Osteoarthritis - Supplements

About this treatment

What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

Supplement	Amount	Why
Boswellia, Ashwagandha, Turmeric, and Zinc	1,000 mg daily boswellia resin herbal extract or two capsules, three times per day of Aticulin-F (formula containing 100 mg boswellia, 450 mg ashwagandha, 50 mg turmeric, and 50 mg zinc)	A combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness in one study, without the stomach irritation that is a common side effect of NSAIDs.
Boswellia, Ashwagandha, Turmeric, and Zinc 1,000 mg daily boswellia resin herbal extract or two capsules, three times per day of Aticulin-F (formula containing 100 mg boswellia, 450 mg ashwagandha, 50 mg turmeric, and 50 mg zinc) Boswellia has anti-inflammatory properties that have been compared to those of the NSAIDs used by many for inflammatory conditions.¹¹ Clinical trials have found that boswellia is more effective than a placebo for relieving pain and swelling and preventing loss of function in people with osteoarthritis.¹² Boswellia has also been found to be as effective as the anti-inflammatory drug valdecoxib (Bextra). In addition, while the improvements occurred more slowly in the boswellia group than in the valdecoxib group, they persisted for a longer period of time after treatment was discontinued.¹³ One clinical trial found that a combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness associated with OA but did not improve joint health, according to X-rays of the affected joint.¹⁴ Unlike NSAIDs, long-term use of boswellia does not lead to irritation or ulceration of the stomach.

Supplement	Amount	Why
Cat’s Claw	100 mg of a freeze-dried preparation daily	Cat’s claw has been used traditionally for OA. In one trial, cat's claw was significantly more effective than a placebo at relieving pain and improving overall condition.
Cat’s Claw 100 mg of a freeze-dried preparation daily Cat’s claw has been used traditionally for OA. In a double-blind trial, 100 mg per day of a freeze-dried preparation of cat's claw taken for four weeks was significantly more effective than a placebo at relieving pain and improving the overall condition.¹⁵ What Else Is This Supplement Used For?

Supplement	Amount	Why
Cayenne	Apply 0.025 to 0.075% capsaicin ointment four times per day over painful joints	When rubbed over painful joints, cayenne extract creams containing 0.025 to 0.075% capsaicin may reduce the pain and tenderness of OA.
Cayenne Apply 0.025 to 0.075% capsaicin ointment four times per day over painful joints Several double-blind trials have shown that topical use of cayenne extract creams containing 0.025 to 0.075% capsaicin reduces pain and tenderness caused by OA.¹⁶ ^{, 17} ^{, 18} ^{, 19} These creams are typically applied four times daily for two to four weeks, after which twice daily application may be sufficient.²⁰ Products containing capsicum oleoresin rather than purified capsaicin may not be as effective.²¹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Chondroitin Sulfate	800 to 1,200 mg a day	Many trials have shown that supplementing with chondroitin sulfate reduces pain, increases joint mobility, and promotes healing within the joints.
Chondroitin Sulfate 800 to 1,200 mg a day Chondroitin sulfate (CS) is a major component of the lining of joints. The structure of CS includes molecules related to glucosamine sulfate. CS levels have been reported to be reduced in joint cartilage affected by OA. Possibly as a result, CS supplementation may help restore joint function in people with OA.²² On the basis of preliminary evidence, researchers had believed that oral CS was not absorbed in humans;²³ as a result, early double-blind CS research was done mostly by giving injections.²⁴^{, 25} This research documented clinical benefits from CS injections. It now appears, however, that a significant amount of CS is absorbable in humans,²⁶ though dissolving CS in water leads to better absorption than swallowing whole pills.²⁷ Strong clinical evidence now supports the use of oral CS supplements for OA. Many double-blind trials have shown that CS supplementation consistently reduces pain, increases joint mobility, and/or shows evidence (including X-ray changes) of healing within joints of people with OA.²⁸ ^{, 29} ^{, 30} ^{, 31} ^{, 32} ^{, 33} ^{, 34} ^{, 35} ^{, 36} ^{, 37} Most trials have used 400 mg of CS taken two to three times per day. One trial found that taking the full daily amount (1,200 mg) at one time was as effective as taking 400 mg three times per day.³⁸ Reduction in symptoms typically occurs within several months. What Else Is This Supplement Used For?

