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Glucosamine and Chondroitin for Arthritis

Arthritis is a degenerative disease in the joints, causing pain, inflammation and limitation of movement. Osteoarthritis is one of the most widespread types of arthritis. It affects the body by wearing down the cartilage between the joints. Although there is no known cure for this disease, many people have been turning to supplements in an effort to relieve the pain and hopefully slow the effects of osteoarthritis.

Glucosamine and Chondroitin are both naturally occurring substances in the body. Glucosamine (glue-COSE-a-mean) affects the cartilage by being one of the major "building blocks" for the large molecules in cartilage called proteoglycans. These proteoglycans attract and hold the water necessary to lubricate the cartilage, which in turn acts as a cushion between the bones. Chondroitin (con-DROY-tin) is a molecule shaped like a long chain. The chain acts as a "sweeper" to bring nutrients into the proteoglycans, giving it the "elasticity" needed for joint movement. It also acts somewhat as a preventative against certain enzymes that would break down the cartilage that leads to the pain and inflammation of bone rubbing against bone.

Glucosamine and Chondroitin supplements are used in replace of traditional over the counter pain medications (i.e. aspirin and ibuprofen) for relief, and as an anti-inflammatory treatment to help increase mobility.

Studies have been done for years on the effects of Glucosamine and Chondroitin supplements in osteoarthritis sufferers. In fact, the Institute of Medicine and National Academies shows treatments dating back to the 1960's in Europe, using glucosamine as an injection for the treatment of arthritis.
More recently, a study was published in the March 15, 2000 Journal of the American Medical Association (JAMA) listing the findings of a review of studies done over the past 3 decades. Using a very stringent guideline (i.e. length of usage, placebo-control, double-blind studies, etc.), the findings showed an overall moderate effect on the symptoms of Osteoarthritis. In 2001, the Lancet published the results of a 3 year clinical trial showing similar results. All publications stress the need for further trials and studies and also encouraged caution in the overuse of any supplement as a "miracle drug."
However, grudging admission was given that as a supplement, the use of Glucosamine and Chondroitin were at least moderately effective on the symptoms and pain of osteoarthritis.

Because Glucosamine and Chondroitin are sold as "dietary supplements", they do not fall under the jurisdiction of the FDA, so careful research of individual products is suggested. The Consumer Reports guide from 2001 evaluated over 19 products and reported most "delivered at least 90 percent" of what was promised on the label. Most common side effects have been abdominal gas and diarrhea. One caution to diabetics: animal studies have shown the possibility of increased insulin resistance with glucosamine use. Although no human studies have substantiated that risk yet, diabetics should carefully monitor blood-sugar levels if using this supplement. Also, both glucosamine and chondroitin supplements are made from animal products, including shellfish, so again, careful research and monitoring are encouraged.

Talk to your doctor or pharmacist for suggestions or guidelines. Don't stop current treatments, supplements may take a few months before showing any results. Do your research. Make sure that the manufacturer of the Glucosamine/Chondroitin supplement you are considering is producing a quality product.

Sources
Stenlake, Richard, compounding chemist. How does Glucosamine and Chondroitin Work?
Barrett, Stephen, M.D. Glucosamine for Arthritis
Glucosamine and chondroitin for treatment of osteoarthritis: A systematic quality assessment and meta-analysis. JAMA 283:1469-1475, 20