The Missing Ingredient in Most Arthritis Treatments

Dr. Frank Shallenberger, MD

September 7, 2020



One of the most common problems I see in the clinic every week is arthritic knees. In many cases, the symptoms are bad enough to prevent my patients from doing things they love to do, such as dancing or playing golf.

Of course, they can always take Advil or Aleve. While these medications can reduce the pain, they don’t stop the arthritis from getting worse. They can also damage the kidneys. And, in fact, the frequent use of these medications actually speeds the progression along.

So why are arthritic knees becoming such a big problem?

It’s possible we’re becoming more and more deficient in a particular trace mineral. And that mineral could hold the key to the whole problem.

Since 1963, evidence has been accumulating that suggests that deficiencies in the trace mineral boron might be the prime cause of most cases of osteoarthritis. One of the most convincing facts to support this is epidemiologic.

In areas of the world where boron intakes usually are 1.0 mg or less per day, the estimated incidence of osteoarthritis ranges from 20-70%. But in areas of the world where boron intakes are 3-10 mg a day, the estimated incidence of arthritis plunges from 10% to zero. And that’s not all.

When researchers look at the content of boron in the bones and joint linings of people with arthritis, they find significantly lower levels of boron than they do in people without arthritis.

One particular study showed that the levels of boron in arthritic hips were one-half the level in healthy hips. And when researchers give rats injuries that lead to arthritis, they find that boron supplementation stops the arthritis.

One published double-blind placebo study looked at 20 men and women with X-ray evidence of osteoarthritis. The researchers gave half of them 6 mg of boron a day. They gave the other half a placebo. In only two months, 50% of the subjects receiving the supplement improved compared to 10% receiving the placebo.

The form of boron that they used was sodium tetraborate decahydrate. This particular form of boron called borax is used in cleansers and insecticides. As you will see in a moment, it is not the best form of boron. But despite this fact, it still worked. Why?

What Is It About Boron That Can Stop Arthritis?

A recent study showed some remarkable properties of boron. And it may help to explain why most cases of osteoarthritis of the knee are in men.

Researchers recently looked at the effect of a boron supplement on eight healthy men. Before the experiment started, they measured the following: sex hormone binding globulin (SHBG), high sensitive C-reactive protein (hsCRP), TNF-α, testosterone, dihydrotestosterone, cortisol, vitamin D, and estradiol. SHBG is the protein that binds and deactivates testosterone.

So when it’s high it has an anti-testosterone effect. Keep that in mind. The hsCRP and TNF-α are markers of inflammation. They go up as inflammation increases. Cortisol is an anti-inflammatory hormone. It acts to decrease inflammation. Dihydrotestosterone is the strongest form of testosterone. You already know about vitamin D, testosterone, and estradiol.

The researchers gave the men 10 mg of boron every day for seven days. At the end of the seven days, they repeated the blood tests. And the results explain why boron may be the key to preventing and treating arthritis. According to the authors, they found, “a significant decrease in SHBG, hsCRP, and TNF-α. And, after one week, the mean plasma free testosterone increased and the mean plasma estradiol decreased significantly. The dihydrotestosterone, cortisol, and vitamin D were elevated.” So let’s go over this.

Just one week of boron therapy reduced every single marker of inflammation. It increased the hormone cortisol that reduces inflammation. It increased the hormones testosterone, dihydrotestosterone, and free testosterone that build up bone and cartilage. It decreased SHBG, the protein that decreases the bone and cartilage rejuvenating effect of testosterone. And it increased vitamin D, a vitamin that’s critical for bone health. Amazing!

Every single action of boron was to decrease the inflammatory effects of arthritis and rebuild cartilage and bone. What’s more, the study also helps to explain why men are more likely to have arthritis of the knees than women. It’s because boron has such a positive effect on the male hormone balance.

So Let’s Sum Up What We Know So Far About Boron

The higher the intake of boron, the lower the chance of getting arthritis. It has significant anti-arthritic effects in healthy men, works great in animals, and is higher in the bones of people who don’t get arthritis. But does it really work to reduce the pain and inflammation of arthritis in the real world of humans?

A few years ago, researchers looked at 60 men and women with painful arthritic knees. They gave half of them 110 mg of calcium fructoborate. I’ll tell you more about this important compound of boron in a minute. They gave the other half a placebo. The study went on for two weeks.

Before the study, at the seven-day mark, and at the end of the study, the researchers asked the men and women to rate their pain and functional levels. The authors used the two most well-known instruments for measuring pain and function from arthritis. These are the Western Ontario and McMaster Universities Arthritis Index (WOMAC score) and McGill Pain Questionnaire (MPQ score). Here’s what they found.

