Carol Simontacchi
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 As we age, the body's ability to produce both glucosamine and chondroitin decreases, causing the wear and tear and hardening of cartilage associated with osteoarthritis. Supplements of glucosamine and chondroitin, which are extracted from animal tissue, have been found to support cartilage repair, thereby reducing both pain and inflammation. Many researchers have found that effectiveness is increased by using these products together.
The Science Behind It
Glucosamine and chondroitin have been studied for many years. |
J. Douglas Bremner
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 Overall the studies of glucosamine and chondroitin show some evidence for efficacy of the combination, although the results are not definitive. These supplements do not have potentially dangerous side effects, unlike other medications for arthritis, like Celebrex. Therefore I would not try to dissuade you from taking glucosamine and chondroitin for arthritis pain. See Chapter 2 for more information on arthritis treatments.
The Bottom Line
We often look to and depend on government experts to accurately tell us how to eat healthy and live right. |
| Most of the earlier studies of glucosamine and chondroitin were performed by manufacturers and were not well controlled.16 In 2000 a metaanalysis of studies of glucosamine and chondroitin found that the studies that were funded by supplement manufacturers resulted in more favorable results for the supplement combo than did independent studies; few of the manufacturers' studies were properly controlled. Overall there was a moderate effect for both, and the authors concluded that some degree of efficacy was probable. |
Thomson Healthcare, Inc.
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 TMJ
Decreased temporomandibular joint (TMJ) tenderness, fewer TMJ sounds, and fewer over-the-counter analgesics resulted with supplementation of glucosamine and chondroitin. In a 12-week, double-blind, placebo-controlled study, patients received 750 mg of glucosamine HC1 and 600 mg of chondroitin sulfate twice daily (n=23) or placebo (n=22). |
Mark Sircus
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 Between 2000 and the present, FDA prohibits companies that sell glucosamine and chondroitin sulfate from telling Americans that those dietary ingredients treat osteoarthritis and relieve osteoarthritic pain and stiffness. Approximately 20 million Americans suffer needlessly from osteoarthritis.
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Since ending one s life with cancer is not pleasant it behooves all of us to be concerned with its prevention.
""1 WT" t certainly is time to get serious about cancer prevention, with the disease predicted to surge in the next 15 years. |
Carol Simontacchi
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| Studies of both glucosamine and chondroitin frequently show reduction in pain and improvement in function. However, the combination of the two components of the cartilage matrix, in supplement form, provides a synergistic effect, with a greater increase in the production of new cartilage tissue than either agent alone. The mechanisms of action are different for the products.17
Are They Safe?
So far, glucosamine and chondroitin have not been found to have serious side effects. The most common problems have been increased intestinal gas and loose stools. |
Bottom Line Health
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| Important: It can take six to eight weeks for glucosamine and chondroitin to take full effect.
AT-HOME PHYSICAL THERAPY
In addition to taking natural painkillers, try these therapies...
•Hot/cold therapy. Alternately applying heat and cold increases and decreases blood flow to the joints, flushing out lactic acid, which irritates nerve endings.
What to do: First apply a heating pad on top of a moistened towel (place the heating pad in a waterproof bag for safety) to the painful joint for 10 minutes. |
Carol Simontacchi
See book keywords and concepts |
| Supplements of glucosamine and chondroitin, which are extracted from animal tissue, have been found to support cartilage repair, thereby reducing both pain and inflammation. Many researchers have found that effectiveness is increased by using these products together.
The Science Behind It
Glucosamine and chondroitin have been studied for many years. |
Thomson Healthcare, Inc.
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| A meta-analysis of 15 randomized, placebo-controlled trials evaluating the structural and symptomatic efficacy of oral glucosamine and chondroitin in knee osteoarthritis demonstrated efficacy for glucosamine on joint space narrowing (JSN) and WOMAC. Similar efficacies were demonstrated for chondroitin and glucosamine on the Lequesne Index (LV, and visual analog scale (VAS) for pain and mobility. Join cartilage degeneration was slowed by the long-term daib administration of oral glucosamine at the minimal dose o 1,500 mg during a minimal period of 3 years (Richy et e
2003). |
| Patients with asthma may be at risk for symptom exacerbation when taking a combination of glucosamine and chondroitin (Tallia et al 2002).
