Anti-Inflammatory Supplements and Herbs

Changing your diet to include anti-inflammatory foods, spices, herbs, and beverages is the first and most important step in the battle against inflammation and chronic disease. Getting a lot of good exercise — both heart pumping cardiovascular workouts and relaxing yoga — is another good step.

Finding those supplements — natural herbs and enzymes — that give your new diet that extra boost is an added bonus in the fight against inflammation. From herbs that keep migraines at bay to vitamins that help reduce the risk of cancer, supplements should be part of your daily routine. We discuss our top ten anti-inflammatory herb and supplement picks in this article. Read on for info on the benefits, the recommended dosages, and the cautions and contraindications associated with these supplements.

Always consult a physician or pharmacist who is knowledgeable in herbs and supplements and their interactions before trying any herbs or supplements on your own.

1. Omega-3 Fatty Acids: Mixed EPA and DHA from Fish Oils

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are two essential fatty acids derived from fish and some vegetarian sources. You can’t make these fatty acids in your body — that’s why they’re essential fatty acids — so you need to get them from food or supplements daily. EPA and DHA are anti-inflammatory superstars because they compete against a pro-inflammatory compound called arachidonic acid (AA) for incorporation into cellular membranes.

Use fish (such as salmon and sardines) and fish oils as your primary sources of EPA and DHA. Vegetarian sources of omega-3 fatty acids (flax and chia, for example) contain alpha linolenic acid (ALA), which gets converted into EPA.

If you can’t find fish that are low in mercury and other toxins, take a high quality fish oil supplement with both EPA and DHA for an anti-inflammatory diet.

Just as important as the positives that take place when you do supplement your diet with fish oils is what happens when you don’t: Some studies have linked an omega-3 deficiency to an increased risk of depression.

Here are some basic ideas you should know about increasing your intake of mixed EPA and DHA from fish oils:

  • Checking for quality: Choose fish oil supplements that are good manufacturing practice (GMP) certified and tested for heavy metals. They should smell like fresh fish when you bite into a capsule. Quality fish oils cost a little more than other brands and have been tested for shelf stability.
  • Dosing: Take 1 to 4 grams daily of a mixed EPA/DHA.
  • Cautions/contraindications: Because fish oils have benefits similar to blood thinners, they may increase the effect of pharmaceutical blood thinners, such as warfarin (Coumadin).

2. Ginger

The root of the ginger plant has increased in popularity in recent years, and no wonder — it has multiple anti-inflammatory benefits and helps reduce symptoms in inflammatory disorders. Among the benefits of ginger, and more specifically ginger root, are the following:

  • It decreases inflammation by inhibiting the cyclooxygenase and lipoxygenase pathways, prostaglandin E2, thromboxane B2, and tumor necrosis factor (TNF-alpha).
  • It decreases pain in disorders such as osteoarthritis and rheumatoid arthritis.
  • It’s antibacterial and antifungal.
  • It decreases fevers.
  • It aids with nausea, including the nausea of pregnancy and the nausea and vomiting of chemotherapy.
  • It decreases the risk of heart and cardiovascular disease by increasing circulation and preventing the clotting of blood.
  • It may be used as a prophylactic for migraine headaches.

Here are some basic facts you should know about taking ginger:

  • Checking for quality: Fresh is always best, but you can use dried ginger or encapsulated ginger extracts.
  • Dosing: 1 to 2 grams of fresh or dried ginger a day can help with pain, aches, and inflammation. Drink 1 to 3 cups of ginger tea for aches and pains or add a 1⁄4-inch piece of peeled, diced ginger to your stir-fry. Capsules containing at least 170 milligrams of ginger root extract, taken three times a day, are helpful with arthritis.
  • Caution/contraindications: Ginger may interact with blood thinners like warfarin (Coumadin), so consult your physician before adding it to your diet in large amounts. People with gallstones or those who have experienced a peptic ulcer should take caution in taking ginger, as should anyone taking antacids.

3. Turmeric/Curcumin

Turmeric comes from the root of the Indian Curcuma longa plant and is a main ingredient in curry. It contains an extract called curcumin that researchers have studied extensively for its multiple anti-inflammatory benefits. Curcumin lends the spice its bright orange color.

Curcumin works in much the same way as ibuprofen but without the gastrointestinal side effects. That is, it inhibits the inflammatory cascade (the competition of different cells for the same enzyme) in the body mediated by cyclooxygenase (COX-2), prostaglandins, and leukotrienes. Curcumin also works as an antioxidant and stimulates the immune system.

