Joint-protection supplements: nutrition science. These all-natural substances will slow joint damage and speed healing

Men's Fitness, Sept, 2001 by Brian Rowley

Diving full-length for a volleyball save, shooting hoops on an outdoor court, or just hitting the weights can deliver serious wear and tear to your joints, ligaments and tendons. If your shoulders pop or your hips grind, you need to prevent further damage as well as kick-start the healing process.

To do so, most guys inhale nonsteroidal anti-inflammatory drugs such as ibuprofen, acetaminophen or aspirin. While they control inflammation, these drugs also slow healing by hampering production of glycosaminoglycans, necessary components for new connective tissue, says a review in the European Journal of Rheumatology and Inflammation. The potential side effects of taking too many of them are another downer and include stomach ulcers, kidney problems and ringing in the ears. Instead of chomping on NSAIDs like they're M&Ms, try some of these well-researched supplements for faster healing and less soreness.

CHONDROITIN AND GLUCOSAMINE SULFATE

Two great alternatives to over-the-counter pain relievers are chodroitin and glucosamine sulfate. Both are natural building blocks used to repair connective tissue such as cartilage, tendons and ligaments. Because your body is slow to make glucosamine, taking it as a supplement speeds joint and tendon healing.

Unlike fish-oil extracts (see page 124), which act by reducing inflammation, glucosamine and chondroitin behave in the other direction, enhancing the rebuilding of joint and tendon cartilage as well as tendons and ligaments. In contrast, while NSAIDs do ease pain and decrease inflammation, their action may inhibit the repair of joints and tendons. In fact, because NSAIDs slow your body's natural production of glucosamine and chondroitin, it's probably a good idea to take these as dietary supplements if you are currently taking a lot of pain relievers.

Chondroitin is an advanced molecule, created when many glucosamine molecules stick together. It is closer to being cartilage than glucosamine is, but isn't as well-absorbed (only 10 percent to 15 percent is absorbed, compared to 90 percent to 98 percent for glucosamine). Chondroitin is also a bit more expensive at about $1 per gram, whereas glucosamine goes for about one-third less. As a result, chondroitin is sometimes not marketed as aggressively, but evidence suggests it's as good or better at supporting connective-tissue renewal as glucosamine.

Both supplements have been used successfully to reduce osteoarthritis symptoms and to speed healing of joints. However, chondroitin has the unique ability to distract enzymes bent on destroying cartilage, causing them to target chondroitin instead. The chondroitin that gets chewed up is then converted to ordinary glucosamine and used to heal joints and tendons.

Recommended dosages are 800 to 1,200 milligrams of chondroitin and 1,500 mg of glucosamine sulfate every day for an extended period, especially during times when you're recovering from a bout of tendonitis or arthritis, or just the wear and tear of hard training.

SAMe

Another joint supplement that may be useful--although unlikely to be as efficacious as the aforementioned duo--is S-adenosyl-L-methionine, known as SAMe (pronounced "Sammy"). It sticks methyl groups onto other molecules, an essential reaction used by your body to produce glucosamine. In fact, SAMe has been well-studied as a treatment for depression, and has been used for this purpose by German psychiatrists for about 20 years.

Will SAMe cure aches or pains? Reports in the Scandinavian Journal of Rheumatology suggest that the answer is a maybe. Some evidence points to a benefit for patients suffering from fibromyalgia, a disorder characterized by muscle pain, stiffness and fatigue. Another clinical trial found SAMe to be helpful for patients with osteoarthritis, and it's plausible that it my help other tendon and joint concerns as well. (Doses of SAMe used to combat arthritis range from 400 mg to 1,200 mg per day, taken orally on an empty stomach in two or three divided doses.) Unfortunately, trials with SAMe are to date preliminary--in spite of claims, the supplement is probably not as effective as NSAIDs.

Because much of SAMe's benefit comes from its ability to increase glucosamine production (for which it is an essential factor), it seems cheaper (SAMe costs from $1.20 to $3.60 a day) and more sensible to simply take glucosamine for joint complaints. Also, unless you buy individually foil-wrapped SAMe, it may not be biologically active, as SAMe is unstable and destroyed by light if not properly packaged.

FISH OIL

A standout among joint supplements is fish-oil extract, more specifically, the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid. Both EPA and DHA fight joint-damaging enzymes called collagenases and reduce inflammation, factors believed to play a role in joint aches and pains, including arthritis. As a result, fish oil is a great supplement for the active guy who wishes to reduce joint and tendon pain and prevent any damage. In fact, a number of top-notch clinical trials, including one published in Journal of Rheumatology, have found that about six grams of fish-oil extract per day reduces symptoms of rheumatoid arthritis (which is essentially joint inflammation raging out of control). To get the equivalent amount of omega-3s from your diet, eat fish twice a week (see table for best choices). For instance, two nine-ounce salmon steaks a week provide about 42 grams of fish oil.