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Quotes From Book on Anti-Inflammation Treatments

Natural Anti-Inflammatories

Top 100 Natural Anti-Inflammatory Agents

Approximate ranking by strength of human evidence, reproducibility, biologic plausibility, and clinical relevance. “Natural” does not imply safe, and biomarker lowering is not equivalent to demonstrated treatment of a specific inflammatory disease.

Curcumin / turmeric (Curcuma longa) — Modulates NF-κB, COX-2, LOX, NLRP3, TNF-α, IL-1β and IL-6; one of the most extensively studied botanical anti-inflammatory compounds.

_{Reference 1. Jafari A, Abbastabar M, Alaghi A, et al. Curcumin on human health: a comprehensive systematic review and meta-analysis of 103 randomized controlled trials. Phytotherapy Research. 2024;38(12):6048-6061. doi:10.1002/ptr.8340.}

Omega-3 fatty acids—EPA and DHA — Precursors of resolvins, protectins and maresins; can decrease inflammatory eicosanoid and cytokine signaling, with particularly useful evidence in rheumatoid arthritis.

_{Reference 2. Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007;129(1-2):210-223. doi:10.1016/j.pain.2007.01.020.}

Ginger (Zingiber officinale) — Gingerols and shogaols influence COX/LOX, NF-κB and cytokine signaling; RCT meta-analysis found reductions in CRP, hs-CRP and TNF-α.

_{Reference 3. Morvaridzadeh M, Fazelian S, Agah S, et al. Effect of ginger (Zingiber officinale) on inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Cytokine. 2020;135:155224. doi:10.1016/j.cyto.2020.155224.}

Boswellia serrata / boswellic acids — Particularly AKBA; inhibits 5-lipoxygenase-associated inflammatory pathways. Human evidence is strongest for osteoarthritis.

_{Reference 4. Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complementary Medicine and Therapies. 2020;20:225. doi:10.1186/s12906-020-02985-6.}

Resveratrol — Polyphenol affecting NF-κB, SIRT1, oxidative signaling and cytokines; umbrella meta-analysis found reductions in CRP and TNF-α.

_{Reference 5. Molani-Gol R, Rafraf M. Effects of resveratrol on the anthropometric indices and inflammatory markers: an umbrella meta-analysis. European Journal of Nutrition. 2024;63(4):1023-1040. doi:10.1007/s00394-024-03335-9.}

Garlic / aged garlic extract (Allium sativum) — Organosulfur compounds modulate inflammatory transcription and oxidative stress; human trials show CRP reduction, with aged garlic extract also influencing TNF-α.

_{Reference 6. Mirzavandi F, Mollahosseini M, Salehi-Abargouei A, et al. Effects of garlic supplementation on serum inflammatory markers: a systematic review and meta-analysis of randomized controlled trials. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(5):1153-1161. doi:10.1016/j.dsx.2020.06.031.}

Probiotics — Effects are strain-dependent; pooled randomized data support reductions in CRP, TNF-α and IL-6.

_{Reference 7. Faghfouri AH, Gol Mohammad Pour Afrakoti L, Kavyani Z, et al. The role of probiotic supplementation in inflammatory biomarkers in adults: an umbrella meta-analysis of randomized controlled trials. Inflammopharmacology. 2023;31(5):2253-2268. doi:10.1007/s10787-023-01332-8.}

Alpha-lipoic acid — Redox-active endogenous cofactor; randomized-trial meta-analysis found reductions in CRP, IL-6 and TNF-α.

_{Reference 8. Vajdi M, Mahmoudi-Nezhad M, Abbasalizad Farhangi M. An updated systematic review and dose-response meta-analysis of the randomized controlled trials on the effects of alpha-lipoic acid supplementation on inflammatory biomarkers. International Journal for Vitamin and Nutrition Research. 2023;93(2):164-177. doi:10.1024/0300-9831/a000702.}

N-acetylcysteine (NAC) — Cysteine/glutathione precursor that modifies redox-sensitive inflammatory signaling; human meta-analysis found reductions in CRP and IL-6.

_{Reference 9. Faghfouri AH, et al. The effects of N-acetylcysteine on serum level of inflammatory biomarkers in adults: findings from a systematic review and meta-analysis of randomized clinical trials. Cytokine. 2020;135:155239. doi:10.1016/j.cyto.2020.155239.}

Cinnamon (Cinnamomum spp.) — Polyphenolic compounds influence NF-κB, oxidative stress and inflammatory signaling; pooled RCTs demonstrate CRP reduction.