Here are some of the anti-inflammatory benefits of curcumin:

  • It helps relieve indigestion by increasing digestive enzymes.
  • It has hepatoprotective effects, which protect against liver damage.
  • It helps with cognitive function and may decrease the risk of dementia and Alzheimer’s disease.
  • It reduces the pain and inflammation symptoms of rheumatoid arthritis.
  • It works as a cancer preventative by inhibiting tumor promotion, inhibiting the growth of cancer cells, and reducing their blood supply.
  • It may help with circulation by preventing the platelets from clumping together.

Here are some basic facts you should know about taking curcumin:

  • Checking for quality: The price of a curcumin extract may reflect its quality and standardization. The better quality companies ensure that they have a good quality of turmeric to start and have the right amount of curcumin in each bottle, so quality extracts cost a bit more.
  • Dosing: For anti-inflammatory benefit, you may need to take 500 milligrams up to three times a day. Turmeric and curcumin seem to be better absorbed with food.
  • Caution/contraindications: Curcumin should not be taken by people with gallstones or obstructed bile ducts without first consulting a physician. It can increase risk of serious bleeding, so it shouldn’t be taken by people with bleeding disorders or those who are taking blood thinning medication.

4. NAC (N-acetyl cysteine)

N-acetyl cysteine (NAC) is a derivative of amino acids, the building blocks of protein. NAC reduces free-radical damage and stops inflammation by acting as an antioxidant.

Here are some of the anti-inflammatory benefits of NAC:

  • It protects against drug toxicity and aspirin poisoning.
  • It promotes liver detoxification.
  • It helps lower the risk of cardiovascular disease by decreasing homocysteine.
  • It prevents bronchitis and improves the condition of people with chronic obstructive pulmonary disease (COPD).
  • It’s a cancer protective.
  • It increases circulation by preventing platelet aggregation.
  • It helps protect the immune system in HIV disease.
  • It helps relieve compulsive psychiatric disorders.

Here are some basic facts you should know about taking NAC:

  • Checking for quality: Make sure you get your supplements from a reputable source or a doctor who specializes in nutritional supplements.
  • Dosing: A general safe dose is 600 milligrams once or twice a day. Always consult your physician before starting any new herbs or supplements.
  • Caution/contraindications: NAC is generally safe, although people taking blood pressure medications, diabetes medications, and anticoagulants should avoid NAC due to some gastrointestinal side effects. Pregnant women should also avoid taking NAC.

5. Bromelain

Bromelain, an enzyme derived from pineapple, decreases the inflammatory response of the immune system and works as an antioxidant to increase reactive oxygen species (ROS) that clean up the mess of inflammation.

Bromelain also helps with circulation by inhibiting platelet aggregation, and it works against cancer by disrupting the growth of cancer cells. A study in osteoarthritis of the knee showed that a combination of bromelain with other antioxidants at 50 milligrams three times a day worked as well as the medication diclofenac (Voltaren) in reducing pain and improving function.

Here are some other anti-inflammatory benefits of bromelain:

  • It aids in digestion.
  • It helps with healing after surgery and trauma.
  • It helps alleviate allergy symptoms.
  • It eases aches and pains by acting as a smooth muscle relaxant, and it reduces muscle soreness after workouts.
  • It has cardiovascular and circulatory applications, including the inhibition of thrombus formation and platelet aggregation.
  • It helps reduce the inflammatory symptoms of inflammatory bowel diseases such as ulcerative colitis.

Here are some basic facts you should know about taking bromelain:

  • Checking for quality: Make sure you get your supplements from a reputable source or a doctor who specializes in nutritional supplements.
  • Dosing: 200 to 1,000 milligrams a day is generally used for arthritis and pain. It should be taken in divided doses on an empty stomach.
  • Caution/contraindications: Because bromelain has anti-platelet aggregation activity, you should use it with caution alongside other medications that work the same way, such as warfarin (Coumadin) and other blood thinners. Those with allergies to pineapple should avoid this supplement.

6. Boswellia

Boswellia, the tree resin from the Boswellia serrata plant, is also called Indian frankincense. It contains boswellic acid and alpha and beta boswellic acid, which researchers found to have anti-inflammatory properties in laboratory research. The anti-inflammatory properties of the boswellic acids come from their ability to prevent the formation of chemical signals in the body for inflammation, namely 5 lipoxygenase, leukotrienes, and leukocyte elastase.