Pregnancy and lactation: Scientific evidence for the safe use of chondroitin sulfate during pregnancy and lactation is not available. drug interactions
POTENTIAL INTERACTIONS
Antiplatelet and Anticoagulant Agents: Theoretically, concurrent use with chondroitin may increase the risk of bleeding. |
| Shankland WE: The effects of glucosamine and chondroitin sulfate on osteoarthritis of the TMJ: a preliminary report of 50 patients. J Craniomandibular Pract; 16(4):230-235. 1998
Steinhoff G, Ittah B, and Rowan S: The efficacy of chondroitin sulfate 0.2% in treating interstitial cystitis. Can J Urol; 9(1): 1454-1458. 2002
Tallia A, Cardone D: Asthma exacerbation associated with glucosamine- chondroitin supplement. J Am Board Fam Pract; 15(6):841-848. |
Jonny Bowden, Ph.D., C.N.S.
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 The Annual Scientific Meeting of the American College of Rheumatology in 2005 reported that the combination of glucosamine and chondroitin sulfate is at least as effective as the prescription drug cele-coxib (brand name Celebrex) in treating pain caused by moderate to severe osteoarthritis of the knee. So for best results, use them together.
Glucosamine/chondroitin therapy requires patience: You may have to wait anywhere from eight to twelve weeks to see results. |
| Some studies suggest that about two-thirds of adults who use glucosamine and chondroitin will experience benefits but that one-third will experience nothing.
To increase the odds that you'll be in the majority of people who reap the benefits of this terrific natural combination, use it properly. There are different "versions" (called salts) of glucosamine, including glucosamine sulfate, glucosamine hydrochloride, and glucosamine hydroiodide. |
| Adding to the Arsenal
In addition to glucosamine sulfate and chon-droitin sulfate, other nutrients have been shown to have benefit and may work synergistically with glucosamine and chondroitin.
Methyl sulfonylmethane (MSM) (see page 66) is terrific for joint pain, largely because of its high sulfur content. (There's a reason people all over the world flock to hot sulfur baths for pain relief.) MSM blocks the transmission of impulses in nerve fibers that carry pain signals. |
Thomson Healthcare, Inc.
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| Another study published in the same year showed a benefit for the combined regimen of glucosamine and chondroitin. In that 12-week, double-blind, placebo-controlled study, patients received 750 mg of glucosamine hydrochloride and 600 mg of chondroitin sulfate twice daily (n=23) or placebo (n=22). Statistically significant improvements were seen in measures of joint tenderness and jawbone noises (eg, cracking). In addition, the mean number of over-the-counter analgesics (mainly acetaminophen) used was significantly lower in the treatment group (p=0.03). |
J. Douglas Bremner
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| Therefore I would not try to dissuade you from taking glucosamine and chondroitin for arthritis pain. See Chapter 2 for more information on arthritis treatments.
The Bottom Line
We often look to and depend on government experts to accurately tell us how to eat healthy and live right. The primary source of government information on eating healthy is its widely distributed food pyramid, which is constructed by the U.S. Department of Agriculture (USDA). |
| In 2000 a metaanalysis of studies of glucosamine and chondroitin found that the studies that were funded by supplement manufacturers resulted in more favorable results for the supplement combo than did independent studies; few of the manufacturers' studies were properly controlled. Overall there was a moderate effect for both, and the authors concluded that some degree of efficacy was probable.17
Only one of the studies reviewed in 2000 reported that patients definitely did not know whether they were being given a supplement or a placebo. |
| However, for those of you who have been diagnosed with osteoarthritis, two popular natural arthritis remedies, glucosamine and chondroitin, may help. But if you don't have osteoarthritis there is no evidence that these over-the-counter products prevent the development of osteoarthritis or reduce aches and pains unrelated to osteoarthritis, in spite of the claims of the manufacturers of vitamins and supplements.
Glucosamine is derived from the shells of crabs and oysters and is widely promoted as a natural substance for the treatment of arthritis and joint pain. |
| Chondroitin stimulates the production of proteoglycans and hyaluronic acid and inhibits proteolytic enzymes, which destroy cartilage. glucosamine and chondroitin are often combined and sold in health-food stores.
One placebo-controlled study in older males with osteoarthritis of the knee showed no difference in pain ratings between patients treated with glucosamine and those treated with placebo.34 Glucosamine was also associated with more side effects, including loose stools, nausea, heartburn, and headache. |
Thomson Healthcare, Inc.
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| Richy F, Bruyere O, Ethgen O et al: Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis. Arch Intern Med; 163(13): 1514-1522. 2003
Rindone JP, Hiller D, Collacott E, et al. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med. Feb;172(2):91-4. 2000.
RTECS: Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health, Cincinnati, OH (internet version), Thomson Micromedex, Greenwood Village, CO; 2001. |
The Editors of FC&A
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| And buyers beware - some glucosamine and chondroitin supplements contain dangerous amounts of manganese. Humans only need about 2 mg of this trace mineral each day. More could be toxic. Play it safe and only take these supplements under a doctor's supervision.