_{Reference 10. Morvaridzadeh M, Fazelian S, Agah S, et al. Impact of cinnamon supplementation on cardiometabolic biomarkers of inflammation and oxidative stress: a systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine. 2020;53:102517.}

Green tea catechins / EGCG — EGCG modifies NF-κB, AP-1, MAPK and inflammasome pathways; human results for systemic biomarkers are mixed, although IL-1β and oxidative stress measures may improve.

_{Reference 11. Effects of green tea supplementation on antioxidant status and inflammatory markers in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomised controlled trials. British Journal of Nutrition. 2025. PMID:40160899.}

Quercetin — Flavonol influencing NF-κB, cytokines and mast-cell signaling; human meta-analysis suggests subgroup-dependent effects.

_{Reference 12. Ou Q, Zheng Z, Zhao Y, Lin W. Impact of quercetin on systemic levels of inflammation: a meta-analysis of randomised controlled human trials. International Journal of Food Sciences and Nutrition. 2020;71(2):152-163. doi:10.1080/09637486.2019.1627515.}

Anthocyanins — Berry-derived flavonoids affecting NF-κB and vascular inflammatory signaling.

_{Reference 13. Zhu Y, Ling W, Guo H, et al. Anti-inflammatory effect of purified dietary anthocyanin in adults with hypercholesterolemia: a randomized controlled trial. Nutrition, Metabolism and Cardiovascular Diseases. 2013;23(9):843-849.}

Pomegranate / punicalagins — Polyphenols alter oxidative and NF-κB-associated inflammatory signaling.

_{Reference 14. Sahebkar A, Gurban C, Serban A, Andrica F, Serban MC. Effects of supplementation with pomegranate juice on plasma C-reactive protein concentrations: a systematic review and meta-analysis of randomized controlled trials. Phytomedicine. 2016;23(11):1095-1102.}

Extra-virgin olive oil polyphenols — Hydroxytyrosol, oleuropein and oleocanthal contribute to anti-inflammatory effects of Mediterranean dietary patterns.

_{Reference 15. Schwingshackl L, Christoph M, Hoffmann G. Effects of olive oil on markers of inflammation and endothelial function—a systematic review and meta-analysis. Nutrients. 2015;7(9):7651-7675. doi:10.3390/nu7095356.}

Oleocanthal — EVOO phenolic compound with COX-1/COX-2 inhibitory activity reminiscent mechanistically of ibuprofen.

_{Reference 16. Beauchamp GK, Keast RSJ, Morel D, et al. Phytochemistry: ibuprofen-like activity in extra-virgin olive oil. Nature. 2005;437(7055):45-46. doi:10.1038/437045a.}

Hydroxytyrosol — Major olive phenol with antioxidant and inflammatory signaling effects.

_{Reference 17. EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific opinion on the substantiation of health claims related to polyphenols in olive. EFSA Journal. 2011;9(4):2033.}

Tart cherry / cherry anthocyanins — Investigated in arthritis, exercise-induced inflammation and gout-related pathways.

_{Reference 18. Kelley DS, Adkins Y, Laugero KD. A review of the health benefits of cherries. Nutrients. 2018;10(3):368. doi:10.3390/nu10030368.}

Bromelain — Pineapple-derived proteolytic enzymes with effects on inflammatory mediators, edema and immune-cell signaling.

_{Reference 19. Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnology Research International. 2012;2012:976203. doi:10.1155/2012/976203.}

Spirulina / phycocyanin — Recent RCT meta-analysis found a modest CRP reduction.

_{Reference 20. Hariri M, Azizi-Soleiman F, Baradaran HR, Heshmati M, Gholami A. Spirulina supplementation can reduce serum levels of C-reactive protein: a systematic review and meta-analysis on randomized clinical trials. International Journal for Vitamin and Nutrition Research. 2026;96(1):44330. doi:10.31083/IJVNR44330.}

Saffron / crocin / crocetin — Some favorable inflammatory subgroups have been reported, although pooled CRP, TNF-α and IL-6 effects have not been consistently significant.

_{Reference 21. Pourmasoumi M, Hadi A, Najafgholizadeh A, et al. Effects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: a systematic review and meta-analysis. Phytotherapy Research. 2020. doi:10.1002/ptr.6748.}

Black cumin (Nigella sativa) / thymoquinone — Modulates NF-κB, cytokine and oxidative-inflammatory pathways.

