Oct. 28, 2013 at 8:14 PM ET
Why go natural?
Rheumatoid arthritis (RA) occurs when the immune system mistakenly attacks the membranes that line the joints and causes inflammation. There’s no cure for this chronic condition, and the drugs used to control symptoms—serious pain, swelling and even bone loss—can have side effects ranging from nausea to anemia to liver damage. So what can alternative treatments do? While natural remedies usually can’t take the place of conventional meds, they can help you reduce the dosage or frequency of these drugs to the point where side effects aren’t a problem, says David Leopold, M.D., of the Scripps Center for Integrative Medicine, in La Jolla, Calif. Here are the most effective and best-studied ways to alleviate RA symptoms—naturally.
Omega-3 fatty acids
There are lots of natural anti-inflammatories, but the best studied by far are omega-3 fatty acids. These heart-healthy, brain-boosting fats are especially prevalent in seafood, especially fatty fish such as salmon, sardines and tuna. Studies have found that adding omega-3s to the diet can reduce joint pain and morning stiffness in people with RA, says Chaim Putterman, M.D., chief of rheumatology at Montefiore Medical Center and Albert Einstein College of Medicine in New York City. Not a fan of fish? Fish oil capsules can give you the same benefits. But beware: High concentrations of omega-3s can thin the blood, so consult your doctor for the right dose.
Gamma linolenic acid
Gamma linolenic acid (GLA) is another fatty acid with anti-inflammatory properties, says Robert Zurier, M.D., who has studied the effects of GLA in rheumatoid arthritis patients at the University of Massachusetts Medical School. GLA is found mostly in botanical oils—evening primrose, black currant seed and especially borage oil, its richest source. The patients in Dr. Zurier's studies took three 1,000-milliliter capsules of borage oil every day for six months and reported less joint pain and stiffness than patients who took placebo capsules, and they also reduced their dose of nonsteroidal anti-inflammatory drugs.
You can find natural anti-inflammatories in a variety of spices, including turmeric, curcumin (turmeric's active ingredient) and ginger. "In effect, these spices act like low-dose versions of aspirin and ibuprofen," Dr. Leopold explains. Studies on ginger extract have found that it inhibits the inflammatory chemicals cranked out by the immune system. Don't feel like cooking with these spices? You can take supplements. Just remember that capsules contain higher concentrations, and overdosing can cause the same side effects as aspirin and ibuprofen, including stomach irritation, gastric ulcers and bleeding.
An anti-inflammatory diet
"Study after study shows that what people eat affects the body's inflammatory response," Dr. Leopold says that while some foods, such as processed foods, promote inflammation, others have the opposite effect. The anti-inflammatory diet, popularized by Andrew Weil, M.D., is rich in whole grains, fruits and veggies, olive oil, fish, beans, herbs, spices and green or white tea. It's scant on red meat, sugar, flour and saturated fat, with no recommendation for trans fats. Another aspect of the anti-inflammatory diet: "Not eating too much," says Dr. Leopold. Fat cells churn out a variety of inflammatory chemicals that can make RA symptoms worse.
Here's how your colon affects rheumatoid arthritis symptoms: It's home to beneficial bacteria, which help break down food, but also to harmful bacteria, which can proliferate when there's a change in the intestinal environment (from taking antibiotics, for instance). Harmful bacteria can trigger inflammation—worsening symptoms—while probiotics, or beneficial microorganisms, can reduce inflammation. Which probiotics may be most helpful? Bifidobacterium infantis, found in supplements such as Align and others, and probiotic mixtures containing bifidobacteria and other organisms such as lactobacilli, found in Ortho Biotic and VSL#3. Talk to your doctor before starting probiotics—some can interfere with RA medication.
Many natural anti-inflammatories have been turned into supplements, including bromelain (enzymes found in pineapple), EGCG (green tea extract), oleanolic acid (from olive oil) and herbs such as boswellia (Indian frankincense), devil's claw, ginkgo and thunder god vine. You can try any of these, but be patient. "I tell patients that they should generally see some type of benefit in three to four weeks if they're going to get any benefit," Dr. Leopold says. Because supplements also come with side effects, let your doctor know what you're taking, especially if you're also on over-the-counter or prescription drugs. To maximize safety, Dr. Leopold recommends buying only supplements made in the United States.
Hot springs and spas have a long tradition of easing the pain of rheumatoid arthritis, Dr. Putterman says. But you don't have to travel to get the same healing effects. Try soaking in a hot bath or Jacuzzi, or taking a hot shower to relieve your aching joints, help relax tense muscles and ease stiffness. Choose a comfortable water temperature—you may only need mild heat—and soak for about 15 minutes. What else helps? Exercising in warm water, either by swimming or taking a water aerobics class. On the other hand, pain and swelling in a joint may be eased by cold. Wrap a towel around a bag of ice or frozen vegetables and hold it on the painful joint for about 10 minutes. If pain and swelling in a single joint persists for more than a few hours, it could be a sign of infection, so seek medical care.
Put it all together
If you have rheumatoid arthritis, there are three lifestyle changes you must make:
“Everything else is a drop in the bucket if those three pieces aren’t in place,” Dr. Leopold says. And while exercise may not sound so enjoyable to someone with stiff, painful joints, regular physical activity can decrease your aches and pains while increasing flexibility. What types of workouts work best? Low-impact ones like walking or swimming that don’t jar or place stress on the joints. And while stretching, strengthening and conditioning are important, weight training should be gradual and controlled.
A version of this story originally appeared on iVillage.