What are the herbs and spices that can help reduce inflammation and symptoms of rheumatoid arthritis? Find out about dietary options that may help.

Ginger: A Powerful Anti-Inflammatory Herb

Used in Asian medicine and cuisine for centuries, ginger has anti-inflammatory properties, including the ability to suppress inflammatory molecules called leukotrienes and to synthesize prostaglandins, which are hormone-like substances that cause pain and inflammation, according to research published in the journal Arthritis. In a study published in May 2019 in the journal Gene, 70 patients with rheumatoid arthritis took either 1,500 milligrams (mg) of ginger powder or a placebo for 12 weeks, and the results suggested that ginger may improve RA symptoms by affecting the expression of certain genes. Try stir-frying a chicken or veggie dish with chopped fresh ginger, eating fresh pickled ginger, or adding grated ginger to soups or smoothies.

Thyme: A Flavorful Herb with Anti-Inflammatory Properties

A fragrant herb that has high antioxidant capabilities, thyme has a rich history as a food flavoring. And it’s been found to have anti-inflammatory and anti-microbial properties that could be therapeutic for rheumatoid arthritis, according to research published in Pharmacognosy Communications [PDF]. In fact, thyme was found to be the most commonly used herbal medicine among people with RA, according to a study published in December 2018 in Complementary Therapies in Medicine. A sprig of fresh thyme or the fresh leaves can be flavorful additions to meat, poultry, bean, tomato, or egg dishes, as well as soups and stews.

Turmeric: A Golden Spice with Anti-Inflammatory Benefits

A golden spice that’s long been used to lend color and flavor to foods, turmeric also has been used in ayurvedic and Chinese medicine for a variety of conditions, including arthritis and musculoskeletal disorders. Besides having anti-inflammatory properties, turmeric and curcumin (the active ingredient that gives turmeric its yellow color) also have analgesic effects, according to research published in August 2016 in the Journal of Medicinal Food. Want to try turmeric? Add it to soups, stews, and curry dishes. Helpful hint: Combining turmeric with black pepper helps your body absorb the yellow spice even better, according to research published in the International Journal of Food Sciences and Nutrition.

Green Tea: An Antioxidant-Rich Beverage for Reducing Inflammation

Consumed in Asia for millennia, green tea contains polyphenols, which are antioxidant-rich substances that can help reduce inflammation, according to research. A study published in the Journal of the American College of Nutrition in 2004 found that green tea may help prevent and treat rheumatoid arthritis by reducing the production of inflammatory cytokines. The Arthritis Foundation recommends drinking three to four cups of green tea per day to reap the anti-inflammatory benefits.

Cinnamon: A Fragrant Spice with Anti-Inflammatory Properties

Cinnamon is a fragrant spice that has been used in traditional medicine for centuries to treat a variety of ailments, including arthritis. Research has shown that cinnamon has anti-inflammatory and analgesic (pain-relieving) properties that may be beneficial for people with rheumatoid arthritis. A study published in the Journal of Ethnopharmacology in 2012 found that cinnamon extract reduced inflammation and joint damage in rats with experimentally induced arthritis.

Rosemary: A Versatile Herb with Antioxidant and Anti-Inflammatory Effects

Rosemary is a fragrant herb that has been used in traditional medicine for its anti-inflammatory and antioxidant properties. Research has shown that rosemary extract can reduce inflammation and joint damage in animal models of rheumatoid arthritis. A study published in the Journal of Ethnopharmacology in 2007 found that rosemary extract inhibited the production of inflammatory cytokines and enzymes in cells taken from patients with rheumatoid arthritis.

Cayenne Pepper: A Spicy Addition to an Anti-Inflammatory Diet

Cayenne pepper is a spicy chili pepper that contains a compound called capsaicin, which has potent anti-inflammatory and analgesic properties. Research has shown that capsaicin can reduce the production of inflammatory cytokines and inhibit the activity of enzymes that contribute to joint inflammation and damage. A study published in the Journal of Alternative and Complementary Medicine in 2010 found that a topical cream containing capsaicin was effective in reducing pain and improving function in people with rheumatoid arthritis.

15 Herbs and Spices for Rheumatoid Arthritis Symptom Relief

Herbs and spices can be used as natural remedies to reduce the inflammation of rheumatoid arthritis. Find out about dietary options that may help.

By Chris Iliades, MDMedically Reviewed by Alexa Meara, MD

Reviewed: January 28, 2022

Medically Reviewed

Some flavorful, aromatic spices also have anti-inflammatory properties, while certain medicinal herbs may help RA symptoms.

Nadine Greeff/Stocksy

It’s no secret that rheumatoid arthritis (RA) involves inflammation, so adding anti-inflammatory herbs and spices to your diet is a good idea. Admittedly, on their own, these food ingredients aren’t likely to have a significant impact on easing symptoms of rheumatoid arthritis. But as part of an anti-inflammatory diet, consuming certain herbs and spices throughout the day could have an additive effect in reducing inflammation and other symptoms, according to the Arthritis Foundation. And, at the very least, adding them to your recipes will liven up your meals.

Related: The Best Foods to Add to Your Diet to Fight Rheumatoid Arthritis

In addition, some medicinal herbs can help you manage or even minimize uncomfortable symptoms.