_{Reference 22. Majdalawieh AF, Fayyad MW. Recent advances on the anti-cancer properties of Nigella sativa, a widely used food additive. Journal of Ayurveda and Integrative Medicine. 2016;7(3):173-180.}

Berberine — Plant alkaloid affecting AMPK, NF-κB, NLRP3 and metabolic inflammation.

_{Reference 23. Habtemariam S. Berberine pharmacology and the gut microbiota: a hidden therapeutic link. Pharmacological Research. 2020;155:104722.}

Sulforaphane — Cruciferous-vegetable isothiocyanate; activates Nrf2 and suppresses several NF-κB-associated responses.

_{Reference 24. Houghton CA. Sulforaphane: its “coming of age” as a clinically relevant nutraceutical in the prevention and treatment of chronic disease. Oxidative Medicine and Cellular Longevity. 2019;2019:2716870. doi:10.1155/2019/2716870.}

Gamma-linolenic acid (GLA) — Precursor of dihomo-γ-linolenic acid and potentially less-inflammatory eicosanoids; clinical evidence exists in rheumatoid arthritis.

_{Reference 25. Zurier RB, Rossetti RG, Jacobson EW, et al. Gamma-linolenic acid treatment of rheumatoid arthritis: a randomized, placebo-controlled trial. Arthritis & Rheumatism. 1996;39(11):1808-1817.}

Avocado-soybean unsaponifiables (ASU) — Studied primarily for osteoarthritis and cartilage-associated inflammatory pathways.

_{Reference 26. Christensen R, Bartels EM, Astrup A, Bliddal H. Symptomatic efficacy of avocado-soybean unsaponifiables in osteoarthritis of the knee and hip: a meta-analysis of randomized controlled trials. Osteoarthritis and Cartilage. 2008;16(4):399-408.}

Rosehip (Rosa canina) — Galactolipids and polyphenols may affect leukocyte chemotaxis and inflammatory signaling.

_{Reference 27. Christensen R, Bartels EM, Altman RD, Astrup A, Bliddal H. Does the hip powder of Rosa canina reduce pain in osteoarthritis patients? A meta-analysis of randomized controlled trials. Osteoarthritis and Cartilage. 2008;16(9):965-972.}

Devil’s claw (Harpagophytum procumbens) — Harpagoside-containing extracts studied for musculoskeletal pain and inflammatory pathways.

_{Reference 28. Gagnier JJ, van Tulder MW, Berman B, Bombardier C. Herbal medicine for low back pain. Cochrane Database of Systematic Reviews. 2006;(2).}

Willow bark / salicin — Botanical precursor of salicylate compounds with COX-related anti-inflammatory pharmacology.

_{Reference 29. Vlachojannis JE, Cameron M, Chrubasik S. A systematic review on the effectiveness of willow bark for musculoskeletal pain. Phytotherapy Research. 2009;23(7):897-900.}

Capsaicin — TRPV1 agonist; repeated topical exposure suppresses neurogenic inflammatory pain signaling.

_{Reference 30. Derry S, Rice ASC, Cole P, Tan T, Moore RA. Topical capsaicin for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews. 2017;1.}

Vitamin D — Immunomodulates innate and adaptive immunity; anti-inflammatory effects are most relevant when deficiency is present.

_{Reference 31. Calton EK, Keane KN, Newsholme P, Soares MJ. The impact of vitamin D levels on inflammatory status: a systematic review of immune cell studies. PLoS ONE. 2015;10(11).}

Magnesium — Magnesium insufficiency can promote inflammatory signaling; supplementation may lower CRP in selected populations.

_{Reference 32. Mazidi M, Rezaie P, Banach M. Effect of magnesium supplements on serum C-reactive protein: a systematic review and meta-analysis. Archives of Medical Science. 2018;14(4):707-716.}

Melatonin — Endogenous indoleamine with antioxidant, NLRP3-, NF-κB- and cytokine-modulating actions.

_{Reference 33. Carrascal L, Nunez-Abades P, Ayala A, Cano M. Role of melatonin in the inflammatory process and its therapeutic potential. Current Pharmaceutical Design. 2018;24(14):1563-1588.}

Taurine — Taurine chloramine generated by neutrophils can down-regulate inflammatory mediator production.

_{Reference 34. Marcinkiewicz J, Kontny E. Taurine and inflammatory diseases. Amino Acids. 2014;46(1):7-20. doi:10.1007/s00726-012-1361-4.}

Prebiotic fiber — Fermentation promotes short-chain fatty acids that alter regulatory T-cell and epithelial inflammatory signaling.

