Glucosamine Chondroitin for Osteoarthritis

What are glucosamine and chondroitin?

Glucosamine and chondroitin sulfate are compounds that are thought to have a protective effect on the cartilage, as well as to help manage osteoarthritis, particularly of the knee. Currently there are still many controversies around the effectiveness glucosamine and chondroitin sulfate in actually preventing the degeneration of joint cartilage. In Europe, glucosamine is a prescription drug with a standardized formula. In the United States and some parts of Asia, glucosamine is sold over-the-counter as dietary supplements.

Both glucosamine and chondroitin sulfate are found in normal joint cartilage and synovial fluid. Researchers proposed that glucosamine may stimulate production of cartilage-building proteins. Glucosamine in supplements is extracted from animal tissues such as crab, lobster or shellfish and marketed as glucosamine sulfate or glucosamine hydrochloride. They are considered to be equally effective, but the hydrochloride form is absorbed more easily by the body and can be taken in lower dosage than glucosamine sulfate.

Chondroitin sulfate is part of a protein molecule that maintains cartilage elasticity and is also thought to have an anti-inflammatory effect. Chondroitin sulfate in supplements is extracted from animal cartilage such as trachea or shark cartilage.

Do glucosamine and chondroitin really work for osteoarthritis?

In reality, some studies have found that either glucosamine or chondroitin sulfate given together or separately may relieve osteoarthritis pain with fewer side effects than conventional arthritis drugs. However, there are also studies that have shown no benefit. Although currently positive reports outnumbered negative ones, the negative ones have been larger and better designed.

The largest clinical trial that studies the effect of glucosamine and chodroitin sulfate is the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT), which is funded by the National Institutes of Health. In 2006, the researchers reported that glucosamine and chondroitin, alone or together, did not reduce osteoarthritis knee pain more effectively than a placebo. Follow up reports from this study also failed to show any promising result.

However, despite this discouraging result many people who take glucosamine and chondroitin sulfate supplements did report subjective reduction in arthritis pain. There are preliminary reports that suggest addition of vitamin C, bromelain, or manganese may enhance the effectiveness of glucosamine and chondroitin sulfate. And because these supplements are thought to have very few side effects, people keep taking them anyway.

Be wise if you decide to take glucosamine and chondroitin supplement.

Severe form of osteoarthritis may require surgery.

So, what to do? If you decide to try glucosamine and chondroitin sulfate supplements after all, give it three months time to evaluate their efficacy. The typical initial dose is 1500 mg of glucosamine and 1200 of chondroitin daily for 6 to 8 weeks. If a response is obtained, the dose can be reduced to 1000 mg of glucosamine and 800 of chondroitin or less. If you feel there is no change in symptoms after three months, these supplements should be discontinued.

If your symptoms are severe, you should stay on your usual arthritis medications even while you are taking glucosamine and chondroitin. As always, consult your physician before taking any form of supplements. Common side effects include stomach upset, gas, soft stools, drowsiness, headache, racing heart, and skin reactions. Patients with diabetes should pay extra caution because glucosamine is an amino sugar that may affect blood sugar levels. Also, because these supplements contain shellfish and other possible allergens, watch out for allergy symptoms.

Tips For Choosing Supplements

Most people in the United States take one or more supplements either regularly or occasionally. Dietary supplements come in forms of vitamins, minerals, antioxidants, enzymes, herbal products, and many others. The preparation can be a tablets, capsules, soft gels, powders, and liquid. Because there are so many varieties out there, choosing the right kind of supplement may be challenging. Here are a few basic tips to consider before you decided to start consuming one.

Do some preliminary background check

Research the benefits and possible side effects of the particular compound you’re planning to take. Always consult a health care professional beforehand. Dietary supplements are products intended to supplement the diet. They are not drugs and, therefore, are not intended to diagnose, treat, cure, or prevent any diseases. Do not believe whatever claims the manufacturer made before doing some research of your own. Some supplements promise to help make us thinner, smarter, stronger or faster without making any other changes in lifestyle. If it sounds too good to be true, it probably is.

Consider the effectiveness of the supplement

Find out how much you need to consume in order to bring out the health benefits for your body without risking the side effects. Many popular products include ingredients in miniscule quantities, just so a much-publicized ingredient can be listed on the label, or vice versa, they include a very high amount of a particular ingredient while in reality our body only needs a minuscule amount. A good, but not perfect guide is to look up the recommended daily allowances (RDA) of that product. However, keep in mind that a product’s chemical formulation and how it is prepared affect how our body is able to take in the ingredients. This is called bioavailability. A high-dosed product, but low bioavailability is not very effective.

Soft capsules generally have a better bioavailabilty than traditional tablets.

Be aware of safety and risk issues

The term ‘natural’ doesn't always mean safe. Many supplements contain active ingredients that can have strong effects in the body. Always be alert to the possibility of unexpected side effects, especially when taking a new product. Dietary supplements can also interact with certain prescription drugs in ways that might cause problems. Watch out for other catch phrases like ‘clinically tested/proven’ and ‘pharmaceutical strength’. Unlike drugs, which must be approved by the FDA before they can be marketed, dietary supplements do not require premarket review or approval by the FDA and the manufacturers do not have to provide any evidence about the claims they made before the product is marketed.

Look for quality assurance

Since the quality of nutritional supplements can vary widely, one strategy is to choose an established brand name, or one that's recommended by a health professional. Not every product uses high quality raw materials, or is manufactured according to accepted good manufacturing practices. Besides the FDA, several independent organizations like U.S. Pharmacopeia, ConsumerLab.com, and NSF International offer quality testing and allow products that pass these tests to display their seals of approval. These seals of approval provide assurance that the product was properly manufactured, contains the ingredients listed on the label, and does not contain harmful levels of contaminants.