It’s important to note that you should never use herbs or supplements in place of standard medical care for RA. Always consult with your doctor before starting on any supplement, as some can pose harmful interactions with medications.

What follows are 15 herbs and spices worth considering if you have rheumatoid arthritis.

Culinary Herbs and Spices for an Anti-Inflammatory, RA-Friendly Diet

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Ginger

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Used in Asian medicine and cuisine for centuries, ginger has anti-inflammatory properties, including the ability to suppress inflammatory molecules called leukotrienes and to synthesize prostaglandins, which are hormone-like substances that cause pain and inflammation, according to research published in the journal Arthritis. In a study published in May 2019 in the journal Gene, 70 patients with rheumatoid arthritis took either 1,500 milligrams (mg) of ginger powder or a placebo for 12 weeks. Results of this research suggested that ginger may improve RA symptoms by affecting the expression of certain genes.

Try stir-frying a chicken or veggie dish with chopped fresh ginger, eating fresh pickled ginger, or adding grated ginger to soups or smoothies.

Galina Roofener, a licensed acupuncturist and Chinese herbalist, agrees that ginger can be a beneficial part of your plan to alleviate joint pain caused by arthritis and recommends working with a trained herbalist. Find one near you one with the directory of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

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Thyme

Nata Vkusidey/Getty Images

A fragrant herb that has high antioxidant capabilities, thyme has a rich history as a food flavoring. And it’s been found to have anti-inflammatory and anti-microbial properties that could be therapeutic for rheumatoid arthritis, according to research published in Pharmacognosy Communications [PDF]. In fact, thyme was found to be the most commonly used herbal medicine among people with RA, according to a study published in December 2018 in Complementary Therapies in Medicine.

A sprig of fresh thyme or the fresh leaves can be flavorful additions to meat, poultry, bean, tomato, or egg dishes, as well as soups and stews. It has long been used in Italian, French, Mediterranean, and Middle Eastern cuisines, and “thyme’s pungency is one of its greatest benefits, but can be a drawback if it is used incorrectly,” according to Spiceography. So don’t go overboard with it.

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Turmeric

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A golden spice that’s long been used to lend color and flavor to foods, turmeric also has been used in ayurvedic and Chinese medicine for a variety of conditions, including arthritis and musculoskeletal disorders. Besides having anti-inflammatory properties, turmeric and curcumin (the active ingredient that gives turmeric its yellow color) also have analgesic effects, according to research published in August 2016 in the Journal of Medicinal Food.

Want to try turmeric? Add it to soups, stews, and curry dishes. Helpful hint: Combining turmeric with black pepper helps your body absorb the yellow spice even better, according to research published in the International Journal of Food Sciences and Nutrition.

If you’re taking it as a supplement, the Arthritis Foundation recommends 500 mg of curcumin extract capsules twice a day.

Remember to consult with your doctor before starting on turmeric. Roofener cautions that because turmeric has blood-thinning properties, it should be avoided in large doses if you take a blood-thinning medicine.

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Green Tea

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Consumed in Asia for millennia, green tea contains polyphenols, which are antioxidant-rich substances that can help reduce inflammation, protect joints, and trigger changes in immune responses that would ease the severity of arthritis. Research published in the International Journal of Rheumatic Diseases compared the effects of green tea and black tea on arthritis and found that green tea extract had superior anti-inflammatory effects.

So treat yourself to a daily tea break with a cup of hot green tea, iced green tea, or even a cup of matcha, using a powder made from ground green tea leaves. You’ll do your health, and perhaps your joints, a world of good.

Related: Can Drinking Tea Help Ease Rheumatoid Arthritis Symptoms?

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Cinnamon

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A delicious spice, cinnamon has powerful antioxidant properties that help inhibit cell damage from free radicals. But that’s only part of what’s behind cinnamon’s health halo: It also helps reduce blood sugar and cholesterol levels, and it appears to protect cognitive function as people get older.

What’s more, a study published in May 2018 in the Journal of the American College of Nutrition found that when women with rheumatoid arthritis consumed four capsules of 500 mg of cinnamon powder daily for eight weeks, they had a significant decrease in blood levels of C-reactive protein (a marker of inflammation), as well as reduced disease activity, including tender and swollen joints.

Another study published in September 2020 in the journal Complementary Therapies in Medicine also found that supplementation with cinnamon lessened C-reactive protein levels and other biomarkers for inflammation and oxidative stress, which occur in people with RA. Authors of this research concluded that cinnamon supplementation may enhance the reduction of inflammation and oxidative stress levels in humans.

Related: Cinnamon May Be a Safe Way to Reduce RA Symptoms

Dried cinnamon can be added to oatmeal, smoothies, soups, stews, or even oranges for a delicious and healthy dessert. Cinnamon sticks can be added to teas or ciders for an extra flavor infusion. Just don’t overdo it, Roofener cautions. “Although it’s fine on your cinnamon bun, if it’s overdosed, it might not be safe for pregnant women.” Large doses of the spice also could interfere with blood clotting and blood thinner medication.

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Garlic

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Sliced, minced, or chopped, fresh garlic can liven up any dish and may help ease rheumatoid arthritis pain. Like leeks and onions, garlic contains diallyl disulfide, an anti-inflammatory compound that decreases the effects of pro-inflammatory cytokines. Experimental research published in the Journal of Environmental Pathology, Toxicology, and Oncology found that the administration of garlic had anti-arthritic activity — preventing cartilage destruction and reducing inflammation — in arthritis-induced rats.