Boswellia is an arthritis pain reliever in that it decreases the breakdown of cartilage and helps keep the joints lubricated. For autoimmune disease, boswellia appears to inhibit the chemical signals of autoimmune disease and reduce the formation of antibodies, the body’s attack cells.

Among boswellia’s benefits are the following:

  • It decreases inflammation in osteoarthritis, rheumatoid arthritis, tendonitis, bursitis, and general aches and pains.
  • It’s used to decrease inflammation in inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.
  • It may help decrease inflammation in asthma and allergies.
  • It has antibacterial and antiviral properties.
  • It has been shown to prevent cancer cell growth and help with programmed cancer cell death in colon cancer.
  • It protects against certain autoimmune diseases and their symptoms.

Here are some basic facts you should know about taking boswellia:

  • Checking for quality: Make sure you get your supplements from a reputable source or a doctor who specializes in nutritional supplements.
  • Dosing: 300 milligrams three times a day is generally used for arthritis and inflammatory disorders.
  • Caution/contraindications: Boswellia is generally safe.

7. Vitamin D

Vitamin D is probably one of the easiest nutrients to obtain, yet is one in which the majority of people have deficiencies. Vitamin D is a fat-soluble vitamin that is stimulated in the skin by exposure to the sun and is found in small amounts in some foods. A laboratory test called 25-hydroxy vitamin D shows that most people are vitamin D deficient unless they spend time outside in full sun every day.

The following are among vitamin D’s many anti-inflammatory benefits:

  • It boosts the immune system.
  • It prevents rickets, a disorder causing bones to become weak and deformed.
  • It protects against muscle aches and pains.
  • It prevents osteoporosis and osteopenia and reduces the risk of bone fracture.
  • It lowers the risk of autoimmune disorders such as rheumatoid arthritis and MS, and it improves symptoms in people with such disorders.
  • It helps with blood sugar regulation, and it may prevent Type 1 diabetes.
  • It protects against heart and cardiovascular disease. Researchers think vitamin D does this by affecting inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha) and interleukin.
  • It decreases the risk of cancer, specifically breast, prostate, and colon cancers.

Here are some basic facts you should know about vitamin D:

  • Checking for quality: Make sure to use vitamin D3 rather than vitamin D2.
  • Dosing: In general, most adults need 400 to 1,000 IU (international units) of vitamin D daily. However, people with autoimmune disease and who are very deficient in the vitamin may need more to achieve optimal blood levels.
    Full-body sun exposure for about 12 minutes during the sunniest part of the day (midday) produces approximately 10,000 units of vitamin D. If you’re unable to get this exposure, exposing the hands, face, arms, and legs to sunlight two to three times a week for about a quarter of the time it would take you to get a mild sunburn will cause the skin to produce minimal requirements of vitamin D. So if you normally start to turn pink after 20 minutes in the sun, try for 5 minutes of sun exposure two to three times a week; that could be as easy as walking to the end of your street and back. It’s important to mention, however, that a variety of factors — clothing, sunscreen, dark skin pigmentation, and air pollution, among others — can limit the sun’s strength and therefore the amount of vitamin D the body is stimulated to produce.
  • Caution/contraindications: Toxicity due to too much vitamin D is rare; in fact, the only studies that showed toxicity used 100,000 IU or more given intravenously. You’d need 25-hydroxyvitamin D blood levels of 150 ng/mL or more to get toxicity from vitamin D. Caution is advised with vitamin D in people with liver disease, people with high blood calcium levels, and people with granulomatous disorders such as sarcoidosis and tuberculosis (TB).

8. Vitamin C

Vitamin C, also known as ascorbic acid, is a water-soluble vitamin that decreases inflammation by acting as a potent antioxidant. Vitamin C also decreases C-reactive protein, the protein that gets elevated when your body is inflamed.

You can find high amounts of vitamin C in vegetables and fruits, including broccoli, papaya, bell peppers, oranges, cantaloupe, kiwi, cauliflower, Brussels sprouts, and strawberries. Overcooking and prolonged storage decrease the vitamin C content in food, so eat these fruits and vegetables raw or slightly cooked.

