect profile" is one reason why David Leopold, MD, of the Scripps Center for Integrative Medicine, doesn’t use it in his practice.

Bottom line: If you're interested in trying a supplement, “talk with a physician who is skilled in the use of natural medicines,” Leopold says. “Do not assume that supplements are either safe or effective.”

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