Condition
Arthritis (Multiple Kinds)
Arthritis is joint inflammation, most often osteoarthritis, where cartilage wears down, or rheumatoid arthritis, where the immune system attacks the joints. Omega-3 fatty acids and curcumin have the strongest evidence for easing joint pain and inflammation, and in rheumatoid arthritis, GLA from evening primrose or borage oil reduced pain, swelling and morning stiffness. Thunder god vine lowered rheumatoid disease activity, though toxicity concerns limit it, and most other options have less evidence.
Sources: PMID 24672232; PMID 9732298; PMID 23957087
- Supplements studied
- 11
- Graded outcomes
- 10
- Trials
- 1
- People studied
- 15
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Rheumatoid Arthritis Symptoms Multiple human clinical trials demonstrate that GLA (gamma-linolenic acid) supplementation from evening primrose or borage oil reduces joint pain, swelling, and morning stiffness in rheumatoid arthritis. GLA is converted to DGLA and subsequently to anti-inflammatory series-1 prostaglandins, providing a mechanistic basis for these effects. | Improves (the measure goes down) | Moderate effect | 2 studies | |||
Studies that measured rheumatoid arthritis symptoms | ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Rheumatoid Arthritis Symptoms Multiple human studies demonstrate significant reduction in RA disease activity. A comprehensive review concluded that Lei Gong Teng and its active metabolites show robust anti-inflammatory and immunosuppressive effects in RA patients, with efficacy considered proven but limited by toxicity concerns. | Improves (the measure goes down) | Moderate effect | 2 studies | 150 people | ||
Studies that measured rheumatoid arthritis symptoms | ||||||
Phellodendron amurense
- Osteoarthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Symptoms A pilot double-blind RCT (Oben et al. 2009, n=45 completers) of Phellodendron + Citrus sinensis extract showed significant improvement in Lequesne Algofunctional Index scores at 8 weeks (p<0.0001) and 49% CRP reduction in overweight subjects (p<0.001). In vitro studies demonstrate Phellodendron amurense inhibits IL-1α-induced cartilage degradation and suppresses MMP-1, -3, -13 in human osteoarthritic chondrocytes. | Improves (the measure goes down) | Moderate effect | 3 studies | 45 people | ||
Studies that measured osteoarthritis symptoms
| ||||||
Terminalia Chebula
- Joint Pain and Mobility: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Joint Pain and Mobility A double-blind, placebo-controlled RCT (n=105 overweight adults) found standardized T. chebula extract (AyuFlex, 250-500 mg BID for 84 days) significantly improved knee joint comfort, 6-minute walk distance, and overall joint function scores compared to placebo. | Improves (the measure goes down) | Moderate effect | 1 study | 105 people | ||
Pyritinol
- Rheumatoid Arthritis Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Rheumatoid Arthritis Symptoms Multiple human RCTs have investigated pyritinol's anti-inflammatory effects in rheumatoid arthritis, an unusual indication for a compound marketed as a nootropic. Some trials report modest reductions in inflammatory markers and symptom scores, though the evidence base remains limited and this use has not been widely adopted. | Improves (the measure goes down) | Small effect | 200 people |
Salidrosides
- Joint and Cartilage Degeneration: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Joint and Cartilage Degeneration In rat models of osteoarthritis, salidroside relieved symptoms in the early acute stage and alleviated cartilage degeneration through NF-κB pathway modulation. No human clinical data is available for this outcome. | Improves (the measure goes down) | Small effect | 6 studies | |||
Studies that measured joint and cartilage degeneration | ||||||
Loquat
- Anti-inflammatory Effects: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anti-inflammatory Effects In animal models of acute and chronic inflammation, loquat leaf extract reduced leukocyte infiltration, paw edema, and hyperalgesia. Ursolic acid suppressed hepatic oxidative stress and AGE formation in diabetic mice via the LKB1/AMPK/FOXO3 pathway. In vitro studies show inhibition of phospholipase A2, COX-2, and iNOS expression. | Improves (the measure goes down) | Moderate effect | 4 studies | |||
Studies that measured anti-inflammatory effects | ||||||
Piperine
- Anti-arthritic Effects: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anti-arthritic Effects In vitro studies using IL-1beta-stimulated human fibroblast-like synoviocytes showed piperine dose-dependently inhibited PGE2 production, IL-6, and MMP13 expression, and blocked AP-1 nuclear migration. In a rat adjuvant arthritis model, piperine significantly reduced nociceptive behavior and inflammatory ankle joint pathology. No human clinical trials have been conducted. | Improves (the measure goes down) | Moderate effect | 3 studies | |||
Studies that measured anti-arthritic effects
| ||||||
Lactobacillus acidophilus
- Osteoarthritis Pain and Cartilage Degradation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Osteoarthritis Pain and Cartilage Degradation A single animal study found that L. acidophilus ameliorated pain and cartilage degradation in an experimental osteoarthritis model, suggesting potential anti-inflammatory effects on joint tissue. No human clinical trials have been reported for this indication. | Improves (the measure goes down) | Moderate effect | 2 studies | |||
Studies that measured osteoarthritis pain and cartilage degradation | ||||||
Paederia foetida
- Inflammation: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Inflammation Preclinical data suggest anti-inflammatory activity of Paederia foetida extracts. Evidence is limited to early-stage in vitro or animal models with no human confirmation. | Improves (the measure goes down) | Small effect |
Valerian
- Sleep Quality: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Sleep Quality | Improves (the measure goes up) | 6 studies | 15 people | |||
Key findings
- Rheumatoid Arthritis SymptomsImproves (the measure goes down)
- Osteoarthritis SymptomsImproves (the measure goes down)
- Joint Pain and MobilityImproves (the measure goes down)
Safety notes in the studies
- A comprehensive review concluded that Lei Gong Teng and its active metabolites show robust anti-inflammatory and immunosuppressive effects in RA patients, with efficacy considered proven but limited by toxicity concerns.
