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Supplements for RA: What To Take and What To Avoid

Medically reviewed by Diane M. Horowitz, M.D.
Written by Ashley Knox
Posted on April 13, 2021

Many individuals with rheumatoid arthritis (RA) look for natural ways to help manage their condition as a complement to their medical treatment. Dietary supplements, including vitamins, minerals, herbs, and other ingredients, have become popular for their potential health benefits. A 2018 review in Arthritis Care and Research found that 47 percent of people with RA used dietary supplements, and about half of them found the supplements to be effective.

Although there are many supplements people take to relieve RA symptoms, the following list focuses on supplements that have been well-researched. Talk with your rheumatologist for medical advice about any supplements you plan on trying.

Supplements That May Help RA

Evidence suggests that certain supplements may help relieve inflammation and ease symptoms in people with RA, including omega-3 fatty acids, vitamin D, calcium, and others.

Omega-3 Fatty Acids

Omega-3 fatty acids are a type of polyunsaturated fat. Polyunsaturated fatty acids are fat molecules that can have health benefits, unlike the unhealthy forms of fat like saturated or trans fats. Omega-3s include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).

Fish oil supplements — which contain omega-3 fatty acids — are popular and may provide a benefit. One 2017 study found that people with RA who took 1 gram of concentrated fish oil for 12 weeks reported fewer tender joints and less pain compared to people with RA who did not take the supplements.

It appears omega-3 fatty acids have some anti-inflammatory effects that may make them helpful in reducing pain as a safe alternative to nonsteroidal anti-inflammatory drugs. Although studies on fish oil and omega-3 supplementation for RA are widely varied, the overall evidence suggests this supplement can help relieve joint pain and tenderness.

Vitamin D

Vitamin D is a nutrient that your body needs to absorb calcium properly and keep your bones strong. Your immune system also needs vitamin D to protect you against viruses and bacteria. A 2012 study showed that vitamin D deficiency is common in people with RA, and low vitamin D was related to more severe RA. People with RA are also more likely to experience bone loss (osteoporosis).

Recent evidence suggests that vitamin D supplementation may help decrease the risk of RA. It’s still unclear whether taking vitamin D can improve outcomes once RA has already developed, however.

Read more about vitamin D and RA here.

Calcium

Calcium is a mineral that is stored in the bones and teeth. Calcium helps make bones stronger, and vitamin D is also needed to absorb calcium.

People with an increased risk of bone loss from RA must get enough calcium. The dosage of calcium supplementation typically ranges from 1,000 milligrams to 1,300 milligrams per day. Having too much calcium can cause some health issues, such as constipation and kidney stones, and may be linked to a risk of heart disease and prostate cancer.

Turmeric

Turmeric (curcumin) is a plant in the ginger family that is mainly grown in India. A major part of the turmeric plant is called curcumin. Curcumin is believed to have anti-inflammatory properties and immunosuppressive effects that may make it helpful in treating autoimmune, inflammatory diseases like RA. A meta-analysis of several studies on curcumin use in people with RA showed that people using curcumin experienced less pain. Curcumin was safe when using less than 1,200 milligrams per day for up to four months.

There are not enough studies in people with RA to prove that turmeric or curcumin supplementation is effective in relieving RA symptoms, but the studies that have been done so far are promising.

Cannabidiol

Cannabidiol (CBD) is a substance found in the cannabis plant, Cannabis sativa. Unlike another popular cannabinoid, called tetrahydrocannabinol (THC), CBD does not cause the “high” people get when using marijuana.

Anecdotally, some people with RA have reported that CBD relieves their symptoms, including pain, anxiety, and poor sleep. Some studies also suggest that CBD can help relieve the symptoms of RA, but not enough is known yet about the effects of CBD on RA symptoms. More studies are needed.

The sale of CBD is also a legal gray zone and may depend on the state you live in. Like supplements, CBD is not regulated by the FDA.

Probiotics

Probiotics are food or supplements that contain microorganisms like yeast and bacteria. Evidence suggests that adding these microorganisms to your microbiome (the community of bacteria that live in your body) can help reduce inflammation in the body.

Some studies have shown that changes in the microbiome might play an important role in RA. One study found that taking a probiotic called Lactobacillus helped suppress arthritis disease activity compared to a placebo. Although researchers are continuing to learn how changing the microbiome can have health benefits, probiotics may be a useful therapy for RA alongside standard treatment.

Supplements To Avoid

Studies have shown that certain supplements, including thunder god vine and cat’s claw, can be detrimental to people with RA.

Thunder God Vine

Thunder god vine is a plant that commonly grows in southeast China. A couple of study reviews have shown that thunder god vine can relieve pain in people with RA, but more studies need to be done to be certain. Thunder god vine also has risks that may outweigh its potential benefits. Thunder god vine can have side effects like high blood pressure, digestive problems, diarrhea, headache, kidney issues, bone loss, and infertility. It can also be extremely poisonous if not prepared properly.