In a study published in June 2020 in Phytotherapy Research, 70 women were randomly assigned to take either 500 mg of garlic powder tablets twice a day or a placebo for eight weeks. At the end of the study period, those who took the garlic reported significantly lower pain intensity and fatigue scores. They also had lower levels of C-reactive protein and tumor necrosis factor (TNF), which are proteins involved in inflammation.

Related: Pain Management in Rheumatoid Arthritis

Garlic can be added to many foods, including pasta dishes, roasted chicken or vegetables, stir-fries, and sandwich spreads.

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Black Pepper

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It’s a staple on most dining tables and widely used to add a dash of flavor to everyday dishes. But did you know that black pepper, including piperine, the active compound it contains, has bona fide health benefits? It’s true. Research has found that black pepper has antioxidant, antimicrobial, anti-inflammatory, and gastro-protective effects.

A study published in September 2018 in the European Journal of Pharmacology suggested that the administration of piperic acid has anti-inflammatory effects, inhibiting swelling and the production of cytokines in animals. Earlier research, published in the journal Arthritis Research & Therapy, found that piperine administration relieved inflammation, pain, and other symptoms of arthritis in animals.

Related: Rheumatoid Arthritis and Your Diet: What to Consider

You already know what to do with black pepper: Use it to season any dish you’d like — salads, soups, eggs, and more.

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Cayenne

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Cayenne and other chili peppers contain capsaicinoids, which are natural compounds that have anti-inflammatory properties, according to the Arthritis Foundation.

Many ointments and creams containing capsaicin (the main ingredient in cayenne) are available to relieve arthritis pain. A study published in the December 2018 issue of Osteoarthritis Cartilage found that capsaicin cream was just as effective as nonsteroidal anti-inflammatory drugs (NSAIDs) at reducing pain for people with osteoarthritis.

You can add cayenne pepper to sauces, marinades, and rubs. Or simply sprinkle dried cayenne onto your favorite dish. But beware: This spice can be hot and may irritate the digestive tract.

If you can’t take the heat, cayenne also comes in a capsule form.

Cayenne may interact with different medicines, so be sure to talk to your doctor before trying this supplement.

Medicinal Herbs for an Anti-Inflammatory, RA-Friendly Diet

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Willow Bark

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Willow bark has significant anti-inflammatory properties and reduces various markers of inflammation, according to an article published in Phytotherapy Research. When researchers gave willow bark extract to 436 people with rheumatic pain due to osteoarthritis and back pain, they saw a significant reduction in pain after three weeks, according to a report published in the journal Phytomedicine.

Roofener stresses that you should consult with your doctor before taking willow bark, as it may increase the action of aspirin or an NSAID.

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Indian Frankincense

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Derived from the bark of the Boswellia tree, found in India and North Africa, Indian frankincense has strong anti-inflammatory properties as well as analgesic effects. It also may help prevent cartilage loss. However, the Arthritis Foundation notes that there’s some concern that Boswellia may stimulate the immune system, and advises caution for those with RA.

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Green-Lipped Mussel Extract

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Technically this substance is a seafood extract (not an herb) that is touted for inflammation-fighting properties. Nutritional supplements containing extracts from the New Zealand green-lipped mussel (Perna canaliculus) are rich in omega-3 fatty acids, which have anti-inflammatory effects. So it stands to reason that these supplements could be helpful for RA; however, little research has been done in people, and so far results from studies in animals and humans have been mixed, according to the Arthritis Foundation.

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Borage Seed Oil

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The oil comes from the seeds of the borage plant, native to certain parts of Europe and North Africa, and it’s a rich source of gamma linoleic acid (GLA), a type of omega-6 fatty acid. Research published in the journal Rheumatology suggested that when people with RA take daily oral supplements of borage seed oil, they experience significant improvements in joint tenderness, swelling, and pain after six months.

Related: Home Remedies and Alternative Treatments for Rheumatoid Arthritis

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Thunder God Vine

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Used for hundreds of years in traditional Chinese medicine, thunder god vine reduces inflammation from autoimmune diseases, including RA, when taken as an oral extract. A review published in July 2016 in BMC Complementary and Alternative Medicine found that treatment with thunder god vine (aka Tripterygium wilfordii Hook F) was superior to conventional drugs, including sulfasalazine and methotrexate, in treating RA symptoms.

According to the National Center for Complementary and Integrative Health (NCCIH), “some studies have suggested that thunder god vine plus standard medical treatment may be more effective than standard treatment alone for symptoms such as joint swelling and tenderness.”

However, thunder god vine should never be used as a substitute for standard RA treatments.

On a cautionary note, the NCCIH warns: “Thunder god vine can be extremely poisonous if the extract is not prepared properly.” According to Roofener, it also has strong emetic properties, which means it could cause vomiting.

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Devil’s Claw

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A plant used for centuries in Africa to treat pain and many other medical conditions, devil’s claw (Harpagophytum procumbens) has considerable anti-inflammatory effects. One study found that when 259 people with rheumatic disorders took daily tablets of devil’s claw for eight weeks, they experienced significant improvements in pain, stiffness, and function, especially in the hand, wrist, elbow, shoulder, hip, knee, and back. Research published in 2021 in the Pakistan Journal of Medical Research has suggested that devil’s claw may be as effective as certain osteoarthritis medicines at helping knee and hip pain after 16 weeks of treatment.

