Table of ContentsView AllTable of ContentsGlucosamine and ChondroitinHyaluronic AcidBoron/Calcium FructoborateMSMVitamin D3TamarindTurmericKrill Oil/Omega-3AstaxanthinType II CollagenWhat to Look ForFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Glucosamine and Chondroitin
Hyaluronic Acid
Boron/Calcium Fructoborate
MSM
Vitamin D3
Tamarind
Turmeric
Krill Oil/Omega-3
Astaxanthin
Type II Collagen
What to Look For
Frequently Asked Questions
If you havearthritisor another joint condition, you may be looking for supplements that can help with joint pain. There are a variety of nutritional supplements forjoint painon the market, and often it may be hard to separate those that may be effective from those that likely aren’t.
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If you’re currently on prescription or over-the-counter (OTC) medication or regularly take other nutritional supplements, consider that even “natural” remedies could interact with these. So, before trying new supplements, consult with a healthcare provider first.
This article explains the benefits of joint supplements and details how they might help with pain in the elbows, knees, fingers, toes, neck, andlower back.
Glucosamineand chondroitin are supplements that some people use for joint pain. They are naturally occurring components of the cartilage that provide a cushion between the hard surfaces of the bones that form joints.
Glucosamine supplements are often derived from shellfish. Some chondroitin comes from the cartilage of sharks or cows, and some are synthesized in the lab. Both are available in the form of supplements, either separately or together.
What the research says:Some studies suggest that taking glucosamine and chondroitin supplements can improve cartilage health. However, there are mixed results, with some showing a benefit and others showing no benefitor even worsening joint pain.
A 2016 study reported that they appeared about as effective as the drug celecoxib in improving osteoarthritis (OA) of the knee.Still, a 2017 study found that it didn’t result in any clinical improvements.
A review of literature, also published in 2018, concluded that either supplement could reduce pain in knee OA, but combining them didn’t offer a greater benefit and neither improved the condition overall.
How to take it:A typical dosage for glucosamine and chondroitin, whether together or separate, is:
These dosages can be divided into two or three equal doses throughout the day, preferably taken with meals.
Side effects and interactions:Glucosamine and chondroitin supplements may interact negatively with the blood-thinning drug warfarin.
Many of the common side effects of glucosamineare digestive in nature, and so taking it with food can help to prevent them:
In rare cases, glucosamine may cause:
If You’re Allergic to Shellfish…
Chondroitin may cause side effects as well, including:
Hyaluronic acid is a component of the fluid that lubricates joints. For this reason, some research has evaluated its use as a supplement for joint pain. For treatment purposes, it is sometimes extracted from rooster combs or produced in a laboratory using bacteria. As such, it can be injected directly into the joints or, with less proven results, taken as an oral supplement.
What the research says:A small but growing body of evidence suggests supplements may increase the amount of hyaluronic acid in joint fluids as well as relieve pain and inflammation. As a bonus, they may even improve sleep quality.
A 2016 review of studies of this supplement for knee osteoarthritis concluded that it is a safe and effective treatment for mild knee pain and may also help prevent OA.
How to take it:There is no medically-determined advisable dosage of hyaluronic acid. Manufacturers recommend between 200 mg and 1,000 mg per day. Clinical studies have often reported positive results with daily dosages of 240 mg or less.
Side effects and interactions:When injected, hyaluronic acid can cause an allergic reaction or unpleasant side effects at the site along with some systemic effects. It’s theoretically possible oral supplements could cause similar systemic reactions:
In-Depth: Hyaluronic Acid Supplements
Boron, a mineral found in some nuts, fruits, and vegetables as well as in the environment, may be beneficial as a joint supplement.
What the research says:Boron and boron-containing molecules, such as calcium fructoborate help the body maintain healthy levels of vitamin D, calcium, and magnesium—nutrients that are essential for healthy bones and joints.
It has also been shown to lower inflammation and possibly even reduce the risk of developing arthritis.
Although most of the evidence is positive, more research is needed to definitively show thatboron supplementsare effective for improving joint health or relieving pain from arthritis.
Calcium fructoborate is a sugar-borate, which means that the molecule contains one or two sugar molecules attached to a boron atom. Most of the borate in foods is in the form of a sugar-borate.
A 2019 review concluded that calcium fructoborate supplements offer better health benefits than regular borate and describes it as a safe, natural, and effective way to manage joint discomfort and improve mobility in older people.
How to take it:As a supplement, boron is believed to be safe at doses of 20 mg per day or less. Data suggest that it’s ideal to get more than 1 mg of boron per day as part of a healthy diet. Many people get less than this amount through food.
Side effects and interactions:Side effects aren’t typically a problem except for at high doses, when it can cause:
Boron is not considered safe for everyone. People who should not take boron supplements are those who:
Boron doses of more than 20 mg a day may impair male fertility. Large doses may also cause poisoning, which causes symptoms of tremors, convulsions, diarrhea, vomiting, etc.
