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Glucosamine-Chondroitin: A Powerful One-Two Punch Against Joint Pain

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Posted Tuesday, Aug. 2nd, 2016

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Glucosamine-Chondroitin
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Would you eat a dog biscuit just because your pup enjoys Milk Bones?

It’s a ridiculous question, to be sure.

Yet one supplement combination has become a popular treatment for people in part based on its success in treating canine health.

See, these two supplements appear to help ease the pain of arthritis in dogs and other animals.  Veterinarians have been recommending them for years.

Some studies suggest they may have similar benefits for humans – a fact that’s made this combination one of the top-selling supplements in the United States.

But is what’s good for Fido really what’s best for you?

A Doggone Good Supplement?

Glucosamine and chondroitin are substances that help create the molecules that form cartilage, the spongy material that helps cushion joints.  Glucosamine is typically derived from the exoskeletons of shellfish, such as shrimp, crabs, and lobster.  Chondroitin is found naturally in cartilage, including cow and shark cartilage.  Both of these substances can also be created synthetically in the lab.

Glucosamine was first discovered in 1876, but it wasn’t actually studied for its potential health benefits until the 1960s.  It was also around that time that chondroitin was first extracted and purified for possible medical use.

Chondroitin is usually sold as chondroitin sulfate, which is a combination of chondroitin and a mineral salt.  Glucosamine comes in several different forms, including glucosamine hydrochloride, glucosamine sulfate, and N-acetyl-glucosamine.1,2

Since their discovery, both glucosamine and chondroitin have been used to treat arthritis in dogs, horses, and other large animals.  Veterinarians and pet owners have long reported that these supplements appear to ease pain, stiffness, and disability, which has made them a standard treatment for these problems – at least in our four-legged friends.

Heartened by such results, researchers began investigating the value of glucosamine and chondroitin in humans.  Still, few people outside of veterinary circles were aware of these supplements.

However, the public learned much more about them in the mid-1990s, when Dr. Jason Theodosakis published his bestselling book, The Arthritis Cure.  In it, he detailed findings of some early studies on glucosamine and chondroitin, suggesting that these supplements could be a boon to people suffering osteoarthritis, or wear and tear of the joints.

Soon, bottles of glucosamine and chondroitin were flying off store shelves, as eager consumers sought to ease their pain naturally.

But how effective are they, really?

Hope for Osteoarthritis…

Research findings for these supplements seem to be all over the map.  Those studies that show positive outcomes suggest that glucosamine and chondroitin might be worth adding to your regimen if you suffer from osteoarthritis – but there’s much we still don’t understand about these supplements.

For example, a 2010 meta-analysis of previously published randomized, controlled trials concluded that glucosamine sulfate is safe and more effective than a placebo pill at improving symptoms of knee osteoarthritis and delaying its progression.6

However, it’s hard to pinpoint the best form of glucosamine for osteoarthritis.  A 2013 analysis looked at 19 trials of glucosamine, but found that many studies had outcomes that were inconsistent.  The researchers concluded that glucosamine sulfate might help improve function in people with osteoarthritis of the knee when used for six months.  However, they determined that another form, glucosamine hydrochloride, did not help relieve pain in patients with this condition.9

There have also been mixed findings for chondroitin sulfate alone.  In one meta-analysis of randomized, controlled trials of chondroitin sulfate, researchers found that the supplement had a slight but significant effect on the rate of decline in joint space (a sign of osteoarthritis progression).  Yet, other research has found no such benefits.4,11,12

Investigators have also looked at the effects of a combination of glucosamine and chondroitin on osteoarthritis ­– again, with mixed results. 3,7,8

For example, the large GAIT (Glucosamine/chondroitin Arthritis Intervention Trial) study, sponsored by the National Institutes of Health, compared glucosamine hydrochloride, chondroitin sulfate, a combination of glucosamine and chondroitin sulfate, the drug celecoxib, and a placebo in a parallel, blinded 6-month multicenter study of patients with osteoarthritis of the knee.

This trial showed that glucosamine hydrochloride and chondroitin sulfate, either alone or in combination, did not significantly reduce pain in the overall group of patients with osteoarthritis of the knee. However, the researchers found that the combination of glucosamine hydrochloride and chondroitin sulfate might be effective in a subgroup of patients with moderate-to-severe knee pain.6

Curiously, several studies that have had positive findings have used a product called Cosamin DS, which contains a combination of glucosamine hydrochloride, chondroitin, and the mineral manganese.5  This is intriguing, because glucosamine sulfate has been shown to be more effective at treating osteoarthritis of the knee than glucosamine hydrochloride when taken alone.