_{Reference 35. Makki K, Deehan EC, Walter J, Bäckhed F. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host & Microbe. 2018;23(6):705-715.}

Butyrate — Microbial short-chain fatty acid affecting histone deacetylases, epithelial integrity and regulatory T-cell biology.

_{Reference 36. Furusawa Y, Obata Y, Fukuda S, et al. Commensal microbe-derived butyrate induces the differentiation of colonic regulatory T cells. Nature. 2013;504(7480):446-450.}

Propionate — Gut-derived SCFA with immunometabolic and T-regulatory effects.

_{Reference 37. Arpaia N, Campbell C, Fan X, et al. Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation. Nature. 2013;504(7480):451-455.}

β-Glucans — Fungal, yeast and cereal polysaccharides that modulate innate immunity through receptors including dectin-1.

_{Reference 38. Vetvicka V, Vetvickova J. β-Glucan: supplement or drug? From laboratory to clinical trials. Molecules. 2019;24(7):1251.}

Astaxanthin — Xanthophyll carotenoid with NF-κB and oxidative-inflammatory effects.

_{Reference 39. Fassett RG, Coombes JS. Astaxanthin: a potential therapeutic agent in cardiovascular disease. Marine Drugs. 2011;9(3):447-465.}

Lycopene — Tomato carotenoid that can influence oxidative-inflammatory processes.

_{Reference 40. Story EN, Kopec RE, Schwartz SJ, Harris GK. An update on the health effects of tomato lycopene. Annual Review of Food Science and Technology. 2010;1:189-210.}

Lutein — Xanthophyll carotenoid concentrated in neural and retinal tissue with antioxidant-inflammatory actions.

_{Reference 41. Buscemi S, Corleo D, Di Pace F, Petroni ML, Satriano A, Marchesini G. The effect of lutein on eye and extra-eye health. Nutrients. 2018;10(9):1321.}

Luteolin — Flavonoid modulating mast cells, microglia, NF-κB and cytokine production.

_{Reference 42. Aziz N, Kim MY, Cho JY. Anti-inflammatory effects of luteolin: a review of in vitro, in vivo, and in silico studies. Journal of Ethnopharmacology. 2018;225:342-358.}

Apigenin — Flavone present in parsley, celery and chamomile; suppresses several NF-κB/MAPK-associated inflammatory responses.

_{Reference 43. Salehi B, Venditti A, Sharifi-Rad M, et al. The therapeutic potential of apigenin. International Journal of Molecular Sciences. 2019;20(6):1305.}

Kaempferol — Flavonol with Nrf2-, NF-κB- and inflammasome-related effects.

_{Reference 44. Calderón-Montaño JM, Burgos-Morón E, Pérez-Guerrero C, López-Lázaro M. A review on the dietary flavonoid kaempferol. Mini-Reviews in Medicinal Chemistry. 2011;11(4):298-344.}

Rutin — Quercetin glycoside with antioxidant and inflammatory signaling effects.

_{Reference 45. Ganeshpurkar A, Saluja AK. The pharmacological potential of rutin. Saudi Pharmaceutical Journal. 2017;25(2):149-164.}

Fisetin — Flavonol with NF-κB, inflammasome and senescence-associated signaling effects.

_{Reference 46. Pal HC, Pearlman RL, Afaq F. Fisetin and its role in chronic diseases. Advances in Experimental Medicine and Biology. 2016;928:213-244.}

Baicalin — Major Scutellaria baicalensis flavone glycoside with inflammatory cytokine and NF-κB actions.

_{Reference 47. Li-Weber M. New therapeutic aspects of flavones: the anticancer properties of Scutellaria and its main active constituents wogonin, baicalein and baicalin. Cancer Treatment Reviews. 2009;35(1):57-68.}

Baicalein — Aglycone of baicalin; affects LOX, NF-κB and cytokine pathways.

_{Reference 48. Dinda B, Dinda M. Natural products in obesity and diabetes: therapeutic potential of flavonoids including baicalein. Springer Nature. 2020.}

Wogonin — Scutellaria flavone with immunomodulatory and NF-κB-related activity.

_{Reference 49. Li-Weber M. New therapeutic aspects of flavones: the anticancer properties of Scutellaria and its main active constituents wogonin, baicalein and baicalin. Cancer Treatment Reviews. 2009;35(1):57-68.}

Rosmarinic acid — Polyphenolic ester found in rosemary, lemon balm and perilla; inhibits complement and inflammatory signaling experimentally.

