Although there isn’t much extensive research available to support the effectiveness and safety of botanicals for the treatment of arthritis, it is known that many plants used for medicinal purpose have powerful effects similar to those of conventional drugs.  The National Center for Complementary and Alternative Medicine (NCCAM) conducted early studies showing future promise in the effectiveness of botanicals to treat certain diseases and conditions. However, it is important to be very informed about the supplement you are considering using along with its safety record. The following is an overview of the effectiveness of botanical supplements and diet for the treatment of rheumatoid arthritis and osteoarthritis:

Thunder God Vine:

This perennial vine plant is native to China, Japan, and Korea. Preparations of this root have been traditionally used in Chinese medicine to treat inflammatory and autoimmune diseases. The vine is also used to kill insects in farm fields.

• Effectiveness:  This botanical has anti-inflammatory and immune-system-suppressing abilities that have been seen in laboratory and animal studies. A 2002 study conducted by the University of Texas Southwestern Medical Center examined 21 patients for whom traditional rheumatoid arthritis treatment had not worked. Everybody in the trial received the herb and experienced improvement in their rheumatoid arthritis symptoms and physical functioning. However, longer studies need to be conducted to confirm these findings.
• Safety: Parts of this herb, including the leaves, the flowers, the main stem, and the skin covering the root, are poisonous. No one should try to make this medication themselves. However, in the United States, currently there are no high-quality portions of this herb being made. It can be obtained overseas from China, but the safety and effectiveness cannot be guaranteed.

An expert at the University of Texas, National Institute of Health, advises consumers to not use the herb until more reliable preparations become available. One study reveals that if this botanical is taken for over five years, it has the possibility to decrease the density in a woman’s bones, which is of a special concern for women who have osteoporosis. If taken at high doses, it has the high ability to suppress the immune system and increase the effects of other immune-suppressing drugs. Most individuals in the studies tolerated the extract well, but side effects such as stomach upset, diarrhea, skin rash, changes in menstrual periods, and hair loss can occur.

Gamma-Linolenic Acid (GLA):

This an omega-6 fatty acid found in the oil of some plant seeds including evening primrose, borage, and black currant. The extract is used by the body to make substances that reduce inflammation.

• Effectiveness: According to the National Center of Complementary and Alternative Medicine, seven placebo-controlled studies revealed that it is difficult to draw conclusions about the effectiveness of the extracts of evening primrose, borage, and black currant oils. The better studies do indicate that that the botanical provides potential relief from arthritis pain, morning stiffness, and tenderness of the joints.
• Safety: There are potential risks to be aware of when considering GLA. First, these plant seed oils can affect certain medical conditions and they can interact with prescription medications. For example, borage seed oil contains PAs (pyrrolizidine alkaloids) that can have potentially dangerous effects on the liver. Only PA-free preparations should be taken. Borage seed oil and evening primrose oil increase the risk of bleeding and bruising, mostly in people taking blood-thinning drugs like aspirin, clopidogrel, NSAIDs, or warfarin. Evening primrose oil can also cause problems for individuals taking psychiatric drugs called phenothiazines. General side effects include nausea, diarrhea, soft stool, intestinal gas, burping, and stomach bloating.

Fish Oil:

Fish oil has high levels of two omega-3 fatty acids which can be used to reduce inflammation.

• Effectiveness: Encouraging evidence from a number of studies indicate the usefulness of fish oil and other omega-3 fatty acids to treat various symptoms of rheumatoid arthritis such as tender joints and stiffness. Unfortunately more studies are needed to determine what the most effective dosage should be and the most appropriate length of treatment.
• Safety: In certain people, the high levels of omega-3s that are present in fish oil can significantly increase the risk of bleeding or the amount of time it takes for blood to clot. If a person is taking drugs for high blood pressure or ones that affect bleeding, or having surgery, taking fish oil should be cautioned.

Certain types of fish, such as shark, swordfish, king mackerel, and tilefish, contain high levels of mercury contaminants. Those deciding to use fish oil should look for products with the lowest mercury levels. People who decide to use fish oil should contact the manufacturer to find out the type of fish used in the product. In general, low doses of fish oil supplements have mild side effects that can include a fish aftertaste, belching, stomach disturbances, and nausea.

Valerian:

This herb has been used to treat sleep problems and anxiety disorders. Disrupted sleep patterns are a common and often neglected symptom of arthritis. The National Center of Complementary and Alternative Medicine feels that sleep disruptions caused by arthritis are the main reason people seek out alternative therapies from conventional medical treatments. Valerian can be taken for other reasons, mostly to relieve muscle and joint pain.

