Best Anti Inflammatory Supplements to Fight Inflammation | Pain Care

11 Natural & Best Anti-Inflammatory Supplements, Dosage & Side Effects

Inflammation is not only caused by injuries, but it can be a result of chronic stress, unhealthy foods and our bad habits like chronic drinking or smoking.

To combat the bad effect of inflammation, taking naturally best anti-inflammatory supplants can help.

Different physiological conditions are developed naturally due to undesirable exposure.

Therefore, we should select some ingredients, which are naturally available in the natural care regimen, to help us combat inflammation.

This concept not only improves our disease condition but also strengthen immunity naturally.

Know about chronic inflammation and pain symptoms

The concept of inflammation is changing.

Our ancestors believed that inflammation is a part of healing process.

In the 19th century, even the researchers also described inflammation as a body defensive mechanism and indication of undesirable response against harmful stimuli in the host.

However, the present medical science describes an inflammation as a fundamental etiology which is observed during disease progression or after a damage after an injury. It is especially true in the cases of chronic diseases.

The typical symptoms of inflammation are redness, swelling, raising the temperature of the site, pain, and functional inability, which mainly arise after an injury or microbial infection.

In these cases, inflammation is resultant to a full defensive cycle.

Initially, the cycle starts as the response of a harmful event with clinical signs of inflammation.

The gradual healing process is then continued and restoration of tissue structures and normal functionality developed but the pathophysiology of chronic inflammation is complex, which involves inflammatory mediator-induced altered immune signalling pathways and causes multiple chronic diseases, such as:

  • Atherosclerosis, in which arterial wall structural alteration occurs due to chronic inflammation.
  • Asthma and chronic bronchitis, in which lungs and bronchial wall get affected due to inflammatory process .
  • Arthritis is an outcome of the devastating damage to the joints and bone structures.

Apart from the above mentioned inflammatory condition, some other common chronic inflammation associated problems are inflammatory bowel diseases, multiple sclerosis,  retinitis, psoriasis, etc. 

The chronic inflammatory condition is also associated with pain and discomfort.  The reasons for pain are:

  • Inflammatory mediators, which arise due to direct injury or inflammatory response and provoke pain symptom.
  • Underlying sensory nerves become stretched  due to inflammation or edema.

The usual outcome of the chronic inflammation and pain is a loss of functionality; which can be referred as difficulty in movement; or when the functional tissues are replaced with scar tissues. [1]

11 Best Anti Inflammatory Supplements

Alpha(α) Lipoic Acid

Alpha Lipoic Acid

Alpha(α) lipoic acid is a fatty acid and are easily absorbable from dietary sources and become a common nutritive supplement.

Alpha(α) lipoic acid is also naturally produced in our mitochondrial cellular structures with the help of certain enzymes.

The production of Alpha(α) lipoic acid in mitochondria is an important cellular physiological functioning for maintaining energy levels.

There are different research results that show, Alpha(α) lipoic acid is effective to reverse chronic inflammatory condition, as it can mitigate lipopolysaccharide-induced inflammatory responses.

Lipopolysaccharide (LPS) is an inflammatory mediator, which stimulates inflammatory cytokines and increases the synthesis of cyclooxygenase-2 and nitric oxide synthase.  

Alpha(α) lipoic acid can inhibit NF-κB signaling pathway and diminish LPS - induced inflammatory responses.

An animal study showed this anti-inflammatory effect of Alpha(α) lipoic acid is effective to treat sepsis-associated acute kidney injury. [2]

Alpha(α) lipoic acid is a potent antioxidant.

The antioxidant property of Alpha(α) lipoic acid does not only act as a scavenger of free radicals but also reduce different inflammatory cytokines like interleukin-6 and plasminogen activator inhibitor-1.

Thus, it can improve cardiac health by treating endothelial dysfunction.

 The reduction of interleukin-6 and plasminogen activator inhibitor-1 by consuming Alpha(α) lipoic acid can also combat obesity and related metabolic symptoms. [3]

Dosage:

The usual dose of Alpha(α) lipoic acid varies from 300 mg to 600mg per day depending upon the individual's requirement. [4]

Side effect

A higher dose of Alpha(α) lipoic acid i.e. 3 to 5 gm per day can cause mineral deficiency as it has the metal chelating ability.