_{Reference 50. Petersen M, Simmonds MSJ. Rosmarinic acid. Phytochemistry. 2003;62(2):121-125.}

Rosemary (Salvia rosmarinus) — Contains carnosic acid, carnosol and rosmarinic acid.

_{Reference 51. González-Trujano ME, Peña EI, Martínez AL, et al. Evaluation of the antinociceptive effect of rosemary (Rosmarinus officinalis L.) using three different experimental models in rodents. Journal of Ethnopharmacology. 2007;111(3):476-482.}

Carnosic acid — Rosemary diterpene activating Nrf2 and influencing inflammatory transcription.

_{Reference 52. Satoh T, McKercher SR, Lipton SA. Nrf2/ARE-mediated antioxidant actions of pro-electrophilic drugs. Free Radical Biology and Medicine. 2013;65:645-657.}

Ellagic acid — Polyphenol occurring in berries and pomegranate; inhibits oxidative/NF-κB-related pathways experimentally.

_{Reference 53. García-Niño WR, Zazueta C. Ellagic acid: pharmacological activities and molecular mechanisms involved in liver protection. Pharmacological Research. 2015;97:84-103.}

Urolithin A — Gut microbial metabolite of ellagitannins with mitochondrial and inflammatory effects.

_{Reference 54. Ryu D, Mouchiroud L, Andreux PA, et al. Urolithin A induces mitophagy and prolongs lifespan in C. elegans and increases muscle function in rodents. Nature Medicine. 2016;22(8):879-888.}

Hesperidin — Citrus flavanone glycoside with vascular antioxidant-inflammatory effects.

_{Reference 55. Li C, Schluesener H. Health-promoting effects of the citrus flavanone hesperidin. Critical Reviews in Food Science and Nutrition. 2017;57(3):613-631.}

Hesperetin — Aglycone metabolite of hesperidin; modifies NF-κB and oxidative-inflammatory pathways.

_{Reference 56. Parhiz H, Roohbakhsh A, Soltani F, Rezaee R, Iranshahi M. Antioxidant and anti-inflammatory properties of the citrus flavonoids hesperidin and hesperetin. Phytotherapy Research. 2015;29(3):323-331.}

Naringenin — Citrus flavanone affecting NF-κB, NLRP3 and metabolic inflammation.

_{Reference 57. Salehi B, Fokou PVT, Sharifi-Rad M, et al. The therapeutic potential of naringenin: a review of clinical trials. Pharmaceuticals. 2019;12(1):11.}

Naringin — Grapefruit flavonoid glycoside with experimental inflammatory and oxidative actions.

_{Reference 58. Chen R, Qi QL, Wang MT, Li QY. Therapeutic potential of naringin: an overview. Pharmaceutical Biology. 2016;54(12):3203-3210.}

Genistein — Soy isoflavone with estrogen-receptor, NF-κB and cytokine-modulating actions.

_{Reference 59. Spagnuolo C, Russo GL, Orhan IE, et al. Genistein and cancer: current status, challenges, and future directions. Advances in Nutrition. 2015;6(4):408-419.}

Daidzein — Soy isoflavone and precursor to equol in capable gut microbiomes.

_{Reference 60. Vitale DC, Piazza C, Melilli B, Drago F, Salomone S. Isoflavones: estrogenic activity, biological effect and bioavailability. European Journal of Drug Metabolism and Pharmacokinetics. 2013;38(1):15-25.}

Equol — Intestinal metabolite of daidzein with antioxidant and immunomodulatory properties.

_{Reference 61. Setchell KDR, Clerici C. Equol: history, chemistry, and formation. Journal of Nutrition. 2010;140(7):1355S-1362S.}

Catechin — Tea/cocoa flavanol influencing redox-sensitive inflammatory signaling.

_{Reference 62. Bernatoniene J, Kopustinskiene DM. The role of catechins in cellular responses to oxidative stress. Molecules. 2018;23(4):965.}

Epicatechin — Cocoa flavanol with vascular and inflammatory effects.

_{Reference 63. Shay J, Elbaz HA, Lee I, Zielske SP, Malek MH, Hüttemann M. Molecular mechanisms and therapeutic effects of (-)-epicatechin and other polyphenols in cancer, inflammation, diabetes, and neurodegeneration. Oxidative Medicine and Cellular Longevity. 2015;2015:181260.}

Cocoa flavanols — Human trials suggest effects on endothelial activation and selected inflammatory measures.

