Supplements for autoimmune conditions

The autoimmune adjunct stack — broadly safe across most conditions

Vitamin D3 — the single most-evidenced supplement here

The VITAL trial extension (Hahn 2022) showed vitamin D 2000 IU/day (with omega-3) reduced autoimmune disease incidence by 22% over 5 years. Test 25-OH-D; supplement to 30–50 ng/mL. Doses up to 4000 IU/day are reasonable in deficient patients with rheumatologist oversight. Higher doses (≥10,000 IU/day) without monitoring are not appropriate. Particularly important in MS (Coimbra protocol claims notwithstanding, evidence supports correction-to-target, not megadosing).

Omega-3 (EPA/DHA) 2–3 g/day

RA: multiple RCTs show reduced disease activity and reduced NSAID need. IBD: trial-level signal smaller, but anti-inflammatory rationale and cardiovascular adjacency favour use. Lupus: small signal on disease activity. Choose a quality product (third-party-tested for oxidation); take with a fat-containing meal. Note recent AF signal at very high doses (≥4 g/day) — discuss with prescriber if going above 2 g/day or if you have atrial fibrillation.

Curcumin (bioavailable form) 500 mg b.i.d.

Strong anti-inflammatory rationale; trial signal in RA (Daily 2016 meta-analysis), psoriasis, IBD adjunct, and OA. Use a bioavailability-enhanced form (Meriva/Theracurmin/phytosome). Modest interaction profile — avoid in active gallstone disease and discuss with prescriber if on anticoagulants.

Magnesium glycinate 300–400 mg elemental/day

Adjunct to sleep, muscle, and mood symptoms commonly comorbid in autoimmune disease. Inexpensive and broadly tolerated.

Specific-deficiency repletion based on testing

Autoimmune gastritis, coeliac disease, and Crohn's commonly cause B12, iron, folate, zinc, and fat-soluble-vitamin deficiencies. Test before supplementing — empirical supplementation without testing can mask diagnosis and miss reversible problems.

Selenium 100–200 mcg/day specifically for Hashimoto's

Multiple RCTs show selenium reduces TPO antibody titres in Hashimoto's. Use selenomethionine form. Avoid >400 mcg/day chronic (selenosis risk). Particularly relevant in selenium-poor soil regions.

Boswellia serrata (AKBA-standardised) for joint or IBD inflammation

5-LOX inhibitor with trial signal in RA, ulcerative colitis (Gupta 1997), and OA. Boswellia 100 mg/day (Aflapin) or 250 mg/day (5-Loxin). Useful adjunct when joint or gut symptoms persist despite DMARDs.