The Arthritis General Support protocol
2 primary supplements · 7 supporting supplements
- Omega-3 Fatty Acids3–4 g EPA+DHA daily
- Curcumin500–1,000 mg enhanced-absorption curcumin 2–3 times daily
Shop the evidence-backed picks
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Or shop one supplement
The supplements graded A or B for Arthritis (Multiple Kinds). Each opens third-party tested products for that supplement.
- Grade B
- Grade B
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Studies cited
100 studies from PubMed
- The impact of piperine on the metabolic conditions of patients with NAFLD and early cirrhosis: a randomized double-blind controlled trial
- Salidroside directly activates HSC70, revealing a new role for HSC70 in BDNF signalling and neurogenesis after cerebral ischemia.
- Comprehensive review on fruit of Terminalia chebula: traditional uses, phytochemistry, pharmacology, toxicity, and pharmacokinetics
- A novel SPE-LC-MRM strategy for serum demethylzeylasteral quantitation developed with an 18O-labeled internal standard
- The effects of curcumin-piperine supplementation on inflammatory, oxidative stress and metabolic indices in patients with ischemic stroke in the rehabilitation phase: a randomized controlled trial
- Salidroside pretreatment alleviates PM2.5 caused lung injury via inhibition of apoptosis and pyroptosis through regulating NLRP3 Inflammasome.
- Network pharmacology analysis combined with experimental validation to explore the therapeutic mechanism of salidroside on intestine ischemia reperfusion.
- Randomized, double-blind, placebo-controlled trial of oral Terminalia chebula extract on skin health parameters
- Protective mechanisms of loquat leaf extract and ursolic acid against diabetic pro-inflammation
- Traditional uses, phytochemistry, pharmacology, and toxicity of Eriobotrya japonica leaves: A summary
- Turmeric supplementation with piperine is more effective than turmeric alone in attenuating oxidative stress and inflammation in hemodialysis patients: A randomized, double-blind clinical trial
- Salidroside Attenuates Airway Inflammation and Remodeling via the miR-323-3p/SOCS5 Axis in Asthmatic Mice.
- Salidroside Exerts Beneficial Effect on Testicular Ischemia-Reperfusion Injury in Rats.
- Safety of a Sustainably Produced, Bioengineered, Nature-Identical Salidroside Compound.
- Salidroside in the Treatment of NAFLD/NASH.
- A comprehensive review on the diverse pharmacological perspectives of Terminalia chebula Retz
- Potential benefits of L. acidophilus in dyslipidemic rats
- Effect of a Probiotic Supplement Containing Lactobacillus Acidophilus and Bifidobacterium Animalis Lactis on Urine Oxalate in Calcium Stone Formers with Hyperoxaluria: A Randomized, Placebo-controlled, Double-blind and In-vitro Trial
- Eriobotrya japonica leaf water extract in the treatment of cough variant asthma
- Effectiveness of the piperine-supplemented Curcuma longa L. in metabolic control of patients with type 2 diabetes: a randomised double-blind placebo-controlled clinical trial
- Salidroside protects endothelial cells against LPS-induced inflammatory injury by inhibiting NLRP3 and enhancing autophagy.
- The bioinformatics and metabolomics research on anti-hypoxic molecular mechanisms of Salidroside via regulating the PTEN mediated PI3K/Akt/NF-κB signaling pathway.
