Q. Is there convincing evidence that glucosamine and chondroitin supplements can provide arthritis relief?
A. Yes. Along with diet, exercise and treatment of any underlying causes of arthritis, glucosamine and chondroitin hold much promise in halting, perhaps even reversing, osteoarthritis, says Jason Theodosakis, M.D., member of a National Institutes of Health (NIH) steering oversight committee and author of The Arthritis Cure (St. Martin’s Press, revised edition 2004).
Glucosamine and chondroitin are produced naturally in the body and stimulate the formation of cartilage (the material that cushions joints, but wears away in osteoarthritis) and inhibit enzymes that break it down. Chondroitin also promotes elasticity in joints and has a mild anti-inflammatory effect.
Mounting Evidence. Studies have shown that glucosamine and chondroitin not only relieve pain and improve function in osteoarthritis, they may also improve cartilage structure.
Laboratory research suggests the two act synergistically. And some studies show they relieve arthritis pain even better than nonsteroidal anti-inflammatory drugs like ibuprofen, but without their serious side effects. Moreover, the benefits may persist even after stopping the supplements. One research review contends, however, that the benefits may be less dramatic than some studies suggest.
Theodosakis advocates glucosamine and chondroitin as a first-line treatment. ?Only if they need additional pain relief should people consider anti-inflammatory drugs,? he says.
We?ll know more in 2005, when a large NIH trial wraps up. It will be the first to compare the two against each substance alone, plus against Celebrex, a popular anti-inflammatory drug, and against placebo.
Quality Varies. Unfortunately, glucosamine/chondroitin supplements vary tremendously in quality. There are different doses, sources (shellfish or corn for glucosamine; cow, pig, fish or shark cartilage for chondroitin) and forms (glucosamine sulfate or glucosamine hydrochloride) available, making it difficult to know what to buy.
Moreover, many supplements contain too little active ingredient?often just a fraction of what their labels claim.
EN‘s Bottom Line. Consider glucosamine/chondroitin supplements if you have osteoarthritis. Their use is embraced by many in the medical community, including the Arthritis Foundation. Research suggests they are safer than anti-inflammatory drugs. EN‘s tips:
? Look for supplements that contain 1,500 milligrams of glucosamine hydrochloride (or 1,800 milligrams of glucosamine sulfate) plus 800 to 1,200 milligrams of chondroitin sulfate.
? Buy products that pass independent testing (see www.consumerlab.com and www.drtheo.com). Some recommended brands include Osteo Bi-Flex (Rexall), Cosamin DS (Nutramax) and TripleFlex (Nature Made).
? Be patient; it takes weeks to feel an effect, during which time you can gradually wean yourself from your regular arthritis meds (don’t stop cold turkey or without a doctor’s supervision).?Andrea Klausner, M.S., R.D.
For more information, EN recommends the 2004 revised edition of The Arthritis Cure.
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