RELATED: 7 of the Best Activity Apps for Rheumatoid Arthritis But as with many chronic diseases, those with rheumatoid arthritis often turn to CAMs to manage the symptoms that their medications don’t eliminate. “I would say more than half of rheumatology patients have taken herbs and remedies,” says Gustavo Carbone, MD, a rheumatologist at the University of Miami Health System. RELATED: Drinks That Don’t Mix With Rheumatoid Arthritis Medications

Some Alternative Therapies for Rheumatoid Arthritis May Be Beneficial

Some holistic remedies, like fish oil, have some — if limited — research indicating their effectiveness, and might be recommended by a physician. “I like people to include fish oil supplements or a Mediterranean diet, which includes fish, to help with autoimmune diseases,” says Carrie Janiski, DO, a family, sports, and neuromuscular skeletal medicine physician in Turlock, California. There are many alternative treatments that might be beneficial, and likely have low levels of risk, for people with RA, Dr. Janiski says. She especially favors acupuncture and osteopathic manipulation to help with pain. RELATED: Try Aromatherapy for Rheumatoid Arthritis Pain

Proceed With Caution, Especially With Supplements

But when it comes to other remedies, it’s important to evaluate carefully. “The web is a black hold of information, much of it not appropriately researched or sourced. It’s often about people’s person experiences and opinions that may not be relevant for you,” she says. RELATED: Apple Cider Vinegar: Benefits, Side Effects, Usage, Dosage, and More It’s especially important to be careful with supplements, which may interact with other medicines you are taking. “If you’re on prescribed medicines, be sure to tell your doctor or pharmacist everything you are taking, so they can tell you how they interact with one another,” Janiski advises. Often, people share treatment ideas with friends or relatives, which can also be risky. Research published in the January–February 2015 issue of journal Geriatric Nursing looked at women with all kinds of arthritis and found that the majority of them taking CAMs rely on family and friends to steer them to these treatments. RELATED: The Benefit of Failed Rheumatoid Arthritis Treatments

Curious About Alternative Therapies? Check in With Your Doctor First

Whether your doctor recommends CAM therapies to you or not, it’s imperative that you tell your doctor everything you are doing. This is especially crucial for herbs, supplements, and other remedies that you ingest. That’s because even though we think of them as “natural,” not all of these remedies are safe, and some can interact with medications you are already taking. RELATED: 7 Popular Supplements With Hidden Risks for Women

Don’t Let Your Doctor or Rheumatologist Dismiss You

The Geriatric Nursing study found that the reasons people choose not to talk to their physicians about their CAM remedies include their belief that the doctor will be unsupportive or not know anything about them, and that they don’t have time. But Robert Moots, PhD, professor of rheumatology at the University of Liverpool in England, says that doctors should ask patients at every visit what they are taking — including herbs and supplements as well as medications. And if they don’t, patients should take it upon themselves to tell. RELATED: Best and Worst Exercise Trends for Rheumatoid Arthritis

4 Specific Remedies People With RA Should Watch Out For

In a study published in April 2017 in the journal Drugs & Aging, Dr. Moots and other British researchers presented a review to inform doctors about some CAM remedies that are especially problematic for people living with rheumatoid arthritis. They include:

1. The Risky Remedy: Thunder God Vine 

This traditional Chinese medicine remedy, also known as Lei Gong Teng, is said to help with inflammatory swelling. The Concern Mild side effects can include nausea, rash, or diarrhea, but it’s the serious possible effects that have doctors alarmed — aplastic anemia and respiratory infections. “Given the unfavorable risk-safety profile, thunder god vine should not be recommended for use in RA,” the review concludes.

2. The Risky Remedy: High Doses of Vitamin B6

This supplement has been used to quell inflammation, especially after a small study published in the European Journal of Clinical Nutrition found a daily dose of 100 milligrams (mg) of vitamin B6 seems to suppress pro-inflammatory cytokines. But the government’s recommended dietary allowance of B6 is only 1.3 mg to 1.7 mg for adults, depending on your age and gender — although it says an upper intake limit (which includes both food and supplements) of as much as 100 mg per day is likely safe. The Concern The Drugs & Aging study warns that overdoses of vitamin B6 can cause such problems as sensory neuropathy and other nervous system dysfunctions.

3. The Risky Remedy: St. John’s Wort

This herb is not used to treat RA, but is often taken for depression, which is a common comorbidity. The Concern While the review in Drugs & Aging stresses that St. John’s wort can be safe and effective for people with mild to moderate depression, it cautions that the herb may decrease the effectiveness of the DMARDs Restasis (cyclosporine) and Trexall (methotrexate), as well as other medications, so it’s critical that you tell your doctor if you using it.

4. The Risky Remedy: Willow Bark

This ancient remedy comes from the same tree that aspirin was developed from, and its active ingredient, salicin, has been claimed to have anti-inflammatory properties. People sometimes take it as a tea, and it also comes in tablets, capsules, and powders. The Concern Willow bark is not as effective as modern COX inhibitors, and taking an aspirin-like product on top of your other medications without your doctor’s approval can lead to too much medicine in your system. RELATED: 8 Home Remedies for Urinary Tract Infections (UTIs)