“Results showed that supplementation with calcium fructoborate significantly improved knee discomfort in the study subjects.” This amount of pain relief is amazing for a natural substance in only two weeks. And not only were the scores much better, the improvement almost doubled in both scores on the 14th day compared to the 7th day. That makes you wonder if the results would have been even better had the study gone on for four to six weeks.

Calcium fructoborate is a natural compound composed of calcium and boron linked to two fructose molecules. Fructose is the main sugar found in fruit. This makes it an excellent carrier for boron. Laboratory studies show that calcium fructoborate suppresses the potent free radical superoxide ion. And it’s also an impressive anti-inflammatory agent.

According to one review article, “The mechanisms by which calcium fructoborate exert its beneficial anti-inflammatory effects are not entirely clear, but some of its molecular biological in vitro activities are understood: inhibition of the superoxide within the cell; inhibition of the interleukin-1β, interleukin-6, and nitric oxide release in the culture media; and increase of the tumor necrosis factor-α production.”

All of these substances that it inhibits are substances that cause inflammation.

But What About Safety?

Some studies have given humans as much as 3 mg of calcium fructoborate per pound without any toxicity or side effects. This amounts to 450 mg for a 150 pound adult for long-term safety that definitely beats Advil or Aleve. And here’s something else.

The most commonly used nutritional substance for arthritis for many years is a combination of glucosamine and chondroitin. Sure these substances are food for the joints. But any doctor who has prescribed them enough has noticed that they don’t work in many cases. Why is that? It might just be because they will not work in a patient who has a boron deficiency. A recent study strongly points to that possibility.

The researchers selected 90 men and women with knee pain. They gave a third of them a placebo. They gave another third a supplement of glucosamine and chondroitin sulfate. And they gave the final third a supplement of glucosamine and chondroitin sulfate combined with calcium fructoborate. Neither the researchers nor the patients knew who was getting what. And, as in the study above, the authors used the WOMAC and the MPQ scores to evaluate efficacy. Here’s what happened.

In the authors’ words, “Treatment with glucosamine combined with chondroitin sulfate and calcium fructoborate resulted in a statistically significant 24% reduction of the average WOMAC score and a 25% reduction of the average MPQ index at day 14 over baseline... Results showed that short-term treatment with glucosamine and chondroitin could be efficacious only if used in combination with calcium fructoborate.”

So if you’ve taken a glucosamine chondroitin supplement and had no results, this could be why.

I was very excited to learn about these studies. So in the past year, I have been combining the glucosamine and chondroitin with calcium fructoborate and willow bark extract. You have heard me talk about willow bark extract before. It has the pain-relieving properties of aspirin without the side effects. This has meant a lot of pills for my patients. But I haven’t had any complaints because the results have been so good.

All of these are excellent nutrients to take if your knees – or any of your joints – are bothering you. The results can be fantastic!


Environ Health Perspect. 1994 November;102 Suppl 7:83-5. “Essentiality of boron for healthy bones and joints.”

Naghii, M.R., M. Mofid, et al. “Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines.” J Trace Elem Med Biol. 2011.

Pietrzkowski, Z., M.J. Phelan, et al. “Short-term efficacy of calcium fructoborate on subjects with knee discomfort: a comparative, double-blind, placebo-controlled clinical study.” Clin Interv Aging. 2014 June 5;9:895-9.

Reyes-Izquierdo, T., M.J. Phelan, and R. Keller. “Short term efficacy of a combination of glucosamine and chondroitin sulfate compared to a combination of glucosamine, chondroitin sulfate and calcium fructoborate on improvement of knee discomfort in healthy subjects. A comparative, double blind, placebo controlled acute clinical study.” Journal of Aging Research & Clinical Practice, volume 3, number 4, 2014.

Scorei, R.I. and P. Rotaru. “Calcium fructoborate—potential anti-inflammatory agent.” Biol Trace Elem Res. 2011 December;143(3):1223-38.

Ready To Upgrade?

Upgrade now to a Second Opinion Newsletter Subscription so you don't miss out on the healthy, active life you deserve.

Plus, Get Up To 18 Free Reports When You Click Here To Upgrade Today!

Get A Free Copy Of This Powerful Report

Inside You'll Discover

► A little secret that not only relieves stress but can actually banish stress from your life!

► If you are exercising too hard to be healthy.

► And, an optimal exercise regimen to excerise smarter, not harder!

Enter your name and email to claim this free report and join our newsletter

Get Report!