Confused yet?

I don’t blame you.  But that doesn’t mean you should completely rule out glucosamine and chondroitin.

How to Get Joint Pain Relief…

Because the most effective form of glucosamine remains to be determined, it’s tough to know whether or not this supplement alone will help ease osteoarthritis. And the research so far suggests that the effects of chondroitin on its own are slight.  So I certainly recommend you start by looking for a combination product. These show the most promise for treating joint pain, and it happens to be how they are most often sold these days.

I also recommend including MSM in the mix.  Good research shows that MSM in combination with glucosamine helps to relieve joint pain better than placebo.13  So you can either look for a product that contains all three, or you can seek out a separate high-quality MSM supplement to take with your glucosamine-chondroitin.  I’ve outlined what to look for in an MSM supplement in my previous post here[SS1] .

There’s less data to support the use of glucosamine-chondroitin for other conditions (such as rheumatoid arthritis, back pain, and temporomandibular joint (TMJ) pain), so your best bet is to try a combination product if you have osteoarthritis, especially of the knee.

Not everyone should take glucosamine and chondroitin, however.

Because glucosamine is derived from shellfish, you should avoid it if you have an allergy to these creatures.  You should also pass on glucosamine if you have diabetes, asthma, or high cholesterol, as it may worsen these conditions.

Chondroitin appears to raise the risk of bleeding and may increase pressure in the eye, so you shouldn’t take it if you also take anticoagulant drugs or herbs (such as warfarin, aspirin, and ginkgo), or if you have glaucoma.

Most sources recommend taking up to 1,500 mg of glucosamine and 1,200 mg of chondroitin a day in divided doses, or combined in one supplement (the product used in most studies is called Cosamin DS).

Watch out for side effects such as gas, bloating, abdominal cramps, edema (swelling), and pain or burning in the genitals and urinary tract. If these occur, stop using the supplement and see your physician.

And here’s one other tip to reduce joint pain: Eat an anti-inflammatory diet and get enough (but not too much) exercise. Stick to high-quality protein sources like pastured meat and eggs, and fresh, organic, low-glycemic veggies. Couple this with an interval training routine three times per week (moderating it as needed to accommodate your joint pain).

Reducing the overall inflammation load in your body will help to reduce your pain and will keep the uncomfortable swelling of osteoarthritis at bay. Supplements like glucosamine-chondriotin and MSM should always be used as an adjunct to a healthy, anti-inflammatory diet and lifestyle plan, not as a cure all.

Finally, remember to keep an open mind to new ideas, but ALWAYS do your own homework…and combine that with common sense to figure out what’s best for YOU.

References

1http://www.mayoclinic.org/drugs-supplements/chondroitin-sulfate/background/HRB-20058926

2http://www.drugs.com/npp/chondroitin.html

3Kanzaki N, Saito K, Maeda A, et al. Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study. J Sci Food Agric. 2012 Mar 15;92(4):862-9.

4Hochberg MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis Cartilage. 2008;16 Suppl 3:S22-4.

5Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999 Feb;164(2):85-91.

6Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010 Aug;69(8):1459-64.

7Sawitzke AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum. 2008 Oct;58(10):3183-91.

8Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808.

9Wu D, Huang Y, Gu Y, Fan W. Efficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised, double-blind, placebo-controlled trials. Int J Clin Pract. 2013 Jun;67(6):585-94.

10Poolsup N, Suthisisang C, Channark P, et al. Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. Ann Pharmacother. 2005 Jun;39(6):1080-7.

11Hochberg MC. Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Osteoarthritis Cartilage. 2010 Jun;18 Suppl 1:S28-31.

12Hochberg MC, Zhan M, Langenberg P. The rate of decline of joint space width in patients with osteoarthritis of the knee: a systematic review and meta-analysis of randomized placebo-controlled trials of chondroitin sulfate. Curr Med Res Opin. 2008 Nov;24(11):3029-35.

13Xie Q, Shi R, Xu G, et al. Effects of AR7 Joint Complex on arthralgia for patients with osteoarthritis: results of a three-month study in Shanghai, China. Nutr J. 2008 Oct 27;7:31.

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