Nausea and itching can also develop in some patient with the higher dose( 1,200-1,800mg) of Alpha(α) lipoic acid intake per day. [4]

Curcumin

Curcumin Supplement

Anti-inflammatory effect of curcumin is well versed.

It provides an anti-inflammatory effect by exerting the following mechanism of action:

Research findings showed that in most of the inflammatory conditions, TNF-a and NF-kB levels are increased.

Curcumin inhibits the activation of TNF-a. Furthermore, the antioxidant property of curcumin prevents TNF-a induce activation of NF-kB.  [5]

TNF-a inhibitory induce the anti-inflammatory effect of curcumin which can also prevent obesity and insulin resistance and decrease the scope of diabetes. [6]

Curcumin can also down-regulate cyclooxygenase 2 by blocking TNF-a. [7] Following anti-inflammatory benefits are well researched through preclinical and clinical studies:

Animal research already supported that anti-inflammatory effect of curcumin is effective to control edema, ulcerative colitis, rheumatoid arthritis, pancreatitis, and cancer. [8]

Several human studies showed that the potent anti-inflammatory effect of curcumin reduces postoperative inflammation, arthritis, uveitis, pancreatitis, inflammatory bowel disease,  irritable bowel syndrome, and Helicobacter pylori infection. [8,9]

A comparative study result reported that the efficacy of curcumin in the reduction of inflammation and pain is similar to other popular commercial NSAIDs like ibuprofen, diclofenac, and glucosamine. [10]

It has been also found that curcumin provides a synergistic effect to diclofenac and can be effectively used in the treatment of arthritis. [10]

Dosage

2 to 4 gms per day of curcumin supplementation is effective to provide an anti-inflammatory effect.

But curcumin rapidly breaks down in the liver and gut wall and unable to absorb in the blood. [11]

However, research study report suggested of adding a small quantity of black pepper to turmeric, which can enhance curcumin level in blood. [12]

Side effects

Higher dose-related side effects of Curcumin are nausea, diarrhea, abdominal distension, GERD may observe. [11]

Fish Oil

Fish Oil Capsules

Fish oil is a rich source of polyunsaturated fatty acids (PUFA).

The polyunsaturated fatty acids are typical combination of omega 3 PUFA  including DHA (docosahexaenoic acid) and EPA (Eicosapentaenoic acid).

Both DHA and EPA have anti-inflammatory properties, as they pursue the following mechanism of action:

  • Altering phospholipid fatty acid content in the cell membrane and disrupt lipid molecules.
  • Inhibit NFkB (the pro-inflammatory transcription factor) and reduce inflammatory gene expression.
  • Activation of NR1C3, which acts as an anti‐inflammatory transcription factor.
  • They produce two inflammation resolving factors termed as resolvins and protectins. [13]

The above mentioned anti-inflammatory effect of omega 3 fatty acids present in fish oil able to resolve chronic inflammatory conditions.

Animal study report showed that fatty acids present in fish oil provide the beneficial result to combat inflammatory conditions like in rheumatoid arthritis, asthma, and inflammatory bowel disease. [13]

Human study report also reported fish oil supplementation improves rheumatoid arthritis. [13]

Patient with chronic neck and back pain also showed the beneficial result after consumption of fish oil supplement. [14]

Dosage

Depending upon the physical condition experts recommended the dose of the fish oil.

However, according to the American Heart Association, the recommended dose is 1g daily. [15]

Side effects

Fish oil supplement is safer than other non-steroidal anti-inflammatory drugs.  

No side effect is reported after human use; however, some may have frequent fish oil burp after oral intake.

Human study report showed no such side effect associated with fish oil. [14]

Ginger

Gigner Anti Inflammatory Supplement

In folk medicine, ginger is used to treat an inflammatory condition like arthritis.

It has been observed that ginger intake prior to performing strenuous physical activities provide less pain generation due to reduced production of quadriceps in the muscle.

This indicates ginger has analgesic property due to an anti-inflammatory effect.

In addition, the antioxidant activity of ginger also prevents several degenerative diseases including cardiac disease, neuronal conditions, and cancer.  

Gingerol, shogaol and other bioactive phytochemicals in ginger are mainly involved in anti-inflammatory effect.

