is a shrub-like tree that grows in the dry hills of the Indian subcontinent. It is the source of a resin called salai guggal, which has been used for thousands of years in Ayurvedic medicine, the traditional medicine of the region. It is very similar to a resin from a related tree,
which is also known as frankincense. Both substances have been used historically for arthritis.
Recent research has identified boswellic acids as the likely active ingredients in boswellia. In animal studies, boswellic acids have shown anti-inflammatory effects, but their mechanism of action seems to be quite different from that of standard anti-inflammatory medications.
An issue of
that was devoted to boswellia briefly reviewed previously unpublished studies on the herb.
A pair of placebo-controlled trials involving a total of 81 people with rheumatoid arthritis found significant reductions in swelling and pain over the course of 3 months. Furthermore, a comparative study of 60 participants over 6 months found the boswellia extract relieved symptoms about as well as oral gold therapy. However, keep in mind that while gold shots can induce remission in rheumatoid arthritis, we have no evidence that boswellia can do the same.
Another double-blind study found no difference between boswellia and placebo.
The bottom line is that we need more research to know for sure whether boswellia is an effective treatment for rheumatoid arthritis.
For more information, including dosage and safety issues, see the full
Other Herbs and Supplements
is best known as a proposed treatment for osteoarthritis. However, it might be helpful for RA as well. A double-blind, placebo-controlled study of 51 people with RA found that glucosamine at a dose of 1,500 mg daily significantly improved symptoms.
It did not, however, alter measures of inflammation as determined through blood tests.
Some evidence, including small double-blind trials, additionally support the use of the following herbs and supplements for the treatment of rheumatoid arthritis:
is believed to be unsafe for pregnant or nursing women, and may present risks in other groups as well.
Highly preliminary evidence suggests potential benefits with the following herbs and supplements:
methyl sulfonyl methane (MSM)
and a mixture of poplar, ash, and
may reduce pain in rheumatoid arthritis, but it does not seem to reduce inflammation.
Some evidence suggests that adding vitamin E, or vitamin E plus other antioxidants, to standard rheumatoid arthritis therapy might improve results.
However, an extremely large randomized trial involving over 39,000 women found that taking 600 IU of vitamin E every other day did not reduce the risk of rheumatoid arthritis.
Individuals taking the drug
for treatment of rheumatoid arthritis may benefit by taking
supplements. Folate appears to reduce methotrexate side effects, including mouth sores, nausea, and liver inflammation.
In addition, folate supplements may help reverse a more subtle methotrexate side-effect: a rise in blood levels of
Elevated levels of homocysteine are thought to increase risk of heart-disease.
The following treatments are also sometimes proposed as effective for rheumatoid arthritis, but there is as yet little to no scientific evidence for or against their use:
, sea cucumber, and
Current evidence regarding
green lipped mussel
for rheumatoid arthritis is more negative than positive.
One study failed to find
at a dose of 50 mg daily helpful for rheumatoid arthritis, despite a general B6 deficiency seen in people with this condition.
supplements have been evaluated as a treatment for rheumatoid arthritis, but overall the study results have not been encouraging.
Other treatments that have as yet generally failed to prove effective in small double-blind trials include
Ayurvedic herbal mixture
containing extracts of
Two studies commonly cited as evidence that turmeric alone is useful for rheumatoid arthritis actually fail to provide any meaningful supporting evidence.
A 6-month, double-blind, placebo-controlled study of 168 people with rheumatoid arthritis failed to find that elk velvet antler enhanced the effectiveness of conventional treatment for
Other Alternative Therapies
(pure vegetarian) diet might help mild rheumatoid arthritis, although the supporting evidence is weak.
Identifying and avoiding
has also been tried,
but one controlled trial found no clear evidence of benefit with a low saturated fat, hypoallergenic diet.
Balneotherapy (hot baths)
have shown a bit of promise for rheumatoid arthritis.
Two separate groups of researchers conducting detailed reviews of 8 randomized controlled trials found some beneficial effects of
for rheumatoid arthritis, but were unconvinced that it was more beneficial than sham acupuncture or other standard treatments.
Another review of 11 randomized trials did not find that mediation, progressive muscle relaxation, static magnetic therapy, acupuncture or tai chi relieved pain in patients with rheumatoid arthritis. The 11 trials included a total of 607 patients.
has also been evaluated for rheumatoid arthritis with no consistent evidence of beneficial effect.