PT on the Net Research

Glucosamine and Chondritin


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:

  1. Cannon, Joe (2006). Nutritional Supplements: What Works and Why. A Review from A to Zinc and Beyond. www.Joe-Cannon.com
  2. 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.
  3. 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.
  4. Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2005;(2):CD002946.
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