Supplement	Amount	Why
Ginger	510 mg daily of a concentrated herbal extract, taken in divided doses	Ginger has historically been used for arthritis and rheumatism. Studies have shown it to be effective at relieving pain and swelling in people with OA.
Ginger 510 mg daily of a concentrated herbal extract, taken in divided doses Ginger has historically been used for arthritis and rheumatism. A preliminary trial reported relief in pain and swelling among people with arthritis who used powdered ginger supplements³⁹ More recently, a double-blind trial found ginger extract (170 mg three times a day for three weeks) to be slightly more effective than placebo at relieving pain in people with OA of the hip or knee.⁴⁰ In another double-blind study, a concentrated extract of ginger, taken in the amount of 255 mg twice daily for six weeks, was significantly more effective than a placebo, as determined by the degree of pain relief and overall improvement.⁴¹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Glucosamine	1,500 mg daily	Glucosamine sulfate is necessary for joint cartilage synthesis and repair. It has been shown to significantly reduce osteoarthritis symptoms and appears to be virtually free of side effects.
Glucosamine 1,500 mg daily Glucosamine sulfate (GS), a nutrient derived from seashells, is a building block needed for the synthesis and repair of joint cartilage. GS supplementation has significantly reduced symptoms of osteoarthritis in uncontrolled⁴²^{, 43} and single-blind trials.⁴⁴^{, 45} Many double-blind trials have also reported efficacy.⁴⁶^{, 47}^{, 48}^{, 49}^{, 50}^{, 51} One published trial has reported no effect of GS on osteoarthritis symptoms,⁵² and GS has been found to be ineffective for low back pain related to lumbar spine osteoarthritis.⁵³ While most research trials use 500 mg GS taken three times per day, results of a three-year, double-blind trial indicate that 1,500 mg taken once per day produces significant reduction of symptoms and halts degenerative changes seen by x-ray examination.⁵⁴ GS does not cure people with osteoarthritis, and they may need to take the supplement for the rest of their lives in order to maintain benefits. Fortunately, GS appears to be virtually free of side effects, even after three or more years of supplementation. Benefits from GS generally become evident after three to eight weeks of treatment. What Else Is This Supplement Used For?