According to the Arthritis Foundation, you should not take devil’s claw if you’re pregnant or have gallstones or ulcers. It can also affect your heart rate and could interfere with blood-thinning and cardiac medications, as well as diabetes medications.

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Ashwagandha

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Ashwagandha, also called “Indian ginseng,” is an herbal treatment that’s been used for thousands of years to ease pain, reduce stress, and treat other conditions. Research published in the Indian Journal of Medical Research found that taking ashwagandha powder followed by treatment with Sidh Makardhwaj (another type of Indian medicine with herbal and mineral ingredients) eases pain and joint swelling in people with rheumatoid arthritis. The dosage will depend on the type you take.

“There have been many human clinical trials that have found anti-inflammatory and pain-relieving effects associated with ashwagandha,” says Lise Alschuler, ND, professor of clinical medicine at the University of Arizona Andrew Weil Center for Integrative Medicine in Tucson. “Many of these trials suggest that at least two to three months of usage is necessary before the benefits will be noted.”

Alschuler says ashwagandha is generally safe for people with RA. However, patients should consult with their doctors if they are taking diabetes or thyroid medicines, as the supplement could cause an additive effect. Additionally, pregnant women should talk to their providers before taking ashwagandha.

The Bottom Line

“Adding herbs and spices to your diet for their anti-inflammatory properties is usually safe,” Roofener says. To keep it that way, she advises using herbs or supplements at least two hours before or after taking your medication. She adds, “if you want to use them in high doses as medicine, make sure to check with your doctor first,” or work with a Board Certified Traditional Chinese Herbalist. After all, some herbal supplements can cause unpleasant side effects or interact with medication you may be taking.

Additional reporting by Julie Marks, Madeline Vann, MPH, and Stacey Colino.

Herbal Remedies, Supplements & Acupuncture for Arthritis

Herbal Remedies

For over 5,000 years, herbs have been used for their medicinal properties. The ancient science of Ayurveda emphasizes the importance of foods as medicine and many different plants/vegetables are valued for their medicinal-like properties and health benefits. While there can be benefit to these herbs in helping to treat certain conditions, they should never be used alone as sole treatment. It should be known that the companies that create these herbal remedies and supplements do not undergo monitoring and evaluation from the Food and Drug Administration (FDA) so long-term safety is not established.

Herbal Remedies and Supplements for Arthritis

Osteoarthritis is a degenerative arthritis caused by wear and tear of the joints. It is a chronic condition and can cause pain. There are several herbal compounds that are marketed today that provide relief in arthritis pain such as turmeric, ginger, devil’s claw, willow bark, and Boswellia serrata.

Ginger and willow bark extract may relieve pain, and interestingly these products have compounds in them similar to NSAIDs such as ibuprofen and naproxen. Turmeric has gained more recent fame in managing pain from osteoarthritis due to its anti-inflammatory and antioxidant properties. The current recommendation is to take curcumin, the active form of turmeric at 500 mg–1000 mg daily.

Supplements are also available over the counter for treatment of rheumatologic symptoms. Some of the most common are glucosamine sulfate along with omega 3. These supplements can provide modest pain relief in patients that have osteoarthritis but use of pain relievers such as NSAIDs and acetaminophen may still be needed in conjunction with these supplements.

Acupuncture for Arthritis

Developed in Asia over 2,000 years ago, acupuncture is a treatment modality consisting of needles which are inserted into the skin at specific points along meridians or channels which are deemed to be associated with various organ and bodily functions.

There have been many studies demonstrating the use of acupuncture for relief of pain caused by osteoarthritis. Due to the low risk profile of acupuncture, it is considered to be a safe therapy and may be considered in addition to conventional treatment for management of osteoarthritis pains.

For More Information

In conclusion, many herbal remedies and supplements are available on the market to manage pain. While they can be helpful, there is limited data to prove efficacy and these agents are not reviewed by the FDA so long-term safety has not been determined. Acupuncture can also be a beneficial modality of treatment to relieve pain. It is best to speak to your doctor about which complimentary medical therapies can be right for you.

Updated April 2023 by Bhakti Shah, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

8 herbs to relieve rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory joint disease of unknown etiology, characterized by progressive destruction of synovial joints with degradation of cartilage and bone.

Peak onset of incidence reaches 45-65 years and occurs 2-3 times more often in women. With untimely or incorrect treatment, about 30% of patients become disabled during the first 10 years of the disease.

Rheumatoid arthritis requires mandatory drug therapy. Auxiliaries, in particular some medicinal plants, can also temporarily alleviate the symptoms of this disease. This is evidenced by the results of scientific research.

Here are 8 herbs scientifically proven to help relieve rheumatoid arthritis.

9000

The seeds of this herb contain gamma-linolenic acid, which reduces inflammation, pain and swelling of the joints in rheumatoid arthritis [1, 2]. Studies have also shown that some patients have been able to reduce their main rheumatoid arthritis medications by consuming borage oil [3]. The Arthritis Foundation recommends taking 1300 mg of borage oil capsules daily.