• Effectiveness:  Evidence suggests that valerian has mild benefits for sleep problems, including insomnia. It is theorized that valerian can benefit people with sleep problems that have rheumatoid arthritis. However, research with valerian and rheumatoid arthritis has not specifically been conducted. There also is not enough reliable evidence to truthfully declare whether valerian is effective for muscle and joint pain, including pain from rheumatoid arthritis.
• Safety:  Valerian is considered generally safe. However, more evidence is needed on how long it is safe to take valerian and what dosage is appropriate. It should not be taken with sedative drugs (for example, alcohol or narcotics) or herbs (melatonin or St. John’s wort) because the sedative effect can be increased. Side effects include drowsiness in the morning, headache, stomach problems, excitability or anxiety, and sleeplessness.

Four Other Botanicals:

The following four botanicals have a history of use in Ayurvedic medicine to treat inflammatory conditions. The National Center of Complementary and Alternative Medicine plans on doing more research to determine whether these extracts are truly effective for treating chronic inflammatory conditions like arthritis and asthma.

• Ginger:
• Safety: Possible side effects include stomach upset, diarrhea, and irritation of the mouth and throat. Ginger is not recommended for people with  bleeding disorders, a heart conditions, or diabetes. It can further slow blood clotting when combined with other herbs and drugs that do the same. Also, it adds to the blood pressure-lowering abilities of drugs to treat high blood pressure and heart disease and adds to the blood sugar- lowering effects of diabetes drugs.
• Curcumin: (a component of the spice turmeric)
• Safety:  Side effects include stomach problems, nausea, and diarrhea. Like ginger, curcumin can add to the effects of other herbs and drugs that slow blood clotting. Curcumin should not be used by people with gallbladder disease.
• Boswellia: (also called Indian frankincense, made from the resin of a tree that grows in India)
• Safety: Side effects include stomach pain, stomach upset, nausea, and diarrhea. Not much is known on whether boswellia interacts with any drugs, supplements, or diseases and conditions.
• Feverfew:
  • Safety:  Short-term use appears to be safe, but long-term is unknown. Feverfew can cause allergic reactions and side effects are diarrhea and other stomach problems. Chewing fresh leaves of feverfew can cause mouth irritation and sores and the supplement may interact with medications that are broken down by the liver. It also may increase the actions of drugs that slow blood clotting. Pregnant women are advised not to take it

Glucosamine and Chondroitin:

Glucosamine  and chondroitin continue to be popular dietary supplements for arthritis. They are sold individually and in combination with each other. Glucosamine is a substance found in the fluid surrounding the joints, and chondroitin is a substance found in the cartilage of our joints. The body uses glucosamine to create and repair cartilage, the tissue that covers the ends of bones, keeping them from rubbing against each other. Glucosamine can also be found in the shells of shrimp, lobster, or crabs or made in a laboratory. Chondroitin can be obtained from sources such as sharks and cattle.

• Effectiveness: Both show anti-inflammatory effects in animal studies. However, in humans, these supplements have been studied only for osteoarthritis, not rheumatoid arthritis. Studies show a modest benefit for osteoarthritis. No evidence suggests effectiveness for rheumatoid arthritis.
• Safety: Both appear to be safe for most people. Glucosamine might worsen asthma with an allergic reaction and it might increase blood sugar levels for those with diabetes. Glucosamine might decrease the effectiveness of certain medications such as acetaminophen, some anti-cancer drugs, and anti-diabetes drugs with side effects including mild stomach problems, nausea, sleepiness, skin reactions, and headaches. Chondroitin can also possible worsen asthma, blood clotting disorders, and prostate cancer. Side effects include stomach pain, nausea, sometimes diarrhea or constipation, swelling, and heart rate problems.

Special Diets:

Most people with rheumatoid arthritis are concerned about whether certain foods affect their symptoms. Foods believed to worsen symptoms include white potatoes, tomatoes, eggplant, peppers, dairy, citrus fruits, acidic foods, sweets, coffee, and animal protein. The following are theories about how foods affect rheumatoid arthritis:

• Food has been known to affect the digestive and immune system’s function. Rheumatoid arthritis is a disease of the immune system, so a connection between diet and the disease is proposed.
• Fats from animal sources, and corn and sunflower oils break down in the body into substances that can cause inflammation. Rheumatoid arthritis and medications to treat it can negatively affect a person’s ability to handle certain foods.
• Rheumatoid arthritis affects a person’s ability to prepare and eat food, leading to improper nutrition.
• The truth behind this theory:  No strong, reproducible evidence exists that proves any foods or diets have a specific role in causing or treating rheumatoid arthritis. People with these types of conditions need to eat a healthy, balanced diet; if foods are eliminated from one’s diet, it is possible to neglect needed nutrients and to not receive the proper caloric amount.

Discuss any dietary changes with your health care provider. A true food allergy can be present in only a small percentage of those with rheumatoid arthritis. Some people think they have food allergies when they possibly have a different condition called a food intolerance. Again, check with your health care provider to discover what the real source is.

Source: Research Report:  Rheumatoid Arthritis and Complementary and Alternative Medicine, National Center for Complementary and Alternative Medicine (NCCAM).