Boron: Benefits, Side Effects, and Dietary Sources
Supplements of methylsulfonylmethane, better known as MSM, have been shown to reduce inflammation, joint pain, and muscle pain. This important source of sulfur is naturally found in plants and animals, including humans, and can be synthesized in a lab.
What the research says:A 2017 review explored the different aspects of MSM as an anti-inflammatory, antioxidant, and immune modulator, and the impact of each one of these on your health.
How to take it:MSM is generally well-tolerated at a daily dosage of up to 4 grams.
Side effects and interactions:MSM is associated with few mild side effects:
MSM contains sulfur and other sulfur-containing molecules are known to cause adverse reactions when combined with alcohol. Future studies are needed to gauge the effects of combining alcohol with MSM.
How MSM Might Help Your Arthritis
Vitamin D is derived from food and sunlight. While the evidence is mixed, some studies show a correlation between low vitamin D and pain, as a vitamin D deficiency can lead to bone loss and fractures, weak muscles, and pain in muscles and bones.Therefore, some research has evaluated whether it may be beneficial as a supplement for joint pain.
Vitamin D3 is often recommended because research suggests that it’s themost potent formof vitamin D, which means lower doses may achieve the desired benefits.
What the research says:A 2017 review of vitamin D for knee osteoarthritis found insufficient evidence that it neither significantly reduced pain or stiffness nor improved overall function.These results were consistent with the results of a 2018 review on osteoarthritis treatments that also declared vitamin D ineffective.
However, a 2017 study concluded thatvitamin D supplementationfor six months decreased pain; improved physical performance, strength, and quality of life; and reduced damage from oxidative stress in people with OA.
How to take it:The U.S. Recommended Dietary Allowance (RDA) for adults under 70 is 600 IU (international units) per day. For adults over 70, it’s 800 IU.
Side effects and interactions:A standard dose of vitamin D is not associated with significant side affects. However, vitamin D is believed to cause harmful effects at dosages of 4,000 IU or higher. In large doses, it can become toxic and result in high blood calcium levels (hypercalcemia) which in turn may cause:
Tamarind(Tamarindus indica L.orFabaceae) is a tropical fruit with numerous uses in traditional medicine, including for joint pain.
What the research says:Research has shown that tamarind seed extract is a potent protector of joints because it appears to inhibit the activity of several enzymes that degrade bone and cartilage. It also is thought to relieve inflammation and act as an antioxidant.
A 2019 short-term study suggested a supplement formulation of tamarind and turmeric provided substantial relief from post-exercise knee pain not due to arthritis as well as improved joint function.
How to take it:No official dosage is established for tamarind. However, studies have reported positive results with doses between 240 mg and 400 mg.
Side effects and interactions:Tamarind seeds, thus far, have not been associated with any known negative side effects.Eating the pulp of the fruit may have a laxative effect, especially in large amounts.
Turmeric (Curcuma longa) is a popular spice that’s long been a traditional remedy for inflammation, infection, and wounds. For this reason, some people use tumeric supplements for joint pain.
What the research says:A primary component of turmeric is curcumin, which has been shown to downregulate inflammatory processes and relieve joint pain associated with arthritis.
A 2019 study on turmeric for knee osteoarthritis suggested that it brought about a “rapid and significant decrease of pain.“A 2014 study found it to be as effective as ibuprofen for reducing inflammation in knee OA with fewer gastrointestinal side effects.
How to take it:No official recommended dosage for turmeric has been established, but clinical studies have reported positive results with 1,000 mg per day, often divided into two equal doses.
Side effects and interactions:Side effects associated with turmeric include:
In people who are prone to kidney stones, turmeric may increase the risk of stone formation.
Krill oil, which comes from a crustacean called krill that’s similar to shrimp, is rich in omega-3 fatty acids. Research suggests that the omega-3 in krill oil may be easier for the body to absorb than omega-3 from fish oil.
What the research says:Omega-3 is known to reduce inflammation and help reduce pain. Therefore, some researchers have considered its use as a supplement for joint pain.
Animal studies suggest that omega-3 from krill oil in particular reduces the levels of pro-inflammatory cytokines (specialized cells from the immune system) that trigger inflammation.
In humans, preliminary research found that it improved subjective symptoms of mild knee pain.Further research on understanding its benefits is ongoing.
How to take it:There is no official dosage for omega-3 fatty acids. Supplements are available with amounts ranging from about 650 mg to 1,500 mg, with instructions to take two or three times a day.
Side effects and interactions:Common side effects of omega-3s include:
It may help you avoid side effects if you start with a low dose and increase it gradually.
More Benefits of Omega-3
Astaxanthin is a pigment found in micro-algae and other aquatic organisms, including salmon, shrimp, and krill.
