Structural Effects In Oa
The structural effect of oral glucosamine in knee OA was assessed in double-blind, randomized, controlled trials, lasting at least 1 year and reporting as outcome measures both the symptom severity and the radiological joint space width progression over time . Glucosamine sulphate was found to be more effective than placebo in reducing the rate of joint space narrowing at the tibiofemoral compartment in patients with knee OA, slowing its progression by 54% with NNT of 9 . Although the figures appear very encouraging , they may logically be considered as non-clinically relevant when limiting results to the rate of joint space narrowing compared with placebo, which is only 1/10th of a millimetre per year for placebo and 0.06 mm for glucosamine sulphate over a 3-year period) . Nevertheless these values are not lower than those obtained by Sprifermin which is nonetheless often presented as the next generation chrondroprotector. It is particularly interesting to note that in patients with a high cartilage turnover, demonstrated by a very high level of urinary CTX-II before treatment, Christgau et al. noted a significant decrease in CTX-II levels after 12 months of glucosamine treatment and that the change in this level was predictive of radiologically-visible joint narrowing at 3 years . These data tend to support an effect, admittedly modest, but statistically significant, of glucosamine in secondary prevention of exacerbation of OA of the knee.
Topical Or Oral Nonsteroidal Anti
Dr. Newsum explains that topical over-the-counter anti-inflammatory medications in the form of gels or creams can be even more effective than similar medications taken by mouth.
Since the finger joints are right under the skin, topical anti-inflammatories can deliver the active ingredient quite well and even offer less side effects compared to oral anti-inflammatories.
Though, oral anti-inflammatories can be an effective treatment, too, if needed.
Your doctor can help you determine which is best for you, says Dr. Newsum.
Serious Side Effects Of Glucosamine Chondroitin
There have been concerns that glucosamine chondroitin can cause more serious side effects, but the research has not been conclusive. For example:
- Does glucosamine affect your blood pressure? Taking glucosamine might increase your blood pressure, but it might not. Some people in studies who took glucosamine saw their blood pressure go up. However, in other studies, people taking glucosamine did not have any changes in their blood pressure.
- Can glucosamine cause liver damage? Glucosamine might change liver function but it’s not clear if the supplement actually damages the liver. In some studies, people with chronic liver disease who took glucosamine supplements had some changes in their lab tests that looked at liver function.
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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.
More information
- 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.
What Are The Benefits Of Chondroitin Glucosamine Msm
Chondroitin, glucosamine and methylsulfonylmethane, or MSM, are commonly found, either separately or together as a complex, in supplements marketed for joint health. They are also taken for relieving pain associated osteoarthritis a painful degenerative condition that results in stiff, achy joints. These substances may offer anti-inflammatory and pain-relieving benefits, taken alone or in combination.
What actually is MSM? Methylsulfonylmethane is an organosulfur compound with the formula 2SO2.
Chondroitin Cushions JointsChondroitin is a major constituent of the connective tissue in your body known as cartilage, which helps cushion your joints and prevent your bones from rubbing against each other. Chondroitin absorbs water and other fluids, which helps keep your cartilage hydrated and healthy. Its taken as a supplement to treat osteoarthritis, a form of arthritis that results from the breakdown of cartilage.
Glucosamine and Joint HealthLike chondroitin, glucosamine is produced naturally in your body and plays a role in joint health. It helps build and repair cartilage that connects the joints. Its common to take glucosamine alone or with chondroitin for osteoarthritis. Glucosamine possesses anti-inflammatory properties, and data suggests it may help relieve osteoarthritis pain, according to the American Academy of Orthopaedic Surgeons.
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Are There Side Effects From Glucosamine And Chondroitin Sulfate
The most common side effects of glucosamine and chondroitin sulfate are indigestion and nausea. Diarrhea, constipation, vomiting or heartburn may also occur. Significant adverse events have not been associated with long-term use of glucosamine and chondroitin sulfate. Be sure to talk to your doctor if you notice any unusual or new symptoms while taking glucosamine and/or chondroitin sulfate.
Glucosamine Chondroitin: Uses Benefits Side Effects And Dosage
Glucosamine and chondroitin are two popular supplements said to help manage joint pain.
Despite their widespread use, though, research on glucosamine and chondroitin has showed mixed results. In fact, some studies have shown theyre not effective.
This may leave you wondering whether you should take glucosamine and chondroitin or if youre better off without them.
This article discusses the uses, potential benefits, side effects, and recommended dosage of glucosamine and chondroitin.
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Complementary And Alternative Therapies
Some people with osteoarthritis try complementary or alternative therapies such as acupuncture and aromatherapy and find them helpful.
However, theres a lack of medical evidence to suggest theyre effective and they generally are not recommended by the National Institute for Health and Care Excellence .
Supplements To Avoid With Rheumatoid Arthritis
Certain dietary supplements can interact with your RA medication and lead to bad reactions.
While some dietary supplements can be a great add-on to your treatment plan, others can interact with your RA medications and lead to bad reactions.
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The idea of taking a dietary supplement for rheumatoid arthritis has its appeal. Natural relief from inflammation and joint pain? Check. Fewer daily medications to swallow? Check.
In some cases, supplements can be a great addition to your RA management plan. For example, curcumin, the active ingredient in the spice known as turmeric, has been proven to lessen markers of RA inflammation, according to a review published in August 2018 in the International Journal of Molecular Sciences.
But the reality is that a number of dietary supplements touted for RA relief may actually do more harm than good.
According to the Arthritis Foundation, some supplements can interfere with the way your body processes other medications you might be taking.
