Background Facts: Glucosamine, Chondroitin and Osteoarthritis

The pain of osteoarthritis may not seem like much at first. Yet, what starts as a little stiffness can eventually lead to debilitating pain and limited function as the smooth cartilage that cushions joints starts to degenerate. Osteoarthritis affects more than 21 million American adults and there is no cure. While conventional treatments focus on easing the pain, the combination of glucosamine and chondroitin may offer more.

Long a part of the veterinary pharmacopoeia, these supplements have been used to treat osteoarthritis in Europe for more than a decade. Intense American public interest was sparked in 1997 by the bestselling The Arthritis Cure (St. Martin's Press, 1997) by Jason Theodosakis, M.D., and since then the National Institutes of Health (NIH) has spent $6.6 million to study the efficacy, safety, and side effects of the two substances, as well as how exactly they work, together and separately, on people suffering from osteoarthritis of the knee.

What is known is that glucosamine and chondroitin naturally occur in cartilage and researchers think they may work to repair and maintain cartilage glucosamine by inhibiting inflammation and stimulating cartilage cell growth, and chondroitin by giving cartilage strength and resilience. Studies suggest taking glucosamine and chondroitin may not only stop the pain but actually halt the degeneration process itself. In addition, some doctors with an alternative bent also recommends increased dietary intake of essential fatty acids, which combined with glucosamine and chondroitin may build cartilage and reduce joint inflammation.

Unfortunately, the evidence remains inconclusive and the experts are divided. Researchers at the Boston University School of Medicine reviewed 37 studies of glucosamine and chondroitin and found a small to moderate effect on osteoarthritis. This led to a report in the March 15, 2000, issue of the Journal of the American Medical Association (JAMA), which suggests that there is little harm from supplementing traditional medical regimens with these additional drugs though a clear benefit has not been established. The author conceded that while more studies should be done, he would not, in the meantime, advise patients against using the supplements. Less supportive are the positions of the Arthritis Foundation and the American College of Rheumatology, which urge patients with osteoarthritis to continue with their conventional treatments and to speak with their doctors before adding glucosamine and chondroitin to their regimen.

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