Best Supplements for Rheumatoid Arthritis

Your gut may play a starring role in the treatment for RA. Supplemental probiotics may improve gut health and can be added to your diet by your food choices, says Jenna Litt, a registered dietitian at Lenox Hill Hospital in NYC. “RA is a condition of excess inflammation and probiotic rich foods have been shown to reduce inflammation and in certain cases even prevent inflammation,” she says. Try including yogurt, cottage cheese, tempeh, sauerkraut or Kombucha in your diet. Probiotics can interact with certain medications, so talk to your doctor first, says Litt.

Litt says that adding certain spices such as ginger and turmeric may help RA. “A great way to utilize these in your diet is to add them in with your foods as a seasoning,” she says. Dr. Yuan agrees and has noticed turmeric has been especially helpful in her patients with milder symptoms. Turmeric may also relieve acid reflux (a possible side effect of some RA medications) and is known to protect the gastrointestinal tract according to the International Journal of Molecular Sciences. However, don’t expect results overnight; give it at least three months, suggests Dr. Yuan.

Vitamin D deficiency goes beyond poor bone health. It has also been linked to RA, according to researchers at the University of Birmingham in the UK. But while some studies have found lower values of vitamin D in those with RA, whether or not vitamin D supplementation can help RA is still under review. In nine trials of vitamin D supplementation, RA recurrence decreased; however, not significantly. If your doctor determines your vitamin D levels are low, vitamin D supplements may be recommended. If so, look for vitamin D3, which is more easily absorbed, recommends Dr. Yuan.

Omega-3 fatty acids are unsaturated fatty acids that have a beneficial effect in the treatment of RA, so says a 2020 review of the effect of omega-3 fatty acids on RA. Investigators looked at results from both animal and human studies and came to the following conclusion: “Omega-3 fatty acids have been shown to ameliorate or prevent experimental arthritis and may decrease disease activity in rheumatoid arthritis.” Omega-3 fatty acids are in foods, such as fish and flaxseed, and in dietary supplements, such as in fish oil. Talk to your doctor before you take omega-3 supplements as they may interact with medicines you take.

Calcium is an essential mineral that helps to keep bones strong and prevents osteoporosis (loss of bone density). This is especially important for people with RA who are taking corticosteroids, who may be at increased risk of bone loss. According to the Arthritis Foundation, 1,200 mg a day is recommended for healthy adults, but people with inflammatory arthritis may need more—up to 1,500 mg for men and postmenopausal women. Dairy products, seeds, and leafy greens are good sources of calcium. You can also ask your provider to recommend the best calcium supplement to meet your needs.

Zinc is well known for its anti-inflammatory effects and its involvement with neutrophils. Neutrophils are core immune cells involved in the early stage of rheumatoid arthritis (RA) and they are believed to participate in the disease progression. Research in the journal Thorax found that in mice models, supplementation of zinc by injection decreased the recruitment and activity of neutrophils, therefore decreasing inflammation and tissue damage. People with RA tend to have lower zinc levels than people without RA. Researchers say zinc supplementation may be helpful, but suggest proceeding carefully after consultation with your doctor. Zinc can interact with antibiotics, diuretics, and calcium, per the Arthritis Foundation.

If you take methotrexate to treat your RA, folic acid may be a key supplement. The reason: Methotrexate destroys folate, but folic acid is also necessary to counterbalance side effects of the drug. You can take it in supplement form, or find it in some foods such as beef liver, spinach, and black-eyed peas. The recommended dietary allowance of folate is 400 micrograms, according to the National Institutes of Health. If you take methotrexate, are a heavy alcohol drinker, or plan to become pregnant, these are all reasons to talk to your doctor about folic acid supplementation.

When it comes to vitamin/mineral supplementation, Christine Allen, R.D., clinical nutrition manager at University of Maryland Shore Medical Center in Easton, MD, recommends a one-a-day complete multivitamin with minerals. Allen cautions that more is not always better when it comes to supplements. “Water soluble vitamins such as C and B vitamins when taken in excess of the dietary reference intakes will just be excreted in your urine, but with your fat-soluble vitamins (A, D, E, K) you can actually build up a vitamin toxicity,” she explains, which can make you sick.

Sufficient amounts of vitamins and minerals are critical when you are living with RA. However, it is important to remember that just because something is natural or available over the counter, it doesn’t mean it is without possible side effects or medication interference. Each year there are close to 60,000 vitamin toxicities reported in the United States. To prevent excess supplementation, your doctor can order a blood test that will give you an idea of which supplements may be needed and at what dose. A balanced and nutritious diet will also help you get the vitamins and minerals your body needs.