Bromelain is naturally found in the pineapple plant. When taken on an empty stomach, bromelain acts as an anti-inflammatory. Phlogenzym, a combination of trypsin protein and rutin from buckwheat with bromelain has reduced pain and improved knee function in people with arthritis.
According to a 2016 review of studies, bromelain can reduce levels of a compound associated with inflammation in rheumatoid arthritis and osteomyelofibrosis. a
In a review published in the journal Arthritis Research & Therapy, in seven of nine trials, bromelain was as effective as diclofenac (a pain medication applied as a gel to sore joints), but in two trials it was no more effective than a placebo. The authors hypothesize that in the five trials that showed efficacy, the participants may have experienced a spontaneous resolution of the flare-up episode.
Allergic reactions can occur in people with allergies to pineapple, latex, honeybees, birch, cypress, and grass pollens who take bromelain supplements. There have been some reports of gastrointestinal problems, increased heart rate, and menstrual problems in people who have taken bromelain orally. The National Institutes of Health state that the research to date is mixed about whether bromelain, alone or with other medications, is effective in treating osteoarthritis. People with peptic ulcers or who will be having surgery should not take bromelain; it is a blood thinner.
SAMe is commonly used for painful conditions including osteoarthritis, fibromyalgia, bursitis, tendonitis, and chronic low back pain, as well as depression. In some studies, it has proven to be as effective an anti-inflammatory painkillers. According to the Arthritis Foundation, results may be felt in just one week, but it could take more than a month.
However, a 2009 review found that in four clinical trials that compared SAMe against a placebo; the difference between groups was small and could be attributed to chance.
In another study, 1200 mg of SAMe was compared with 200 mg of Celebrex (a prescription arthritis medication) for 16 weeks in patients with knee osteoarthritis. In the first month, Celebrex was the apparent winner and provided more pain relief than the SAMe. In the second month, though, SAMe and Celebrex provided the same amount of relief.
People who take SAMe should also take a B complex supplement. High doses of SAMe can cause flatulence, vomiting, diarrhea, headache, and nausea. It can interfere with antidepressant medications, which can be quite dangerous. People with bipolar disorders or who take monoamine oxidase inhibitors (MAOIs) should avoid SAMe. It can also interact with a variety of other dietary supplements, including L-tryptophan and St. John’s Wort. SAMe may worsen the symptoms of Parkinson’s disease.
Stinging nettle is used in folk medicine to treat arthritis symptoms and is said to ease gout. It is thought that certain irritants in the plant inhibit the same enzymes targeted by nonsteroidal painkillers like Aleve, Voltaren, and Celebrex. There is some preliminary evidence showing that it helps to reduce inflammation and modify the immune system. of
In a randomized, controlled trial from 2009, 81 study participants received either a placebo or a supplement containing fish oil, vitamin E, and stinging nettle. Those who took the active supplement reported fewer symptoms and used less anti-inflammatory medication compared to the placebo group over three months.
Unfortunately, most research done to date on stinging nettle is of poor quality. Stinging nettle can cause stomach complaints and sweating. Stinging nettle can decrease blood glucose and blood pressure levels, so caution is warranted among people with diabetes or those with hypotension or who take blood pressure medication. Stinging nettle contains large amounts of vitamin K and should not be used by individuals on certain blood thinners. Individuals who take lithium should not use stinging nettle. Long-term use of stinging nettle might increase the risk of kidney damage.
Pycnogenol is an extract of the maritime pine trees grown in Europe. It is believed to have anti-inflammatory effects and has decreased c-reactive protein levels by 70% in some research. Pycnogenol contains procyanidin, a powerful antioxidant that seems to inhibit COX 1 and COX 2, which are the pro-inflammatory enzymes targeted by many prescription medications. It also increased the amount of plasma-free radicals simultaneously scavenged by 30% in one study.
Three clinical studies, all of which were randomized, double-blind, and placebo-controlled, demonstrated a highly significant improvement of symptoms in mild osteoarthritis, despite a reduced intake of NSAID medications among participants. In one of the studies, the pycnogenol group experienced a 53% reduced score for stiffness and a 64% increase in well-being (emotion scores) after three months of supplementation with 100 mg of pycnogenol daily.
Side effects of pycnogenol include dizziness, vertigo, headache, sleepiness, and upset stomach. Individuals with immune disorders should not take pycnogenol.
Turmeric is used in China and India to treat arthritis by reducing pain, inflammation, and stiffness. Curcumin is the active ingredient in turmeric. A 2016 systematic review examined data from eight randomized clinical trials and determined that there was enough evidence to suggest that taking 1,000 mg of curcumin each day for eight to 12 weeks can help to reduce the pain and inflammation of arthritis and might be as effective as nonsteroidal anti-inflammatory drugs. However, the sample size of the studies reviewed were quite small, ranging from 45 to 124 participants.
A 2017 study of 36 people compared the efficacy of two different doses of curcumin vs. placebo in rheumatoid arthritis. The active therapy or the placebo was taken twice per day for 90 days. The participants who took the bioavailable formulation of curcumin in either the 250 mg or the 500 mg dose reported significant improvements in pain and inflammation compared to the placebo group. These changes were confirmed by erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor blood tests, as well as scoring on the visual analog scale and the Disease Activity Score 28.
Turmeric is poorly absorbed so has been formulated in a variety of ways, but there’s not much high-quality evidence to determine if one form is better than the others. Like ginger, turmeric is a blood thinner. High doses of turmeric can cause stomach upset. Individuals with gallbladder disease hould not take turmeric or curcumin. High doses of curcumin might cause iron-deficiency anemia in some people.