5 natural supplements that are as powerful as Rx drugs

In today’s booming health and wellness market, thousands of supplements are readily available and tirelessly promoted. Some are effective and can bring health benefits, while others may be purely snake oil. But, as physicians, did you know that there are several little-known supplements whose health benefits rival those of currently available prescription drugs? And that these effects are supported by research? 

Here’s a list of five such supplements--made from naturally occurring ingredients--with a brief overview of each, and some of their research-backed benefits. 

Curcumin (turmeric). Curcumin is a biologically active polyphenolic compound found in turmeric, which is a spice made from the rhizomes of Curcuma longa Linn, a perennial shrub indigenous to India. Curcumin has been used for centuries for medicinal purposes and is most commonly cultivated and consumed in Asian countries.

The potential health benefits of curcumin are many. To begin with, it has anti-inflammatory effects, which it achieves by blocking Nf-kB, an inflammatory signaling molecule. In several studies, curcumin has been shown to decrease pain when taken over the long term. For example, in elderly and middle-aged patients with osteoarthritis, curcumin (1,500 mg/d TID for 28 days) was as effective as diclofenac (an NSAID) in reducing pain, and demonstrated better tolerability. When compared with acetaminophen (2,000 mg), 400- to 500-mg doses of curcumin afforded equivalent pain relief for general day-to-day pain.

Curcumin also has antioxidant properties, and may work to decrease C-reactive protein levels and lipid peroxidation, both markers of oxidation. Better yet, curcumin seems to have anti-cancer benefits due to its ability to initiate autophagy. It has also been shown to decrease risks for colorectal, prostate, and breast cancers. And, for those with cancer, curcumin may enhance the efficacy of chemotherapy as well as protect healthy cells from radiation therapy.

The recommended daily dose for curcumin is approximately 500 mg. Because it’s fat soluble, curcumin should be taken with a meal or other source of fat (eg, fish oil) to boost absorption. Because it’s poorly absorbed, taking it concurrently with a supplement that contains bioperine and piperine, the active ingredient in black pepper, is recommended.

Berberine. Berberine is a compound found in many plants, including European barberry and the Oregon tree. Like curcumin, it is yellow, and—in ages past—used to dye wool, leather, and wood. This substance has anti-inflammatory properties and may also have lipid-lowering and anti-diabetic effects. These health benefits may be due to berberine’s ability to activate AMPK, an enzyme vital for cell growth, function, and maintenance of the cellular energy balance. Berberine may also have anti-fungal and antibiotic properties.

In one study, researchers found that berberine was as effective as metformin in lowering blood sugar levels.  In other studies, berberine was found to lower not only triglyceride and blood pressure levels, but total and LDL cholesterol levels as well. Finally, its antimicrobial effects, cardiovascular protection, and cancer-fighting abilities make berberine a multitasking supplement superhero.

The most common dosage is 1,500 mg/d, divided into 3 equal doses throughout the day, taken with meals. Take care, however: Berberine is a powerful supplement and has the potential to interact with numerous medications.

Spirulina. A type of cyanobacteria, spirulina is blue-green mixture of algae species that contains bioactive compounds. It was a food source for the Aztecs and other Mesoamericans until the 16th century, but was recently popularized when NASA considered growing it in space to feed astronauts. And now we know why: Spirulina is chock-full of nutrients.

Consider that 7 g of dried spirulina powder (1 tbsp) contain 4 g of protein, 11% of the recommended dietary allowance (RDA) of vitamin B1 (thiamine), 15% of the RDA of vitamin B2 (riboflavin), 4% of the RDA of vitamin B3 (niacin), 21% of the RDA of copper, and 11% of the RDA of iron. It also includes both omega-6 and omega-3 fatty acids.

Another big plus: Spirulina contains vitamin C, magnesium, potassium, and manganese, and small amounts of almost every nutrient the human body needs.

Its health benefits are many and may stem from its ability to inhibit nicotinamide adenine dinucleotide phosphate oxidase (NADPH), a pro-oxidation compound that generates reactive oxygen species (ROS) that are important in antimicrobial defense and inflammation. Spirulina has been shown, in preliminary studies, to not only lower lipid peroxidation, triglyceride, and blood pressure levels, but also boost the immune system. And, great news for all the allergy sufferers out there: Spirulina may even significantly reduce nasal allergy symptoms.

The general dosage of spirulina is 1-3 g/d, usually taken in divided doses throughout the day.

Rhodiola rosea. This herb grows in the cold climates and mountainous regions of Europe and Asia—such as Russia, Scandinavia, and China—where it is commonly used in traditional medicine. The substances found in the roots of rhodiola are considered adaptogens, which help the body adapt to stress. As such, rhodiola can decrease mental and physical fatigue, and may be particularly beneficial in those faced with prolonged stress—like physicians struggling with stress or burnout. It is also thought to support overall good health and decrease depression and anxiety.

There’s a lot of research backing up the health benefits of rhodiola, but most of it is inconclusive. For example, in a meta-analysis of 11 clinical trials, researchers found that rhodiola reduced physical and mental fatigue, but noted that “methodological flaws limit accurate assessment of efficacy.”

In a systemic review, rhodiola was found to alleviate the symptoms of mild to moderate depression and mild anxiety, as well as enhance mood. However, the authors stated that their findings were “not definite due to the lack of available experimental data,” further noting that “randomized controlled trials with a low risk of bias are needed to further study the herb.”

Rhodiola is available in capsule or tablet forms, as a dried powder, or as a liquid extract. Dosages and amounts of the extract vary widely between brands and formulations. In general, normal doses range from 250 mg to 680 mg.

Red yeast rice. Red yeast rice is a fermented product of rice on which red yeast has been grown. It has been used in China for centuries as a medicinal food that promotes circulation. HMG-CoA reductase inhibitors—or monacolins—occur naturally in red yeast rice. If this sounds familiar, it may be because monacolins are also the active ingredients in statins (like lovastatin). Other active ingredients of red yeast rice include betasitosterol, campesterol, stigmasterol, and sapogenin (sterols), as well as isoflavones and monounsaturated fatty acids.

In light of this, it is not surprising that red yeast rice may reduce cholesterol levels and be beneficial in those with hyperlipidemia. In a meta-analysis of 93 studies on three red yeast rice preparations, researchers found mean decreases in total and LDL cholesterol levels of 34 mg/dL and 28 mg/dL, respectively, and a mean decrease in triglyceride levels of 35 mg/dL. They also observed increased HDL cholesterol levels (6 mg/dL). They concluded that the lipid-modifying effects of red yeast rice were similar to those seen with pravastatin, simvastatin, lovastatin, atorvastatin, and fluvastatin.  

Red yeast rice may also be useful for the secondary prevention of myocardial infarction. In a large study including nearly 5,000 participants with coronary heart disease and myocardial infarction history, researchers observed a 45% reduction of secondary myocardial infarction risk and a 33% reduction in mortality risk in participants taking a red yeast rice capsule formation (0.6 g bid) compared with placebo.

Red yeast rice formulations that contain monacolin K are considered to be drugs rather than supplements, according to the FDA. If you do buy a supplement formulation, in which there may be only trace amounts of monacolin K, make sure it is from a reputable vendor, and check the label carefully for ingredients and concentrations of monacolin. Of note, these supplements may not offer the same health benefits as those with monacolin K.