In late 1997 Dr. Jason Theodosakis was making the talk show rounds promoting his new book, The Arthritis Cure. The word “cure” made the book an instant best seller though Dr. Theodosakis admits it is an overstatement, treatment is the more appropriate word.
What was this new book about? Glucosamine and chondroitin sulfate, two naturally occurring substances found in the joints. Glucosamine is synthesized in the body and is one of the building blocks of cartilage, which becomes degraded in osteoarthritis. Chondroitin is also a part of cartilage and may also block enzymes that degrade cartilage.
For the next couple of years, many doctors who did not feel them to be beneficial would frown upon these supplements. Lately however, many doctors recommend them to their patients with OA. Why the change in opinion? Mostly reports from patients who claim they work.
A few studies have been done, most with results favoring the supplements. One compared glucosamine to ibuprofen, a commonly prescribed NSAID. The results of this study showed glucosamine to be more effective at relieving the pain of OA. It should be noted that 10% of the ibuprofen subjects dropped out of the study because of a variety of adverse reactions to the medication, whereas no subjects in the glucosamine group dropped out for drug-related reasons. Another large, multicenter, randomized, double-blind, placebo-controlled trial study of 150 patients showed that fifty-five percent of the glucosamine group were responders compared with 33% of the group receiving placebo. Very few studies have been done on chondroitin sulfate, which is usually sold in combination with glucosamine.
The National Institutes of Health is sponsoring a large clinical trial, including more than 1,000 patients. This study is currently under way, so we may have a definitive answer on the effectiveness of these supplements soon.
Side effects of the combo seem to be relatively minor. Most often reported are GI complaints, which often can be avoided by taking it with food or switching brands. There is some concern that glucosamine can raise the blood sugar of diabetics and that chondroitin sulfate may enhance the blood thinning effects of anticoagulants. Diabetics and people taking coumadin or heparin should be observed for these side effects.
We should point out that not all brands are the same, buyer beware. The FDA does not regulate these supplements and there are some unscrupulous people out there passing off pills that contain virtually none of the promised ingredients. A recent study of thirty-two chondroitin-containing products purchased from pharmacies and health food stores showed Twenty-six products had contain less than 90% of the chondroitin sulfate stated on the label, with 17 products containing less than 40% of label claim. Only 5 out of the 32 products analyzed contained the greater than 90% of the labeled amount of chondroitin sulfate in the product. Your best bet is to go with a recognized brand. The two most popular brands are CosaminDS(TM) (Nutramax Labs) and Osteo Bi-Flex(TM) (Sundown Vitamins). Dr. Theodosakis approves both of those brands as well as Twinlab Maxlife Glucosamine & Chondroitin Sulfate and Thompson Gluco-Pro 900 Glucosamine Chondroitin. Most experts recommend the following dosage:
Under 120 lbs: 1,000 mg glucosamine and 800 mg Chondroitin sulfate
Between 120 and 200 lbs: 1,500 mg glucosamine and 1,200 mg Chondroitin sulfate
Over 200 lbs: 2,000 mg glucosamine and 1,600 mg Chondroitin sulfate
You should expect to take the supplements for several weeks before noticing any results. As with any other supplement or medication we recommend that you let your physician know you are taking it.
At this time there are no indications that glucosamine or chondroitin have any benefit for any other type of arthritis. It has been studied only in OA.
Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients.
Lopes Vaz A – Curr Med Res Opin – 1982; 8(3): 145-9
Well-Connected-Osteoqrthritis Copyright ? Nidus Information Services 2000
Glucosamine in the treatment of osteoarthritis.
Rheumatic Diseases Clinics of North America
Volume 26 o Number 1 o February 2000
Copyright ? 2000 W. B. Saunders Company
Cush’s Osteoarthritis & G/CS Page
American Nutraceutical Association
The Arthritis Foundation’s Guide to Alternative Medicine