Joint checking

Men's Fitness, Feb, 1999 by Jose Antonio

Weak in the knees? Tennis elbow? New dietary supplements may provide relief for sore joints.

You've just finished an interval session of sprints - or maybe it was heavy shoulder day - and you hit the shower with a little more strut in your stride. A few hours later, both your strut and your stride have been sidelined by aching joints. You try the RICE routine (rest, ice, compress, elevate), but nothing seems to help. So you start popping ibuprofen or some other nonsteroidal anti-inflammatories, hoping that your stomach is strong enough to handle the stress that NSAIDs deliver to your gut.

Maintaining healthy joints is one of the keys to consistent physical development, whether you're slamming an ace at Wimbledon or simply walking up a flight of stairs. If working out properly, eating right and getting adequate rest and recuperation still leave you smarting, you might consider supplements to help strengthen or repair your joints.

Most of the research in this area has been done on joint disease rather than the wear and tear that usually precedes it, yet the relief of minor joint symptoms isn't confined to a particular diagnosis. With 40 million Americans suffering from some sort of arthritis - and many more on their way to joining them - a number of health professionals are urging active men to take special care of their knees, wrists and shoulders. (Consult your health pro prior to starting or altering a supplement program.)

Cartilage and cocktails

Before you begin begging your local fishmonger for leftover shark cartilage, you should know that some of the best things you can take for your joints are sitting on your kitchen counter (and probably shaped like Fred, Wilma, Barney, Betty and Dino).

"Of particular importance is supplying adequate levels of antioxidant nutrients like selenium, manganese, vitamins C and E, [but also] those nutrients important in the manufacture of joint substances, especially niacinamide, pantothenic acid and zinc," says Michael T. Murray, author of Natural Alternatives to Over-the-Counter and Prescription Drugs (William Morrow, $25). Multivitamins contain these elements in varying amounts; check your label.

According to a study published in the Annals of Internal Medicine, high intake of antioxidant vitamins, most notably vitamin C, shows promise in reducing risk of cartilage loss. Low levels of vitamin D have been linked to arthritis progression, and vitamin E has shown an analgesic effect in some patients, possibly by inhibiting the enzymatic breakdown of cartilage.

A study in the journal Inflammation Research found that niacin (vitamin [B.sub.3]) may improve joint flexibility and reduce inflammation. (Murray recommends niacinamide, a more easily tolerated version.) Other research has shown that low levels of pantothenic acid (vitamin [B.sub.5]) are inversely connected to increased joint symptoms, though this seems to apply specifically to rheumatoid arthritis. The list of natural anti-inflammatories also includes selenium, zinc, bromelain, curcumin, and the B-complex vitamins folate and cobalimin.

Several anti-inflammatory "cocktails" have been investigated: A study at the University of Missouri noted that cobalamin increases the effectiveness of folate significantly in reducing joint tenderness. Similarly, bromelain seems to aid the absorption of curcumin, which has been called a safe alternative to phenylbutazone, a potent NSAID with serious side effects.

Gamma linolenic acid, one of the essential fatty acids, is the supplement of choice for many athletes. In a test at the University of Pennsylvania, the use of GLA resulted in a 30 percent reduction in joint tenderness for rheumatoid arthritis patients. Newly popular is phosphatidylserine (PS), a phospholipid that boosts memory function. A team at California State University at Chico found that PS blunted the stress that induces cortisol release and decreased muscle soreness by more than 50 percent after rigorous training.

Feeling your oats

Another substance on the pain horizon is the sulfur-based compound methylsulfonylmethane, or MSM, which helps maintain the structure of proteins in the body and aids the immune system. Originally used for racehorses with joint problems, MSM earned media attention when athletes started shopping at equestrian stores to get it.

"Weightlifters use MSM for delayed-onset muscle soreness, and they claim greater flexibility in their muscles and shorter recovery times," says Ronald Lawrence, MD, assistant clinical professor at the UCLA School of Medicine and co-author of The Miracle of MSM: The Natural Solution for Pain (Penguin-Putnam, $23). "It's nontoxic and it's safer than water." He adds that MSM is effective for rheumatoid arthritis within three or four weeks of supplementation, but takes only a day or two to relieve delayed-onset muscle soreness.

MSM may be promising, but the No. 1 supplement for joint problems is still glucosamine sulfate. An actual component of connective tissue and cartilage, glucosamine plays a vital role in the formation of tendons, ligaments and bones. "Glucosamine is responsible for stimulating the manufacture of substances necessary for joint repair [and] has also been shown to exert a protective effect against joint destruction," explains Murray. "Numerous double-blind studies have shown that glucosamine sulfate produces much better results than NSAIDs in relieving the pain and inflammation of osteoarthritis. While NSAIDs offer purely symptomatic relief and may actually promote the disease process, glucosamine sulfate addresses the root of the problem."