November 01, 2022 6 min read

In this article

    What is inflammation?

    Inflammation is the body's natural response to injury and infection. In order to heal the injury or fight off bacteria, the immune system sends white blood cells to fight the foreign invader. Short-term or acute inflammation may cause temporary swelling and pain, but ultimately it does its job to heal and protect your body and eventually subsides. Issues arise when the inflammation either occurs erroneously, such as with autoimmune disorders where the body perceives its own cells or tissues as harmful, or when the inflammation becomes chronic.

    Inflammation Caused By Autoimmune Disorders

    Inflammation can affect nearly any part of the body, including the joints. The symptoms of chronic inflammation can include stiffness and soreness, throbbing pain, inflammation and swelling, heat, and redness. It's also believed that chronic inflammation underlies many serious health conditions such as diabetes, cardiovascular disease, rheumatoid arthritis and osteoarthritis, allergies, and psoriasis.

    What types of conditions impair joint function?

    Joint inflammation can be caused by one of two things: injury or inflammatory diseases.

    • Osteoarthritisis a common type of arthritis that is caused by everyday “wear and tear” on the joints. Osteoarthritis pain is caused when cartilage, the connective tissue that cushions the joints, becomes thin and the bones begin to rub against each other.
    • Rheumatoid arthritis is an autoimmune disease in which the body attacks its own tissues, especially the joints. Rheumatoid arthritis symptoms include joint pain and stiffness, fatigue, knobs/bumps on the fingers, skin lumps, and dry mouth.
    • Bursitis is inflammation of a bursa, the sacs of fluid that help cushion your joints.
    • Gout is a form of arthritis that causes sudden, severe joint pain and inflammation. This occurs when excess uric acid crystallizes and deposits in the joints.

    Which Nonsteroidal Anti-Inflammatory Drugs cause stomach irritation?

    Chronic use of NSAIDS, or nonsteroidal anti-inflammatory drugs, comes with many side effects including stomach ulcers and irritation, nausea, and heartburn. If you are dealing with chronic inflammation or joint pain, minimize the use of anti-inflammatory drugs such as:

    • Aspirin
    • Ibuprofen (Advil, Motrin)
    • Acetaminophen (Tylenol)
    • Naproxen (Aleve)

    Side Effects of the Chronic Use of NSAIDs

    Dietary Supplements for Better Joint Health and Decreased Stomach Irritation

    Boswellia Serrata: Boswellia Serrata, or Indian frankincense, is a natural supplement with powerful anti-inflammatory properties. Boswellia's effectiveness stems from preventing the formation of leukotrienes, inflammatory chemicals, in the body. Certain studies have found Boswellia Serrata to be effective at decreasing knee pain related to osteoarthritis of the knee. Other studies have shown that Boswellia is an inhibitor of the damaging pro-inflammatory mediators that can compromise collagen proteins. This is important because collagen provides flexible and sturdy support to all of the body's major connective tissues including the joints. Boswellia is one of the few supplements that has not been linked to stomach upset or other damaging side effects.

    Herbal Supplement Cat's Claw

    Omega-3s:Fish oil supplements contain omega-3 fatty acids. On top of improving heart health and even fighting depression and anxiety, long-chain omega-3 fatty acids (DHA and EPA) are known to have potent anti-inflammatory effects. Though the side effects of omega-3 supplements may include gastrointestinal agitation, it is usually mild and only noticed when consumed in very high doses. Taking 250–500 mg of omega-3s per day is generally considered safe.

    If the "fish burps" and heartburn of traditional fish oil supplements scare you off, there are now vegan-friendly algal oil supplements that contain both DHA and EPA that rarely cause stomach upset or indigestion.

    Gamma-Linolenic Acid (GLA)

    Gamma-linolenic acid (GLA): Gamma-linolenic acid or GLA is an omega-6 fatty acid that can be converted into anti-inflammatory chemicals and suppress inflammatory responses. GLA is available in capsules or as oil. When taken at doses of no more than 3g daily, it may be a well-tolerated and effective treatmentfor rheumatoid arthritis.

    Devil's Claw: Despite its name, Devil's Claw is another gentle yet effective herbal remedy that has been shownto reduce joint pain and improve mobility in people with osteoarthritis. According to Mount Sinai,"If taken at the recommended dose for a short time, health practitioners consider Devil's Claw non-toxic and safe, with few side effects. High doses can cause mild stomach problems in some people. Researchers are unsure of the safety of taking Devil’s Claw over an extended period of time.