- Preventive Effect of Lactobacillus acidophilus XY27 on DSS-Induced Ulcerative Colitis in Mice
- Immune enhancing effects of Lactobacillus acidophilus on Newcastle disease vaccination in chickens
- Lactobacillus acidophilus attenuates toxin production by Vibrio cholerae and shigella dysenteriae following intestinal epithelial cells infection
- Anti-inflammatory and anti-arthritic activity in extract from the leaves of Eriobotrya japonica
- Eriobotrya japonica leaf extract attenuates airway inflammation in ovalbumin-induced mice model of asthma
- Contribution of salidroside to the relieve of symptom and sign in the early acute stage of osteoarthritis in rat model.
- Salidroside Alleviates Cartilage Degeneration Through NF-κB Pathway in Osteoarthritis Rats.
- Salidroside inhibits platelet function and thrombus formation through AKT/GSK3β signaling pathway.
- Salidroside as a potential neuroprotective agent for ischemic stroke: a review of sources, pharmacokinetics, mechanism and safety.
- Effect of aqueous extract of Terminalia chebula on endothelial dysfunction, systemic inflammation, and lipid profile in type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled clinical study
- Anticancer activity of Terminalia chebula against lung and breast carcinoma cell lines
- Corosolic acid isolated from Eriobotrya japonica leaves reduces glucose level in human hepatocellular carcinoma cells, zebrafish and rats
- Salidroside Inhibits Lipopolysaccharide-ethanol-induced Activation of Proinflammatory Macrophages via Notch Signaling Pathway.
- Primary prevention of Clostridium difficile infections with a specific probiotic combining Lactobacillus acidophilus, L. casei, and L. rhamnosus strains: assessing the evidence
- Lactobacillus acidophilus Alleviated Salmonella-Induced Goblet Cells Loss and Colitis by Notch Pathway
- Lactobacillus acidophilus ameliorates pain and cartilage degradation in experimental osteoarthritis
- Salidroside inhibits inflammatory factor release in BV-2 cells through p38 and JNK pathways.
- Efficacy of a standardized extract of Matricariae chamomilla L., Melissa officinalis L. and tyndallized Lactobacillus acidophilus (HA122) in infantile colic: An open randomized controlled trial
- Uromodulin-SlpA binding dictates Lactobacillus acidophilus uptake by intestinal epithelial M cells
- Inhibitory effect of the extract of Phellodendron amurense Ruprecht root on collagen-induced arthritis in mice
- Piperine regulates UCP1 through the AMPK pathway by generating intracellular lactate production in muscle cells
- Effects of a standardized aqueous extract of Terminalia chebula (AyuFlex) on joint comfort, functional mobility, and related biomarkers: a randomized, double-blind, placebo-controlled study
- Anti-HSV-2 activity of Terminalia chebula fruit extract and its constituents chebulagic acid and chebulinic acid
- Celastrol inhibits dengue virus replication via up-regulating type I interferon and downstream interferon-stimulated responses
- Toxic effects of Tripterygium wilfordii Hook F on the reproductive system of adolescent male rats
- Lactobacillus acidophilus Mixture in Treatment of Children Hospitalized With Acute Diarrhea
- Efficacy of prolonged ingestion of Lactobacillus acidophilus L-92 in adult patients with atopic dermatitis
- Effect of Loquat Leaf Extract on Muscle Strength, Muscle Mass, and Muscle Function in Healthy Adults
- Salidroside protects against kainic acid-induced status epilepticus via suppressing oxidative stress.
- Salidroside, a Bioactive Compound of Rhodiola Rosea, Ameliorates Memory and Emotional Behavior in Adult Mice.
- Salidroside exhibits anti-dengue virus activity by upregulating host innate immune factors.