Plus, you cant always trust the labels on supplements. The bottle may claim each dose contains a certain amount of active ingredient, but theres no way to know this for sure, as supplements are not regulated the same way conventional food and drugs are by the Food and Drug Administration .
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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.
Results Showed Glucosamine Sulfate To Improve Pain And Function
The research team didnt expect to see any changes until the six-month mark but were surprised to see results after just three months, reporting 18 percent difference in reduction of pain between the study and control group. The only side effects reported by the glucosamine sulfate group were some cases of mild and transient gastrointestinal upset.
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What Does The Research Say
While there have been some claims that glucosamine and chondroitin, either together or separately, can help to reduce pain in people living with OA, these claims are now being questioned. Evidence around the effectiveness of these supplements has always been mixed. However, recent reviews of this evidence now suggest that studies that show positive results may be of low quality and unreliable. Higher quality, independent studies suggest that glucosamine and chondroitin are no better than placebos at reducing pain or slowing the impacts of OA. As a result of this, while glucosamine and chondroitin remain safe for most people, many doctors no longer recommend these supplements as a way of managing arthritis.
To date, there is no evidence that these supplements are effective for any other forms of arthritis.
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.
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What Does It Do
The glucosamine in your body helps keep up the health of your cartilage — the rubbery tissue that cushions bones at your joints. But as you get older, your levels of this compound begin to drop, which leads to the gradual breakdown of the joint.
There’s some evidence that glucosamine sulfate supplements help counteract this effect, although experts aren’t sure how.
Some people have also used glucosamine to try to treat rheumatoid arthritis and other conditions, such as inflammatory bowel disease, asthma, allergies, chronic venous insufficiency, sports injuries, temporomandibular joint problems , and long-term low back pain. So far, though, there’s not much scientific evidence that it works for those problems.
Glucosamine And Chondroitin Reduce Cartilage Loss
There have been a bevy of studies in addition to this new one that show that glucosamine and chondroitin help MRI cartilage findings when taken over many months to years. For example, I blogged on a study a few years ago that showed that chondroitin helped to reduce cartilage loss on MRI. There are other studies for both glucosamine and chondroitin that show this, especially when theyre taken for long periods of time .
Another study shows again that when both are taken together over two years, they slow the progression of arthritis as seen on X rays. The study looked at more than 600 middle-aged and elderly patients who still had a small amount of cartilage and who were randomized to take either supplement alone, the two together, or a placebo. Only the two supplements taken together showed protection of cartilage over the two year period.
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And What About The Downsides
In general, glucosamine and chondroitin are thought to be safe. However, as with any medication, there are potential risks. In some clinical trials, people taking the glucosamine-chondroitin combination have reported
- heartburn or abdominal pain
- allergic reactions .
Another concern is drug interactions, which may be a problem with any combination of medications. For example, chondroitin may interact with blood thinners such as warfarin, so the combination could increase the risk of bleeding.
Check with your doctor or pharmacist before taking glucosamine and/or chondroitin. Many doctors warn patients that the FDA does not regulate supplements such as glucosamine and chondroitin, so they may not contain the amounts stated on the label, or there could be contaminants in them.
And, of course, there is cost to consider health insurance usually doesnt cover these supplements. .
Why Its Important To Trust A Hand And Finger Expert
When youre looking for an expert to guide you to the answers and relief you need, its important to trust a doctor with specialized knowledge and training.
When asked about his expertise and training, Dr. Newsum explained, Two important things to look for in your surgeon are whether they are fellowship-trained and board-certified in their specialty. Meeting the requirements means your doctor has had very specific training in the anatomy, pathophysiology, treatments and the latest nonsurgical surgical techniques to heal a number of conditions that affect the arm, hand and fingers, and that they are up to date on the latest treatments. I focus my time on my specialty exclusively in order to provide evidence-based treatment to both adults and children and deliver expert, compassionate care.
And when asked why he loves to do what he does, Dr. Newsum described two motivating factors: excellent mentors throughout his training and career, and helping people quickly regain their functioning again.
Dr. Newsum concludes, We use our hands for everything, so I get to make an impact in peoples lives that makes a big difference. I really think my specialty and subspecialty reflect the core of values of modern medicine: to reduce pain and restore function.
If youre experiencing pain or stiffness in your fingers or hands, turn to our experts for help. Learn more about AdventHealths Hand to Shoulder Center experts.
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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.
Whats Behind The New Advice To Stop Taking Glucosamine For Arthritis
by Nial Wheate and Joanna Harnett, The Conversation
The Australian Rheumatology Association this week warned people not to take the supplement glucosamine for their osteoarthritis due to possible allergic side-effects.
Whats the evidence behind this latest advice? And do you really need to stop taking it?
How did we get here?
For years, glucosamine has been marketed as a treatment for osteoarthritis, which can occur when the protective cartilage in the joints wears down over time.
This is despite conflicting evidence on whether the supplement works. Yet many patients may buy glucosamine, presuming that even if it doesnt help, at least its natural and so wont do any harm.
But an Australian study, which has been online since last year and was cited in one of this weeks media reports, has given us more information about glucosamines safety.
The study found hundreds of allergic reactions to glucosamine have been reported to Australias medicines watchdog, the Therapeutic Goods Administration .
So is it safe for you to take glucosamine? In short, if it works for you and you havent had any side-effects, and your doctor and pharmacist know you are taking it, it is likely to be safe based on the multiple trials conducted to date.
What is glucosamine?
Whether it works to manage osteoarthritis seems open to debate. The most recent evidence suggests little to no clinical benefit.
Is glucosamine really as dangerous as people say?
Conflicting advice
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