What the research says:Research has shown astaxanthin to be valuable as a nutritional supplement for many reasons, including as an antioxidant that helps reduce oxidative stressand prevent the induction of inflammation. Since inflammation plays a role in joint pain, it’s possible that it may be beneficial as a joint supplement.
It also appears to have some immune-system modifying properties.However, its effectiveness in treating autoimmune diseases is still unknown.
How to take it:According to some research, astaxanthin is safe and effective at doses between 2 mg and 6 mg per day.
Side effects and interactions:No significant side effects of astaxanthin have been reported in humans or animals. In animal studies, high doses have led to skin redness and reduction in blood pressure in hypertensive rats.
In-Depth: Astaxanthin
Using the same protein found in healthycartilage, type II collagen is believed to work with the immune system to preserve cartilage. Since joints contain cartilage, researchers have considered whether collagen supplements may be beneficial for joint pain. This supplement is generally derived from the sternum cartilage of chickens.
What the research says:A 2012 review concluded that evidence was insufficient to recommend this treatment for OA,but more research has been done since then.
Some studies have shown improvement in joint function and pain, including one that concluded it helped with pain from knee OA.
A 2017 review of supplements for osteoarthritis found evidence type II collagen improved pain in the short term, but not medium or long term, in people with OA of the hand, hip, or knee.
How to take it:No standard dosage has been established. Some studies have reported good results with 40 mg per day.
Side effects and interactions:Collagen is generally well-tolerated and isn’t associated with any major side effects. Possible minor side effects include:
No negative drug interactions have been found.
Other supplements that may have benefits for your joint health include:Green tea extractDevil’s clawGingerSAM-eSierraSil
Other supplements that may have benefits for your joint health include:
Do Collagen Supplements Benefit Arthritis?
In addition to heeding instructions on the bottle, talk to your healthcare provider before adding any supplement to your regimen to make sure it’s not dangerous for you and doesn’t conflict with any of your medications, and to determine the best dosage for you.
Frequently Asked QuestionsThe American College of Rheumatology/Arthritis Foundation conditionally recommends chondroitin sulfate for people with hand arthritis but not for other forms of arthritis. However, they advise against most supplements for managing osteoarthritis, primarily due to insufficient evidence that they work.Learn MoreOsteoarthritis TreatmentResearch has found that people with joint pain are frequently deficient in vitamin D. One study found that vitamin D deficiency predicted knee and hip pain.Another found that those with rheumatoid arthritis had lower vitamin D values than those who did not.Learn MoreVitamin D DeficiencySupplements are one way to support joint health. But, there are other things you can do to maintain healthy joints, including regular physical activity, maintaining a healthy weight, eating an anti-inflammatory diet, and quitting smoking.Learn MoreSimple Ways to Keep Joints Healthy
The American College of Rheumatology/Arthritis Foundation conditionally recommends chondroitin sulfate for people with hand arthritis but not for other forms of arthritis. However, they advise against most supplements for managing osteoarthritis, primarily due to insufficient evidence that they work.Learn MoreOsteoarthritis Treatment
The American College of Rheumatology/Arthritis Foundation conditionally recommends chondroitin sulfate for people with hand arthritis but not for other forms of arthritis. However, they advise against most supplements for managing osteoarthritis, primarily due to insufficient evidence that they work.
Learn MoreOsteoarthritis Treatment
Research has found that people with joint pain are frequently deficient in vitamin D. One study found that vitamin D deficiency predicted knee and hip pain.Another found that those with rheumatoid arthritis had lower vitamin D values than those who did not.Learn MoreVitamin D Deficiency
Research has found that people with joint pain are frequently deficient in vitamin D. One study found that vitamin D deficiency predicted knee and hip pain.Another found that those with rheumatoid arthritis had lower vitamin D values than those who did not.
Learn MoreVitamin D Deficiency
Supplements are one way to support joint health. But, there are other things you can do to maintain healthy joints, including regular physical activity, maintaining a healthy weight, eating an anti-inflammatory diet, and quitting smoking.Learn MoreSimple Ways to Keep Joints Healthy
Supplements are one way to support joint health. But, there are other things you can do to maintain healthy joints, including regular physical activity, maintaining a healthy weight, eating an anti-inflammatory diet, and quitting smoking.
