Glucosamine And Chondroitin For Osteoarthritis Pain
Research is mixed on whether these supplements help with OA pain and stiffness, but they are safe to try.
Glucosamine and chondroitin are popular supplements used to treat osteoarthritis . According to one estimate from the National Institutes of Health, 6.5 million adults, or 2.6% of the population, has used one or both of these products. Although studies on glucosamine and chondroitin have been mixed, some evidence suggests they may help relieve OA joint pain and stiffness.
What Are Glucosamine and Chondroitin?
Glucosamine and chondroitin are natural compounds found in healthy cartilage the connective tissue that cushions joints. Supplements are manufactured from the cartilage of animals such as cows, pigs or shellfish, or are made in a lab. Glucosamine is sold in different forms, including glucosamine sulfate and glucosamine hydrochloride. You can buy glucosamine and chondroitin individually, but most often theyre sold together in a single supplement.
In many European countries, these supplements are a prescribed treatment for OA. In the U.S., the recommendations on glucosamine and chondroitin are more moderate, due to the mixed results of studies.
How Do They Work?
Glucosamine and chondroitin protect cells called chondrocytes, which help maintain cartilage structure. In theory, these supplements have the potential to slow cartilage deterioration in the joints, and to reduce pain in the process.
Which Form Is Best?
Are They Safe?
The Bottom Line
Glucosamine Not An Option With Rheumatoid Arthritis
Q. In a recent column, you said that a person should not take glucosamine if they have rheumatoid arthritis but that it was useful for people with osteoarthritis. I have just been diagnosed with rheumatoid arthritis, and my doctor started me on glucosamine and chondroitin immediately. Why is this a problem?
C.P., Coral Springs, Fla.
A. You should talk to your doctor about discontinuing this supplement and trying something else. Let me give you some background. Glucosamine and chondroitin are used to build cartilage within the joints. In osteoarthritis, there is a deficit of cartilage in the joints, so these supplements are helpful. Any supplement that improves the shock-absorbing quality of the joints is useful to an osteoarthritic sufferer. But the most important point here is that osteoarthritis is basically limited to joint degeneration.
People with rheumatoid arthritis have what is called an autoimmune disorder. Its an inflammatory process affecting the entire body. Essentially, something goes wrong and causes the immune system to go berserk. The body suddenly views itself as a foreign substance and launches an attack on itself. The joints bear the brunt of the assault, although the whole body is affected.
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D.G., Round Rock, Texas
Dosage And Side Effects
Generally, glucosamine should be taken with meals three times per day.
Doses usually range from 300500 mg with each meal, adding up to a total daily dose of 9001,500 mg. Most studies used 1,500 mg per day.
Salts of glucosamine sulfate or the Rotta formulation only need to be taken once per day. Make sure to follow the instructions on the packaging.
These supplements are considered safe and no serious side effects have been reported. Flatulence is the most common complaint.
Studies also indicate that glucosamine injections may worsen insulin sensitivity, but supplements do not seem to have the same effect (
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Glucosamine And Chondroitin Together
Though the two can be taken separately, glucosamine and chondroitin are commonly taken as a single supplement. This combination has been more extensively studied.
A 2015 2-year double-blind, randomized study showed no differences in pain or joint space narrowing a sign of cartilage deterioration after taking either 1,500 mg/day of glucosamine sulfate, 800 mg/day of chondroitin sulfate, a combination of both, or a placebo .
Similar results were observed in a 2018 analysis, where combined glucosamine and chondroitin didnt significantly improve pain or stiffness. Meanwhile, chondroitin alone led to minor improvements in pain .
On the other hand, another 2018 analysis observed a significant improvement in pain scores when glucosamine and chondroitin were taken together, while no improvements were found when the supplements were taken separately .
