Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

Questions & Answers

Worst Pills, Best Pills Newsletter article January, 2016

In your article on osteoarthritis pain, you didn’t talk about cetyl myristoleate, SAMe or aloe vera. Why not?

Many readers wrote to us after our article on osteoarthritis pain asking about additional treatments. A large number of dietary supplements and vitamins are used for osteoarthritis, including many we did not cover. Because these types of treatments are not approved by the Food and Drug Administration (FDA) for osteoarthritis, it is impossible to find evidence verifying whether...

In your article on osteoarthritis pain, you didn’t talk about cetyl myristoleate, SAMe or aloe vera. Why not?

Many readers wrote to us after our article on osteoarthritis pain asking about additional treatments. A large number of dietary supplements and vitamins are used for osteoarthritis, including many we did not cover. Because these types of treatments are not approved by the Food and Drug Administration (FDA) for osteoarthritis, it is impossible to find evidence verifying whether most of them are effective, safe and of consistent high quality.

For example, various fats and oils, including cetyl myristoleate, may promote the growth of connective tissue and have other effects when studied in a laboratory setting.[1] However, the few trials testing the effects of these oils in humans have been of poor quality and have had unclear results, making it difficult to confirm whether these substances provide any benefit.[2],[3]

While slightly more research has been done on s-adenosylmethionine, or SAMe, here too results are inconclusive.[4],[5] In addition, SAMe can affect the central nervous system and has the potential to be linked to anxiety, headache and insomnia.[6] The quality of this expensive supplement also varies greatly, and a number of products sold as SAMe do not actually contain the amount of SAMe stated on the label.[7],[8]

Aloe vera may function like ibuprofen (ADVIL, MOTRIN) and other nonsteroidal anti-inflammatory drugs (NSAIDs) to suppress certain enzymes responsible for pain, but these possible benefits have never been systematically tested in humans.[9] Also, while applying aloe vera to the skin carries no known serious side effects, swallowing it can cause abdominal cramps, diarrhea and possibly cancer.[10]

Based on the limited evidence available, we cannot recommend these, or any other products not approved by the FDA, as effective and safe for osteoarthritis treatment.

References

[1] Ameye LG, Chee WS. Osteoarthritis and nutrition. From nutraceuticals to functional foods: Systematic review of the scientific evidence. Arthritis Res Ther. 2006;8:R127.

[2] Ibid.

[3] De silva V, El-Metwally A, Ernst E, et al. Evidence for the efficacy of complementary and alternative medicines in the management of osteoarthritis: A systematic review. Rheumatology. 2011;50:911-920.

[4] Agency for Healthcare Research and Quality. S-Adenosyl-L-Methionine (SAMe). August 2002. http://archive.ahrq.gov/clinic/tp/sametp.htm.

[5] Soeken K, Lee W, Bausell R, et al. Safety and efficacy of s-adenosylmethionine (SAMe) for osteoarthritis: A meta-analysis. J Fam Practice. 2002;425-430.

[6] Gregory PJ, Sperry M, Friedman Wilson A. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77(2):177-184.

[7] Ibid.

[8] Soeken K, Lee W, Bausell R, et al. Safety and efficacy of s-adenosylmethionine (SAMe) for osteoarthritis: A meta-analysis. J Fam Practice. 2002;425-430.

[9] Cowan D. Oral aloe vera as a treatment for osteoarthritis: A summary. Br J Community Nurs. 2010;15(6):280-282.

[10] National Center for Complementary and Integrative Health. Aloe Vera. Updated April 2012. https://nccih.nih.gov/health/aloevera. Accessed October 21, 2015.