2. Cayenne pepper ( Capsicum spp. )

This plant contains the active substance capsaicin, which blocks nerve cells and, as a result, reduces pain [4]. The Arthritis Foundation recommends using capsaicin creams three times a day.

3. Cat’s claw ( Uncaria tomentosa )

When this plant was used along with the main therapy, scientists noted relief of joint pain, swelling and morning stiffness [5]. The Arthritis Foundation recommends 250 to 350 mg of cat’s claw per day in capsule form.

4. Evening Primrose ( Onagraceae )

This wild flower is rich in gamma-linolenic acid, which helps reduce inflammation. It is recommended to take 540 mg of evening primrose daily. It is forbidden to use this oil for people with epilepsy.

5 Celery ( Apium graveolens )

]. This plant contains antioxidants and polysaccharides that act as anti-inflammatory agents, especially flavonoid and polyphenolic antioxidants. Other beneficial antioxidants include the phenolic acids caffeic and ferulic, as well as flavanols such as keketin.

6. Turmeric ( Curcuma longa )

Curcumin has anti-inflammatory properties that help reduce swelling and tenderness in rheumatoid arthritis [7]. It is recommended to introduce turmeric into your diet in the form of tea, curry and as a spice. Doses that have been shown to be effective in studies have been 500 mg twice daily. Curcumin is generally safe and has low toxicity.

7. Ginger ( Zingiber officinale )

This spice is known for its ibuprofen-like anti-inflammatory effect and may possibly relieve symptoms of rheumatoid arthritis [8]. Fresh ginger root can be added to tea. You can drink up to four glasses of ginger tea a day. Those who are taking blood thinners or have gallstones should not consume ginger due to the risk of side effects.

8. Green tea

Green tea contains a lot of catechins, which have antirheumatic activity. Studies have shown that this drink, when combined with exercise, is effective in reducing the symptoms of rheumatoid arthritis [9, 10]. Experts recommend drinking 4-6 glasses of green tea a day. However, it should be remembered that it negatively interacts with some drugs.

Showed promise in scientific research as anti-inflammatory agents in rheumatoid arthritis and dietary supplements based on quercetin and rosemary ( Rosmarinus officinalis ) [11–13]. Scientists are conducting their further research.

Fish oil also helps to alleviate the course of rheumatoid arthritis. This is already a product of animal origin. Omega-3 fatty acids, a major component of fish oil, may help prevent chronic inflammation and relieve symptoms associated with arthritis pain [14, 15]. The Arthritis Foundation recommends 2.6 grams of fish oil twice a day. Or you can add varieties of oily fish to your diet on a regular basis. At the same time, we note that more than 3 g of this substance per day may increase the risk of bleeding.

Before taking any herbal or animal supplements in addition to the main therapy, you should always consult your doctor, as they can cause side effects or lead to dangerous interactions with medications you are already taking.

For those who are interested in medicinal plants and their use, we recommend reading the following articles in our Phytoblog:

• Type 2 diabetes mellitus. What herbs normalize blood sugar levels?
• Garlic, parsley and basil help reduce high blood pressure
• Antiviral phytopreparations. Top 15 Plants That Help Fight Viruses

Olga Ostrinskaya,

PhD, Researcher

Sources

1. International Immunopharmacology
2. Ann Intern Med
3. Evid Based Complement Alternat Med.
4. Br J Anaesth.
5. J Rheumatol
6. Research Journal of Pharmaceutical, Biological and Chemical Sciences
7. Journal of Medicinal Food
8. Arthritis
9. Arthritis & Rheumatology
10. J Phys Ther Sci.
11. Afr J Tradit Complement Altern Med.
12. British Journal of Medical and Health Research
13. Phytother Res
14. Annals of the Rheumatic Diseases
15. Arthritis Rheum

Phytotherapy for rheumatoid arthritis.

An Overview of Herbs and Herbal Supplements

Here’s what you need to know about herbal treatment for rheumatoid arthritis

Traditional medicine cannot replace medications and will not help avoid side effects. Most often, patients who are afraid of side effects from drugs turn to traditional medicine. They could experience side effects both during treatment and read about them on the Internet [1].

After studying the side effects, it seems much safer to be treated with herbal remedies. However, this is a myth – unlike drugs, medicinal herbs are almost not studied. While the patient tries new methods, his joints continue to deteriorate, and over time, the chronic inflammatory process will lead to disorders of the internal organs.

Rheumatoid arthritis is a serious autoimmune disease that is treated with drugs that suppress one’s own immune system. Each of these drugs can cause side effects, but even if they occur, they will do less harm to the body than no treatment at all. Many side effects can be avoided if the following conditions are met:

• Take this medicine as directed by your doctor. Do not skip a dose, do not change dosages, do not replace one drug with another on your own.
• Get your prescribed tests done regularly to see how the drug is affecting your body.
• Read instructions. So, during treatment with certain drugs, you need to stop taking vitamins or alcohol, as this can lead to increased side effects. As a rule, they write about this in the sections “Special Instructions” and “Drug Interactions”.

Natural does not mean safe. The composition of medicinal herbs is not fully understood, and the concentration of active substances depends on many factors: the type of plant, place of growth, harvest time, storage conditions, etc. Because of this, dietary supplements have not established the exact dosage of active substances that are in medicines. And vegetable raw materials – herbs, roots, leaves, bark and fruits can contain toxic impurities and metals if they were collected in places unsuitable for cultivation.

