Herbs and dietary supplements for rheumatoid arthritis

Herbs and dietary supplements for rheumatoid arthritis

  • • Black cohosh
    • Uses: treats hot flashes and moodiness at menopause.
  • • Cayenne
    • Uses: contains the chemical capsaicin that gives hot cayenne peppers their heat. When applied as a skin cream, it can deplete substance P from nerve endings, thus decreasing pain. Used for postherpetic neuralgia and rubbed on single joint with arthritis.
  • • Coenzyme Q-10
    • Uses: relieves chronic fatigue, immune stimulant, heart failure. Contains ubiquinone, which is a cofactor for metabolic pathways that generate ATP. Also a free radical scavenger and can act as an antioxidant.
    • Drug interactions: can decrease warfarin’s effect.
  • • Echinacea
    • Uses: stimulates immune system, upper respiratory infections.
    • Disease precautions: liver disease.
    • Drug interactions: chemotherapy drugs for cancer treatment, HIV drugs, anticoagulants, immunosuppressive drugs, drugs that may be toxic to liver.
  • • Feverfew
    • Uses: migraine prophylaxis.
    • Disease precautions: pregnancy—uterine contraction causing abortion, ragweed allergy.
    • Drug interactions: anticoagulants, antiplatelet medications.
  • • Garlic
    • Uses: lowers low-density lipoprotein cholesterol, platelet inhibition.
    • Disease precautions: surgery.
    • Drug interactions: anticoagulants, antiplatelet medications.
  • • Ginkgo biloba
    • Uses: treatment of dementia, vertigo, ringing in ears. Can inhibit platelets and increase blood flow.
    • Disease precautions: intracranial bleeding, GI bleeding, seizures, surgery, peripheral vascular disease. Ginkgo has anticoagulant effects and decreases platelet aggregation. Can cause GI upset.
    • Drug interactions: anticoagulants, antiplatelet medications, thiazide diuretics, tricyclic antidepressants, monoamine oxidase (MAO) inhibitors.
  • • Ginseng
    • Uses: to fight fatigue, improve performance, reduce stress. Can inhibit platelets.
    • Disease precautions: heart disease, diabetes, pregnancy/nursing, surgery.
    • Drug interactions: caffeine (using both may cause high blood pressure [BP]), antiplatelet medications, insulin (ginseng may lower blood sugar), anticoagulants, MAO inhibitors, loop diuretics.
  • • Goldenseal
    • Uses: it is not absorbed through GI tract. Used topically on canker sores.
  • • Grape seed extract
    • Uses: antioxidant similar to pycnogenol.
  • • Green tea
    • Uses: antioxidant, improves cardiovascular health.
    • Disease precautions: asthma, hypertension.
    • Drug interactions: decreases absorption of atropine, codeine, ephedrine, and asthma medications. Can cause hypertension.
  • • Indian frankincense ( Boswellia serrata )
    • Uses: antiinflammatory by inhibiting LTs.
    • Disease precautions: none.
    • Drug interactions: none.
  • • Kava Kava (Piper methysticum)
    • Uses: reduces anxiety and insomnia.
    • Disease precautions: persistent depression—increased risk of suicide, pregnancy/nursing, surgery (potentiates anesthesia), hepatotoxicity.
    • Drug interactions: alcohol, alprazolam, barbiturates, St. John’s wort.
  • • Ma-Huang (Ephedra sinica)
    • Uses: for cough/bronchitis, as a stimulant and for weight loss.
    • Disease precautions: anxiety and restlessness, high BP, heart disease, glaucoma, prostate adenoma, cardiac arrhythmias, surgery (causes high BP).
    • Drug interactions: caffeine, decongestants, digoxin, MAO inhibitors.
    • This is a dangerous herb.
  • • Milk thistle
    • Uses: as a liver protectant.
    • Disease precautions: none.
    • Drug interactions: phenothiazines.
  • • Pycnogenol ( Pinus pinaster )
    • Uses: antioxidant because it is a bioflavonoid. Protects from heart disease and cancer.
  • • Saw palmetto (herbal catheter)
    • Uses: prostate and irritable bladder, stimulates libido. Inhibits 5-alpha reductase thus decreasing dihydrotestosterone levels.
    • Disease precautions: hormone-dependent cancer, pregnancy/nursing. Can cause diarrhea.
    • Drug interactions: hormone replacements, oral contraceptives, finasteride, dutasteride.
  • • St. John’s wort ( Hypericum perforatum ) (Nature’s Prozac)
    • Uses: treatment of mild depression.
    • Disease precautions: can cause photosensitivity.
    • Drug precautions: MAO inhibitors (Nardil, Parnate), SSRIs (Prozac, Zoloft, Paxil) (mild serotonin syndrome), digoxin (decreases blood concentration), tramadol, oral contraceptives (decreased efficiency), photosensitizers (tetracycline, quinolones, Feldene), Dyazide, Bactrim, Septra, theophylline (decreased levels of theophylline), HIV protease inhibitors (decreased levels of Indinavir), cyclosporine (decreases levels of cyclosporine).
  • • Valerian root (Nature’s Ambien)
    • Uses: insomnia.
    • Disease precautions: can cause hepatitis.
    • Drug interactions: increased sedation with alcohol and other sedating medications.
  • • Wild yam
    • Uses: natural source of DHEA. Cannot be utilized by body.
  • • Yucca (Adam’s needle)
    • Uses: contains saponin, which decreases abnormal fat content in blood and improves intestinal circulation. Claimed to have analgesic and antiinflammatory properties.
    • Disease precautions: current or previous GI ulcers. These stimulate gastric acid.
  • • Zinaxin —Ginger root extract called hydroxy-methoxy-phenyl-33 (see Ginger).

Pearl: There is no standardization of herbal medicine in the United States. Consequently, a patient has little idea of how much active herb they are getting in what they buy over the counter. Daily cost of most herbs ranges between $0.30 and 1.50 a day.

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