Avocado-soybean unsaponifiables (ASU)

WHAT IT IS: A supplement composed of one-third avocado oil and two-thirds soybean oil

HOW IT WORKS: ASU blocks pro-inflammatory chemicals, prevents deterioration of synovial cells, which line joints, and may help regenerate normal connective tissue.

STUDIES: It has been studied extensively in Europe, where it is routinely used to treat OA. A 2008 meta-analysis found that ASU improved symptoms of hip and knee OA and reduced or eliminated NSAID use. Especially notable: A large, three-year study published in 2013 in the BMJ showed that ASU significantly reduced progression of hip OA compared with placebo.

BEST FOR RA

Cat’s claw (Uncaria tomentosa)

WHAT IT IS: The bark and root of a South American vine

HOW IT WORKS: Cat’s claw is an anti-inflammatory that inhibits tumor necrosis factor (TNF), a target of powerful RA drugs. It also contains compounds that may benefit the immune system.

STUDIES: A small 2002 trial showed it reduced joint pain and swelling by more than 50 percent compared with placebo.

HOW MUCH: Capsule, tablet, tea, extract: 60 mg daily in divided doses. Look for a brand that is free of tetracyclic oxindole alkaloids.

Fish oil

WHAT IT IS: Oil from cold-water fish such as herring and salmon – a rich source of the omega-3 fatty acids EPA and DHA

HOW IT WORKS: Omega-3s block inflammatory cyto-kines and prostaglandins, and are converted by the body into powerful anti-inflammatory chemicals called resolvins.

STUDIES: EPA and DHA have been extensively studied for RA and dozens of other inflammatory conditions. A 2010 meta-analysis found that fish oil significantly decreased joint tenderness and stiffness in RA patients and reduced or eliminated NSAID use.

HOW MUCH: Softgel, liquid: 3.8 grams EPA and 2 grams DHA daily for RA. (Look for 85 percent to 90 percent concentrations of omega-3s).

NOTE: Studies show fish oil also can relieve symptoms of OA, depression and Sjögren’s syndrome.

GLA (gamma linolenic acid)

WHAT IT IS: An omega-6 fatty acid found in some plant-seed oils, including black currant, borage and evening primrose

HOW IT WORKS: The body converts GLA into anti-inflam--matory chemicals.

STUDIES: In a 2005 trial, 56 patients with active RA showed significant improvement in joint pain, stiffness and grip strength after six months and progressive improvement in control of disease activity at one year. A smaller study found that a combination of evening primrose oil and fish oil significantly reduced the need for conventional pain relievers.

HOW MUCH: Capsule, oil, softgel: 300 mg to 3 grams daily in divided doses or 450 mg GLA and 240 mg EPA daily

Ginger (Zingiber officinale)

WHAT IT IS: The dried or fresh root of the ginger plant

HOW IT WORKS: Used in Asian medicine for centuries, ginger has been shown to have anti-inflammatory properties similar to ibuprofen and COX-2 inhibitors. Ginger also suppresses leukotrienes (inflammatory molecules) and switches off certain inflammatory genes, making it potentially more effective than conventional pain relievers.

STUDIES: In a 2012 in vitro study, a specialized ginger extract called Eurovita Extract 77 reduced inflammatory reactions in RA synovial cells as effectively as steroids did.

HOW MUCH: Capsules, extract, tea: In studies, 255 mg of Eurovita Extract 77 twice daily.

NOTE: Several trials show ginger may help relieve OA pain

Honorable Mentions

These nine supplements aren’t the only ones that might be worth trying for your arthritis symptoms. Although the available studies on the following supplements are less compelling or more preliminary than for our top picks, they hold some promise for OA or RA.

Osteoarthritis: Chondroitin sulfate, glucosamine sulfate, pine bark extract

Rheumatoid arthritis: Rosehips, green-lipped mussel extract