The chaparral plant, which has been used to treat the pain of rheumatoid arthritis, has been removed from the list of safe food supplements due to being hepatotoxic [41]. And Duke Thunder Vine, or Tripterygium Wilford, used in Chinese traditional medicine to treat inflammation, has been associated with anemia, nausea, amenorrhea, and hair loss [29].

If you decide to buy a supplement, check that the packaging has the GMP mark. This means that the manufacturer complies with international production standards. Products with this label are considered safer.

Some traditional medicines can still be used as an addition to the main treatment. But before that, in any case, be sure to consult a doctor. Dietary supplements and herbs may cause allergies or increase the side effects of medications the patient is taking. Not all doctors are against alternative medicine, so if the method that the patient wants to try does not interfere with the main treatment, the doctor may approve it [1].

Supplements come in a variety of dosage forms—tablets, tinctures, syrups, teas, capsules, etc. Take only one dosage form of supplements. If you use several dosage forms at the same time, for example, taking rosehip tincture and capsules with its extract, this can lead to overdose and side effects.

Review of Herbs and Herbal Supplements for RA

There are dozens of different herbs on the internet that have been suggested to treat rheumatoid arthritis. For the review, we have selected the most common ones both in the Russian and in the foreign segment of the Internet.

🌿 Velvet antlers (deer antlers)

In short: there is no evidence that velvet antlers help with RA.

What it is: is a dietary supplement made from young deer or elk antlers derived from traditional Chinese medicine. Various manufacturers claim that antlers can have an anti-inflammatory effect in RA, as well as restore damaged joints, since they contain chondroitin sulfate, collagen and glucosamine sulfate [1].

What the studies say: In two randomized clinical trials, researchers found no statistically significant difference between patients who took moose antlers and those who took placebo. In patients taking velvet antlers, the activity of the disease and the feeling of pain did not change both within 1 month and within 6 months [2, 3]. The authors of a scientific review that examined studies of antler supplements also concluded that such supplements have no proven effectiveness [13].

How safe is it: may have rare and minor side effects if taken as directed. According to one study and scientific review, antler supplements are safe and can be combined with rheumatoid arthritis medications. However, there are no studies to date on how supplements can affect treatment. And also there is no proven optimal dose that would have a therapeutic effect [3, 30].

🌿 Blackcurrant seed oil

Brief: despite short-term improvements, blackcurrant seed oil appears to be ineffective in treating RA.

What it is: blackcurrant seed oil supplement. Contains alpha-linolenic and gamma-linolenic acids, which can suppress inflammation in the joints [1, 40].

What the studies say: Although there was no statistically significant difference between patients who took blackcurrant seed oil and those who took placebo, the authors of a scientific review argue that the oil may improve some of the symptoms of RA [11].

In clinical studies, patients who took the oil experienced a reduction in pain and a decrease in the duration of morning stiffness. However, after 6 weeks, when repeated tests were carried out, these effects were not observed. In two clinical studies, there was no statistically significant improvement in the oil group compared to the placebo group [15, 27].

How safe is it: may have rare and minor side effects if taken as directed. In studies, patients who took the oil experienced minor side effects. There are currently no studies investigating the safety of the oil [1].

🌿 Borage Seed Oil

Brief: Borage Seed Oil in combination with therapy can help with RA. However, the dose at which the oil will give a therapeutic effect and cause a minimum of side effects has not been identified.

What it is: is a dietary supplement made from the seeds of the borage plant, or Borago officinalis. Like blackcurrant seed oil, it contains various fatty acids, mainly linolenic and gamma-linolenic acids, which reduce inflammation in the joints [1].

What the studies say: In two clinical trials, patients who took borage seed oil along with anti-inflammatory medications showed improvements compared to patients who took placebo. The subjects had a reduction in the number of painful and inflamed joints, as well as a decrease in the duration of morning stiffness [17].

Further studies are needed to determine the optimal dosage and duration of treatment.

How safe is it: According to the encyclopedia for patients drugs.com, serious side effects can occur if the oil is taken [36]:

• while pregnant or breastfeeding;
• together with hepatotoxic drugs as this increases the load on the liver;
• together with anabolic steroids;
• together with anticoagulants – in this case, the risk of bleeding increases;
• while taking tricyclic antidepressants or phenothiazine antipsychotics;
• patients suffering from epilepsy.

In general, borage oil supplements are relatively safe. During clinical trials, only belching, diarrhea, and flatulence were reported as side effects [1, 17].

🌿 Cat’s claw plant

In short: cat’s claw plant extract may help with RA.

What it is: extract from the Uncaria pubescent plant, native to Peru. The plant got its name “cat’s claw” because of the curved spines that look like cat’s claws. Contains alkaloids that disrupt the activation of substances that cause inflammation.

What the studies say: According to clinical studies, scientists noted an improvement in patients who took cat’s claw along with sulfasalazine or hydroxychloroquine [21]:

• decreased number of painful joints;
• reduced joint pain on palpation;
• reduced the time of morning stiffness.

Further research is needed to investigate optimal dosage and safety as even different batches of the same product may contain different amounts of active ingredients.