Supplement	Amount	Why
SAMe	1200 mg daily	SAMe has anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints and reduce OA symptoms.
SAMe 1200 mg daily SAMe (S-adenosyl methionine) possesses anti-inflammatory, pain-relieving, and tissue-healing properties that may help protect the health of joints,⁵⁵^{, 56} though the primary way in which SAMe reduces OA symptoms is not known. A very large, though uncontrolled, trial (meaning that there was no comparison with placebo) demonstrated “very good” or “good” clinical effect of SAMe in 71% of over 20,000 OA sufferers.⁵⁷ In addition to this preliminary research, many double-blind trials have shown that SAMe reduces pain, stiffness, and swelling better than placebo and equal to drugs such as ibuprofen and naproxen in people with OA.⁵⁸^{, 59}^{, 60}^{, 61}^{, 62}^{, 63}^{, 64}^{, 65} These double-blind trials all used 1,200 mg of SAMe per day. Lower amounts of oral SAMe have also produced reductions in the severity of OA symptoms in preliminary clinical trials. A two-year, uncontrolled trial showed significant improvement of symptoms after two weeks at 600 mg SAMe daily, followed by 400 mg daily thereafter.⁶⁶ This amount was also used in a double-blind trial, but participants first received five days of intravenous SAMe.⁶⁷ A review of the clinical trials on SAMe concluded that its efficacy against OA was similar to that of conventional drugs but that patients tolerated it better.⁶⁸ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B3	Refer to label instructions	Supplemental niacinamide (a form of vitamin B3) has been reported to increase joint mobility, improve muscle strength, and decrease fatigue in people with osteoarthritis.
Vitamin B3 In the 1940s and 1950s, one doctor reported that supplemental niacinamide (a form of vitamin B3) increased joint mobility, improved muscle strength, and decreased fatigue in people with OA.⁶⁹ ^{, 70} ^{, 71} In the 1990s, a double-blind trial confirmed a reduction in symptoms from niacinamide within 12 weeks of beginning supplementation.⁷² Although amounts used have varied from trial to trial, many doctors recommend 250 to 500 mg of niacinamide four or more times per day (with the higher amounts reserved for people with more advanced arthritis). The mechanism by which niacinamide reduces symptoms is not known. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Avocado and Soybean Unsaponifiables	Refer to label instructions	An extract of avocado and soybean oils, known as avocado/soybean unsaponifiables, appears to reduce inflammation and help repair damaged cartilage tissue.
Avocado and Soybean Unsaponifiables An extract of avocado and soybean oils, known as avocado/soybean unsaponifiables (ASU), was found in a double-blind trial to reduce joint pain and improve overall functioning in people with osteoarthritis of the knee or hip. The amount used was 300 mg per day for six months.⁷³ In a three-month double-blind trial, 71% of people taking ASU, but only 36% of those taking a placebo, were able to decrease their pain medicine or anti-inflammatory medicine by more than 50%.⁷⁴ In a longer-term double-blind trial (two years), ASU treatment did not improve symptoms when compared with a placebo, and did not slow the progression of osteoarthritis (as determined by the amount of joint cartilage lost). However, in the subgroup of patients with the most severe disease, ASU treatment did significantly decrease the loss of joint cartilage.⁷⁵ ASU is believed to work by reducing inflammation and by aiding in the repair of damaged cartilage tissue. ASU is approved as a prescription drug in France and is available over the counter in some other countries.

Supplement	Amount	Why
Cartilage and Collagen	Refer to label instructions	Taking collagen hydrolysate may help relieve pain associated with osteoarthritis of the hip and knee.
Cartilage and Collagen In a double-blind study, collagen hydrolysate was compared with gelatin and egg protein as a treatment for osteoarthritis of the hip and/or knee. When subjects took 10 grams per day either of gelatin or collagen hydrolysate for two months, they reported significantly more pain relief than when they took a similar amount of egg protein.⁷⁶ More research is needed to confirm the benefits of gelatin or collagen hydrolysate in OA. What Else Is This Supplement Used For?

Supplement	Amount	Why
Cetyl Myristoleate	540 mg per day by mouth for 30 days	Cetyl myristoleate appears to be effective as a joint “lubricant” and anti-inflammatory agent.
Cetyl Myristoleate 540 mg per day by mouth for 30 days Cetyl myristoleate (CMO) has been proposed to act as a joint “lubricant” and anti-inflammatory agent. In a double-blind trial, people with various types of arthritis who had failed to respond to nonsteroidal anti-inflammatory drugs (NSAIDs) received CMO (540 mg per day orally for 30 days), while others received a placebo.⁷⁷ These people also applied CMO or placebo topically, according to their perceived need. A statistically significant 63.5% of those using CMO improved, compared with only 14.5% of those using placebo. What Else Is This Supplement Used For?

Supplement	Amount	Why
Devil’s Claw	2,610 mg daily (containing 57 mg harpagoside, 87 mg total iridoid glycosides daily)	Devil’s claw extract was found in one trial to reduce pain associated with OA as effectively as the slow-acting analgesic/ cartilage-protective drug diacerhein.
Devil’s Claw 2,610 mg daily (containing 57 mg harpagoside, 87 mg total iridoid glycosides daily) Devil’s claw extract was found in one clinical trial to reduce pain associated with OA as effectively as the slow-acting analgesic/cartilage-protective drug diacerhein.⁷⁸ The amount of devil’s claw used in the trial was 2,610 mg per day. The results of this trial are somewhat suspect, however, as both devil’s claw and diacerhein are slow-acting and there was no placebo group included for comparison. What Else Is This Supplement Used For?

