Glucosamine and Chondroitin

Glucosamine and chondroitin have been shown to have some beneficial effects on osteoarthritic joints, and so may be worth trying if you have this kind of joint problem.You can try this type of product by clicking on the image for this liquid form of glucosamine, said to have a much faster and more complete uptake than capsules.

Osteoarthritis (OA) is the most widespread type of arthritis, a degenerative condition of the joints. Acute inflammation is uncommon in OA and it is mostly a “wear-and-tear” disease involving degeneration of joint cartilage and the formation of bony spurs in various joints.

Joint trauma, repetitive joint stresses in jobs, and obesity are risk factors. OA is very common over 60 years of age, but not always troublesome.

You will have seen advertising and promotion of glucosamine and chondroitin as a treatment for OA.

What are these substances?

Glucosamine, an amino sugar, is a natural substance made by your body, an essential building block of joint cartilage, ligaments, bones and blood vessels, and is thought to promote the formation and repair of cartilage.

Chondroitin, a carbohydrate, is a natural cartilage component linked to levels of water retention and elasticity and to the inhibition of enzymes that break down cartilage. Both compounds are manufactured by the body.

You can buy both these dietary supplements as tablets from your local health food shop or chemist and they are often taken together.

What does the research say?

Glucosamine may stimulate the production of cartilage-building proteins and chondroitin may inhibit the production of cartilage-destroying enzymes and fight inflammation. The shells of shellfish are the source of glucosamine, while chondroitin supplements are extracted from the cartilage of cows.

Studies on people have shown that both may relieve arthritic pain and stiffness with fewer side effects than conventional arthritis drugs. However, there isn’t enough good research to know whether their use is sensible. The manufacture of these kinds of supplements is not regulated and product quality, especially of chondroitin products, is not predictable.

So, does glucosamine and chondroitin work?

We don’t really know as there isn’t any convincing evidence that glucosamine or chondroitin help to ease the symptoms of osteoarthritis. There is some weak evidence that glucosamine, or a combination of glucosamine and chondroitin, might be helpful and no evidence that taking chondroitin on its own is helpful.

Glucosamine may help by reducing pain and stiffness rather like a non steroidal anti-inflammatory drug (NSAID) and some trials have shown that glucosamine, or glucosamine plus chondroitin, can help to control the symptoms of osteoarthritis. However, these trials have faults in them which make the results unreliable. So it is difficult to be sure whether these treatments work or not.

Just keep in mind that there isn’t any definite proof (or even good evidence) that either of these supplements is useful in treating osteoarthritis.

Products

In the US, glucosamine and chondroitin products are marketed as “dietary supplements”. Glucosamine is available in many forms, including glucosamine sulfate, glucosamine hydrochloride (HCl), and N-acetylglucosamine (NAG), and have various other contents. However, there appears to be no conclusive evidence that one form is better than another.

The safety of the substances

No serious side effects from either glucosamine or chondroitin have been found in the trials to date.

Do the experts agree?

The use of these agents is thought to be reasonable but more research is needed to place them in their proper roles. There is disagreement about how practical or sensible it is to use them now.

Is there a bottom line?

It is difficult to make a decision about using these agents because the information is far less convincing than desirable. Quality control of the products is also a significant problem, with the chemical makeup varying with different brands.

It’s not clear whether they actually do work at all but they could help the body make new joint cartilage and to repair damaged cartilage.

What should you do?

• Get a concrete diagnosis from a competent physician.
• Discuss the benefits and potential risks with your physician
• If you decide to try the compounds, ask your physician for guidance on dosage/frequency etc.
• Get your doctor’s help, or the help of Consumer reports or Consumerlab.com, in choosing a product.
• Ignore all “miracle cure” claims for arthritis. Anything that seems too good to be true, is.
• Don’t buy products in response to junk mail, tv or other advertising, and check carefully for price and good value. It won’t be cheap, even if it helps.
• Do not trust any seller of dietary supplements, herbs, or homeopathic remedies to give you impartial advice about whether you should use their products.

You want to see the evidence?

Go to Best Treatments and Clinical Evidence and put “glucosamine” or “chondroitin” into the search boxes. Both these useful sites give reference lists to the medical evidence.

ConsumerLab is a very useful site, with analysis of all the evidence and also of the products. Some products don’t have any of the substance in them that they claim to have!

If you’d like to think about the issues and make an informed decision, the US Food and Drug Administration Centre for Food Safety and Applied Nutrition has issued a document Tips for the Savvy Supplement User: Making Informed Decisions And Evaluating Information which may be of interest.