_{Reference 64. Ellinger S, Stehle P. Impact of cocoa consumption on inflammation processes—a critical review of randomized controlled trials. Nutrients. 2016;8(6):321.}

Chlorogenic acid — Coffee/plant polyphenol affecting glucose metabolism, oxidative stress and inflammatory signaling.

_{Reference 65. Naveed M, Hejazi V, Abbas M, et al. Chlorogenic acid (CGA): a pharmacological review and call for further research. Biomedicine & Pharmacotherapy. 2018;97:67-74.}

Caffeic acid phenethyl ester (CAPE) — Propolis constituent and experimentally potent NF-κB inhibitor.

_{Reference 66. Natarajan K, Singh S, Burke TR Jr, Grunberger D, Aggarwal BB. Caffeic acid phenethyl ester is a potent and specific inhibitor of activation of nuclear transcription factor NF-κB. Proceedings of the National Academy of Sciences USA. 1996;93(17):9090-9095.}

Propolis — Bee resin containing CAPE and multiple flavonoids with immune and inflammatory activity.

_{Reference 67. Wagh VD. Propolis: a wonder bees product and its pharmacological potentials. Advances in Pharmacological Sciences. 2013;2013:308249.}

Royal jelly — Bee-derived mixture with experimental and small-human-study immunomodulatory actions.

_{Reference 68. Ramadan MF, Al-Ghamdi A. Bioactive compounds and health-promoting properties of royal jelly: a review. Journal of Functional Foods. 2012;4(1):39-52.}

Honey — Phenolic and enzymatic constituents can modulate wound-associated and systemic inflammatory processes.

_{Reference 69. Ahmed S, Othman NH. Review of the medicinal effects of tualang honey and a comparison with manuka honey. Malaysian Journal of Medical Sciences. 2013;20(3):6-13.}

Aloe vera — Contains acemannan and other compounds with topical anti-inflammatory effects.

_{Reference 70. Surjushe A, Vasani R, Saple DG. Aloe vera: a short review. Indian Journal of Dermatology. 2008;53(4):163-166.}

Chamomile (Matricaria chamomilla) — Source of apigenin and terpenoids; traditionally and experimentally anti-inflammatory.

_{Reference 71. Srivastava JK, Shankar E, Gupta S. Chamomile: a herbal medicine of the past with bright future. Molecular Medicine Reports. 2010;3(6):895-901.}

Licorice / glycyrrhizin — Influences HMGB1 and inflammatory signaling; important drug-interaction and mineralocorticoid toxicity concerns exist.

_{Reference 72. Mollica L, De Marchis F, Spitaleri A, et al. Glycyrrhizin binds to high-mobility group box 1 protein and inhibits its cytokine activities. Chemistry & Biology. 2007;14(4):431-441.}

Andrographolide / Andrographis paniculata — Diterpenoid affecting NF-κB and immune signaling.

_{Reference 73. Lim JCW, Chan TK, Ng DSW, Sagineedu SR, Stanslas J, Wong WSF. Andrographolide and its analogues: versatile bioactive molecules for combating inflammation and cancer. Clinical and Experimental Pharmacology and Physiology. 2012;39(3):300-310.}

Ashwagandha (Withania somnifera) / withanolides — Immunomodulatory botanical with experimental NF-κB and cytokine effects.

_{Reference 74. Singh N, Bhalla M, de Jager P, Gilca M. An overview on ashwagandha: a Rasayana of Ayurveda. African Journal of Traditional, Complementary and Alternative Medicines. 2011;8(5 Suppl):208-213.}

Ginseng / ginsenosides — Ginsenosides influence macrophages, NF-κB, inflammasome signaling and adaptive immunity.

_{Reference 75. Ratan ZA, Haidere MF, Hong YH, et al. Pharmacological potential of ginseng and its major component ginsenosides. Journal of Ginseng Research. 2021;45(2):199-210.}

Rhodiola rosea / salidroside — Adaptogenic botanical with antioxidant and NF-κB-associated effects, but limited clinical inflammatory-disease evidence.

_{Reference 76. Panossian A, Wikman G, Sarris J. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy. Phytomedicine. 2010;17(7):481-493.}

Arctigenin — Lignan from Arctium lappa with NF-κB, MAPK and cytokine actions demonstrated predominantly in experimental mammalian systems.

_{Reference 77. Gao Q, Yang M, Zuo Z. Overview of the anti-inflammatory effects, pharmacokinetic properties and clinical efficacies of arctigenin and arctiin from Arctium lappa L. Acta Pharmacologica Sinica. 2018;39(5):787-801.}

Honokiol — Magnolia-derived biphenol affecting NF-κB and multiple inflammatory pathways.