Supplement	Amount	Why
Digestive Enzymes	90 mg of bromelain and 48 mg of trypsin, with 100 mg of rutosid, taken in enteric-coated pills three times per day	In one study, people with painful OA of the knee who received an oral enzyme-flavonoid preparation saw more improvement in pain and joint function than those who took a nonsteroidal anti-inflammatory (NSAID).
Digestive Enzymes 90 mg of bromelain and 48 mg of trypsin, with 100 mg of rutosid, taken in enteric-coated pills three times per day In a double-blind study, a group of people with painful OA of the knee received an oral enzyme-flavonoid preparation or a nonsteroidal anti-inflammatory (NSAID) for six weeks. While both treatments relieved pain and improved joint function, the enzyme-flavonoid product appeared to be slightly more effective than the NSAID. No serious side effects were seen.⁷⁹ The enzyme-flavonoid product used in this study was Phlogenzym (Mucos Pharma, Geretsried, Germany). Each enteric-coated tablet contained 90 mg of bromelain, 48 mg of trypsin, and 100 mg of rutosid (a derivative of the flavonoid rutin); one tablet was given three times a day. What Else Is This Supplement Used For?

Supplement	Amount	Why
DMSO	Apply a gel containing 25% DMSO under the direction of a qualified healthcare practitioner	Topical DMSO appears to be anti-inflammatory and able to relieve pain associated with OA, possibly by inhibiting the transmission of pain messages by nerves.
DMSO Apply a gel containing 25% DMSO under the direction of a qualified healthcare practitioner The therapeutic use of DMSO (dimethyl sulfoxide) is controversial because of safety concerns, but some preliminary research shows that diluted preparations of DMSO, applied directly to the skin, are anti-inflammatory and alleviate pain, including pain associated with OA.⁸⁰ ^{, 81} A recent double-blind trial found that a 25% concentration of DMSO in gel form relieved OA pain significantly better than a placebo after three weeks.⁸² DMSO appears to reduce pain by inhibiting the transmission of pain messages by nerves⁸³ rather than through a process of healing damaged joints. DMSO comes in different strengths and different degrees of purity; in addition, certain precautions must be taken when applying DMSO. For these reasons, DMSO should be used only with the supervision of a doctor. What Else Is This Supplement Used For?

Supplement	Amount	Why
Green-Lipped Mussel	1,050 to 2,100 mg daily of freeze-dried powder or 210 mg daily of lipid extract	New Zealand green-lipped mussel supplements have been shown in various studies to reduce joint tenderness and stiffness and improve pain, including knee pain in people with OA.
Green-Lipped Mussel 1,050 to 2,100 mg daily of freeze-dried powder or 210 mg daily of lipid extract The effects of New Zealand green-lipped mussel supplements have been studied in people with OA. In a preliminary trial, either a lipid extract (210 mg per day) or a freeze-dried powder (1,150 mg per day) of green-lipped mussel reduced joint tenderness and morning stiffness, as well as improving overall function in most participants.⁸⁴ In a double-blind trial, 45% of people with OA who took a green-lipped mussel extract (350 mg three times per day for three months) reportedly had improvements in pain and stiffness.⁸⁵ Another double-blind trial reported excellent results from green-lipped mussel extract (2,100 mg per day for six months) for pain associated with arthritis of the knee.⁸⁶ Side effects, such as stomach upset, gout, skin rashes, and one case of hepatitis have been reported in people taking certain New Zealand green-lipped mussel extracts.⁸⁷ What Else Is This Supplement Used For?

