by Jackie Hart, MD
Q: Does the dietary supplement glucosamine sulfate or anything else really work to rebuild cartilage?
A: Cartilage is soft tissue located between joints that provides resilience for the bones to absorb shock with motion and impact and protects the bones from grinding against one another, which can cause damage. As we age, we lose cartilage at different rates; a certain degree of loss is called osteoarthritis. The development of osteoarthritis translates into pain and loss of mobility. There are other types of arthritis, but it is osteoarthritis for which the glucosamine and chondroitin supplements are touted.
Glucosamine is a substance found naturally in cartilage; chondroitin, another frequently discussed substance, is also found in the cartilage. Both are available as dietary supplements.
Glucosamine sulfate, the form of glucosamine most commonly studied to date, stimulates the production of substances known as proteoglycans; these are necessary for keeping the matrix of joint cartilage intact. So, the short answer is yes, glucosamine does seem to rebuild cartilage. Chondroitin sulfates, frequently taken with glucosamine, also provide necessary substrates for a healthy joint matrix. It is unclear, however, whether any additional benefit is gained from taking chondroitin with glucosamine; studies to date have looked primarily at either glucosamine or chondroitin alone and each one shows some individual promise for improvement of arthritis.
The goals for treating osteoarthritis are to reduce pain and to improve mobility. There have been many studies dating back to the early 1980s comparing glucosamine sulfate to placebo and to anti-inflammatory drugs, which are the standard treatment prescribed by Western physicians to alleviate arthritis pain. Most of these trials, all conducted in either Europe or Asia, have shown glucosamine to reduce pain, improve mobility, and increase activity levels for many arthritis patients. When compared to anti-inflammatories, glucosamine generally does not alleviate pain as quickly, but it may provide longer-lasting pain control in some people. Plus, there are fewer potential risks and side effects, such as ulcers and bleeding, from glucosamine than from anti-inflammatories.
Glucosamine sulfate does not work for everyone, but it may be worth a try because of the potential side effects of anti-inflammatories. The recommended dose of glucosamine is 1500 milligrams per day in two to three divided doses. Glucosamine is metabolized quickly, so if you can find a time-release version, that may be better. The potential side effects, which happen rarely and often dissipate after several weeks, include stomach upset, headache, and drowsiness.
Some new and exciting developments in the treatment of osteoarthritis include a second generation of anti-inflammatories that do not seem to cause the same risks as traditional anti-inflammatories. These new drugs, called Cox-2 inhibitors, are expensive, however, and not appropriate for everyone. Plus, anti-inflammatories only treat the symptoms of osteoarthritis, while glucosamine may work more on the root of the problem.
Also new and exciting is that the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) has awarded the University of Utah a $6.6 million, four-year grant to study the effects of glucosamine and chondroitin on knee osteoarthritis. This will be the first long-term, large-scale study of these supplements and the first in the United States. The researchers are hoping to recruit more than 1,000 participants for research slated to begin after the first of the year.
Q: Does the dietary supplement glucosamine sulfate or anything else really work to rebuild cartilage?
A: Cartilage is soft tissue located between joints that provides resilience for the bones to absorb shock with motion and impact and protects the bones from grinding against one another, which can cause damage. As we age, we lose cartilage at different rates; a certain degree of loss is called osteoarthritis. The development of osteoarthritis translates into pain and loss of mobility. There are other types of arthritis, but it is osteoarthritis for which the glucosamine and chondroitin supplements are touted.
Glucosamine is a substance found naturally in cartilage; chondroitin, another frequently discussed substance, is also found in the cartilage. Both are available as dietary supplements.
Glucosamine sulfate, the form of glucosamine most commonly studied to date, stimulates the production of substances known as proteoglycans; these are necessary for keeping the matrix of joint cartilage intact. So, the short answer is yes, glucosamine does seem to rebuild cartilage. Chondroitin sulfates, frequently taken with glucosamine, also provide necessary substrates for a healthy joint matrix. It is unclear, however, whether any additional benefit is gained from taking chondroitin with glucosamine; studies to date have looked primarily at either glucosamine or chondroitin alone and each one shows some individual promise for improvement of arthritis.
The goals for treating osteoarthritis are to reduce pain and to improve mobility. There have been many studies dating back to the early 1980s comparing glucosamine sulfate to placebo and to anti-inflammatory drugs, which are the standard treatment prescribed by Western physicians to alleviate arthritis pain. Most of these trials, all conducted in either Europe or Asia, have shown glucosamine to reduce pain, improve mobility, and increase activity levels for many arthritis patients. When compared to anti-inflammatories, glucosamine generally does not alleviate pain as quickly, but it may provide longer-lasting pain control in some people. Plus, there are fewer potential risks and side effects, such as ulcers and bleeding, from glucosamine than from anti-inflammatories.
Glucosamine sulfate does not work for everyone, but it may be worth a try because of the potential side effects of anti-inflammatories. The recommended dose of glucosamine is 1500 milligrams per day in two to three divided doses. Glucosamine is metabolized quickly, so if you can find a time-release version, that may be better. The potential side effects, which happen rarely and often dissipate after several weeks, include stomach upset, headache, and drowsiness.
Some new and exciting developments in the treatment of osteoarthritis include a second generation of anti-inflammatories that do not seem to cause the same risks as traditional anti-inflammatories. These new drugs, called Cox-2 inhibitors, are expensive, however, and not appropriate for everyone. Plus, anti-inflammatories only treat the symptoms of osteoarthritis, while glucosamine may work more on the root of the problem.
Also new and exciting is that the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) has awarded the University of Utah a $6.6 million, four-year grant to study the effects of glucosamine and chondroitin on knee osteoarthritis. This will be the first long-term, large-scale study of these supplements and the first in the United States. The researchers are hoping to recruit more than 1,000 participants for research slated to begin after the first of the year.