- Analgesic activity of standardized aqueous extract of Terminalia chebula in healthy human participants using mechanical pain model
- Lactobacillus acidophilus attenuates Salmonella-induced intestinal inflammation via TGF-β signaling
- The effects of Lactobacillus acidophilus as feed supplement on skin mucosal immune parameters, intestinal microbiota, stress resistance and growth performance of black swordtail
- Lactobacillus acidophilus CP23 with weak immunomodulatory activity lacks anchoring structure for surface layer protein
- Anti-inflammatory and antioxidant properties of Eriobotrya japonica leaves extracts
- Evaluation of the antimutagenic, antigenotoxic, and antioxidant activities of Eriobotrya japonica leaves
- Tolerance of Phellodendron amurense bark extract (Nexrutine®) in patients with human prostate cancer
- Evaluation of the anti-plaque efficacy of a herbal-based toothpaste: a double-blind, randomized controlled clinical trial with Terminalia chebula mouthwash
- Analgesic activity of standardized aqueous extract of Terminalia chebula in healthy human participants using hot air pain model
- Hepatoprotective effect of Terminalia chebula extract against t-BHP-induced acute liver injury in mice
- Wound healing efficacy of Terminalia chebula extract in burn wound model
- Celastrol blocks binding of lipopolysaccharides to a Toll-like receptor4/myeloid differentiation factor2 complex in a thiol-dependent manner
- Lactobacillus acidophilus modulates the virulence of Clostridium difficile
- Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum cytokines of atopic dermatitis in Japanese adults: a double-blind, randomized, clinical trial
- Tormentic acid, a major component of suspension cells of Eriobotrya japonica, suppresses high-fat diet-induced diabetes and hyperlipidemia
- Effects of resveratrol alone or in combination with piperine on cerebral blood flow parameters and cognitive performance in human subjects: a randomised, double-blind, placebo-controlled, cross-over investigation
- Salidroside protects Caenorhabditis elegans neurons from polyglutamine-mediated toxicity by reducing oxidative stress.
- Antidepressant-like effects of salidroside on olfactory bulbectomy-induced pro-inflammatory cytokine production and hyperactivity of HPA axis in rats.
- Piperine reverses high fat diet-induced hepatic steatosis and insulin resistance in mice
- Salidroside attenuates LPS-stimulated activation of THP-1 cell-derived macrophages through down-regulation of MAPK/NF-kB signaling pathways.
- Efficacy of Terminalia chebula rinse on salivary pH and periodontal health: a randomized controlled trial
- Traditional immunosuppression--Lei Gong Teng in modern medicine
- Rhodiola rosea extracts and salidroside decrease the growth of bladder cancer cell lines via inhibition of the mTOR pathway and induction of autophagy.
- Salidroside and tyrosol from Rhodiola protect H9c2 cells from ischemia/reperfusion-induced apoptosis.
- Neuroprotective effects of Terminalia chebula on OGD-induced PC12 cell death and LPS-induced microglia activation
- Triptolide inhibits the proliferation of prostate cancer cells and down-regulates SUMO-specific protease 1 expression
- Effects of oral administration of Lactobacillus acidophilus L-92 on the symptoms and serum markers of atopic dermatitis in children
- Effect of Phellodendron amurense in protecting human osteoarthritic cartilage and chondrocytes
- Dietary administration of berberine or Phellodendron amurense extract inhibits cell cycle progression and lung tumorigenesis
- Effect of piperine in the regulation of obesity-induced dyslipidemia in high-fat diet rats
- Probiotic Lactobacillus acidophilus and L. casei mix sensitize colorectal tumoral cells to 5-fluorouracil-induced apoptosis
- Effects of Eriobotrya japonica seed extract on oxidative stress in rats with non-alcoholic steatohepatitis
- Control of Fatty Acid Intake and the Role of Essential Fatty Acids in Cognitive Function and Neurological Disorders.
- Adiposity suppression effect in mice due to black pepper and its main pungent component, piperine
- Anticariogenic effect of Terminalia chebula mouthwash on Streptococcus mutans
- Report of 12 cases of ankylosing spondylitis patients treated with Tripterygium wilfordii
- Hypoglycemic and hypolipidemic effects of the total triterpene acid fraction from Folium Eriobotryae
- Hypoglycemic effect of the total flavonoid fraction from folium Eriobotryae
- Cinchonain Ib isolated from Eriobotrya japonica induces insulin secretion in vitro and in vivo
- Phellodendron and Citrus extracts benefit joint health in osteoarthritis patients: a pilot, double-blind, placebo-controlled study
- Anti-inflammatory and antiarthritic effects of piperine in human interleukin 1beta-stimulated fibroblast-like synoviocytes and in rat arthritis models
- Hypoglycemic activity of Eriobotrya japonica seeds in type 2 diabetic rats and mice
- Co-supplementation of healthy women with fish oil and evening primrose oil increases plasma docosahexaenoic acid, gamma-linolenic acid and dihomo-gamma-linolenic acid levels without reducing arachidonic acid concentrations.
- Polyunsaturated fatty acids in the pathogenesis and treatment of multiple sclerosis.
- Anti-oxidative effect of triterpene acids of Eriobotrya japonica leaf in chronic bronchitis rats
- Hepatoprotective activity of Terminalia chebula against anti-tuberculosis drug-induced hepatotoxicity
- Antidiabetic and renoprotective effects of Terminalia chebula seeds in streptozotocin-induced diabetic rats