What Do Experts Recommend
The American Academy of Orthopedic Surgeons advises against using supplements like glucosamine sulfate, chondroitin sulfate, and glucosamine hydrochloride to treat symptomatic knee osteoarthritis.
Glucosamine chondroitin and other supplements that are advertised to improve joint health can be confusing and misleading because these products do not have to go through the rigorous testing that pharmaceutical drugs do.
That means that the recommended dose of a glucosamine chondroitin supplement is not backed up by as much research evidence as a prescription medication would be.
If you take too little glucosamine chondroitin, you will not get the potential benefits and are probably wasting your money. If you take too much glucosamine chondroitin, you might be more likely to have side effects.
What Are Glucosamine And Chondroitin
Glucosamine and chondroitin are structural components of cartilage, the tissue that cushions the joints. Both are produced naturally in the body. They are also available as dietary supplements. Researchers have studied the effects of these supplements, individually or in combination, on osteoarthritis, a common type of arthritis that destroys cartilage in the joints.
Cartilage is the connective tissue that cushions the ends of bones within the joints. In osteoarthritis, the surface layer of cartilage between the bones of a joint wears down. This allows the bones to rub together, which can cause pain and swelling and make it difficult to move the joint. The knees, hips, spine, and hands are the parts of the body most likely to be affected by osteoarthritis.
For more information about osteoarthritis, visit the National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site at www.niams.nih.gov. For more information on complementary health approaches for osteoarthritis, see the National Center for Complementary and Integrative Health fact sheet Osteoarthritis and Complementary Health Approaches.
Does Glucosamine Help Knee Pain
May 24, 2016
You’ve seen the commercials advertising the natural supplements glucosamine and chondroitin to reduce joint pain, and maybe you’ve wondered: Could these claims be true?
Researchers wondered the same thing, leading to numerous studies examining the results of these supplements in patients. Although the research results are somewhat mixed, there appears to be little evidence that these supplements help reduce pain and swelling for people with osteoarthritis. A review of 10 different studies in the British Medical Journal showed no evidence that glucosamine supplements reduce inflammation.
“While some of my patients have had improved symptoms of arthritis, which they attribute to glucosamine, the evidence and my experience suggest that in the end, a significant expense has yielded little relief to most patients,” says Dr. Jeremy McCandless, an orthopedic surgeon affiliated with Sharp Coronado and Sharp Grossmont hospitals.
Glucosamine and chondroitin are both naturally occurring substances found in joints and connective tissue, and help create the tissue that forms cartilage. In patients with osteoarthritis, that cartilage wears away, reducing the padding in joints such as knees, hips and shoulders, which results in pain and stiffness.
“Arthritis is disabling and people are desperate. Supplements like glucosamine fill a void by providing hope to patients. Unfortunately, it is largely false hope,” says Dr. McCandless.
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What Do Glucosamine And Chondroitin Sulfate Do
A number of well designed clinical studies have been done mostly in Europe to determine the effectiveness of glucosamine and chondroitin, and the results are mixed. Several studies have demonstrated some degree of pain relief and improved joint function in people with mild to moderate OA who took these supplements. Other studies have shown no benefit at all.
In studies where the supplements were reported to work, results showed they provided pain relief at a level similar to that of nonsteroidal anti-inflammatory drugs , such as ibuprofen and naproxen sodium . However, more recent studies performed in North America and the United Kingdom havent confirmed these benefits.
Two studies performed by a manufacturer of glucosamine sulfate supplements suggest that glucosamine sulfate may be helpful for not only relieving pain but also for slowing cartilage loss in people with knee OA. Two studies performed by another manufacturer have suggested that chondroitin sulfate may slow cartilage loss in people with knee OA.
The National Institutes of Health recently completed the Glucosamine/Chondroitin Arthritis Intervention Trial , a long-term clinical study of glucosamine hydrochloride and chondroitin sulfate in people with OA of the knee. The study looked at two specific issues: whether glucosamine and/or chondroitin could treat the pain of OA in the knee, and whether the dietary supplements could help reduce damage and slow the breakdown of cartilage surrounding the knee.