The following mechanism of action may be responsible for the anti-inflammatory effect of ginger:

  • The different bioactive component of ginger can suppress prostaglandin synthetase or 5-lipoxygenase and thus it inhibits different inflammatory biosynthesis like prostaglandin and leukotriene etc.
  • Ginger can suppress pro-inflammatory cytokines productions, including IL-1, TNF-α, and IL-8 by downregulating  Inducible Nitric Oxide Synthase and cyclooxygenase-2 pathways.
  • Ginger can decrease the elevated level of NFκB and may effective to treat or prevent different inflammatory conditions like cancer, osteoporosis, arthritis, myocardial infarction, atherosclerosis,  diabetes, asthma, Crohn's disease, allergy,  multiple sclerosis, psoriasis, Alzheimer's disease, AIDS and septic shock.

Research evidence showed ginger is effective to relieve osteoarthritis symptoms and reduce muscle pain. [16]

Dosage

The dose of ginger is 1 gm/day for adults. 

In the market, several ginger supplement dosage forms are available, including capsule, liquid extract, syrup, ginger tea etc.

However, you can take fresh grated 1 teaspoonful of ginger root, which is equivalent to 1 gm of ginger.  [17]

Side effect

Usually, 1 gm of the ginger dose does not provide any side effect but can interact with anticoagulant therapy like Warfarin, Aspirin (NSAIDs).

Therefore, concurrent administration with these drugs is not advisable, especially in case f pregnancy. [17]

Resveratrol

Red Grapes Best Anti Inflammatory Supplement

This is a polyphenolic phytochemical present naturally in grapes, berries, nuts and other plants.

The following mechanisms are involved to provide anti-inflammatory effects:

It inhibits production and secretion of pro-inflammatory mediators by suppressing cyclooxygenase enzymes. [18]

Down-regulates activation of immune cells. [18]

Resveratrol has an inhibitory effect in NFkappaB, IκBα and activator protein-1. [19]

It also downregulates high-mobility group box 1 and modulates  Janus kinase/STAT signaling pathways and provide anti-inflammatory effect against lipopolysaccharide-induced inflammatory response. [19]

The anti-oxidant and anti-inflammatory effect of Resveratrol has anti-aging property and prevent several degenerative diseases including cardiac diseases, [20] and chemo-preventive effect. [19]

Dosage

The dose of Resveratrol depends upon the age, gender, physical condition of the individuals. [21]

However, up to 5 gm dose per day does not cause any significant side effect. [22]

Side effect

 There is no significant side effect associated with Resveratrol; however, some patient may have nausea and intestinal upset.[22]

Spirulina

Spirulina - Natural Anti Inflammatory Supplements

Spirulina is a type of blue-green algae.

The anti-inflammatory effect of Spirulina can be effective to treat and prevent arthritis, colitis, and allergic rhinitis.

The anti-inflammatory effect of this alga is obtained due to following pathways:

  • It reduces lipopolysaccharide synthesis, suppresses the expression of TNFα.  Thus, it inhibits secretion of pro-inflammatory cytokines.
  • Spirulina modulates histone deacetylases in macrophages and alters histone H3 acetylation pathways. This alteration inhibits the activity of NF-κB and decreases the activity of Il-1β and tumor necrosis factor α promoters. Thus Spirulina provides an anti-inflammatory effect. [23]

Dosage

Spirulina has multiple health benefits including controlling of cholesterol level, blood pressure, blood glucose, muscle mass development and treating fatty liver.

The dose of Spirulina depends upon body weight and the physiological requirement. For example 10.9 gm /day is recommended for a person with 68 kg body weight. [24]

Side effects

Fresh and dried adulteration free Spirulina is safe and does not cause any side effect.  [25]

Anti-Oxidant Suppements (Vit. C & D)

Orange - Rich Source of Vitamin C

Oxidative stress triggers inflammatory cytokines release and causes inflammation.

Alone or combination of anti-oxidants can alter inflammatory parameters and provide anti-inflammatory effects. [26]

Study research showed that vitamin C can control chronic gingival inflammation and can be used as adjunctive therapy.

Vitamin C  reduces the release of cytokines and chemotaxis, activates phagocytosis process, accelerates healing procedure and increase antibody production.  [27]

Dosage

A range of 100-200mg/ day of vitamin C is considered as Recommended Daily Intake (RDI) of vitamin C. [28]

For a normal individual with adequate diet does not require vitamin E supplementation.