Similarly, a 2015 sponsored study showed that combining 1,500 mg of glucosamine hydrochloride with 1,200 mg of chondroitin sulfate effectively reduced knee osteoarthritis pain, stiffness, and swelling compared with 200 mg of the osteoarthritis NSAID celecoxib (
However, keep in mind that glucosamine is commonly derived from chitin a compound found in shellfish. Therefore, those with a shellfish allergy should read the label carefully and opt for varieties made from cows or pigs .
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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Does It Really Work
Though broad claims are made about glucosamines positive effects on many diseases, available research only supports its use for a narrow range of conditions.
Currently, the strongest evidence supports glucosamine sulfate use for long-term treatment of osteoarthritis symptoms. That said, it may not work for everyone .
According to available data, its less likely to be an effective treatment for other diseases or inflammatory conditions.
If youre considering using glucosamine, keep in mind the quality of the supplement you choose as this could make a difference in how it affects you.
In some countries including the US there is very little regulation of dietary supplements. Therefore, labels may be deceptive .
Its always best to check for third-party certification to ensure youre getting exactly what youre paying for. Manufacturers willing to have their products tested for purity by a third party tend to have higher standards.
ConsumerLab, NSF International and US Pharmacopeia are a few independent companies that provide certification services. If you see one of their logos on your supplement, its probably of good quality.
Most research supports the use of glucosamine-sulfate solely for managing osteoarthritis symptoms. Its less likely to be effective in other applications.
With under 400 mg of glucosamine per tablet, all the extras like MSM and chondroitin take up too much tablet space to allow a large dosage.
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.
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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What The Science Says About Safety And Side Effects
- No serious side effects have been reported in large, well-conducted studies of people taking glucosamine, chondroitin, or both for up to 3 years.
- However, glucosamine or chondroitin may interact with the anticoagulant drug warfarin .
- A study in rats showed that long-term use of moderately large doses of glucosamine might damage the kidneys. Although results from animal studies dont always apply to people, this study does raise concern.
- Glucosamine might affect the way your body handles sugar, especially if you have diabetes or other blood sugar problems, such as insulin resistance or impaired glucose tolerance.
If you use dietary supplements, such as glucosamine and chondroitin, read and follow the label instructions, and recognize that natural does not always mean safe.
The U.S. Food and Drug Administration regulates dietary supplements, but the regulations for dietary supplements are different and less strict than those for prescription or over-the-counter drugs.
Some dietary supplements may interact with medications or pose risks if you have medical problems or are going to have surgery. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.
For more information, see .
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. .
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Clinical Trials: Glucosamine/chondroitin Versus Undenatured Collagen Type Ii Placebo Or Glucosamine/chondroitin/undenatured Collagen Type Ii
Gupta et al. conducted a prospective, randomized, double-blinded study that included approximately 31-37 client-owned dogs weighing > 40 lbs with moderate osteoarthritis. The trial consisted of four arms in which the subjects received either 1) glucosamine HCl, chondroitin sulfate, and undenatured collagen type II , 2) glucosamine HCl and chondroitin sulfate, 3) UCII, or 4) placebo. For complete dosing schedules, please see . Outcomes included therapeutic efficacy, tolerability, and safety. Efficacy was measured objectively through peak vertical force and impulse area measurements obtained with a piezoelectric sensor-based ground force plate and subjectively through observational pain assessments on a monthly basis for 150 days. Additionally, the physical, hepatic, and renal functions of the dogs were monitored each month via body weight, temperature, pulse, alkaline phosphatase , alanine transaminase , bilirubin, blood urea nitrogen , and creatinine measurements. The placebo arm showed no statistically significant changes in any of the outcome measures by trial end. The glucosamine and chondroitin arm exhibited a significant reduction in subjectively-assessed pain at 90 days with maximal effects observed at 150 days. The GFP-based parameters remained significantly unchanged by trial end. Supplementing glucosamine and chondroitin with UCII did not provide any additional benefit. None of the dogs receiving dietary supplements showed any signs of adverse effects.