Among the anti-inflammatory benefits of vitamin C are the following:

  • It’s an antioxidant.
  • It stimulates the immune system and prevents infections.
  • It helps decrease allergy symptoms.
  • It prevents gout by decreasing uric acid levels.
  • It helps people with cardiovascular disease by preventing free radical damage.
  • It helps maintain connective tissue integrity to prevent wrinkles.
  • It protects the skin against sun damage.
  • It can be used adjunctively in cancer care or to help with cancer prevention (although consultation with an oncologist is necessary and appropriate).
  • It prevents scurvy, a disease caused by a deficiency in vitamin C that includes the swelling and bleeding of the gums and the opening of previously healed wounds.
  • It aids in wound healing.
  • It may aid in increasing HDL (good) cholesterol.

Here are some basic facts you should know about increasing your intake of vitamin C:

  • Checking for quality: Vitamin C can be made synthetically in a lab or derived from food sources, such as rose hips. Food-derived sources may be better absorbed than synthetic sources because the body can’t absorb more than 1 gram at a time — the rest is lost through urine.
  • Dosing: You need at least 100 milligrams a day to prevent scurvy and 1 to 3 grams a day for optimal function in preventing oxidative damage due to free radicals and increasing immune support. Start with 100 milligrams a day and slowly increase to 1 to 3 grams. The upper limit of vitamin C is determined by bowel tolerance (too much vitamin C will lead to loose stools). If you hit that upper limit, begin scaling back your daily amount of vitamin C.
  • Caution/contraindications: Too much vitamin C causes diarrhea and stomach upset. It’s safe in doses up to the point where it causes loose stools, called bowel tolerance. For adults, the recommended daily maximum of vitamin C is 2,000 milligrams.

9. Papain

Papain, an enzyme derived from the fruit of the papaya plant, helps reduce inflammation by breaking down harmful substances in the body and releasing substances such as reactive oxygen species (ROS) and cytokines that reduce inflammation and have antioxidant function.

Here are some of papain’s anti-inflammatory benefits:

  • It’s a digestive aid/enzyme.
  • It’s used to help reduce inflammation and improve healing after surgery and trauma.
  • It can help prevent post-operative adhesions.
  • It can help reduce inflammation of the throat and may reduce symptoms of tonsillitis.
  • It aids in wound healing.
  • It may reduce pain and inflammation in rheumatic disease.

Here are some basic facts you should know about taking papain:

  • Checking for quality: Make sure you get your supplements from a reputable source or a doctor who specializes in nutritional supplements.
  • Dosing: 1,500 milligrams a day is the dose used to treat inflammation and swelling after surgery or trauma. Take it on an empty stomach for best results.
  • Caution/contraindications: Some people may be allergic to papaya and papain. People with GERD and ulcers, as well as those taking immunosuppression therapy and radiation therapy, should be especially cautious when eating papain.

10. Coenzyme Q10

Coenzyme Q10 is a vitamin-like substance that provides energy to all the cells of your body. It’s an antioxidant, and it helps stabilize the cell membranes. You need coenzyme Q10 to complete many of your metabolic functions. For example, the mitochondria in your cells use it to make adenosine triphosphate (ATP), your cells’ main energy source.

Among the anti-inflammatory benefits of coenzyme Q10 are the following:

  • It provides energy for all the cells of your body.
  • It protects the heart and body against free-radical damage.
  • It reduces the risk of heart disease and helps normalize blood pressure.
  • It protects the body against muscle damage due to statin (cholesterol-lowering) drugs, such as Lipitor. Statins inhibit the enzyme needed to make cholesterol and coenzyme Q10.
  • It may protect the brain against damage and aids in treating Parkinson’s disease.
  • It helps reduce the occurrence of migraine headaches.
  • It has benefits in cancer protection.
  • It helps protect the gums against gingivitis.

Here are some basic facts you should know about taking coenzyme Q10:

  • Checking for quality: Coenzyme Q10 needs to be in an emulsified (fat-soluble) form in order to be absorbed. Some people who have difficulty absorbing coenzyme Q10 may do better with its derivative, called ubiquinol.
  • Dosing: Generally, 60 to 100 milligrams a day provides good antioxidant protection.
  • Caution/contraindications: Coenzyme Q10 looks like the blood thinning vitamin, vitamin K, so coenzyme Q10 may interact with other blood thinners. Have your physician monitor your blood if you’re on a blood thinner such as warfarin (Coumadin).