Any effective supplements to reduce inflammation/reduce pain

This topic is covered every time a new person joins. There is a search function on each forum, if you put in the right key words all the threads about it will pop up for you perusal. My feeling is that those who swear by their supplements don't actually have arthritis, more just the general aches and pains of ageing. Before I knew what was wrong with me I tried glucosamine and cod liver oil but they did not help at all which wasn't surprising as I was producing an excess of joint lubricant . I also tried dietary aspects and magnets but again no true or lasting benefits were gained.

Arthritis is a progressive and degenerative disease, surely if these things were effective none of us would be here, the forum wouldn't exist. By all means try them, plus the copper insoles, bangles, magnets, cider vinegar etc etc etc and try not to expect too much; mind you, you could be exception to the rule and find something that works for you. Now wouldn't that be good? DD

This is one of the few areas on which DD and I differ I have a husband with extremely mild OA ie he plays golf twice a week and goes to the gym or walks up hills on other days. He doesn't consider he has OA just 'a spot of wear and tear'. But he does get hip and knee pain from time to time and he does wince occasionally when getting up from a chair. He takes cod liver oil tablets daily and also glucosamine. If he goes without for a few weeks he soon starts them up again because he feels they make a difference.

It seems like they do help in some way, maybe because his is so mild. He's not over fond of fish, especially oily fish, so the chances of him getting enough fish oil from diet alone are not very high whereas I like it and eat much more.

If you enter 'diet' into the search engine at the top of the page you'll find, on the left, a reference to AC's booklet on Healthy Eating & Arthritis. It has a whole section on supplements and which might be effective. It does also warn, though, that we should always check with the GP before trying any if we're on prescription meds.

Hi again Louisa,

We already ‘met’ in your forum post about osteoarthritis and osteoporosis. You already know that I am not a doctor or a sufferer with years of experience to share, but like you I want to know more about my OA, what is causing it and my various other problems. The doctors say my problems unrelated, but the coincidence seems too unlikely, so I have been reading all I can. Here is what I have found out.

The traditional view is that OA is caused by wear and tear. The newest research seems to show that it is caused by inflammation. There is a good summary here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638313/. The most influential piece of research was published in Nature Medicine in 2011, summary here http://www.nature.com/nm/journal/v17/n12/full/nm.2543.html.

Unfortunately, although this science is very interesting, it doesn't provide us with a cure: people have known for years that rheumatoid arthritis is caused by inflammation, and they still can’t cure that. There have been some mixed results in recent drug trials. A TNF blocker helped in one trial for OA in the hips and not in another for the knee. (Broccoli is high in TNF-blockers, as are cauliflower and cabbage. They might help and they aren't likely to do you any harm.) Anti-bacterial/anti-inflammatory drug Doxycycline also seemed to work in one trial and not in another.

People with gout (another form of arthritis) are routinely treated to reduce a substance called uric acid. This causes crystals that injure the cartilage and more general inflammation and damage. Some people with OA have high levels of this too and can benefit from the same medication or changes in diet to reduce it. I plan to ask my doctor about it.

No one knows whether most inflammation in OA starts spontaneously, or is triggered by factors elsewhere. A test for C-reactive protein can find high levels of inflammation. A high result could simply mean that you are recovering from flu or an injury, or it could show chronic inflammation, which has been linked to heart attack and OA. Despite my heart problems I had not previously had the test but I have now and will get the results on Tuesday. Even it is high, we won’t know what is causing it. It could be the OA itself, or something as simple as a gut infection. (Many people are infected with a thing called Heliobacter Pylori; most show no ill-effects, but some get irritable bowel disease and systemic inflammation.) There is a simple test for this too, and if you have it and high inflammation you should probably get rid of it, and then see whether the inflammation goes down.

It used to be thought that diabetes went with OA just because the same people were at risk for the two diseases, but now some studies have shown that diabetes makes you more prone to OA. If you haven’t had your blood sugar tested, you should. Similarly, people used to think that losing weight helped OA just by reducing joint strain, but it now seems that it can have other benefits in some people – perhaps by reducing the risk of diabetes. Even very slim people like me can have too much fat stored in their livers. This adds to risk of inflammation, diabetes and other problems. I plan to have mine checked. People also used to think that the benefit of exercise to OA sufferers was only in strengthening muscles, but some studies seem to show other benefits too, perhaps by the same route. (Different studies don’t find any benefit.)

