Whether you’re looking for new treatments, want to enhance your current prescription drug regimen, or are simply curious about your options, natural supplements are worth your consideration.

“Supplements” usually refers to the vitamins, minerals, animal extracts, enzymes, and herbs that can be used to supplement the nutrition in your diet and the medicines prescribed by your doctor. Used for centuries to ease aches and pains associated with rheumatic diseases as well as a multitude of other related and unrelated conditions, many supplements have a proven track record, says James McKoy, MD, chief of rheumatology and director of pain management services at Kaiser Permanente in Hawaii. “For mild rheumatoid arthritis [RA] and osteoarthritis [OA], appropriate supplements in appropriate doses can be of great help. And for moderate RA and OA, supplements may be able to keep you from having to use very high doses of traditional medicines and decrease your overall cost of treatment as well as the potential side effects,” he says.

Supplements can be appealing because, let’s face it, most of us would rather not take prescription or over-the-counter drugs. We need them and they help us, yet they’re a reminder that we are not well, and many have potentially unpleasant side effects. So we turn to natural remedies, hoping they will somehow tap into a reservoir of ancient wisdom to help ease our maladies in the way nature intended. Some “natural remedies” – supplements that are readily available on grocery store shelves – really can make a difference in the way we feel.

But many do not live up to their claims. It is important to know what really works, what is just a waste of your money, and what could actually be harmful.

Supplements are increasingly available to people with chronic health problems such as arthritis, and people are buying them record numbers.

Herbs, supplements and other such “natural” remedies have a tremendous attraction for people with arthritis who are frustrated with the solutions offered by conventional medicine. Although most people realize there is no magic bullet to cure arthritis, they hope their pain and other symptoms will be better controlled if they try a supplement or extract in addition to their doctor-prescribed medication.

Supplements offer the convenience of popping a pill or potion along with the premise that the natural ingredients won’t harm you. But “natural” doesn’t always mean “safe.” Some people think that supplements – especially herbs – are safe because they are natural alternatives to the chemicals used in prescription drugs. The fact is, herbs are chemicals. And anything that’s strong enough to help may also be strong enough to hurt.

That doesn’t mean all supplements are bad. In fact, certain types of extracts and supplements have been shown to be useful in treating various types of arthritis. For example, the omega-3 fatty acids found in the oils from certain fish have been shown to modify inflammation associated with rheumatoid arthritis when taken in large quantities. Unfortunately, the effect may only be sustained for a few months. Another study showed that oil extracted from the borage plant had some properties similar to nonsteroidal anti-inflammatory drugs (NSAIDs), without gastrointestinal side effects. However, the best dosages and possible long-term side effects of these supplements have yet to be determined.
 

True Effects Often Unknown

At this point, it is difficult to know the effects of supplements. There’s also a phenomenon known as the placebo effect. In many research studies, some people are given the actual pill or treatment being tested, while others unknowingly receive a placebo (Latin for “I will please”), an inactive pill or treatment. Usually, it’s just a sugar pill – harmless but offering no real physical benefit. Some people taking the placebo will experience the same results (reduced arthritis pain, for example) as the people taking the real drug. That shows the power of suggestion.

For most types of supplements, unfortunately, solid scientific evidence is just not available. Few studies have been done to test supplements, and the studies that do exist usually don’t stand up to rigorous scientific examination. In addition, these types of treatments are not regulated and tested in the same way that pharmaceutical products are to ensure that that they are both safe and effective. Finally, there are a few purity standards or quality control mechanisms in place.

It may seem like a paradox, but most pills that are labeled as a natural contain chemicals that are processed, just like drugs. It’s true that natural substances are chemicals found in the body normally, while drugs are chemicals that are not normally found in the body. But the chemicals in prescription or over-the-counter drugs are tested extensively for safety and purity, while the natural pills are not tested on the same level. That doesn’t mean you shouldn’t consider natural remedies, but you should be aware of the concerns.

Tips for Choosing Supplements

If you decide to try an herbal extract, dietary supplement or other natural remedy, you should proceed with caution and keep these points in mind:

• Ask questions. Don’t be afraid to ask your doctor, pharmacist or other health professionals for their opinions or recommendations.
  
• Buy wisely. When purchasing a supplement, buy from a large company, pharmacy or health food chain. They may have more stringent quality controls than small companies to maintain their good reputation.
  
• Consider the cost. Some supplements can be quite expensive. That first bottle you grab off the grocery store shelf might not seem like too much to spend, but consider how much you’re supposed to take to receive the promised benefits. You might have to buy two or three bottles a month, and the cost really adds up. If you’re going to see real benefits, the cost might be justified. But if you’re trying it because it might help, maybe not.
  
• Watch how much you take. Supplements are not harmless just because they don’t require a prescription. Some minerals and other substances can be harmful if you take too much.
  
• Inform your doctors. Supplements count when a doctor asks what drugs you’re taking, so be sure to report all supplements and how much you take. Some supplements can adversely interact with prescribed medicines, so keep your doctors fully informed. 
  
• Read labels carefully. Be aware that no supplement can lawfully claim to treat, cure, diagnose or prevent disease. Look for products with the USP notation, indicating that the manufacturer followed standards established by the United States Pharmacopoeia.
  
• Be skeptical of advertising claims. Because supplements are not regulated as closely as drugs, manufacturers can make claims that are unfounded. They often will craft their labels and promises very carefully to make their products sound more beneficial than actually could prove.
  
  • Beware of supplements that claim to work by a “secret formula.” You should know what you’re taking and the manufacturer should be willing to tell you.
  • Stay away from any supplement that claims to be a “cure” or “miraculous breakthrough.” Those are dead giveaways that the manufacturer is overpromising what it can do for you, which might be nothing.
  • Also be skeptical of supplements that rely only on testimonials as their proof of benefits. A supplement that truly offers help for arthritis symptoms should be supported by research in established medical journals.