Learn MoreSimple Ways to Keep Joints Healthy
39 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health: National Center for Complementary and Integrative Health.Glucosamine and chondroitin for osteoarthritis.Roman-Blas JA, Castañeda S, Sánchez-Pernaute O, Largo R, Herrero-Beaumont G; CS/GS Combined Therapy Study Group.Combined treatment with chondroitin sulfate and glucosamine sulfate shows no superiority over placebo for reduction of joint pain and functional impairment in patients with knee osteoarthritis: A six-month multicenter, randomized, double-blind, placebo-controlled clinical trial[published correction appears in Arthritis Rheumatol. 2017 Oct;69(10 ):2080].Arthritis Rheumatol. 2017;69(1):77‐85.Hochberg MC, Martel-Pelletier J, Monfort J, et al.Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: A multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.Ann Rheum Dis. 2016;75(1):37-44. doi:10.1136/annrheumdis-2014-206792Lubis AMT, Siagian C, Wonggokusuma E, et al.Comparison of glucosamine-chondroitin sulfate with and without methylsulfonylmethane in grade I-II knee osteoarthritis: A double blind randomized controlled trial.Acta Med Indones. 2017;49(2):105-111.Zhu X, Wu D, Sang L, et al.Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: A network meta-analysis.Clin Exp Rheumatol. 2018;36(4):595-602.Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F, Acosta-Olivo CA, Peña-Martínez VM, Simental-Mendía LE.Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials.Rheumatol Int. 2018;38(8):1413-1428. doi:10.1007/s00296-018-4077-2Palma dos reis R, Giacovelli G, Girolami F, et al.Crystalline glucosamine sulfate in the treatment of osteoarthritis: Evidence of long-term cardiovascular safety from clinical trials.Open Rheumatol J. 2011;5:69-77. doi:10.2174/1874312901105010069Jensen GS, Attridge VL, Lenninger MR, et al.Oral intake of a liquid high-molecular-weight hyaluronan associated with relief of chronic pain and reduced use of pain medication: Results of a randomized, placebo-controlled double-blind pilot study.J Med Food.2015 Jan;18(1):95-101. doi:10.1089/jmf.2013.017Oe M, Tashiro T, Yoshida H, et al.Oral hyaluronan relieves knee pain: A review.Nutr J. 2016;15:11. doi:10.1186/s12937-016-0128-2Pizzorno L.Nothing boring about boron.Integr Med (Encinitas). 2015;14(4):35‐48.Hunter JM, Nemzer BV, Rangavajla N, et al.The fructoborates: Part of a family of naturally occurring sugar-borate complexes-biochemistry, physiology, and impact on human health: A review.Biol Trace Elem Res. 2019;188(1):11‐25. doi:10.1007/s12011-018-1550-4National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Boron.Butawan M, Benjamin RL, Bloomer RJ.Methylsulfonylmethane: Applications and safety of a novel dietary supplement.Nutrients. 2017;9(3):290. doi:10.3390/nu9030290Anari H, Enteshari-Moghaddam A, Abdolzadeh Y.Association between serum Vitamin D deficiency and Knee Osteoarthritis.Mediterr J Rheumatol. 2020;30(4):216-219. doi:10.31138/mjr.30.4.216Hussain S, Singh A, Akhtar M, Najmi AK.Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials.Rheumatol Int. 2017;37(9):1489-1498. doi:10.1007/s00296-017-3719-0Ebell MH.Osteoarthritis: Rapid Evidence Review.Am Fam Physician. 2018;97(8):523-526.Manoy P, Yuktanandana P, Tanavalee A, et al.Vitamin d supplementation improves quality of life and physical performance in osteoarthritis patients.Nutrients. 2017;9(8):799. doi:10.3390/nu9080799Harvard T.H. Chan School of Public Health. The nutrition source.Vitamin D.Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P, Jones G.Vitamin D toxicity-A clinical perspective.Front Endocrinol. 2018;9:550. doi:10.3389/fendo.2018.00550Rao PS, Ramanjaneyulu YS, Prisk VR, Schurgers LJ.A combination ofTamarindus indicaseeds andCurcuma longarhizome extracts improves knee joint function and alleviates pain in non-arthritic adults following physical activity.Int J Med Sci. 2019;16(6):845‐853. doi:10.7150/ijms.32505Bhadoriya SS, Ganeshpurkar A, Narwaria J, Rai G, Jain AP.Tamarindus indica: Extent of explored potential.Pharmacogn Rev. 2011;5(9):73-81. doi:10.4103/0973-7847.79102Henrotin Y, Malaise M, Wittoek R, et al.Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: A double-blind multicenter randomized placebo controlled three-arm study.Arthritis Res Ther. 2019;21(1):179. doi:10.1186/s13075-019-1960-5Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al.Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study.Clin Interv Aging. 2014;9:451-458. doi:10.2147/CIA.S58535Daily JW, Yang M, Park S.Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials.J Med Food. 2016;19(8):717-729. doi:10.1089/jmf.2016.3705Kim D, Ku S, Bae J.Anticoagulant activities of curcumin and its derivative.BMB Reports. 2012;45(4):221-226. doi:10.5483/bmbrep.2012.45.4.221Hewlings SJ, Kalman DS.Curcumin: A review of its' effects on human health.Foods. 