For elderly individual  50-200mg/ day, vitamin E is recommended to improve immunity. [29]

Side effects

A higher dose of vitamin C (2,000-6,000mg) may cause diarrhea. [28]

A higher dose of vitamin E ( more than 400IU/day) can increase the risk of mortality and cancer. [29]

Quercetin

Black Grapes - Source of Quercetin

Quercetin is a flavonoid group of phytochemical widely present in fruits and vegetables.

The anti-inflammatory mechanism of actions of Quercetin involve:

  • It inhibits lipopolysaccharide-induced TNF-α production in macrophages and also suppresses LPS-induced Interleukin-8 production in lung cells.
  • Quercetin can inhibit release of pro-inflammatory cytokines, histamine, and tryptase by deactivating high-affinity IgE receptor (FcεRI).
  • Quercetin stabilizes mast cells and reduce the secretion of histamine and thus inhibits calcium influx and phospho-protein kinase .  [30]

The anti-inflammatory effect of Quercetin are beneficial to prevent allergies. [31]

Dosage

Quercetin dosage varies from 12.5 to 25mg/ kg body weight.  [32]

Side effects

GRAS (Generally Recognized As Safe) is granted for Quercetin, that means the few grams of  Quercetin does not produce any side effect.  [32]

Bromelain

Bromelain  is a proteolytic enzymes  mixture naturally obtained from pineapple.  It down-regulates the expression of Cyclooxygenase-2  and prostaglandin E2 levels.   Bromelain can inhibit inflammatory stimulus induce activation of the immune cell, which is effective to control Interleukins (IL-1β and IL-6) production.  It also decreases secretion of TNF-α secretion. Thus bromelain controls immune system mediated overproduction of cytokines. [33]  Bromelain modulates the activation of CD4+ T cells and reduces the expression of CD25 by splitting CD25 from the CD4+. [34] It also reduces the expression of CD44 at the site of the inflammation due to immuno-modulating effect. [33] Combination therapy of Bromelain with trypsin and rutin is effective to relieve pain and inflammation in patients with osteoarthritis. [35] The analgesic effect of Bromelain is obtained due to bradykinin suppression.  Bromelain is effective to down-regulate TGF -β in osteomyelofibrosis and rheumatoid arthritis affected patients and provides therapeutic benefits by reducing inflammation. [33] Dosage The anti-inflammatory effect of Bromelain can be obtained in a dose range of does range from 200 - 800mg per day. [36]  Side effects Bromelain is safe in recommended dose but mild side effects like farting and pasty feces can occur with higher doses. [36]

Bromelain  is a proteolytic enzymes  mixture naturally obtained from pineapple.

It down-regulates the expression of Cyclooxygenase-2  and prostaglandin E2 levels.

 Bromelain can inhibit inflammatory stimulus induce activation of the immune cell, which is effective to control Interleukins (IL-1β and IL-6) production. 

It also decreases secretion of TNF-α secretion. Thus bromelain controls immune system mediated overproduction of cytokines. [33]

Bromelain modulates the activation of CD4+ T cells and reduces the expression of CD25 by splitting CD25 from the CD4+. [34]

It also reduces the expression of CD44 at the site of the inflammation due to immuno-modulating effect. [33]

Combination therapy of Bromelain with trypsin and rutin is effective to relieve pain and inflammation in patients with osteoarthritis. [35]

The analgesic effect of Bromelain is obtained due to bradykinin suppression.

Bromelain is effective to down-regulate TGF -β in osteomyelofibrosis and rheumatoid arthritis affected patients and provides therapeutic benefits by reducing inflammation. [33]

Dosage

The anti-inflammatory effect of Bromelain can be obtained in a dose range of does range from 200 - 800mg per day. [36]

Side effects

Bromelain is safe in recommended dose but mild side effects like farting and pasty feces can occur with higher doses. [36]

Flax Seed Oil

Flax Seeds

Flax-seed oil is a rich source of n-3 polyunsaturated fatty acids and contains Alpha(α)-linolenic acid (ALA).