Cat’s Claw

Cat’s claw is a vine that mainly grows in the Amazon forest and is used for various health issues. Very little research has been done on using cat’s claw as a supplement, but the National Center for Complementary and Integrative Health warns that it may worsen symptoms of autoimmune diseases such as RA by making the immune system more active.

Safety Considerations

Supplements can have health benefits, but they can also sometimes have side effects when used improperly or excessively.

The U.S. Food and Drug Administration (FDA) warns that it can’t assess or regulate supplements before they are marketed. This means that fraudulent or tainted dietary supplements can end up in the hands of consumers, which may have negative health impacts.

The FDA has some tips for being safe while shopping for supplements:

  • Use government (noncommercial) websites to search for supplements.
  • Remember that claims that sound too good to be true probably are.
  • Don’t confuse the word “natural” for “safe.”

Supplements are not medications and should not replace any doctor-prescribed medications for managing disease. Supplements might affect how medications work, so talk with your doctor before trying dietary supplements for RA.

Talk To People Who Understand

On myRAteam, the social network and online support group for people with rheumatoid arthritis and their loved ones, members discuss the chronic nature of the disease. Here, more than 191,000 members from across the world come together to ask questions, offer advice and support, and share stories with others who understand life with RA.

Are you using dietary supplements to help with RA symptoms? Share your experience in the comments below, or add your story on your Activities page.

References
  1. Dietary Supplements: What You Need To Know — National Institutes of Health Office of Dietary Supplements
  2. Information for Consumers on Using Dietary Supplements — U.S. Food and Drug Administration
  3. Tainted Arthritis/Pain Products — U.S. Food and Drug Administration
  4. Polyunsaturated Fats — American Heart Association
  5. Omega-3 Fatty Acids — National Institutes of Health Office of Dietary Supplements
  6. Polyunsaturated Fatty Acids in the Food Chain in the United States — The American Journal of Clinical Nutrition
  7. Trends in the Use of Complementary Health Approaches Among Adults: United States, 2002-2012 — National Health Statistics Report
  8. Clinical Benefits of n-3 PUFA and Gamma-Linolenic Acid in Patients With Rheumatoid Arthritis — Nutrients
  9. Omega-3 Fatty Acids and Inflammatory Processes — Nutrients
  10. Omega-3 Fatty Acids (Fish Oil) as an Anti-Inflammatory: An Alternative to Nonsteroidal Anti-Inflammatory Drugs for Discogenic Pain — Surgical Neurology
  11. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials — Nutrients
  12. Vitamin D — National Institutes of Health Office of Dietary Supplements
  13. Deficits of Vitamin D Are Strongly Associated With Methotrexate Treatment in Patients With Juvenile Idiopathic Arthritis — Bone Abstracts
  14. Vitamin D and Rheumatoid Arthritis — Therapeutic Advances in Endocrinology and Metabolism
  15. Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis — Current Rheumatology Reports
  16. Immunologic Effects of Vitamin D on Human Health and Disease — Nutrients
  17. Calcium — National Institutes of Health Office of Dietary Supplements
  18. Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide — Drugs & Aging
  19. What People With Rheumatoid Arthritis Need To Know About Osteoporosis — National Institute of Arthritis and Musculoskeletal and Skin Diseases
  20. Turmeric — National Center for Complementary and Integrative Health
  21. Curcumin for the Management of Periodontitis and Early ACPA-Positive Rheumatoid Arthritis: Killing Two Birds With One Stone — Nutrients
  22. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials — Journal of Medicinal Food
  23. Thunder God Vine — National Center for Complementary and Integrative Health
  24. Tripterygium Wilfordii Hook F versus Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs as Monotherapy for Rheumatoid Arthritis: A Systematic Review and Network Meta-Analysis — BMC Complementary and Alternative Medicine
  25. Cat’s Claw — National Center for Complementary and Integrative Health
  26. Cannabis (Marijuana) and Cannabinoids: What You Need To Know — National Center for Complementary and Integrative Health
  27. Joints for Joints: Cannabinoids in the Treatment of Rheumatoid Arthritis — Current Opinion in Rheumatology
  28. Cannabidiol (CBD): A Killer for Inflammatory Rheumatoid Arthritis Synovial Fibroblasts — Cell Death & Disease
  29. CBD for Arthritis Pain: What You Should Know — Arthritis Foundation
  30. What Is the Microbiome? — Archives of Disease in Childhood — Education and Practice
  31. Probiotics — National Institutes of Health Office of Dietary Supplements
  32. Probiotics and Arthritis — Arthritis Foundation
Posted on April 13, 2021
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Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here
Ashley Knox is a doctoral candidate at the University of Colorado, where she studies the noncoding RNAs involved in gammaherpesvirus pathogenesis. Learn more about her here

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