Many people with arthritis want to try natural medicine, including dietary supplements, but they don’t know where to begin. James McKoy, MD, chief of rheumatology at Kaiser Permanente in Honolulu, put together some notes on the way that he prescribes supplements for his patients.

But he cautions that supplements used without necessary lifestyle changes are not magic bullets. “There is no one or two miracle supplements for anything,” Dr. McKoy says.

“In order to effect a change in health outcome, a patients must change their thoughts, attitude and beliefs,” he adds.

In addition to prescribing supplements, Mr. McKoy also counsels his patients to make other lifestyle adjustments, such as establishing a daily exercise program, getting optimal amounts of sleep, and making sure to drink enough water. Additionally, he recommends a diet rich in fruits and vegetables and low in animal products, which he says can lower acid levels in the body. A diet that raises acid levels, he says, can contribute to inflammation.

“It’s not just about pouring drugs or supplements down someone’s throat,” he says.

Before you add these supplements, or any others, to your treatment regimen, however, be sure to clear it with your own doctor. Natural medicines contain potent chemicals that can interact with prescription and over-the-counter drugs.

When Dr. McKoy advises taking supplements, he prescribes a specific regimen for different types of arthritis:

    Osteoarthritis:

• Glucosamine sulfate – 1,500 mg twice a day for three months and then maintenance of 1,500 daily. “I do not use chondroitin sulfate,” Dr. McKoy says. “I don’t think it helps that much and adds to the cost.”
• SAMe – 400 mg three times daily. 
• Vitamin D3 – 2,000 IU a day.
• A good multivitamin with minerals – Once daily. The supplement should contain 40 mg of zinc, 1 mg of copper and 6 mg of boron.
• Fish Oil – At least 3 grams (or 3,000 mg) daily, 1 gram taken with each meal.
• Boswellia – 400 mg three times daily
• Cat’s Claw ­– 60 mg three times a day, to relieve pain
• Kaprex (A proprietary blend of hops, oleanolic acid and rosemary) – 1 tab three times daily
• Acupuncture – Though not a dietary supplement, Dr. McKoy says acupuncture can work well in conjunction with supplements. He advises four times weekly until acute symptoms resolve and then maintenance of once a month, if patients can afford it.

Rheumatoid arthritis:

• Ginger – Fresh ginger root incorporated into the diet, or ginger extract 100 to 200 mg three times daily.
• Multivitamin with minerals – Once daily. The supplement should contain 40 mg of zinc, 1 mg of copper and 6 mg of boron.
• Fish oil – Two grams (or 2,000 mg) with each meal
• Flaxseed – One tablespoon flaxseed meal daily.
• Digestive enzymes (pancreatin/bromelain, etc) – Follow dosing instructions on the bottle.
• SAMe  – 400 mg three times daily.
• Curcumin/Tumeric – 400 mg three times daily
• Vitamin D3 – 2,000 IU daily
• Boswellia – 400 mg three times daily
• Cat’s claw – 60 mg three times daily
• Kaprex – One tablet three times daily.

Fibromyalgia:

• Multivitamin with minerals – Once daily. The supplement should contain 40 mg of zinc, 1 mg of copper and 6 mg of boron.
• B complex – One pill containing 5,000 to 10,000 micro grams of vitamin B12, daily
• Vitamin D3 – 2,000 IU daily
• Calcium– 1,000 mg daily
• Magnesium – 400 mg to 1,000 mg a daily
• SAMe  (S-adenosyl-L-methionine) – 400 mg three times daily
• Vitamin C­– 500 mg three times daily
• Kaprex – 1 tablet 3 times a day
• NADH (reduced nicotinomide adenine dinucleotide) – 5 mg a day, for energy
• CoQ-10 (coenzyme Q10) – 200mg a day, for energy
• Fish oil  – 1 gram (or 1,000 mg) with each meal.

    Regarding Kaprex, Dr. McKoy says research suggests that components of hops, such as reduced isoalpha acids, may inhibit the formation of inflammation-causing prostaglandins. Oleanolic acid is derived from olive leaf extract. Research indicates that it may support joint health as a pain reliever as well as protect against potential damage to your stomach lining. Rosemary leaf extract stimulates circulation and eases pain by increasing your blood supply. Kaprex is manufactured by a company called Metagenics and may be purchased online.