How safe is it: Minor side effects such as upset stomach were seen in the study. Serious side effects were not observed. Cat’s claw is not recommended [33, 39]:

• if pregnant or breastfeeding;
• for low blood pressure;
• for leukemia;
• when taking immunosuppressants;
• for bleeding disorders;
• before surgery.

🌿 Evening Primrose Oil

In short: Evening Primrose Oil is likely to help treat RA.

What it is: is a dietary supplement of evening primrose seed oil, another name is Aspen biennial. Contains a large amount of linolenic and gamma-linolenic acids, which reduce inflammation.

What the studies say: in the first study, the subjects were divided into 3 groups [10]:

• the first group took evening primrose oil;
• the second group took evening primrose oil along with fish oil;
• the third group received a placebo.

All patients were taking non-steroidal anti-inflammatory drugs (NSAIDs), but were able to reduce their dosage or stop using them when they got better.

94% of the patients in the oil-only group and 93% of the patients in the oil plus fish oil group reported improved joint pain and reduced duration of morning stiffness. However, all symptoms returned 3 months after completion of the study.

In another study, patients who received the oil noted that the duration of morning stiffness was reduced. However, pain and disease severity were the same as in patients taking placebo [8].

At the same time, the results of the obtained studies are still not enough to draw unambiguous conclusions about the benefits of evening primrose oil and the possibility of using it for the treatment of RA. The authors of the scientific review note that further large-scale studies are required to determine the optimal dosage and duration of treatment [16].

How safe it is: No side effects should occur if the oil is taken at the dosage recommended by the manufacturer. Some study participants complained of nausea and diarrhea. It is also not recommended to take evening primrose oil [1]:

• for epilepsy and convulsive disorders;
• together with anti-inflammatory drugs and anticoagulants.

🌿 Tansy

In short: Tansy supplements are not effective for treating RA.

What it is: various supplements – capsules, tablets, liquid dosage forms containing extracts from the plant Tansy maiden. It is assumed that tansy reduces inflammation due to the content of substances such as parthenolides and glycosides [1, 37].

What the studies say: No clinical or laboratory differences were found between the tansy powder capsule group and the placebo group [23].

How safe is it: During the 6 weeks of the study, only one patient complained of ulcers and pain in the tongue. The scientific literature describes possible side effects such as [37]:

• mouth ulcers;
• heartburn and indigestion;
• dysgeusia – a disorder of taste, such as a burning sensation;
• migraine, nervousness and insomnia on abrupt discontinuation.

Tansy supplements are contraindicated with anti-migraine drugs, iron supplements, NSAIDs, and anticoagulants [34, 37].

🌿 Flaxseed oil

In short: Flaxseed oil is not likely to be effective in treating RA.

What it is: Flax seed supplement. Contains alpha-linolenic acid, which is an omega-3 polyunsaturated fatty acid. In the body, alpha-linoleic acid is converted into two compounds:

• DHA – docosahexaenoic acid;
• EPA – eicosapentaenoic acid.

In turn, DHA and EPA are involved in the synthesis of anti-inflammatory substances.

What the studies say: in the group of patients who took flaxseed oil for 3 months, the level of DHA and EPA in the blood did not increase. Also in this group, symptoms, clinical and laboratory parameters did not differ from those of the placebo group [22]. The authors of a scientific review did not find evidence that flaxseed oil and its derivatives can reduce the content of C-reactive protein in the blood [25].

However, in a recent 2022 study, flaxseed oil reduced ESR levels in RA patients more effectively than fish oil supplements [4].

How safe is it: The most common side effects are rash and gastrointestinal discomfort. According to the US National Center for Complementary Integrative Medicine, flaxseed oil is well tolerated in limited amounts. Therefore, flaxseed oil supplements should be taken with plenty of water and should not be taken during pregnancy [1, 4].

Also, the oil can theoretically increase the risk of bleeding, so it should be taken with caution in conjunction with anticoagulants [1].

🌿 Rose Hips

In Brief: Rosehip extract supplements may be beneficial and safe in the treatment of RA if the directions for use are followed.

What it is: Food supplement made from rose hips, the Rosa canina species. Sold in the form of capsules, syrups, dried fruits, and more. Rosehip extract contains substances such as polyphenols and anthocyanins, which can reduce inflammation in the joints. Rose hips are also rich in vitamin C, which has antioxidant properties. Vitamin C neutralizes free radicals – harmful substances that damage body cells.

What Research Says: Subjects who received 5 grams of rosehip powder per day for 6 months experienced improved well-being and physical performance compared to the placebo group. In the study, scientists used 3 questionnaires [28]:

• DAS-28 – to assess disease activity;
• RAQoL – to assess the quality of life;
• SF-12 – for general health assessment.

In another study, a group of 20 RA patients received 10.5 grams of rosehip powder daily for 28 days. Compared with the control group, their symptoms and laboratory parameters did not change in any way [14].

How safe it is: Side effects are rare and may include allergic reactions, constipation, nausea, diarrhea and heartburn. There are no studies on what is the optimal dosage of rosehip extract to be used for the treatment of RA, how long the course of treatment should be, and how the extract may interact with other drugs [1].

🌿 Willow Bark

Brief: supplementation of willow bark did not significantly reduce pain in RA patients in studies. There is no evidence that supplements can reduce inflammation or affect other symptoms of rheumatoid arthritis. There is a risk of side effects, such as stomach ulcers.

