Neha Shah, MD, on Which Complementary Medicine and Herbs Are Most Beneficial to Which Rheumatic Diseases?

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In this video, Neha Shah, MD, explains what is known about the impact that complementary medicine and herbs can have on patients with rheumatic diseases.

Additional Resource:

Shah N. Complementary medicine & herbs for the rheumatology patient. Session presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. 

Neha Shah, MD, is a clinical assistant professor in the Division of Immunology & Rheumatology at Stanford University. There, she also serves as the program director for the Adult Rheumatology Fellowship.


Neha Shah: In terms of herbs and how they work in a lot of these diseases, if there are herbs that are coming out from traditional Chinese medicine, for example, or Ayurveda, the difficulty in studying these herbs is that in the traditional practices from which they have originated, these were never used in an isolated way. They usually would be prescribed as part of a larger anti‑inflammatory diet along with, for example, in Ayurveda, yoga poses, certain specific breathing exercises, a whole lifestyle package, so to speak.

Trying to study these in our Western model of a placebo‑controlled trial has some of its challenges and limitations.

At least in early animal studies and human studies of turmeric and ginger, there have been benefits seen in osteoarthritis and rheumatoid arthritis. There have also been some smaller studies looking at omega‑3 fish oil supplementation in rheumatoid arthritis. These have shown some positive results.

There are a host of other anti‑inflammatory herbs — Boswellia, Salai guggul, Devil's Claw, several other herbs from the traditional Chinese medicine tradition — that are currently being studied and have been studied and have been used for thousands of years.

The limitation for us as rheumatologists is we may not know the potential medication interactions of all of these herbs in our clinical practice with the medications that we also prescribe. At least from the standpoint of herbs, my initial recommendation to patients is to make it part of their diet. For example, adding ginger and turmeric to their diets as opposed to taking supplement pills. Eating some fish, or flaxseed, or chia, or olive oil, other sources for omega‑3 fatty acids, so that it’s incorporated as their food. As Hippocrates said, food is medicine. I think that is the first step in moving towards more optimal health.