Combination of docosahexaenoic acid and eicosapentaenoic acid are present in Alpha(α)-linolenic acid and thus Flax-seed oil has an anti-inflammatory effect. [37]

In a combination of Lactobacillus plantarum probiotics, Flax-seed oil is effective to treat intestinal inflammation related to bacterial infection due to its anti-inflammatory effect. [38]

The nutrient composition of flax seeds promotes its anti-inflammatory  and antioxidant property and prevent number of chronic inflammatory conditions, including cancer, osteoporosis, renal inflammation, fibrosis  and cardiovascular diseases etc. [39]

Dosage

There is no recommended anti-inflammatory dose of flex seeds mentioned.

Side effect

Flax seed oil may increase bleeding risk so co-administration with anticoagulant therapy is not recommended.

Some may have the misconception that diabetic patient should not take flaxseed oil.

It increases blood glucose label, but research evidence showed that flaxseed oil does not affect glycemic control in type 2 diabetic patients. [37, 40]

Zinc

Zinc Food Resources

Zinc is a potent anti-oxidant and the evidence show that deficiency of zinc increase interleukin (is an inflammatory cytokine) level. 

The anti-inflammatory effect of zinc involves inhibition of NF-κB activation, which leads to decrease synthesis of inflammatory cytokines.

This anti-inflammatory effect of zinc provides therapeutic benefits against several chronic inflammatory conditions develop in elderly populations.

Zinc supplementation can reduce the risk of chronic inflammatory conditions like atherosclerosis, diabetes, obesity, hypertension, infection etc. [41]

Dosage

A low dose of zinc i.e. 5-10mg/day provides preventive effect and considered as maintenance therapy; whereas higher dose i.e. 25-45mg per day is recommended for zinc deficiency.  [42]

Side effects

A low dose of zinc does not have any significant side effect, but at a long-term higher dose of zinc can cause nausea and vomiting. [42]

Bottom Line: The above mentioned eleven anti-inflammatory agents are naturally obtained from different natural sources.

Most of these anti-inflammatory agents have low side effects and minimum long-term adverse effects than synthetic anti-inflammatory medicines. 

However, these anti-inflammatory agents are effective to reduce chronic inflammatory condition effectively. It is important to discuss these 11 anti-inflammatory agents with a medical professional prior selection.

References +


1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1074343/
2. https://www.ncbi.nlm.nih.gov/pubmed/24962643
3. http://circ.ahajournals.org/content/111/3/343.long
4. https://examine.com/supplements/Alpha(α)-lipoic-acid/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883052/
6. https://www.ncbi.nlm.nih.gov/pubmed/18629684
7. https://www.ncbi.nlm.nih.gov/pubmed/16219905
8. http://www.altmedrev.com/publications/14/2/141.pdf
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535097/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003001/
11. https://examine.com/supplements/curcumin/
12. https://www.ncbi.nlm.nih.gov/pubmed/9619120
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575932/
14. https://www.ncbi.nlm.nih.gov/pubmed/16531187
15. https://examine.com/supplements/fish-oil/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665023/
17. https://examine.com/supplements/ginger/
18. https://www.ncbi.nlm.nih.gov/pubmed/17897053
19. https://www.ncbi.nlm.nih.gov/pubmed/25651848
20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058481/
21. https://www.sciencedirect.com/science/article/pii/S0925443915000071
22. https://examine.com/supplements/resveratrol/
23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924221/
24. https://examine.com/supplements/spirulina/
25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907180/
26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911454/
27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5165168/
28. https://examine.com/supplements/vitamin-c/
29. https://examine.com/supplements/vitamin-e/
30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808895/
31. https://www.ncbi.nlm.nih.gov/pubmed/18026696
32. https://examine.com/supplements/quercetin/
33. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998156/
34. https://nccih.nih.gov/research/results/spotlight/080309.htm
35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529416/
36. https://examine.com/supplements/bromelain/
37. https://www.arthritisresearchuk.org/arthritis-information/complementary-and-alternative-medicines/cam-report/complementary-medicines-for-rheumatoid-arthritis/flaxseed-oil.aspx
38. https://www.ncbi.nlm.nih.gov/pubmed/23465779
39. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152533/
40. https://www.ncbi.nlm.nih.gov/pubmed/18391475
41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429650/
42. https://examine.com/supplements/zinc/

Dr. Nita Sharma Das
 

Dr. Nita is a freelance medical writer with an experience of more than 14 years in Indian healthcare industry with a strong niche in Nutraceutical. As per academia, she is a Doctor of Naturopathy and did her PhD in Alternative Medicine.

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