SAM-e. S adenosylmethionine, The B vitamins folate
"sammy" to its fans, contains sul- (B9) and cobalamin fur, a building block of the body's (B12) help your body cells, including cartilage. In fact, "se SAM-e. Fill your healthy cartilage has two-thirds platf wjth/o|at. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
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 For the study as a whole, the supple-
THE GRAEDONS' G&C GUIDELINES
If you have mild knee arthritis, glucosamine and chondroitin probably won't do you much good. If you're really hurting, these dietary supplements might help somewhat. They're worth a try for a few months to see whether you get relief.
Adverse events appear to be "generally mild." Please have your cholesterol levels measured before starting on G&C and periodically thereafter to make sure they don't go up while on these supplements. |
The Editors of FC&A
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| A number of studies show glucosamine and chondroitin improve arthritis symptoms, but critics argue that the research has been poorly done and that some studies were actually funded by companies that make the supplements.
Talk with your doctor to see if these supplements are right for you. People in most studies took 1,500 milligrams (mg) of glucosamine each day - usually 500 mg three times a day, and 1,200 mg of chondroitin every day - or 400 mg three times a day. They work slowly, so you may have to take them for two or three months before you feel results. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
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| Celebrex.
The investigators did report that "an exploratory analysis suggested that the combination of glucosamine and chondroitin might be effective in osteoarthritis patients who had moderate to severe knee pain." This subset of patients with worse pain did appear to get statistically significant benefit: 79.2 percent on G&C experienced pain relief compared to 69.4 percent on Celebrex and 54.3 percent on placebo. These results were not overwhelming, though, since the researchers were careful to qualify the data as "exploratory" and the result as "might be effective. |
Mark Hyman, M.D.
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 Sylvia had heard of glucosamine and chondroitin, but her doctor had discouraged her from using them because he felt that not only were there no good studies on their effects, they might be dangerous because they aren't regulated by the FDA.
When we saw Sylvia, she was very open to trying something new, so we gave her several of the research articles on glucosamine and chondroitin. She read them, and soon started taking 1,500 mg of glucosamine and 1,200 mg of chondroitin sulfate daily in three divided doses. |
Jonathan V. Wright, M.D. and Alan R. Gaby, M.D.
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 Some doctots tecommend the combination of glucosamine and chondroitin sulfate to treat osteoarthritis. Othets argue that taking chondroitin sulfate is just an expensive way to obtain glucosamine. These doctors believe that chondroitin sulfate is broken down by the digestive enzymes into glucosamine, then reassembled in the joints into chondroitin sulfate. The question of whether orally administered chondroitin sulfate can be absorbed intact is still being debated, although there is some evidence that it can. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
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| I was taking glucosamine and chondroitin because when I hit menopause I developed arthritis pain in my hands. The folks there suggested I take MSM as well. They said to increase the dose gradually because it gives you diarrhea if you bump it suddenly. I'm taking a great deal of it and I have no unpleasant side effects. It controls the pain beautifully.
I did discover one fantastic side effect. I was also having another issue with menopause. My hair was thinning, falling out in clumps. But as soon as I started taking all this MSM my hair became gorgeous, my skin soft, and my nails fantastic. |
Alan R. Gaby, M.D., Jonathan V. Wright, M.D., Forrest Batz, Pharm.D. Rick Chester, RPh., N.D., DipLAc. George Constantine, R.Ph., Ph.D. Linnea D. Thompson, Pharm.D., N.D.
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 However, specific human trials of glucosamine and chondroitin sulfate for healing sprains and strains are lacking.
The use of DMSO (page 508), a colorless, oily liquid primarily used as an industrial solvent, for therapeutic applications is controversial. However, some evidence indicates that dilutions, when applied directly to the skin, have anti-inflammatory properties and inhibit the transmission of pain messages by nerves, and in this way might ease the pain of minor injuries such as sprains and strains. |
Joe Graedon, M.S. and Teresa Graedon, Ph.D.
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| The investigators did report that "an exploratory analysis suggested that the combination of glucosamine and chondroitin might be effective in osteoarthritis patients who had moderate to severe knee pain." This subset of patients with worse pain did appear to get statistically significant benefit: 79.2 percent on G&C experienced pain relief compared to 69.4 percent on Celebrex and 54.3 percent on placebo. These results were not overwhelming, though, since the researchers were careful to qualify the data as "exploratory" and the result as "might be effective. |
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