All Posts tagged glucosamine sulfate

Nutritional Supplements for Osteoarthritis

There are a number of nutritional supplements that have been proven to help with the symptoms of osteoarthritis.  If you suffer from osteoarthritis, I hope these supplements may give you some relief.

Vitamin C supplementation can help counter the wearing away of cartilage.  Vitamin C is used throughout the body to manufacture a variety of tissues, including collagen.  Collagen forms a network of protein fibers that lay down the structural foundation for many tissues, including cartilage, bone, tendons and muscles, all necessary to keep joints strong and operating smoothly.  One study by the University of New York at Stony Brook found that vitamin C encourages the growth of cartilage cells by stimulating synthesis of these cells’ genetic material.  The recommended dosage is 3,000-10,000mg daily in divided doses.  High doses of vitamin C can lead to diarrhea so gradually start taking it until you see how sensitive you are to it.

Vitamin E supplementation can provide some pain relief.  Vitamin E fights inflammation by neutralizing the biochemicals that are produced during inflammation.  These biochemicals, which are released by immune cells, contain free radicals that can damage your cells.  Vitamin E acts as an antioxidant which protects the cells from the free radicals.  In a study by Israeli researchers, people with osteoarthritis who took 600 IU of vitamin E per day for 10 days had significant reduction in pain compared to those not taking vitamin E.  The recommended dosage is 400-600 IU/day.  You can also supplement with selenium, a mineral that increases the effectiveness of vitamin E in an amount of about 200 micrograms a day.

Vitamin B12 can help build up bones.  A few years ago researchers at the University of Southern California School of Medicine in Los Angeles discovered that B12 stimulates cells in the bone that generate new bone.  This could be important to people with osteoarthritis because underneath the degenerating cartilage, the bone also deteriorates, causing additional pain and further cartilage erosion.  This led researchers at the University of Missouri in Columbia to try giving B12 to people with osteoarthritis in their hands.  They found that people who took 20 micrograms of B12 and 6,400 micrograms of folic acid (another B vitamin that works in concert with B12) for two months had fewer tender joints and better hand strength and took less medicine for pain that people not getting this B vitamin combo.

Niacinamide can also help osteoarthritis.  Niacinamide is a form of niacin, one of the B-complex vitamins.  Niacinamide is often recommended as an alternative to n iacin because it produces fewer side effects.  Some nutrition-oriented doctors have been recommending nicinamide for osteoarthritis since the 1940s, when it was found to be helpful in relieving swelling and joint pain and improving muscle strength.   Improvement is usually noticeable after the first few weeks and becomes even more pronounced with continued treatment.  Very severely damaged arthritis joints respond slowly or don’t respond at all.  If you decide to try niacinamide for osteoarthritis, make sure you do so under medical supervision.  Treatment requires dosages of 500 mg twice a day to 1,000 mg three times a day.  Any dosage of 1,500 mg/day or more has the potential to cause liver problems.  Blood tests for liver enzymes should be performed after three months of treatment and then annually thereafter to make sure there is no liver damage.

Glucosamine and Chondroitin Sulfate have both been proven to help with osteoarthritis.  These supplements give your body the nutrients it needs to build cartilage.  You can see the research behind these supplements in a previous post I wrote on Glucosamine sulfate and chondroitin sulfate.  A few warnings about these supplements:  glucosamine sulfate can raise blood sugar in diabetics.  Chondroitin sulfate can cause bleeding in those taking blood thinners.  Also glucosamine sulfate should not be taken if you are allergic to shellfish because it is derived from the shells of shellfish.

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Glucosamine and Chondroitin Sulfate….Garbage or Gold?

Does Glucosamine and Chondroitin Sulfate really work?  I don’t know a week that goes by in my practice where I don’t get a comment from one of my patients about this supplement.  Some of my patients swear by it and others don’t think it’s worth the breath it takes to talk about it.  So I decided to do some research into the subject to help to clarify things with my patients.

The first article I found in my research was performed by the National Center for Complementary and Alternative Medicine (NCCAM)  and was published in the New England Journal of Medicine. This study showed that the supplement helped those individuals with moderate to severe pain from osteoarthritis of the knee, but did little to improve those with mild pain from the knee arthritis. You can click here to see the link:  http://www.nih.gov/news/pr/feb2006/nccam-22.htm.   Another study that was performed in Canada and published in the Arthritis Research & Therapy journal found that glucosamine and chondroitin sulfate improved some of the bony changes that occur in patients with osteoarthritis.  This shows that the supplements have a positive effect on arthritic joints.

 Another article I read on chiroweb.com stated that Glucosamine sulfate has been the subject of more than 300 scientific investigations and over 20 double-blind clinical studies.   The site cited a recent meta-analysis of glucosamine clinical trials in the treatment of osteoarthritis.  In this meta-analysis there were 13 studies that met the inclusion criteria for double-blind, placebo-controlled trials of greater than four weeks’ duration; using global pain score or the Lequesne index joint as the primary outcome measure and considered the trial positive if improvement in the treatment group was equal to or greater than 25 percent compared with the placebo group.  This meta-analysis revealed that glucosamine supplementation reduced the symptoms and signs of osteoarthritis by 40.2 percent on average, compared with the placebo.

Another study that was performed by Reginster, et al., in 1999 and 2001, published in Arthritis and Rheumatology (1999;42, supplement) and Lancet (2001;357). The three-year randomized study by Dr. Reginster was a large analysis that was placebo-controlled, double-blind, and prospective in nature. It involved 212 patients with knee osteoarthritis. Weightbearing and anteroposterior radiographs of each knee were obtained at one and three years, and joint space width was also measured. Symptom and functional status were scored every four months using the Western Ontario and McMaster University Osteoarthritis index. The two groups had comparable baseline status, but after three years there was no further joint space narrowing in the glucosamine group. The placebo group had further joint space narrowing and objective evidence of disease progression. Subject symptoms worsened in the placebo group, but the group taking glucosamine realized a marked reduction in symptoms of osteoarthritis over the three-year period. The authors concluded that glucosamine sulfate supplementation significantly reduced progression of knee osteoarthritis. Patients in the glucosamine group did not experience any untoward side-effects.

So where does all of this information leave us?  There are a number of studies out there showing glucosamine and chondroitin sulfate supplementation helps reduce the progression of osteoarthritis and does not have any of the side effects that the medications for that condition has.  To me, that’s a significant plus when it comes to dealing with a condition that affects so many and has no known cure.  The main things I tell my patients when they’re considering taking any supplement…make sure the supplement is high quality – not all supplements are made the same.  Supplements are not regulated by the FDA in the U.S. so what’s on the label may not be what’s in the pill.  The best thing is to buy your supplements from a reputable company.  Also, most supplements take at least 3 months to make a difference in your body, so give them time.  With glucosamine and chondroitin sulfate we’re looking for it to make changes to an actual joint – that takes time.   If you have any comments of your own about these supplements, we’d love to hear from you.

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