What Is The Recommended Dose
- Glucosamine sulfate: 1500mg per day
- Glucosamine hydrochloride: 1500mg per day
- Chondroitin sulfate: 800 1000mg per day
Different brands contain different amounts of glucosamine and chondroitin. Read the label carefully to see how many tablets you need to take to get the right dose, or ask your pharmacist for advice.
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Risk Factors For Hand And Finger Arthritis
According to Dr. Newsum, finger or hand arthritis can occur years after of an old injury, but most of the time, it affects people age 50 and older.
If you do, however, its important to get medical help to find your path toward relief.
Other factors that can increase your risk of arthritis in your hands and fingers include:
- Enlarged bumps at the fingers knuckles
Its also important to distinguish between the different types of hand or finger arthritis.
Dr. Newsum explains, Osteoarthritis affects the middle knuckles and knuckles near the nails and can appear as large bumps on the knuckle, which are bone spurs that are caused from bone rubbing on bone when the joint moves.
Rheumatoid arthritis, on the other hand, is an autoimmune disease that attacks tendons, ligaments, the joint lining and bones.
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What Do We Know About The Safety Of Glucosamine And Chondroitin Supplements
- Studies have found that glucosamine and chondroitin supplements may interact with the anticoagulant drug warfarin . Overall, studies have not shown any other serious side effects.
- If you take glucosamine or chondroitin supplements, tell your health care providers. They can do a better job caring for you if they know what dietary supplements you use.
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How Should Glucosamine And Chondroitin Sulfate Be Taken
Its recommended that you take the amount that has been used in most clinical studies, which is 1,500 milligrams of glucosamine and 1,200 mg of chondroitin sulfate daily. As a general rule, take the dose recommended on the bottle because tablet concentrations of the supplements may vary from brand to brand.
Some physicians may recommend that glucosamine be taken as a single 1,500 mg dose at one time, rather than dividing the dose during the day. If that relieves your symptoms, you may be able to gradually decrease the amount you take after a few months. Your doctor may also suggest that glucosamine and chondroitin sulfate be taken together for maximum benefit.
The length of time necessary to evaluate the supplements effect is generally a minimum of six to eight weeks, however a full trial of 12 weeks may be necessary. During this time, you should take the supplements with your current medications. If theres improvement in your pain, talk to your doctor about decreasing or stopping your other medicines for a while to see if there is a change in pain and stiffness levels.
If you dont notice any difference in your symptoms after taking the supplements for three to six months, you probably will not get any relief and should discontinue use. Some people may get some relief by using the supplements, but they may still have to take their other medications for full relief.
Finger Or Hand Arthritis These 5 Nonsurgical Treatments May Help
Hand or finger arthritis can limit your ability to live your best, active life. And if you cant open a jar, grip your grocery bags or write a letter to a loved one without wincing in pain, it might be time to seek some solutions that may help. Many of these treatments are even safe and effective without surgery.
In fact, Nicholas J. Newsum, MD, board-certified orthopedic surgeon with fellowship training in hand, wrist, elbow and microsurgery, spoke to us about these five nonsurgical treatments for hand and finger arthritis.
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What Are Glucosamine And Chondroitin Made Up Of
Glucosamine and chondroitin are cartilage components that the body naturally produces. By supplementing the cartilage tissue, discomfort and swelling in the joints that are most prone to be affected by osteoarthritis can be lessened. Also, this can prevent the breakdown of connective tissues.
Chondroitin is derived from the cartilage of cow tracheas, whereas glucosamine is derived from shellfish shells . Their chemical composition is similar to cartilage molecules, and their manufacturers claim that they help worn cartilage. However, medical experts and researchers are skeptical about their benefits.
Australian Rheumatology Association And Arthritis Australia Statement Regarding The Use Of Glucosamine For The Treatment Of Osteoarthritis
Recent media reports have raised concern over the use of glucosamine in the treatment of osteoarthritis. These reports appear to be based on two unrelated recent events:
In October 2019 the ACR updated their guidelines for the management of osteoarthritis from a longstanding conditional recommendation against the use of glucosamine for osteoarthritis , to a strong recommendation against the use of glucosamine for osteoarthritis . They did not cite new safety concerns.