    Cat's Claw: Cat's Claw is an herbal supplement derived from a woody vine found in South and Central America. While more studies need to be done, preliminary studies have found that Cat's Claw has antioxidant and anti-inflammatory properties with no known side effects.

    Methylsulfonylmethane (MSM): MSM is an organic sulfur that can be found in raw foods such as fruits, vegetables, and meat. When consumed via dietary sources, it can be broken down, rendering it less effective. When consumed in a supplement, it is well-tolerated as a short-term treatment for joint pain and discomfort. Long-term consumption may lead to mild gastrointestinal discomfort.

    Collagen: Though collagen should not be taken as a pain-relief medication, daily collagen supplementation may help support joint health and mobility. In one 24-week study on athletes, daily collagen consumption was linked to decreased joint pain and faster recovery compared to the placebo. It may also be helpful in preventing joint pain and arthritis, especially osteoarthritis. It is also used to strengthen the gut lining if you are in need of help recovering from NSAID-related gastrointestinal upset.

    Supplements you should skip (for now)

    Glucosamine: Glucosamine is a natural compound found in cartilage. There are three forms of glucosamine that are commonly used to treat arthritis pain: glucosamine sulfate, glucosamine hydrochloride, and N-acetyl glucosamine. While glucosamine is considered safe, more clinical evidence is needed before we can say that it can effectively treat rheumatoid or osteoarthritis pain.

    Chondroitin sulfate: Chondroitin is a complex sugar and another important component of cartilage. Studies have found that chondroitin supplementation may reduce the activity of enzymes and other substances that can break down collagen in the joints. Chondroitin sulfate is often recommended alongside glucosamine as it may have complementary effects. However, because nausea, heartburn, and stomach upset are known side effects of this supplement, it may not be your best choice.

    Turmeric (Curcumin): Turmeric is another widely available and effective anti-inflammatory supplement thanks to its active ingredient curcumin. Data from randomized clinical trials revealed that curcumin supplements were more effective than some anti-inflammatory prescription drugs at managing joint pain and inflammation, including osteoarthritis-related knee pain. However, some people have found that taking turmeric supplements can cause stomach upset. A better alternative may be to take a low-dose turmeric supplement alongside another anti-inflammatory supplement such as Boswellia Serrata.

    Low-Dose Turmeric Supplement

    Avocado-soybean unsaponifiables (ASUs):Avocado-soybean unsaponifiables are chemicals found in avocado and soybean oils. While few studies have been done to show the effect of ASU supplementation on joint pain, they do contain ingredients like vitamin E which may improve joint health. Until more solid studies are done, ASUs are considered "possibly safe" and should only be taken under the supervision of a healthcare professional.

    S-adenosyl-methionine (SAM-e): SAM-e is a compound that's produced naturally in the body. It has been used to treat depression for decades and some studies have found that it is effective at managing osteoarthritis pain as well as some NSAID painkillers. Since dosages of SAME-e are relatively high at 600-1,200 milligrams per day and side effects may include stomach upset, it should only be taken in low doses or when recommended by a doctor.

    The Bottom Line

    For indigestion-free pain relief, your best bets may be Boswellia Serrata, Omega-3s, GLA, Cat's Claw, or Devil's Claw. The other commonly used joint relief supplements either have little evidence to support them or are known to cause stomach upset. In any case, if you are struggling with joint pain, consider speaking to a healthcare professional to create a complete therapy and supplementation plan.

    Summary Points:

    Issues arise when the inflammation either occurs erroneously, such as with autoimmune disorders where the body perceives its own cells or tissues as harmful, or when the inflammation becomes chronic

    Chronic use of NSAIDS, or nonsteroidal anti-inflammatory drugs, comes with many side effects including stomach ulcers and irritation, nausea, and heartburn

    Boswellia's effectiveness stems from preventing the formation of leukotrienes, inflammatory chemicals, in the body

    If the "fish burps" and heartburn of traditional fish oil supplements scare you off, there are now vegan-friendly algal oil supplements that contain both DHA and EPA that rarely cause stomach upset or indigestion.   

    References:

    1. https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/types-of-complementary-treatments/chondroitin/
    2. https://www.medicalnewstoday.com/articles/248423#_noHeaderPrefixedContent
    3. https://www.verywellhealth.com/anti-inflammatory-supplements-options-190474



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