Herbal anti-inflammatories (Part 1)
A range of herbs available in oral supplements may be useful in helping to control inflammation associated with RA. It is important to note that herbal supplements are not a replacement for proven disease-modifying anti-rheumatic drugs (DMARDs), including both conventional DMARDs and newer biologics that have been shown to slow or prevent the progression of joint damage in RA. Herbal supplements may be useful as adjunctive treatments (this means secondary treatments used in conjunction with a primary treatment).
As with all supplements, whether vitamins, minerals, herbal or chemical products, consult with your doctor before you start taking an herbal supplement. There may be health risks associated with use of any supplement, including interactions with medications that you are taking and negative effects associated with health conditions you may have. Your doctor is also in the best position to determine the proper and safe dosage for any supplement.
Alfalfa is a plant with a long history of nutritional and medicinal use, including as treatment for arthritis. It has a range of medicinal properties, including anti-fungal, anti-microbial, and anti-inflammatory effects. Its medicinal use has been studied mainly in atherosclerosis, diabetes, and hyperlipidemia (high cholesterol), but it has also been used traditionally for centuries as a treatment for arthritis, disorders of the bladder or kidney, menstrual irregularities, and for upset stomach.1
Bladderwrack is a type of seaweed that grows on the Atlantic and Pacific coasts. Traditionally, it has been used to treat thyroid disorders and is included as part of weight loss formulas. It has been shown to have anticoagulant and hypoglycemic properties, and has been associated with anti-inflammatory, anti-arthritic, and anti-fungal effects. Results from studies conducted in patients with osteoarthritis suggest that bladderwrack may provide benefits, including control of pain and inflammation.2
Resins extracts from the plant boswellia have been used for centuries in China, India, and Africa as an anti-inflammatory agent. Studies have shown that boswellia inhibits pro-inflammatory chemicals in the body. Boswellia is said to provide an advantage over non-steroidal anti-inflammatory drugs (NSAIDs) in that it causes few gastrointestinal side effects. In China and India, boswellia has a long tradition as a treatment for inflammation in rheumatic diseases. It has been evaluated as a treatment for RA in a small number of studies. In a few of these studies, boswellia resulted in modest improvements in RA symptoms, including pain, morning stiffness, grip strength, and disability.3
Boswellia should be used with caution in patients with stomach ulcers or a history of gastrointestinal reflux. It should also be used with caution in patients with decreased liver function or lung disorders. It may interact with medications metabolized in the liver by cytochrome P450 enzymes and should be used with caution with sedative medications. Boswellia should be avoided by women who are pregnant or breastfeeding.4
Cat’s claw (Uncaria tomentosa and Uncaria guianensis) is a woody vine originating in Amazon rainforest, but several plant species are sold under the name cat’s claw. It has been used traditionally as a contraceptive, anti-inflammatory agent, and immune system stimulant. Results from animal and laboratory studies have confirmed the anti-inflammatory properties of this herb and have led to studies evaluating its use in RA (as well as osteoarthritis). Results from studies in RA have been promising, with cat’s claw resulting in reductions in painful and swollen joints. However, it is too early to make any definitive conclusions concerning the benefits of cat’s claw in RA.5
Cat’s claw should be avoided by patients with a history of immune system disorders and should be used with caution in patients with bleeding disorders or in patients with a history of stroke. It should be stopped at least 2 weeks before and after surgery or other procedures where there is increased risk for bleeding. Cat’s claw should be avoided by women who are pregnant or breastfeeding.4
The seeds of the plant borage (Borago officinalis) are a source of gamma-linolenic acid (GLA), which has been shown to inhibit the synthesis of certain immune system chemicals (leukotrienes). Seed oils are a source of GLA, and borage seed oil has one of the highest concentrations of GLA among various seed oils, including evening primrose and black current seed oils. Preliminary evidence indicates that GLA may have anti-inflammatory properties that make it beneficial in RA. However, more research is needed to determine the proper dosage of GLA, especially when taken in the form of an herbal supplement such as borage seed oil.
Borage seed oil should be used with caution in patients with bleeding disorders and in those who are being treated with anticoagulant (warfarin [Coumadin]) or anti-platelet treatments (blood thinners). Additionally, borage seed oil should be used with caution in patients with seizure disorders (epilepsy) and in those taking anticonvulsants. Borage seed oil should be avoided during pregnancy or while breastfeeding.
Read more in Part 2!