12 Supplements for Osteoarthritis

Before you buy supplements to treat your OA, see which ones have the best evidence behind them – and which do not.

12 Supplements for Osteoarthritis
Numerous natural supplements are promoted for treating osteoarthritis (OA), from glucosamine and chondroitin to curcumin. Some are better than others at easing pain and stiffness. Check with your doctor before trying any of these products – many have some side effects and some may interfere with your medications. Be informed when buying them. Use them only as part of a comprehensive OA management plan that includes exercising regularly, maintaining a healthy weight and protecting your joints.
Fish Oil
Fish oil is loaded with the omega-3 fatty acids DHA and EPA, which help bring down inflammation in the body. These supplements have the potential to protect the heart and brain, which may be why they’re so widely used. However, there’s no clear evidence that fish oil does anything to improve OA symptoms. In fact, based on the quality of evidence available, the American College of Rheumatology (ACR) does not recommend using it for hand, hip or knee OA.
Glucosamine and Chondroitin
Research has shown mixed results for using these popular supplements for OA, but there’s no proof that they ease OA pain in the knee, hip or other joints. Plus, they may interact with the blood thinning drug warfarin (Coumadin), and glucosamine can affect blood sugar control in people with diabetes. Based on available evidence, the ACR recommends against these supplements for hip or knee OA and against glucosamine for hand OA, although evidence is more mixed for chondroitin for hand OA.
Vitamin D
This vitamin strengthens bones, but it doesn’t do much, if anything, to relieve OA pain. Although one study suggested that vitamin D supplements might improve joint pain in people who are low in this nutrient, most other studies have found no significant benefit.
Methylsulfonylmethane (MSM)
MSM, a compound found in green fruits and vegetables, is used in the body to maintain and repair connective tissue, and it may have anti-inflammatory properties. Some studies found it may improve pain and function in knee OA, and a recent review says that, despite poor quality of studies, limited evidence does support using it for OA. Doses used in the studies ranged from 1.5 g to 6 g per day. MSM can cause side effects, including allergic reactions.
Pycnogenol, a bark extract of the maritime pine, is thought to have anti-inflammatory properties. A systematic review found that limited evidence supports trying this for OA for a few months; studies show improvements in knee OA pain and function when taken at 50 mg two or three times daily for three months. Side effects may include stomach upset and increased symptoms of autoimmune diseases so talk to your doctor before trying it.
S-Adenosyl-L-methionine (SAMe)
SAMe is a substance your body naturally produces. Studies on SAMe supplements for OA have been inconsistent. Some have found it to be as effective as NSAIDs at improving joint pain and function, but others haven’t shown any benefit at all. Although this supplement is generally safe, it could be risky for people with bipolar disorder or who are immune-compromised, and it may interact with drugs, including antidepressants and the Parkinson’s treatment levodopa.
Boswellia serrata
This plant extract has been used in Ayurvedic medicine for centuries to treat inflammatory diseases. In studies, proprietary extracts of Boswellia serrata (5-Loxin, Aflapin) temporarily reduced inflammation and pain and disability in knee OA. A systematic review found noteworthy effects in easing OA symptoms, although the quality of the evidence was weak. Minor side effects included nausea, headache, fever, diarrhea, abdominal pain and general weakness.
Curcumin, the active component that gives turmeric its distinctive yellow color, has anti-inflammatory and anti-rheumatic properties One review of studies on knee OA found that formulations of curcumin that are more easily absorbed by the body (such as Theracurmin or C3 Complex) reduced pain. As with MSM, pycnogenol and Boswellia, a recent review found that limited evidence does support using it for OA, although the studies were weak. Curcumin may interact with blood thinners, such as warfarin.
Avocado/Soybean Unsaponifiables (ASUs)
Made of extracts from avocado and soybean oils, these hard-to-pronounce supplements block inflammatory substances that break down cartilage. Some studies found ASUs improved pain, stiffness and joint function in knee and hip OA, although a recent review of studies concluded that the quality of studies was weak and improvements were modest. In certain people, ASUs can trigger an allergic reaction.
Willow bark
Willow bark comes from the same type of tree – Salix – that gives us salicylic acid, or aspirin. It’s been used for thousands of years to treat pain and inflammation. Whether willow bark works for OA hard to say, because study results have been mixed or have not shown any improvement compared to placebo. And though its side effects are minimal, willow bark can cause allergic reactions in people who are sensitive to aspirin.
Undenatured type II collagen (UC-II)
Collagen is the structural protein in skin, tendons, and bones. Collagen type II is the form in the cartilage lining the joints. Undenatured type II collagen (UC-II) supplements come from the breastbone of chickens. One study showed that UC-11 improved pain, stiffness, and function in knee OA better than a placebo, and slightly better than glucosamine and chondroitin supplements. Additional research is needed to confirm whether this supplement is effective for OA.

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