Supplement	Amount	Why
Guggul	500 mg of a concentrated extract (3.5% guggulsterones) three times per day	In one trial, supplementing with guggul significantly improved symptoms in people with OA of the knee.
Guggul 500 mg of a concentrated extract (3.5% guggulsterones) three times per day In a preliminary trial, supplementation with 500 mg of a concentrated extract (3.5% guggulsterones) of Commiphora mukul (guggul) three times per day for one month resulted in a significant improvement in symptoms in people with OA of the knee.⁸⁸ Double-blind trials are needed to rule out the possibility of a placebo effect. What Else Is This Supplement Used For?

Supplement	Amount	Why
Krill Oil	300 mg per day	In one study, people who took krill oil saw significant reduction in arthritis severity and used less pain-relief medication than those taking placebo.
Krill Oil 300 mg per day In a double-blind study, people with high levels of C-reactive protein (CRP), an indicator of systemic inflammation in the body, most of whom also had osteoarthritis, were given 300 mg each morning of krill oil from Antarctic krill (a zooplankton crustacean) or a placebo. After one month those taking krill oil had significantly greater reduction in arthritis severity based on a questionnaire focusing on joint pain, stiffness, and loss of function related to osteoarthritis of the knee and hip. Use of pain-relief medication was also reduced compared to those taking placebo.⁸⁹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Methylsulfonylmethane (MSM)	2.25 to 6.0 grams per day	In one trial, supplementing with methyl-sulfonylmethane significantly reduced pain and improved overall physical functioning in patients with OA of the knee.
Methylsulfonylmethane (MSM) 2.25 to 6.0 grams per day According to a small double-blind trial, 2,250 mg per day of oral methylsulfonylmethane (MSM), a variant of DMSO, reduced OA pain after six weeks.⁹⁰ In another double-blind trial, supplementation with 3 grams of MSM twice a day for 12 weeks significantly reduced pain and improved overall physical functioning in patients with OA of the knee.⁹¹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Nettle	Apply stinging nettle under the direction of a qualified healthcare practitioner	Stinging nettle has historically been used for joint pain and has been shown to be safe and effective for relieving the pain of OA.
Nettle Apply stinging nettle under the direction of a qualified healthcare practitioner has historically been used for joint pain. Topical application with the intent of causing stings to relieve joint pain has been assessed in preliminary and double-blind trials. The results found intentional nettle stings to be safe and effective for relieving the pain of OA. The only reported adverse effect is a sometimes painful or numbing rash that lasts 6 to 24 hours. What Else Is This Supplement Used For?

Supplement	Amount	Why
Pycnogenol	100 to 150 mg per day	Double-blind research has shown that Pycnogenol may improve symptoms of osteoarthritis, including reducing pain and the use of pain-relieving medication and improving walking performance.
Pycnogenol 100 to 150 mg per day In a double-blind trial, 100 mg per day of Pycnogenol reduced pain and other osteoarthritis symptoms, improved walking performance, and reduced the use of pain-relieving medication.⁹² Another double blind trial found that 150 mg per day also improved symptoms and reduced use of pain-relieving medication.⁹³ What Else Is This Supplement Used For?

Supplement	Amount	Why
Rose Hips	5 grams of rose hips powder daily	In a study of people with OA of the knee or hip, supplementing with rose hips powder significantly reduced pain, joint stiffness, and overall disease severity.
Rose Hips 5 grams of rose hips powder daily In a double-blind study of people with OA of the knee or hip, supplementation with 5 grams of rose hips powder per day resulted in a significant reduction in pain after three weeks, compared with a placebo.⁹⁴ After three months of treatment with rose hips, joint stiffness and overall disease severity were also improved.