Contraindications Adverse Effects And Interactions
The reported adverse effects have been generally uncommon and minor. Glucosamine is produced from the shells of lobster, crab, and shrimp. However, the antigen proteins associated with seafood allergies are not found in the shell, and there have been no reports of reactions in persons with shell-fish allergies who take glucosamine.33 There also have been no significant supplementdrug interactions involving glucosamine. In one case report, the addition of glucosamine sulfate to a stable-dose regimen of warfarin appeared to magnify the anticoagulant effects of warfarin in a 69-year-old man.34 Only one person has been reported to have had an allergic reaction to oral glucosamine.35
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How Do I Give My Dog Glucosamine
Before giving your dog glucosamine, you should consult with your veterinarian to identify your dogs condition and determine the correct dosage. Most available formulations of glucosamine for dogs are oral, such as flavored tablets, pills, powders, or liquids. These supplements are available in pet supply stores, veterinarians offices, and via online sources.
So whats the bottom line? If your veterinarian agrees, a glucosamine supplement may be worth a try to relieve your dogs arthritis pain and help boost their energy and mobility.
Parnells Glyde Mobility Chews are a joint supplement with strong scientific backing, containing the unique combination of green-lipped mussel , glucosamine, and chondroitin to promote healthy joints. GLM contains beneficial nutrients such as omega-3 fatty acids, vitamins, minerals, and antioxidants. Combined with glucosamine and chondroitin, GLM can help decrease pain and preserve joint function. Glyde Mobility Chews are the only joint supplement with proven levels of these key ingredients to help maintain youthful mobility throughout your dogs life. With Glyde, protecting your dogs joints throughout their life is as easy as giving them a daily chew that they think is a treat.
Ra Treatment: Do Glucosamine And Chondroitin Really Work
Jump to:Pain ReliefResearchPros/ConsThe Verdict
If youre living with Rheumatoid Arthritis , you are no stranger to the pain associated with this condition. Stiffness, swelling, and tenderness in the joints. Back and muscle pain. Whole body fatigue, anemia, skin blemishes/redness, dry mouth, pins and needles sensations. Rheumatoid arthritis affects the whole body. And those that suffer from this chronic condition are seeking relief using a variety of compounds to limit or prevent inflammation.
< h3> Pain Relief via Supplements< /h3>
Glucosamine and Chondroitin Sulfate are compounds that work together to treat inflammation due to arthritis as found in RA and osteoarthritis. Glucosamine is key to cartilage formation and maintenance and is manufactured from shellfish. Chondroitin is also a key component to cartilage maintenance as its main function is to attract water to the cartilage to provide better shock absorption during physical activity.
Glucosamine and Chondroitin Sulfate have been found to have considerable success in the treatment of osteoarthritis in both humans and animals. Results from the American College of Rheumatologys medical studies indicate that both supplements have been found to reduce joint inflammation and swelling, with most evidence being present in the knee.
< h3> What Does the Research Say?< /h3>
< h3> The Case Against These Supplements?< /h3>
< h3> So Whats the Verdict?< /h3>
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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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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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Complementary And Integrative Medicine Treatments
Nutritional supplementsâIn 2006, a nationwide clinical trial led by a VA investigator found little overall benefit for the widely used nutritional supplements glucosamine and chondroitin sulfate. The study’s findings did suggest, however, that the supplements, taken in combination, might help those with more severe pain.
The trial was supported by the National Institutes of Health and involved nearly 1,600 patients with osteoarthritis of the knee.
On a related note, researchers found that participants in a study who used glucosamine for a long time developed fewer cases of lung cancer than others their age who did not take the supplement. No such relationship was found for chondroitin sulfate, however.
Swedish massage treatment for osteoarthritisâIn a small pilot study, published in 2015, researchers from the Durham VA Medical Center and Duke University demonstrated that Swedish massage is an acceptable and feasible treatment for VA health care users with osteoarthritis of the knee.
The Veterans who took part in the study reported, on average, about a 30 percent improvement in pain, stiffness, and function. They did not, however, show improvement in a timed 50-foot walk. A larger clinical trial is planned.