2017;6(10):92. doi:10.3390/foods6100092ConsumerLab.com.Kidney stones from turmeric & curcumin.Zadeh-Ardabili PM, Rad SK.Anti-pain and anti-inflammation like effects of Neptune krill oil and fish oil against carrageenan induced inflammation in mice models: Current statues and pilot study.Biotechnol Rep (Amst). 2019;22:e00341. doi:10.1016/j.btre.2019.e00341Suzuki Y, Fukushima M, Sakuraba K, Sawaki K, Sekigawa K.Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial.PLoS One. 2016;11(10):e0162769. doi:10.1371/journal.pone.0162769Laslett LL, Antony B, Wluka AE, et al.KARAOKE: Krill oil versus placebo in the treatment of knee osteoarthritis: protocol for a randomised controlled trial.Trials. 2020;21(1):79. doi:10.1186/s13063-019-3915-1Kishimoto Y, Yoshida H, Kondo K.Potential anti-atherosclerotic properties of astaxanthin.Mar Drugs. Feb 5 2016;14(2):35. doi:10.3390/md14020035Ambati RR, Phang SM, Ravi S, Aswathanarayana RG.Astaxanthin: Sources, extraction, stability, biological activities and its commercial applications—a review.Mar Drugs. 2014;12(1):128‐152. doi:10.3390/md12010128Van Vijven JP, Luijsterburg PA, Verhagen AP, van Osch GJ, Kloppenburg M, Bierma-Zeinstra SM.Symptomatic and chondroprotective treatment with collagen derivatives in osteoarthritis: A systematic review.Osteoarthritis Cartilage. 2012;20(8):809-821. doi:10.1016/j.joca.2012.04.008Lugo JP, Saiyed ZM, Lau FC, et al.Undenatured type II collagen (UC-II®) for joint support: A randomized, double-blind, placebo-controlled study in healthy volunteers.J Int Soc Sports Nutr. 2013;10(1):48. doi:10.1186/1550-2783-10-48Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ.Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.Br J Sports Med. 2018;52(3):167-175. doi:10.1136/bjsports-2016-097333Lugo JP, Saiyed ZM, Lane NE.Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: A multicenter randomized, double-blind, placebo-controlled study.Nutr J. 2016;15:14. doi:10.1186/s12937-016-0130-8Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee [published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131Laslett LL, Quinn S, Burgess JR, et al.Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study.Ann Rheum Dis. 2014;73(4):697-703. doi:10.1136/annrheumdis-2012-202831Lin J, Liu J, Davies ML, Chen W.Serum Vitamin D level and rheumatoid arthritis disease activity: Review and meta-analysis.PLoS One. 2016;11(1):e0146351. Published 2016 Jan 11. doi:10.1371/journal.pone.0146351
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institutes of Health: National Center for Complementary and Integrative Health.Glucosamine and chondroitin for osteoarthritis.Roman-Blas JA, Castañeda S, Sánchez-Pernaute O, Largo R, Herrero-Beaumont G; CS/GS Combined Therapy Study Group.Combined treatment with chondroitin sulfate and glucosamine sulfate shows no superiority over placebo for reduction of joint pain and functional impairment in patients with knee osteoarthritis: A six-month multicenter, randomized, double-blind, placebo-controlled clinical trial[published correction appears in Arthritis Rheumatol. 2017 Oct;69(10 ):2080].Arthritis Rheumatol. 2017;69(1):77‐85.Hochberg MC, Martel-Pelletier J, Monfort J, et al.Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: A multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.Ann Rheum Dis. 2016;75(1):37-44. doi:10.1136/annrheumdis-2014-206792Lubis AMT, Siagian C, Wonggokusuma E, et al.Comparison of glucosamine-chondroitin sulfate with and without methylsulfonylmethane in grade I-II knee osteoarthritis: A double blind randomized controlled trial.Acta Med Indones. 2017;49(2):105-111.Zhu X, Wu D, Sang L, et al.Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: A network meta-analysis.Clin Exp Rheumatol. 2018;36(4):595-602.Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F, Acosta-Olivo CA, Peña-Martínez VM, Simental-Mendía LE.Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials.Rheumatol Int. 2018;38(8):1413-1428. doi:10.1007/s00296-018-4077-2Palma dos reis R, Giacovelli G, Girolami F, et al.Crystalline glucosamine sulfate in the treatment of osteoarthritis: Evidence of long-term cardiovascular safety from clinical trials.Open Rheumatol J. 2011;5:69-77. doi:10.2174/1874312901105010069Jensen GS, Attridge VL, Lenninger MR, et al.Oral intake of a liquid high-molecular-weight hyaluronan associated with relief of chronic pain and reduced use of pain medication: Results of a randomized, placebo-controlled double-blind pilot study.J Med Food.2015 Jan;18(1):95-101. doi:10.1089/jmf.2013.017Oe M, Tashiro T, Yoshida H, et al.Oral hyaluronan relieves knee pain: A review.Nutr J. 2016;15:11. doi:10.1186/s12937-016-0128-2Pizzorno L.Nothing boring about boron.Integr Med (Encinitas). 2015;14(4):35‐48.Hunter JM, Nemzer BV, Rangavajla N, et al.The fructoborates: Part of a family of naturally occurring sugar-borate complexes-biochemistry, physiology, and impact on human health: A review.Biol Trace Elem Res. 2019;188(1):11‐25. doi:10.1007/s12011-018-1550-4National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Boron.Butawan M, Benjamin RL, Bloomer RJ.Methylsulfonylmethane: Applications and safety of a novel dietary supplement.Nutrients. 