Supplement	Amount	Why
Vitamin E	400 to 1,600 IU per day	As an antioxidant, vitamin E appears to help protect joints.
Vitamin E 400 to 1,600 IU per day People who have OA and eat large amounts of antioxidants in food have been reported to exhibit a much slower rate of joint deterioration, particularly in the knees, compared with people eating foods containing lower amounts of antioxidants.⁹⁵ Of the individual antioxidants, only vitamin E has been studied as a supplement in controlled trials. Vitamin E supplementation has reduced symptoms of OA in both single-blind⁹⁶ and double-blind research.⁹⁷ ^{, 98} In these trials, 400 to 1,600 IU of vitamin E per day was used. Clinical effects were obtained within several weeks. However, in a six-month double-blind study of patients with OA of the knee, 500 IU per day of vitamin E was no more effective than a placebo.⁹⁹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
White Willow	Take an extract supplying 240 mg of salicin per day	Willow has anti-inflammatory and pain-relieving properties. Although pain relief from willow supplementation may be slow in coming, it may last longer than pain relief from aspirin.
White Willow Take an extract supplying 240 mg of salicin per day Willow has anti-inflammatory and pain-relieving properties. Although pain relief from willow supplementation may be slow in coming, it may last longer than pain relief from aspirin. One double-blind trial found that a product containing willow along with black cohosh, guaiac (Guaiacum officinale, G. sanctum), sarsaparilla, and aspen (Populus spp.) bark effectively reduced OA pain compared to placebo.¹⁰⁰ Another trial found that 1,360 mg of willow bark extract per day (delivering 240 mg of salicin) was somewhat effective in treating pain associated with knee and/or hip OA.¹⁰¹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Boron	Refer to label instructions	Boron affects calcium metabolism, and people with OA have been reported to have low bone stores of boron. Supplementing with boron may replenish stores and improve symptoms.
Boron Boron affects calcium metabolism, and a link between boron deficiency and arthritis has been suggested.¹⁰² Although people with OA have been reported to have lower stores of boron in their bones than people without the disease, other minerals also are deficient in the bones of people with OA.¹⁰³ One double-blind trial found that 6 mg of boron per day, taken for two months, relieved symptoms of OA in five of ten people, compared with improvement in only one of the ten people assigned to placebo.¹⁰⁴This promising finding needs confirmation from larger trials. What Else Is This Supplement Used For?

Supplement	Amount	Why
Bovine Cartilage	Refer to label instructions	Several trials have suggested that supplementing with bovine cartilage, either topically or injected, may relieve symptoms.
Bovine Cartilage Several trials have suggested that people with OA may benefit from supplementation with bovine cartilage, which contains a mixture of protein and molecules related to chondroitin sulfate. In one preliminary trial, use of injected and topical bovine cartilage led to symptom relief in most people studied.¹⁰⁵ A ten-year study confirmed improvement with long-term use of bovine cartilage.¹⁰⁶ Optimal intake of bovine cartilage is not known.

Supplement	Amount	Why
Fish Oil	Refer to label instructions	The omega-3 fatty acids present in fish oil, EPA and DHA, have anti-inflammatory effects and may relieve pain.
Fish Oil The omega-3 fatty acids present in fish oil, EPA and DHA, have anti-inflammatory effects and have been studied primarily for rheumatoid arthritis, which involves significant inflammation. However, OA also includes some inflammation.¹⁰⁷ In a 24-week controlled but preliminary trial studying people with OA, people taking EPA had “strikingly lower” pain scores than people who took placebo.¹⁰⁸ However, in a double-blind trial by the same research group, supplementation with 10 ml of cod liver oil per day was no more effective than a placebo.¹⁰⁹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Glucosamine Hydrochloride	Glucosamine hydrochloride	Studies have shown glucosamine hydrochloride to be effective at reducing pain and improving symptoms in people with OA.
Glucosamine Hydrochloride Glucosamine hydrochloride A few trials have evaluated glucosamine hydrochloride (GH), another form of glucosamine, as a single remedy for OA. One trial found only minor benefits from 1,500 mg per day of GH for 8 weeks in people with OA of the knee. However, these people were also taking up to 4,000 mg per day of for pain relief, and that treatment might have masked a beneficial effect of GH. In another study, supplementing with GH (2,000 mg each morning for 12 weeks) significantly improved symptoms, compared with a placebo, in people with knee pain due to cartilage damage or OA. In a four-week study from China, GH was as effective as GS in people with OA of the knee. Another study found that the combination of GH and chondroitin sulfate was more effective than a placebo in people with moderate to severe knee pain from OA, but not in those with mild pain. Despite the reported beneficial effects of GH, some investigators believe that the sulfate component of GS itself helps relieve OA, and that GS would therefore be more effective than GH.

