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Vitamin supplements are also often recommended to especially include Vitamin D (400-600 IU/daily). Avoidance or limitation of certain foods such as those high in sodium which is contained in a variety of food products such as canned soups, bacon, sausage, ham, pickles, sauerkraut and even dehydrated soups is highly recommended for the arthritis patient on steroid therapy.

Most arthritis patients are treated with anti-inflammatory medicines other than steroids. The non-steroidal anti-inflammatory drugs (NSAIDs) including among others, ibuprofen, naproxen and aspirin are useful for reducing pain, but there is no scientific evidence that they alter the course of arthritis or reverse or repair the erosions of cartilage and bone which are hallmarks of arthritis pathology. Patients whose joint swelling and pain cannot be controlled by NSAIDs are often treated with other remittive therapies, which often include methotrexate, hydroxychloroquine and more recently, drugs which neutralize the inflammatory provoking action of soluble mediators of inflammation such as tumor necrosis factor-alpha.

While NSAIDs generally control pain, diets supplemented with omega-3 fatty acids at high doses may actually result in the production of prostaglandins, which are less inflammatory. Thus, decreasing saturated fat (such as found in meat and dairy products) while increasing omega-3 or fish oil products may reduce the level of inflammation. While certain forms of oil such as canola oil and soy oil contain omega-3, the amounts are small compared to the omega-3 content of fish or fish oils. Employing omega-3 as a dietary supplement does not result in an “instant fix.”

Research has shown that while fish oil diet supplementation results in less painful joints and reduced stiffness of joints upon wakening from sleep, it often takes up to three to four months of continuous daily consumption for any benefit to become apparent. Mackerel, salmon, sardines and trout are particularly rich in fish oils. Foods rich in omega-6 fat have also been suggested to have similar anti-inflammatory properties similar to fish oil.

Changes in diet to include fish oils should always be discussed with a physician, as there are potential adverse side-effects, which include increased bleeding time. Arthritis patients with co-morbid conditions such as diabetes should be particularly wary of fish oil diet supplementation as fish oils potentially raise blood sugar levels and increase wound healing time.

Nutritional supplements, which have received considerable recent attention in the popular press, include glucosamine and chondroitin sulfate. Both substances are natural substances, and as such are classified as dietary supplements and not drugs which means that there is no regulation by the FDA to control strength and purity of product. Because glucosamine and chondroitin sulfate are produced in the body as building blocks for the formation of cartilage matrix they are essential for the maintenance of the health of that and other tissues. Thus, it is likely that dietary supplementation with glucosamine and/or chondroitin sulfate may promote the biosynthesis of cartilage matrix in healthy individuals.

Whether or not these dietary supplements influence cartilage matrix formation in the patient with arthritis has not been examined in large trials with acceptable scientific methodology. The National Institutes of Health supported a three-year clinical trial on this matter, which began in 1999. Other nutritional supplements, including copper, zinc, and Vitamin B have been claimed to help arthritis patients. If there is any scientific evidence to support their efficacy in treating arthritis, there have also been reported adverse side-effects, which limit their effectiveness.

The choice of eliminating certain foods from the diet of arthritis patients may result when arthritis patients keep a diary of which foods exacerbate or reduce arthritis symptoms. A careful record maintained over a period of time is recommended. A time period of up to six months may be required to reduce the potential that an arthritis flare is merely coincidental with the consumption or elimination of a particular food product. As always, care must be taken not to eliminate so many foods that a balanced, nutritious diet is compromised.