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Dr. Tori Hudson, Portland, Oregon, Blog Healthline Blog

Rheumatoid arthritis (RA) is three times more likely to develop in women than in men… that is what makes it a women’s health problem.  It is an autoimmune disorder that is progressive, and typically is characterized by inflammation, pain, swelling, and stiffness of joints.
In RA, as in other autoimmune disorders, the immune system attacks the body, in this case, healthy joint tissue, and the release of proinflammatory chemicals such as tumor necrosis factor-alpha (TNF-α). The TNF-α then stimulates production of C-reactive protein (CRP), a marker for inflammation.
Conventional treatments of RA cover a wide range of options, and can indeed reduce the symptoms and slow the progression.  When progression is unchecked, permanent joint damage occurs.  That is why it is important to not completely dismiss the time and place and specific benefits and risks of conventional pharmaceuticals RA treatment. 
herbal powder in capsule and cinnamon on white backgroundSafer and effective therapies will always be welcomed for RA.  Cinnamon holds some modest interest.  Cinnamon bark is a familiar spice and herbal remedy and there is some suggestion that it has anti-inflammatory activity and may be immune regulating.  The current randomized, double-blind, placebo-controlled trial evaluated the effect of cinnamon on disease activity, serum inflammation markers, and cardiovascular risk factors in women with RA.   Forty women, both pre and postmenopausal with a diagnosis of RA were recruited in Iran.  Women had to have had RA for ≥ 2 years, have active disease, currently taking medications called disease-modifying antirheumatic drugs (DMARDs), for 3 or more months, but not taking other prescription RA medications. 
Women were randomly assigned to receive either or 2000 mg/day (two, 500 mg capsules twice daily) encapsulated ground cinnamon bark for eight weeks.  The women were evaluated at baseline and eight weeks after starting the study.  The cinnamon group had significantly more premenopausal women than the placebo group and fewer postmenopausal women than the placebo group.  A rheumatologist evaluated tenders/swelling/pain, and then scored them using the Disease Activity Score of 28 joints (DAS-28), and the Visual Analogue Scale (VAS). Several blood tests were drawn, but of note were the erythrocyte sedimentation rate (ESR), serum TNF-α, and serum C-reactive protein (CRP).  
Results:  Mean serum TNF-α in the cinnamon group decreased from 167.27 pg/mL at baseline to 130.77 pg/mL at eight weeks;  TNF-α increased from 146.11 pg/mL to 162.25 pg/mL in the placebo group, although this was not considered significant.   The difference in the final values between the two groups was not statistically significant, but the mean change from the baseline was significantly better in the cinnamon group.  Serum CRP significantly decreased over time in the cinnamon group, and increased in the placebo group.  After treatment, the DAS-28 and VAS pain scores were significantly lower in the cinnamon group than the placebo group.  Mean tender joint counts decreased from 11.44 to 2.77 in the cinnamon group and swollen joints went from 8.44 to 1.38.  There was no decline in the placebo group. 
The ESR declined significantly from baseline only in the cinnamon group. One woman in the cinnamon group reported mild stomach discomfort.

Commentary:  I’m pleased to consider that cinnamon in this dose of 1,000 mg twice daily improved disease activity and inflammatory markers seen in RA patients.  This is the first study I’ve seen on cinnamon bark and RA, so I will be eager to see if these findings can be duplicated, although I will definitely incorporate this study into my clinical management of women with RA.  It would be important to study cinnamon in patients with RA who were not taking DMARDS to see if there was clinical benefit without the benefits and stability that the drug had imparted already. 
Reference:  Shishehbor F, Rezaeyan Safar M, Rajaei E, Haghighizadeh MH. Small Controlled Trial Reports Cinnamon May Benefit Rheumatoid Arthritis Cinnamon consumption improves clinical symptoms and inflammatory markers in women with rheumatoid arthritis. [published online May 3, 2018] J Am Coll Nutr.

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