_{Reference 78. Fried LE, Arbiser JL. Honokiol, a multifunctional antiangiogenic and antitumor agent. Antioxidants & Redox Signaling. 2009;11(5):1139-1148.}

Magnolol — Magnolia lignan with experimental antioxidant and inflammatory pathway effects.

_{Reference 79. Shen JL, Man KM, Huang PH, et al. Honokiol and magnolol as multifunctional antioxidative molecules for dermatologic disorders. Molecules. 2010;15(9):6452-6465.}

Emodin — Anthraquinone found in rhubarb and other plants; experimental NF-κB and inflammasome inhibition, but clinical use is constrained by toxicity/pharmacokinetics.

_{Reference 80. Dong X, Fu J, Yin X, et al. Emodin: a review of its pharmacology, toxicity and pharmacokinetics. Phytotherapy Research. 2016;30(8):1207-1218.}

Aloe-emodin — Anthraquinone with experimental inflammatory signaling actions; human systemic evidence is sparse.

_{Reference 81. Dong X, Zeng Y, Liu Y, et al. Aloe-emodin: a review of its pharmacology, toxicity, and pharmacokinetics. Phytotherapy Research. 2020;34(2):270-281.}

Ursolic acid — Triterpenoid in apple peel, rosemary and herbs; affects NF-κB and inflammatory gene expression.

_{Reference 82. Ikeda Y, Murakami A, Ohigashi H. Ursolic acid: an anti- and pro-inflammatory triterpenoid. Molecular Nutrition & Food Research. 2008;52(1):26-42.}

Oleanolic acid — Dietary triterpenoid with Nrf2 and inflammatory signaling effects.

_{Reference 83. Pollier J, Goossens A. Oleanolic acid. Phytochemistry. 2012;77:10-15.}

Betulinic acid — Triterpenoid with experimental NF-κB and cytokine effects.

_{Reference 84. Yogeeswari P, Sriram D. Betulinic acid and its derivatives: a review on their biological properties. Current Medicinal Chemistry. 2005;12(6):657-666.}

Celastrol — Triterpenoid from Tripterygium wilfordii with powerful experimental inflammatory effects but a narrow therapeutic window.

_{Reference 85. Kannaiyan R, Shanmugam MK, Sethi G. Molecular targets of celastrol derived from Thunder of God Vine: potential role in the treatment of inflammatory disorders and cancer. Cancer Letters. 2011;303(1):9-20.}

Thunder god vine / triptolide — Strong immunosuppressive botanical constituents with human rheumatoid-arthritis evidence, but substantial reproductive, hepatic and other toxicity prevents casual supplement use.

_{Reference 86. Goldbach-Mansky R, Wilson M, Fleischmann R, et al. Comparison of Tripterygium wilfordii Hook F versus sulfasalazine in the treatment of rheumatoid arthritis: a randomized trial. Annals of Internal Medicine. 2009;151(4):229-240.}

Artemisinin — Artemisia-derived sesquiterpene best established as an antimalarial; also has experimental NF-κB/cytokine effects.

_{Reference 87. Ho WE, Peh HY, Chan TK, Wong WSF. Artemisinins: pharmacological actions beyond anti-malarial. Pharmacology & Therapeutics. 2014;142(1):126-139.}

Artesunate — Semisynthetic artemisinin derivative with experimental immunomodulatory actions; not an established general anti-inflammatory supplement.

_{Reference 88. Ho WE, Peh HY, Chan TK, Wong WSF. Artemisinins: pharmacological actions beyond anti-malarial. Pharmacology & Therapeutics. 2014;142(1):126-139.}

Eugenol / clove — Phenylpropanoid with COX, NF-κB and oxidative-inflammatory effects in experimental systems.

_{Reference 89. Barboza JN, da Silva Maia Bezerra Filho C, Silva RO, Medeiros JVR, de Sousa DP. An overview on the anti-inflammatory potential and antioxidant profile of eugenol. Oxidative Medicine and Cellular Longevity. 2018;2018:3957262.}

Carvacrol / oregano — Monoterpenoid phenol with experimental COX/cytokine and oxidative-inflammatory effects.

_{Reference 90. Sharifi-Rad M, Varoni EM, Iriti M, et al. Carvacrol and human health: a comprehensive review. Phytotherapy Research. 2018;32(9):1675-1687.}

Thymol / thyme — Monoterpene phenol with experimental inflammatory and antimicrobial actions.