Supplement	Amount	Why
Horsetail	Refer to label instructions	Horsetail has anti-arthritis actions and is rich in silicon, a trace mineral that plays a role in making and maintaining connective tissue.
Horsetail Horsetail is rich in silicon, a trace mineral that plays a role in making and maintaining connective tissue. Practitioners of traditional herbal medicine believe that the anti-arthritis action of horsetail is due largely to its silicon content. The efficacy of this herb for OA has not yet been evaluated in controlled clinical trials. What Else Is This Supplement Used For?

Supplement	Amount	Why
Hyaluronic Acid	Refer to label instructions	Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been shown to improve symptoms.
Hyaluronic Acid Hyaluronic acid is a normal component of joint fluid, but its amount and molecular structure are altered in osteoarthritic joints.¹¹⁰ Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been investigated in many double-blind trials with some improvement demonstrated.¹¹¹^{, 112}^{, 113} However, no research has been done to determine whether oral supplementation with hyaluronic acid is an effective treatment for osteoarthritis. What Else Is This Supplement Used For?

Supplement	Amount	Why
Meadowsweet	Refer to label instructions	Meadowsweet has been historically used to treat complaints of the joints and muscles. The herb contains salicylates, chemicals related to aspirin, that may account for its ability to relieve OA pain.
Meadowsweet Meadowsweet was historically used for a wide variety of conditions, including treating complaints of the joints and muscles.¹¹⁴ The herb contains salicylates, chemicals related to aspirin, that may account for its reputed ability to relieve the pain of OA. What Else Is This Supplement Used For?

Supplement	Amount	Why
Phenylalanine	Refer to label instructions	Supplementing with D-phenylalanine (DPA) has been shown to reduce chronic pain due to OA. DPA inhibits the enzyme that breaks down some of the body’s natural painkillers.
Phenylalanine Supplementation with D-phenylalanine (DPA), a synthetic variation of the amino acid, L-phenylalanine (LPA), has reduced chronic pain due to OA in a preliminary trial.¹¹⁵ In that study, participants took 250 mg three to four times per day, with pain relief beginning in four to five weeks. Other preliminary trials have confirmed the effect of DPA in chronic pain control,¹¹⁶ but a double-blind trial found no benefit.¹¹⁷ DPA inhibits the enzyme that breaks down some of the body’s natural painkillers, substances called enkephalins, which are similar to endorphins. An increase in the amount of enkephalins may explain the reported pain-relieving effect of DPA. If DPA is not available, a related product, D,L-phenylalanine (DLPA), may be substituted (1,500 to 2,000 mg per day). Phenylalanine should be taken between meals, because protein found in food may compete for uptake of phenylalanine into the brain, potentially reducing its effect.¹¹⁸ What Else Is This Supplement Used For?

Supplement	Amount	Why
Yucca	Refer to label instructions	Yucca contains saponins, which appear to block the release of toxins from the intestines that inhibit normal cartilage formation. In doing so, yucca may reduce OA symptoms.
Yucca According to arthritis research, saponins found in the herb yucca appear to block the release of toxins from the intestines that inhibit normal formation of cartilage. A preliminary, double-blind trial found that yucca might reduce symptoms of OA.¹¹⁹ Only limited evidence currently supports the use of yucca for people with OA. What Else Is This Supplement Used For?

References

Last Review: 05-11-2011

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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

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