Question:
I have read a lot of your information on glucosamine and
chondritin and its use in alleviating symptoms of osteoarthritis. I
myself take a glucosamine and chondritin supplement as I am a
marathon runner and triathlete. Would this be recommended in
general, or are true effects only seen in people with
osteoarthritis? I have a few clients who are also taking this and
would like to know if they are just wasting their money or if it is
really helping them. Also, newer versions of the supplement contain
MSM. What is this supposed to do, and how does it coincide with
glucosamine? Thanks for your help.
Answer:
As you probably know, glucosamine sulfate is a naturally produced
compound that is involved in the production and maintaining of
cartilage. It’s also a very popular dietary supplement, used by
millions to treat the pain associated with osteoarthritis. In
osteoarthritis, the joint cartilage is damaged or worn away, which
results in pain. Before I address your question, let me first tell
you something that many people are not aware of. There is more than
one type of glucosamine available to consumers. Specifically, three
types are typically found in supplements: glucosamine sulfate,
glucosamine HCL and NAG (N-acetyl-glucosamine). Of these three,
glucosamine sulfate has the most evidence in support of its use for
osteoarthritis. I suggest you look at your supplement to see which
version you are taking. Now, let’s address your question.
Many studies over the past several years do find that glucosamine
sulfate can help reduce the pain and stiffness associated with
osteoarthritis. Most studies involved glucosamine helping treat
osteoarthritis of the knee. As a marathon runner, this is good news
for you. Other areas of the body may also be helped, but the knee is
most often looked at in research.
Usually four to eight weeks of glucosamine treatment is needed
before significant pain reduction is noticed. This also depends on
the severity of osteoarthritis as well. In other words, less severe
cases may notice relief sooner. Conversely, some research finds that
in very severe cases of osteoarthritis, glucosamine may not help at
all. The pain relief associated with glucosamine does not appear to
be related to the placebo effect. In other words, glucosamine has
been shown to reduce pain more than when using nothing at all.
It’s also important to mention that glucosamine appears to only
be effective for the most common type of arthritis: osteoarthritis.
This supplement does not seem to help other types of this disorder.
Because of its effects on arthritis, some may take glucosamine to
help ward off arthritis before it starts. This I think was at the
heart of your question. While glucosamine sulfate does not yet
appear to re-grow cartilage, I feel one of the most intriguing
things about this supplement is new research, which is hinting that
this may actually slow the progression of osteoarthritis. In other
words, glucosamine may help you hold on to your joint cartilage
longer if you have osteoarthritis. So far though, there is no solid
evidence that glucosamine sulfate can help reduce osteoarthritis
from occurring in people who subject their joints to repeated
trauma, like running marathons. This study would be difficult to do
and would require many years, if not decades. Nevertheless, given
its possible effects on helping one maintain joint cartilage, for
athletes like you, glucosamine sulfate may be something to
consider.
Some glucosamine products combine it with another popular
supplement called chondroitin sulfate. Chondroitin sulfate also has
some research that it may help reduce osteoarthritis, but it is less
than that of glucosamine. Some add the two together because of the
thought that they might provide a broader spectrum of benefits than
either would alone. However, research so far has not conclusively
shown that glucosamine plus chondroitin is better than glucosamine
alone.
Glucosamine sulfate appears to be safe with no significant side
effects. Because it is a sugar bonded to an amino acid, some have
speculated that glucosamine might interfere with blood sugar levels.
This might be an issue for diabetics and those with heart disease.
Some research shows that glucosamine does not impact blood sugar
levels but, to be on the safe side, diabetics and persons with heart
disease should consult their endocrinologist and/or cardiologist
before experimenting with this supplement.
The other product you mentioned was MSM. This is the downstream
metabolic byproduct of DMSO, a once popular but now illegal
arthritis treatment in the 1970s. MSM is also found in small amounts
in various fruits and vegetables. Like chondroitin mentioned
previously, some arthritis-related supplements include MSM. Again,
the thought was that the combination would be more effective than
glucosamine alone. There is some research that MSM in conjunction
with glucosamine can mildly help osteoarthritis of the knee;
however, the evidence in support of MSM is less than that of
glucosamine. Whether MSM plus chondroitin plus glucosamine is more
effective than glucosamine alone is also not well known. If I had to
choose, I’d pick glucosamine over MSM or chondroitin. If no
significant reduction in pain is noticed after four to eight weeks,
try switching to another brand of glucosamine sulfate.
I hope that helps.
References:
- Cannon, Joe (2006). Nutritional Supplements: What Works and
Why. A Review from A to Zinc and Beyond. www.Joe-Cannon.com
- Kim LS, Axelrod LJ, Howard P, et al. Efficacy of
methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a
pilot clinical trial. Osteoarthritis Cartilage 2006;14:286-94.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects
of glucosamine sulfate on osteoarthritis progression: a
randomized, placebo-controlled trial. Lancet 2001;357:251-6.
- Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine
therapy for treating osteoarthritis. Cochrane Database Syst Rev
2005;(2):CD002946.