_{Reference 91. Nagoor Meeran MFN, Javed H, Al Taee H, Azimullah S, Ojha SK. Pharmacological properties and molecular mechanisms of thymol: prospects for its therapeutic potential and pharmaceutical development. Frontiers in Pharmacology. 2017;8:380.}

Menthol / peppermint — TRPM8-active monoterpene with local analgesic, counterirritant and neuro-inflammatory effects.

_{Reference 92. Kamatou GPP, Vermaak I, Viljoen AM, Lawrence BM. Menthol: a simple monoterpene with remarkable biological properties. Phytochemistry. 2013;96:15-25.}

1,8-Cineole / eucalyptus — Terpene with clinical evidence in inflammatory airway disorders and effects on cytokine pathways.

_{Reference 93. Juergens UR, Dethlefsen U, Steinkamp G, Gillissen A, Repges R, Vetter H. Anti-inflammatory activity of 1,8-cineol in bronchial asthma: a double-blind placebo-controlled trial. Respiratory Medicine. 2003;97(3):250-256.}

Perillyl alcohol / limonene metabolites — Monoterpenes with experimental inflammatory and signaling effects; human anti-inflammatory evidence remains limited.

_{Reference 94. Sun J. D-Limonene: safety and clinical applications. Alternative Medicine Review. 2007;12(3):259-264.}

D-limonene — Citrus terpene studied for antioxidant, gastroprotective and inflammatory effects.

_{Reference 95. Vieira AJ, Beserra FP, Souza MC, Totti BM, Rozza AL. Limonene: aroma of innovation in health and disease. Chemico-Biological Interactions. 2018;283:97-106.}

β-Caryophyllene — Dietary sesquiterpene and CB2-receptor agonist with substantial animal anti-inflammatory evidence.

_{Reference 96. Gertsch J, Leonti M, Raduner S, et al. Beta-caryophyllene is a dietary cannabinoid. Proceedings of the National Academy of Sciences USA. 2008;105(26):9099-9104. doi:10.1073/pnas.0803601105.}

Myrcene — Monoterpene with analgesic and inflammatory effects demonstrated predominantly in experimental models.

_{Reference 97. Rufino AT, Ribeiro M, Sousa C, et al. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. European Journal of Pharmacology. 2015;750:141-150.}

Sesamin — Sesame lignan with antioxidant and inflammatory transcription effects.

_{Reference 98. Majdalawieh AF, Mansour ZR. Sesamol, a major lignan in sesame seeds (Sesamum indicum): anti-cancer properties and mechanisms of action. European Journal of Pharmacology. 2019;855:75-89.}

Sesamol — Sesame phenolic compound with antioxidant, NF-κB and cytokine-modulating effects in mammalian experiments.

_{Reference 99. Majdalawieh AF, Mansour ZR. Sesamol, a major lignan in sesame seeds (Sesamum indicum): anti-cancer properties and mechanisms of action. European Journal of Pharmacology. 2019;855:75-89.}

Sulfur-rich cruciferous vegetables / glucosinolates — Broccoli, cabbage, kale and related foods generate isothiocyanates including sulforaphane that influence Nrf2, NF-κB and inflammatory responses.

_{Reference 100. Soundararajan P, Kim JS. Anti-carcinogenic glucosinolates in cruciferous vegetables and their antagonistic effects on prevention of cancers. Molecules. 2018;23(11):2983. doi:10.3390/molecules23112983.}

Evidence Caution

The first ~30 agents have substantially more direct human clinical evidence than much of the lower half of the list. For compounds such as arctigenin, honokiol, magnolol, emodin, celastrol, ursolic acid, β-caryophyllene and myrcene, much of the anti-inflammatory evidence comes from cells and mammalian experimental models rather than adequately powered human inflammatory-disease trials. Conversely, recent human meta-analyses provide reasonably strong biomarker evidence for probiotics, alpha-lipoic acid, NAC, ginger and garlic.

Also, quercetin and saffron illustrate why laboratory activity should not automatically be called clinical efficacy: pooled human results are heterogeneous or nonsignificant for several major cytokines.

Safety matters: thunder god vine/triptolide and celastrol are especially poor candidates for unsupervised self-treatment; licorice can cause hypertension/hypokalemia; concentrated essential-oil constituents can be toxic; and garlic, ginger, curcumin, omega-3s and several other agents can interact with anticoagulant/antiplatelet therapy.