Relief for your painful joints - wellness - glucosamine and chondroitin - Brief Article

Better Nutrition, May, 2002 by Jason Theodosakis

Currently, some 20 million Americans stiffer from osteoarthritis (OA), a painful condition caused by a weakening of articular cartilage--a protective substance attached to the ends of bones that prevents them from rubbing together. Although over-the-counter and prescription medications can provide some relief from osteoarthritis pain, they can't cure the disease. The good news, however, is that two dietary supplements--glucosamine and chondroitin--have shown great promise not only in treating joint pain, but also in halting cartilage loss in OA sufferers.

Supplemental glucosamine is derived mostly from crab shells and chondroitin is derived from cow, fish or pork cartilage, but both substances also are produced in small amounts by our cartilage cells. In fact, they're key components to the structure of articular cartilage.

Sold as drugs in many European countries, glucosamine and chondroitin have undergone clinical trials and safety studies by each country's pharmaceutical governing agency. Studies show that both supplements: (1) are absorbed when taken orally; (2) benefit cartilage by several means; (3) decrease pain and improve joint function when compared with placebo or traditional drugs; (4) are safe for long-term use in humans; and (5) show a proven halting of cartilage loss in OA sufferers.

This last point has raised the biggest stir in the arthritis community, as glucosamine and chondroitin are the first substances known to actually help modify the disease condition. Two studies published in 1998 in Osteoarthritis and Cartilage documented significant benefit for chondroitin over placebo for knee and hand OA. Two larger glucosamine studies followed in 1999 and 2000 in the journals Lancet and Arthritis & Rheumatism. In 2001, a landmark study published in Clinical Orthopedic Related Research showed that combining the supplements works better than either one alone at preventing cartilage damage.

Taking both supplements orally, in daily doses of 1,500 mg for glucosamine and 1,200 mg for chondroitin, has been shown to help relieve pain and improve function in arthritic joints as well as--or better than--any pharmaceutical product they've been studied against.

But the supplements do more than control pain. Studies show that they actually increase production of cartilage components, decrease enzymes that break down cartilage, prevent cartilage from fraying--an early step in the OA process--and act as cartilage antioxidants. And chondroitin has additionally been shown to increase production of hyaluronic acid, which helps reduce joint friction and shock. This is why many doctors recommend glucosamine and chondroitin to all OA patients--even the one in every four that doesn't experience pain relief when taking the supplements.

Thus far, no medication interactions with glucosamine and chondroitin have been reported, but about five to 10 percent of people using the supplements experience upset stomach, gas or bloating, symptoms similar to those caused by placebo in controlled studies.

Additionally, no increases in blood sugar levels have been reported after long-term use. About one in 20 people allergic to shellfish can show signs of allergy to glucosamine, even though glucosamine is derived from the shells, not the meaty portion of crab, which is responsible for most allergies.

The supplements haven't been studied in children or pregnant or nursing women, so use in these groups is cautioned. Additionally, age and severity of osteoarthritis aren't reasons to avoid the supplements. In fact, glucosamine and chondroitin have proven to be far safer than traditional drugs or pain relievers in every case.

| fast facts | glucosamine and chondroitin

* Glucosamine and chondroitin are the only known substances that have been shown to halt cartilage loss in osteoarthritis sufferers.

* Combining glucosamine and chondroitin--in daily doses of 1,500 mg and 1,200 mg, respectively--works better than using either one alone at halting cartilage loss.

* Glucosamine and chondroitin can be found on the market in tablet, capsule, liquid and chew forms. None of these forms has been shown to be absorbed or utilized better than another despite some marketing claims.

Jason Theodosakis, MD, is one of the world's leading osteoarthritis specialists and author of The Arthritis Cure. He tracks glucosamine studies and side effects on his Web site (www.drtheo.com).