This paper reviewed 366 glucosamine related adverse drug reactions reported to the Therapeutic Goods Administration between 2000-2011, including 43 classified as severe, possibly related to the known risks of glucosamine in those with shellfish allergy. This highlights a valid concern but the number of adverse events needs to be considered in the context of the many hundreds of thousands of people who took glucosamine during that period. This suggests that severe adverse reactions are very uncommon.
Many other osteoarthritis treatment guidelines make conditional recommendations against the use of glucosamine on the basis that it probably does not help, including The Royal Australian College of General Practitioners guideline for the management knee and hip OA .
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More Study Needed But A Positive Beginning
I think this is an interesting study, which will hopefully lead to a new interventional option for patients who havent had satisfactory results from conventional therapy alone. We know placebo effect is high with glucosamine, yet we can account for this with novel questionnaires to address individual patient beliefs. I will be interested to see additional longer-term studies showing sustained benefit and safety while accounting for the placebo effect. This study shows it is safe, effective, and may be a good option for patients in addition to therapy. Or maybe we can eventually try glucosamine sulfate prior to NSAIDs or acetaminophen, which have reported side effects, says Dr. Botto-van Bemden.
What Is The Role Of Glucosamine And Chondroitin Sulfate In The Treatment Of Osteoarthritis
Glucosamine and chondroitin sulfate have been used in Europe for many years and continue to be popular with patients worldwide. In the United States, however, the glucosamine/chondroitin arthritis intervention trial reported, at best, limited benefit from glucosamine , chondroitin sulfate , or the combination of the 2 in patients with knee osteoarthritis.
In GAIT patients overall, glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively at 24 weeks, but in patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo . At 2 years, no treatment achieved a clinically important difference in loss of joint-space width, though treatment effects on Kellgren-Lawrence grade 2 knees showed a trend toward improvement relative to the placebo group.
The AHRQ comparison found no clear difference between glucosamine or chondroitin and oral NSAIDs for relieving pain or improving function. However, the AHRQ observed that most trials showing therapeutic benefits from glucosamine used pharmaceutical-grade glucosamine that is not available in the United States, noting that the trial findings may therefore be inapplicable to currently available over-the-counter preparations.
Osteoarthritis Fact Sheet. Centers for Disease Control and Prevention. Available at . January 10, 2019 Accessed: February 7, 2020.
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Glucosamine And Chondroitin Supplements
A 2010 trial of 662 people with knee osteoarthritis published in the Annals of the Rheumatic Diseases did find that these supplements relieved pain for some peoplebut over time they were no more effective than a placebo. And more recently, a study of 1,625 people published in the journal Arthritis & Rheumatology in 2015, found that using glucosamine and chondroitin over a four year period did not relieve knee pain or prevent cartilage loss in people with osteoarthritis any better than a placebo. The American Academy of Orthopaedic Surgeons does not recommend these supplements for osteoarthritis of the knee.
Foods That Help Reduce Arthritis Pain
Vegetables, fruits and whole grains provide antioxidants that may ease the pain and swelling of arthritis, an inflammation of the joints. Also helpful are omega-3 fatty acids , which the body converts to anti-inflammatory compounds. Fat eight to 12 ounces weekly of fish rich in omega-3s, such as salmon, mackerel and sardines. Limit polyunsaturated fats, such as corn oil and safflower oil, which are high in omega-6 fatty acids, substances converted in the body into compounds that promote inflammation. Also limit your intake of saturated fat, found primarily in meat and dairy products, because these unhealthy fats may increase inflammation.
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Dont Invest In Otc Supplements Before You Read This First
Theres something appealing about being able to help manage a chronic illness with so-called natural remedies like vitamins and minerals. That explains why theres no shortage of natural remedies marketed to people with rheumatoid arthritis and other forms of inflammatory arthritis.