As well as inflammation, it seems likely that OA can be triggered by shortages of various nutrients – some of which are the same as those which can lead to osteoporosis. There is a good review of this on http://www.arthritisresearchuk.org/arthritis-information/arthritis-and-daily-life/diet-and-arthritis.aspx. Making sure that we have enough calcium and vitamin d seems important for our OA as well as our bone strength. Shortages of selenium (common in the UK according to Arthritis research and easily fixed with Brazil nuts) can have a particularly bad effect. If you haven’t had your vitamin d checked, you should, and if you have a cooperative doctor, you may be able to check for other nutrient/mineral deficiencies too.

I have been told that my homocysteine is so high that I must have inherited a genetic defect. The most common of these mean that the body can’t convert the forms of vitamins B6, B12 or folic acid that we eat into the final forms that the body needs to use. I understand that shortages in these final forms of B vitamins can cause bone deiseases too, and I hope to get myself checked out for them. The final forms of the vitamins can be taken as supplements.

There is also some scientific evidence that omega-3 fatty acids (in fish oil and walnuts) and COX-2 inhibitors (in turmeric, ginger, rosemary, green tea) help to reduce inflammation, and may or may not reduce pain from OA. (They work in the same way as some of the common OA drugs.)

So, it might be worth getting yourself checked for uric acid, for deficiencies in nutrients including vitamin d and selenium, for high blood sugar and for chronic inflammation. Whether or not you have any of these problems, there may be benefits in eating more oily fish (especially sardines or salmon with their bones in – lots of calcium), walnuts, Brazil nuts, broccoli or cabbage, ginger and green tea. Fruit is good too for vitamin C. Losing weight (if you have any to lose), getting more exercise, giving up smoking and cutting down on alcohol are unlikely to do any harm. These things could all help your OP and general health as well as OA.

When I was told that my homocysteine level was 45 compared with a normal range of 4-10, and that it was a risk factor for everything from heart attack and Alzheimer's to fractures and cancer, the endocrinologist said that he was pretty sure that taking folic acid would bring the level down. He didn't know whether that would reduce any of the underlying risks, but it might do, there was nothing better on offer, and it wouldn't do any harm so I might as well try. That's how I feel about the broccoli and sardines too.

Best wishes,

Alan

Thank you, Alan, for sharing your research. Some very helpful information there I think.

Anna

Hi Louisa,

Sorry I'm a bit late to this

Just a flying visit, one thing to add to all the helpful responses above: for anyone interested in taking fish oil to combat inflammation, check out Arthritis Care's Inspire magazine, page 5, via http://portfolio.cpl.co.uk/inspire/2013-spring/1/

Aspirin can be rough on the stomach, of course, but a good proton pump inhibitor might help with this. (I'll check with my doc.)

And many thanks to DD, by the way, for mentioning the magazine on another thread

Best wishes,
Phee

Glucosamine has been researched and shown to be beneficial at 1500mg + it has also been shown that taking it with chondroitin and msm increases its benefit, I won't go into the detail why its beneficial but Google has plenty of info!
Omega 3 has also been researched as beneficial and basically is recommended because the nature of the western diet means we consume too much omega 6 and the balance of the two gets distorted which has various detrimental health effects.

From personal experience when I got diagnosed with ra my hands were scanned and I had some small erosion s in a couple of joints, I took a glucosamine supplement and omega 3 as well as the mainstream meds. I improved loads which I mostly attribute to the meds but on my follow up scan a year later the erosions had healed.
I can add I know several dogs with oa who have responded v well to glucosamine without any other meds, since they can't imagine getting better etc I'd say that's a genuinely positive sign.

My understanding from the scientific studies, is that glucosamine has not been shown to have any beneficial effect. There is a 2010 review of the trials on up until then on patients with OA of the knee/hip in the British Medical Journal available here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941572/

Conclusions Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged

Alan

Just to be cynical it is the pharmaceutical firms that pay for pretty much all the trials appearing in the bmj! There certainly are studies showing a positive effect but it was some time ago I read them so I can't give u the details they're in my copious uni notes somewhere!