2017;9(3):290. doi:10.3390/nu9030290Anari H, Enteshari-Moghaddam A, Abdolzadeh Y.Association between serum Vitamin D deficiency and Knee Osteoarthritis.Mediterr J Rheumatol. 2020;30(4):216-219. doi:10.31138/mjr.30.4.216Hussain S, Singh A, Akhtar M, Najmi AK.Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials.Rheumatol Int. 2017;37(9):1489-1498. doi:10.1007/s00296-017-3719-0Ebell MH.Osteoarthritis: Rapid Evidence Review.Am Fam Physician. 2018;97(8):523-526.Manoy P, Yuktanandana P, Tanavalee A, et al.Vitamin d supplementation improves quality of life and physical performance in osteoarthritis patients.Nutrients. 2017;9(8):799. doi:10.3390/nu9080799Harvard T.H. Chan School of Public Health. The nutrition source.Vitamin D.Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P, Jones G.Vitamin D toxicity-A clinical perspective.Front Endocrinol. 2018;9:550. doi:10.3389/fendo.2018.00550Rao PS, Ramanjaneyulu YS, Prisk VR, Schurgers LJ.A combination ofTamarindus indicaseeds andCurcuma longarhizome extracts improves knee joint function and alleviates pain in non-arthritic adults following physical activity.Int J Med Sci. 2019;16(6):845‐853. doi:10.7150/ijms.32505Bhadoriya SS, Ganeshpurkar A, Narwaria J, Rai G, Jain AP.Tamarindus indica: Extent of explored potential.Pharmacogn Rev. 2011;5(9):73-81. doi:10.4103/0973-7847.79102Henrotin Y, Malaise M, Wittoek R, et al.Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: A double-blind multicenter randomized placebo controlled three-arm study.Arthritis Res Ther. 2019;21(1):179. doi:10.1186/s13075-019-1960-5Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al.Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study.Clin Interv Aging. 2014;9:451-458. doi:10.2147/CIA.S58535Daily JW, Yang M, Park S.Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials.J Med Food. 2016;19(8):717-729. doi:10.1089/jmf.2016.3705Kim D, Ku S, Bae J.Anticoagulant activities of curcumin and its derivative.BMB Reports. 2012;45(4):221-226. doi:10.5483/bmbrep.2012.45.4.221Hewlings SJ, Kalman DS.Curcumin: A review of its' effects on human health.Foods. 2017;6(10):92. doi:10.3390/foods6100092ConsumerLab.com.Kidney stones from turmeric & curcumin.Zadeh-Ardabili PM, Rad SK.Anti-pain and anti-inflammation like effects of Neptune krill oil and fish oil against carrageenan induced inflammation in mice models: Current statues and pilot study.Biotechnol Rep (Amst). 2019;22:e00341. doi:10.1016/j.btre.2019.e00341Suzuki Y, Fukushima M, Sakuraba K, Sawaki K, Sekigawa K.Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial.PLoS One. 2016;11(10):e0162769. doi:10.1371/journal.pone.0162769Laslett LL, Antony B, Wluka AE, et al.KARAOKE: Krill oil versus placebo in the treatment of knee osteoarthritis: protocol for a randomised controlled trial.Trials. 2020;21(1):79. doi:10.1186/s13063-019-3915-1Kishimoto Y, Yoshida H, Kondo K.Potential anti-atherosclerotic properties of astaxanthin.Mar Drugs. Feb 5 2016;14(2):35. doi:10.3390/md14020035Ambati RR, Phang SM, Ravi S, Aswathanarayana RG.Astaxanthin: Sources, extraction, stability, biological activities and its commercial applications—a review.Mar Drugs. 2014;12(1):128‐152. doi:10.3390/md12010128Van Vijven JP, Luijsterburg PA, Verhagen AP, van Osch GJ, Kloppenburg M, Bierma-Zeinstra SM.Symptomatic and chondroprotective treatment with collagen derivatives in osteoarthritis: A systematic review.Osteoarthritis Cartilage. 2012;20(8):809-821. doi:10.1016/j.joca.2012.04.008Lugo JP, Saiyed ZM, Lau FC, et al.Undenatured type II collagen (UC-II®) for joint support: A randomized, double-blind, placebo-controlled study in healthy volunteers.J Int Soc Sports Nutr. 2013;10(1):48. doi:10.1186/1550-2783-10-48Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ.Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.Br J Sports Med. 2018;52(3):167-175. doi:10.1136/bjsports-2016-097333Lugo JP, Saiyed ZM, Lane NE.Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: A multicenter randomized, double-blind, placebo-controlled study.Nutr J. 2016;15:14. doi:10.1186/s12937-016-0130-8Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee [published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131Laslett LL, Quinn S, Burgess JR, et al.Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study.Ann Rheum Dis. 2014;73(4):697-703. doi:10.1136/annrheumdis-2012-202831Lin J, Liu J, Davies ML, Chen W.Serum Vitamin D level and rheumatoid arthritis disease activity: Review and meta-analysis.PLoS One. 2016;11(1):e0146351. Published 2016 Jan 11. doi:10.1371/journal.pone.0146351
National Institutes of Health: National Center for Complementary and Integrative Health.Glucosamine and chondroitin for osteoarthritis.