There is a shortage, however, of solid scientific evidence to support whether or not you should take certain supplements. Will they actually help improve arthritis symptoms? Could they interact with other medications you take? Or might they potentially have negative side effects of their own?
Herbal supplements in particular concern me because theyre marketed using testimonials and not on any clinical data, says William Davis, MD, the chair of rheumatology at Oschner Health System in New Orleans and a fellow of the American College of Physicians and the American College of Rheumatology. As a physician, its my role to recommend treatments where theres a higher understanding of risks and benefits.
There are, however, certain vitamins and minerals that research shows can be an essential part of treatment for many patients with inflammatory arthritis. We asked Dr. Davis which ones you may need as part of your recommended treatment plan, as well as which natural remedies may show the most promise in helping with pain relief.
Glucosamine and chondroitin are two popular supplements said to help manage joint pain.
Who Should Take Glucosamine/chondroitin Sulfate
Many patients who suffer from osteoarthritis may benefit from the positive effects of taking this supplement. The painful symptoms of osteoarthritis may appear when cartilage becomes worn, and exposed bones begin to rub together. Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis. Traditional medical treatment includes drug therapy to control the pain associated with osteoarthritis. These treatments are sometimes disappointing for physicians and patients because medications may not provide complete relief and can have unwanted side effects. Some of these patients may be candidates for nutritional supplements like glucosamine and chondroitin sulfate.
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What Are The Dosages Of Glucosamine And Chondrotin
The typical daily dose is 1,500 mg of glucosamine and 1,200 mg of chondroitin sulfate, either all at once or in divided doses. For heavier individuals, this can be increased to 2,000 mg of glucosamine and 1,600 mg of chondroitin.
Effectiveness of glucosamine and chondroitin
The effects of glucosamine and chondroitin may not be noticeable for at least six to eight weeks, and their benefits become apparent in about four to six months. If no benefit is seen after six months, the supplement should be discontinued.
For Other Parts Of The Body
Only a small amount of research has been done on glucosamine and chondroitin for osteoarthritis of joints other than the knee and hip. Because there have been only a few relatively small studies, no definite conclusions can be reached.
- Chondroitin for osteoarthritis of the handA 6-month trial of chondroitin in 162 patients with severe osteoarthritis of the hand showed that it may improve pain and function.
- Glucosamine for osteoarthritis of the jawOne study of 45 patients with osteoarthritis of the jaw showed that those given glucosamine had less pain than those given ibuprofen. But another study, which included 59 patients with osteoarthritis of the jaw, found that those taking glucosamine did no better than those taking a placebo .
- Glucosamine for chronic low-back pain and osteoarthritis of the spineA Norwegian trial involving 250 people with chronic low-back pain and osteoarthritis of the lower spine found that participants who received glucosamine fared the same at 6 months as those who received placebo.
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What Can I Do To Relieve Aching Joints
- Exercise – a great way to strengthen the muscles around your joints and in turn reduce joint pain
- Eat a healthier diet it has been said that joint pain such as arthritis can be eased with a healthy diet packed with vitamins for joint health like omega-3, vitamin D and C. If you are looking to lose weight, this can also really help ease pressure and pain on your joints
- Use pain relief gel Anti-inflammatory gels such as Flexiseq are specially formulated to ease joint pain and reduce stiffness
- Use anti-inflammatory cream – applied topically to skin, these creams can help to relieve joint pain
- Try supports – If you experience joint pain when exercising, you can use straps or supports to ease pain. Find out more about looking after your joints when you exercise here
- Take joint health supplements supplements such as glucosamine and chondroitin are said to help ease joint stiffness and pain
- Try over the counter pain remedies Ibuprofen, including flarin can help to relieve swelling around the joints, as well as easing stiffness and reduce your pain
- Lose weight – did you know that every pound of excess weight exerts around 4 pounds of extra pressure on your knees? If you would like to know more about how to begin losing weight and perhaps alleviate your knee joint pain, read our healthy weight loss guide