What it is: food supplements from various types of willow – purple, brittle, white, wolfberry and five-stalk willow. Willow bark contains the substance salicin, which in the human body turns into acetylsalicylic acid. Acetylsalicylic acid reduces the production of prostaglandins that cause inflammation [1, 18].

What the studies say: subjects who took 240 mg of salicin once a day for 6 weeks after the start of the study had a 15% decrease in pain. In the placebo group, the level of pain decreased by 4%. Also, in patients who took willow bark extract, indicators such as:

• duration of morning stiffness;
• quality of life, according to the SF-36 questionnaire;
• decreased erythrocyte sedimentation rate and C-reactive protein level;

But in the placebo group, other indicators improved, for example, swelling in the joints decreased.

The authors of the study concluded that there were no statistically significant differences between the extract group and the placebo group, and most patients did not experience significant benefit from the treatment [9].

How safe is it: Willow extract did not result in serious side effects in a study [9]. However, Versus Arthritis warns that willow supplements should be taken with caution by those with gastrointestinal, liver, or diabetes problems. Additives may interact with:

• anticoagulants;
• antihypertensive drugs;
• anti-inflammatory drugs.

Overdose can lead to stomach ulcers and internal bleeding [1].

🌿 Turmeric

Briefly: Curcumin, the active ingredient in turmeric supplements, may improve the condition of RA patients by reducing pain, reducing inflamed joints, and improving laboratory parameters.

What it is: supplements from plants of the genus Turmeric. The most commonly used powder for treatment and nutritional supplements is powdered from the ground roots. Contains the substance curcumin, which blocks certain substances and enzymes that lead to inflammation. For example, curcumin can block the enzyme cyclooxygenase-2. The anti-inflammatory substance celecoxib has the same mechanism of action [31].

What the studies say: The authors of a scientific review analyzed 5 studies that looked at how curcumin affects rheumatoid arthritis. Here are their conclusions [6]:

• In 4 out of 5 studies, disease activity decreased according to the DAS-28 index, and laboratory parameters – CRP and ESR – improved.
• In 3 studies that measured these parameters, VAS pain scores and blood rheumatoid factor levels decreased.

One study found that patients taking curcumin reduced joint swelling, reduced morning stiffness, and increased walking time.

Reviewers suggest that curcumin can be used as an adjunct in the treatment of RA. This requires further large-scale studies [6, 24].

How safe is it: No serious side effects have been found in any of the studies. The Arthritis Foundation recommends using curcumin extract because turmeric itself may contain lead. And also choose brands that add phospholipids and antioxidants – this contributes to better absorption [31].

However, high doses of turmeric can thin the blood and cause indigestion. Therefore, it is not recommended to take curcumin supplements [31]:

• together with anticoagulants;
• during pregnancy;
• before surgery;
• for diseases of the gallbladder.

🌿 Ginger

Briefly: scientists suggest that ginger root supplements may ease RA by reducing inflammation and pain. However, it has not yet been studied how safe it is and how supplements interact with drugs.

What it is: Dietary supplement containing ginger root extract. It is assumed that the supplement, due to the active substance – zingerone, can reduce inflammation in rheumatoid arthritis [7].

What studies say: in patients who took ginger powder for 12 weeks, compared with the placebo group, scientists noted the following changes [5]:

• Decreased activity of genes that are involved in the synthesis of substances that trigger inflammation with RA. Conversely, the activity of genes that are involved in the synthesis of anti-inflammatory substances has increased.
• Decreased disease activity.

In mice with rheumatoid arthritis, injection of zingerone reduced inflammation and also acted as an antioxidant [7].

Under laboratory conditions, active substances isolated from ginger root inhibited the activity of the COX-2 enzyme. This enzyme is involved in the synthesis of prostaglandins, which cause pain and increase inflammation in damaged joints. However, it is not known whether the supplement will produce the same effect in humans [26].

The authors, who conducted studies on rats with RA, came to the conclusion that the anti-inflammatory effect of ginger supplements can be associated not only with zingerone, but also due to other substances in its composition, such as aromatic oils [12].

How safe it is: due to the small number of studies in patients, side effects are poorly understood. According to some nutritionists, ginger supplements can cause indigestion and increase the risk of bleeding, so they are not recommended for patients taking anticoagulants [32].

🌿 Garlic

In short: Supplemented garlic can theoretically relieve RA symptoms.

What it is: some traditional medicine authors claim that the “healing” properties of garlic can cure RA without drugs [42]. However, such statements are not confirmed by anything – there are no results of studies, scientific publications, and the experience of doctors today. Therefore, the treatment of RA with supplements alone is not only useless, but also likely to lead to complications. On the Internet, you can find many recipes for preparing garlic to reduce the symptoms of rheumatoid arthritis – from garlic ointment to various tinctures.

What the studies say: there is only one study in which women with RA were given 1,000 mg of garlic daily for 8 weeks. Compared with the placebo group, they [20]:

• improved laboratory parameters – decreased levels of CBR, TNF-alpha;
• clinical indicators improved – the intensity of pain, the number of painful joints decreased.

However, the authors note that garlic could potentially be used as an adjunct to medical treatment for RA.