Roamset Health Team
The Truth About Supplements and Arthritis
If you’re living with the daily ache of stiff joints, you’ve likely seen the glowing ads for collagen powders promising a “fountain of youth” for your knees and hips. It makes sense on paper: Collagen is the literal scaffolding of your cartilage, but does swallowing a supplement actually translate to smoother movement and less pain? While early research on Type II collagen shows promise in reducing inflammation in rheumatoid arthritis, the “bottom line” for osteoarthritis remains somewhat more complex. Before you stock up on capsules, let’s dive into what the clinical studies actually say about dosage, efficacy, and whether collagen is a breakthrough or just a well-marketed trend.
Less common alternative therapies
- Ginger. A concentrated ginger extract has been shown to provide slightly better pain relief for knee osteoarthritis than a placebo. However, it can cause mild nausea and indigestion.
- Willow bark extract. A study has shown that willow bark extract produced a moderate reduction in pain in hip or knee osteoarthritis, with no significant side effects. Willow bark contains salicin, from which aspirin is derived.
- Selenium. A trial of selenium in rheumatoid arthritis didn’t show a significant benefit compared to a placebo. Pain and inflammation were not helped by selenium. It is not yet known whether selenium helps with osteoarthritis.
Promising studies
A 1998 study involving 60 patients with rheumatoid arthritis found that those taking small doses of chicken collagen for 3 months experienced significant improvement in swollen and tender joints compared with patients taking a placebo. Similar clinical trials involving small numbers of patients were later carried out, with varying results.
In 2001, scientists at Guy’s Hospital in London carried out a double-blind, placebo-controlled clinical trial of type II collagen that found a small but significant improvement in disease score in rheumatoid arthritis among the group given collagen, with no side effects. However, they decided that further research was needed into better ways to deliver an accurate dose to induce tolerance and control disease.
You can buy collagen II capsules from the Internet, but don't assume that more is better: some clinical studies actually suggest that smaller doses may be more effective than larger ones.
The bottom line. Until the results of a large-scale study are available, collagen II must be considered an unproven treatment for rheumatoid arthritis. There is no evidence that it can help people with osteoarthritis. If you do try collagen II supplements, opt for a low daily dose of no more than 60 milligrams.
Cartilage supplements are a ‘no-go’ area
At first glance, the use of cartilage supplements seems to make a lot of sense: since osteoarthritis involves the loss of cartilage from the joints, you should be able to restore the deficit by choosing one of the many cartilage supplements on the market, made from shark, cow or other animals. But there are no studies to suggest that just any cartilage product will help. It is true that glucosamine and chondroitin will be present in any cartilage product, but these two ingredients have been found to be useful only in purified form.
The bottom line. It’s doubtful that cartilage supplements are of any use in treating arthritis.
Plant and fish oils offer modest pain relief
The oils obtained from fatty cold-water fish are rich in omega-3 fatty acids, which can reduce inflammation. At least 20 clinical studies have shown that high daily doses of fish oil can help to relieve the pain and inflammation associated with rheumatoid arthritis.
A major evaluation of available studies in 2001 by UK researchers at Epsom General Hospital and the University of Glasgow concluded that supplementation with fish oils can significantly reduce morning stiffness and the number of painful joints in patients with rheumatoid arthritis. In research reported in the Journal of Rheumatology in February 2000, Spanish researchers concluded that patients with rheumatoid arthritis have a significant deficiency in certain essential fatty acids and suggested that this may explain why fish and specific plant oils may be beneficial.
In Britain, Professor Bruce Caterson and his team at Cardiff University have shown in laboratory studies that the omega-3 fatty acids in cod liver oil can also slow — and possibly reverse — the destruction of cartilage that leads to osteoarthritis. It is not known whether this effect occurs in people with osteoarthritis.
It is best to consult a doctor before taking fish oil supplements if you have high blood cholesterol, as therapeutic doses of fish oils are known to raise blood cholesterol levels. Diabetics should also seek medical advice before using fish oils.
Plant power. Oils pressed from the seeds of the plants evening primrose and borage are rich in the fatty acid gamma linoleic acid (GLA). This fatty acid seems useful against the inflammation of rheumatoid arthritis, although it hasn't been studied as well as the omega-3s. And GLA is said to raise levels of arachidonic acid (AA) in blood serum, associated with an increased risk of blood clotting, a risk factor for heart disease, but taking fish oils at the same time is reported to offset this effect.
Piascledine — a mixture of oils extracted from avocados and soya beans — can also help to minimise the pain of hip and knee osteoarthritis, according to two clinical studies from France. In one study, patients with severe osteoarthritis of the knee or hip who took piascledine experienced less pain and disability after six months than those taking a placebo. Improvements began after two months, with no major side effects. Although piascledine is not yet sold directly in Australia, New Zealand or the United Kingdom, it can be bought in France and is now also available in the United States.
How it works. Although it is unclear exactly how piascledine works, experts suggest that the oils may prompt chondrocytes (cartilage-making cells) to produce chemicals that help repair damaged cartilage.
The bottom line. Rheumatoid arthritis patients may gain some pain relief from taking fish oil, though there is less evidence for evening primrose oil or borage seed oil (and borage seed oil should only be used under medical supervision; see the Caution above). In most cases, supplements may need to be taken for at least 3 months before they have a noticeable effect. Piascledine may also be helpful in treating osteoarthritis.