Roman-Blas JA, Castañeda S, Sánchez-Pernaute O, Largo R, Herrero-Beaumont G; CS/GS Combined Therapy Study Group.Combined treatment with chondroitin sulfate and glucosamine sulfate shows no superiority over placebo for reduction of joint pain and functional impairment in patients with knee osteoarthritis: A six-month multicenter, randomized, double-blind, placebo-controlled clinical trial[published correction appears in Arthritis Rheumatol. 2017 Oct;69(10 ):2080].Arthritis Rheumatol. 2017;69(1):77‐85.
Hochberg MC, Martel-Pelletier J, Monfort J, et al.Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: A multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.Ann Rheum Dis. 2016;75(1):37-44. doi:10.1136/annrheumdis-2014-206792
Lubis AMT, Siagian C, Wonggokusuma E, et al.Comparison of glucosamine-chondroitin sulfate with and without methylsulfonylmethane in grade I-II knee osteoarthritis: A double blind randomized controlled trial.Acta Med Indones. 2017;49(2):105-111.
Zhu X, Wu D, Sang L, et al.Comparative effectiveness of glucosamine, chondroitin, acetaminophen or celecoxib for the treatment of knee and/or hip osteoarthritis: A network meta-analysis.Clin Exp Rheumatol. 2018;36(4):595-602.
Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F, Acosta-Olivo CA, Peña-Martínez VM, Simental-Mendía LE.Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials.Rheumatol Int. 2018;38(8):1413-1428. doi:10.1007/s00296-018-4077-2
Palma dos reis R, Giacovelli G, Girolami F, et al.Crystalline glucosamine sulfate in the treatment of osteoarthritis: Evidence of long-term cardiovascular safety from clinical trials.Open Rheumatol J. 2011;5:69-77. doi:10.2174/1874312901105010069
Jensen GS, Attridge VL, Lenninger MR, et al.Oral intake of a liquid high-molecular-weight hyaluronan associated with relief of chronic pain and reduced use of pain medication: Results of a randomized, placebo-controlled double-blind pilot study.J Med Food.2015 Jan;18(1):95-101. doi:10.1089/jmf.2013.017
Oe M, Tashiro T, Yoshida H, et al.Oral hyaluronan relieves knee pain: A review.Nutr J. 2016;15:11. doi:10.1186/s12937-016-0128-2
Pizzorno L.Nothing boring about boron.Integr Med (Encinitas). 2015;14(4):35‐48.
Hunter JM, Nemzer BV, Rangavajla N, et al.The fructoborates: Part of a family of naturally occurring sugar-borate complexes-biochemistry, physiology, and impact on human health: A review.Biol Trace Elem Res. 2019;188(1):11‐25. doi:10.1007/s12011-018-1550-4
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Boron.
Butawan M, Benjamin RL, Bloomer RJ.Methylsulfonylmethane: Applications and safety of a novel dietary supplement.Nutrients. 2017;9(3):290. doi:10.3390/nu9030290
Anari H, Enteshari-Moghaddam A, Abdolzadeh Y.Association between serum Vitamin D deficiency and Knee Osteoarthritis.Mediterr J Rheumatol. 2020;30(4):216-219. doi:10.31138/mjr.30.4.216
Hussain S, Singh A, Akhtar M, Najmi AK.Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials.Rheumatol Int. 2017;37(9):1489-1498. doi:10.1007/s00296-017-3719-0
Ebell MH.Osteoarthritis: Rapid Evidence Review.Am Fam Physician. 2018;97(8):523-526.
Manoy P, Yuktanandana P, Tanavalee A, et al.Vitamin d supplementation improves quality of life and physical performance in osteoarthritis patients.Nutrients. 2017;9(8):799. doi:10.3390/nu9080799
Harvard T.H. Chan School of Public Health. The nutrition source.Vitamin D.
Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P, Jones G.Vitamin D toxicity-A clinical perspective.Front Endocrinol. 2018;9:550. doi:10.3389/fendo.2018.00550
Rao PS, Ramanjaneyulu YS, Prisk VR, Schurgers LJ.A combination ofTamarindus indicaseeds andCurcuma longarhizome extracts improves knee joint function and alleviates pain in non-arthritic adults following physical activity.Int J Med Sci. 2019;16(6):845‐853. doi:10.7150/ijms.32505
Bhadoriya SS, Ganeshpurkar A, Narwaria J, Rai G, Jain AP.Tamarindus indica: Extent of explored potential.Pharmacogn Rev. 2011;5(9):73-81. doi:10.4103/0973-7847.79102
Henrotin Y, Malaise M, Wittoek R, et al.Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: A double-blind multicenter randomized placebo controlled three-arm study.Arthritis Res Ther. 2019;21(1):179. doi:10.1186/s13075-019-1960-5
Kuptniratsaikul V, Dajpratham P, Taechaarpornkul W, et al.Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: A multicenter study.Clin Interv Aging. 2014;9:451-458. doi:10.2147/CIA.S58535
Daily JW, Yang M, Park S.Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: A systematic review and meta-analysis of randomized clinical trials.J Med Food. 2016;19(8):717-729. doi:10.1089/jmf.2016.3705
Kim D, Ku S, Bae J.Anticoagulant activities of curcumin and its derivative.BMB Reports. 2012;45(4):221-226. doi:10.5483/bmbrep.2012.45.4.221
Hewlings SJ, Kalman DS.Curcumin: A review of its' effects on human health.Foods. 2017;6(10):92. doi:10.3390/foods6100092
ConsumerLab.com.Kidney stones from turmeric & curcumin.
Zadeh-Ardabili PM, Rad SK.Anti-pain and anti-inflammation like effects of Neptune krill oil and fish oil against carrageenan induced inflammation in mice models: Current statues and pilot study.Biotechnol Rep (Amst). 2019;22:e00341. doi:10.1016/j.btre.2019.e00341
Suzuki Y, Fukushima M, Sakuraba K, Sawaki K, Sekigawa K.Krill Oil Improves Mild Knee Joint Pain: A Randomized Control Trial.PLoS One. 2016;11(10):e0162769. doi:10.1371/journal.pone.0162769
Laslett LL, Antony B, Wluka AE, et al.KARAOKE: Krill oil versus placebo in the treatment of knee osteoarthritis: protocol for a randomised controlled trial.Trials. 2020;21(1):79. doi:10.1186/s13063-019-3915-1
Kishimoto Y, Yoshida H, Kondo K.Potential anti-atherosclerotic properties of astaxanthin.Mar Drugs. Feb 5 2016;14(2):35. doi:10.3390/md14020035
Ambati RR, Phang SM, Ravi S, Aswathanarayana RG.Astaxanthin: Sources, extraction, stability, biological activities and its commercial applications—a review.Mar Drugs. 2014;12(1):128‐152. doi:10.3390/md12010128
Van Vijven JP, Luijsterburg PA, Verhagen AP, van Osch GJ, Kloppenburg M, Bierma-Zeinstra SM.Symptomatic and chondroprotective treatment with collagen derivatives in osteoarthritis: A systematic review.Osteoarthritis Cartilage. 2012;20(8):809-821. doi:10.1016/j.joca.2012.04.008
Lugo JP, Saiyed ZM, Lau FC, et al.Undenatured type II collagen (UC-II®) for joint support: A randomized, double-blind, placebo-controlled study in healthy volunteers.J Int Soc Sports Nutr. 2013;10(1):48. doi:10.1186/1550-2783-10-48
Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ.Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.Br J Sports Med. 2018;52(3):167-175. doi:10.1136/bjsports-2016-097333
Lugo JP, Saiyed ZM, Lane NE.Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: A multicenter randomized, double-blind, placebo-controlled study.Nutr J. 2016;15:14. doi:10.1186/s12937-016-0130-8
Kolasinski SL, Neogi T, Hochberg MC, et al.2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee [published correction appears in Arthritis Care Res (Hoboken). 2021 May;73(5):764].Arthritis Care Res (Hoboken). 2020;72(2):149-162. doi:10.1002/acr.24131
Laslett LL, Quinn S, Burgess JR, et al.Moderate vitamin D deficiency is associated with changes in knee and hip pain in older adults: a 5-year longitudinal study.Ann Rheum Dis. 2014;73(4):697-703. doi:10.1136/annrheumdis-2012-202831
Lin J, Liu J, Davies ML, Chen W.Serum Vitamin D level and rheumatoid arthritis disease activity: Review and meta-analysis.PLoS One. 2016;11(1):e0146351. Published 2016 Jan 11. doi:10.1371/journal.pone.0146351
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