WEST INDIAN JOURNAL OF IMMUNOLOGY An official Journal of the West Indies Immunology Society 15 West Ind. J. Immunol. Vol.1, 2022; | DOI: https://doi.org/10.53069/WIJI/0000002 Herbs and dietary supplements in rheumatoid arthritis: The clinical evidence Yuri Clement, PhD Pharmacology Unit, University of the West Indies, St. Augustine, Trinidad and Tobago Email address: Yuri.Clement@sta.uwi.edu Received: 08/06/2021 Revised: 01/08/2022 Published 03/08/2022 ABSTRACT Rheumatoid arthritis (RA) is an autoimmune disease that results in the destruction of joint cartilage and bone with an accompanying cluster of inflammatory symptoms leading to the progressive deformity of multiple joints. Several disease modifying anti- rheumatic drugs (DMARDs) are available for the treatment of RA (which arrest or slow disease progression); however, these are sometimes associated with severe side effects. The market is inundated with herbal preparations and dietary supplements are as beneficial to relieve symptoms in RA either as alternatives to or for use alongside conventional medicines. This mini-review sought to determine whether these therapies are safe and efficacious for the treatment of RA. The strongest clinical evidence exists for short-term complementary use of Tripterygium wilfordii Hook F “thunder god vine”, γ-linolenic acid and fish oils for symptomatic relief. However, no long-term studies support the use of these supplements to either arrest or delay disease progression. Only a few studies are available for saffron, cinnamon, ginger and pomegranate which are insufficient to establish safety and efficacy. Other studies have shown that integrating traditional Chinese medicine with western medicine may be beneficial; however, most of these studies were poorly designed. A few studies have shown that folic acid and folinic acid supplementation may reduce the incidence of methotrexate-induced side effects and prevent discontinuation. Conclusion There is limited and biased evidence regarding the efficacy of probiotics. Keywords: rheumatoid arthritis, Tripterygium wilfordii Hook F, fish oils, γ-linolenic acid.