Glucosamine and Chondroitin
– As people age, the cartilage in their joints becomes compressed, hardened or worn away and can no longer provide the necessary cushion to support healthy joint function. Cartilage is connective tissue that is flexible and covers the ends of the bones in joints such as the knees, hips and vertebrae. Osteoarthritis is a process that causes a breakdown of cartilage, damage of the bones due to bones that rub together, and stretching of surrounding tissues including tendons and ligaments. Symptoms include pain, redness, and swelling. More than 27 million Americans are affected by osteoarthritis.
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Osteoarthritis is treated many ways, including exercise, medication, injections into the affected joints, weight loss when necessary and even the use of supportive devices. Some people choose to take supplements with a belief this will help the body promote greater production of cartilage material and reduce the inflammation and pain associated with osteoarthritis. Two of the most commonly used supplements used in association with osteoarthritis are glucosamine and chondroitin. lucosamine is a naturally occurring amino sugar. It is considered a precursor in the development of glycosaminoglycans, a major component of joint cartilage. Trial studies have shown that only the use of glucosamine sulfate demonstrated improvement in osteoarthritis. More high quality studies are needed to confirm these preliminary findings.
When glucosamine is taken as a supplement, the recommended dosage is 1,500 mg daily in a single or divided dose. It is often combined with chondroitin as a complementary compound. This combination may help reduce the amount of non-steroid anti-inflammatory medications needed to help reduce the pain and possibly other symptoms associated with osteoarthritis but studies are needed to determine overall or long-term effectiveness. Chondroitin sulfate is an important component in the structure of cartilage, which helps it to resist compression. If its levels are reduced in cartilage, over time the joints may experience faster wear as the cushioning properties of the cartilage are lost. It also may have some anti-inflammatory properties but more studies are needed.
There is an overall lack of validating scientific studies for either glucosamine or chondroitin, either alone or in combination. Both the American College of Rheumatology and the American Academy of Orthopedic Surgeons are not recommending the use of either preparation as standard treatment of osteoarthritis. The National Institute of Health conducted a large multi-center trial of both glucosamine and chondroitin, focusing on pain associated with arthritis and, for a small sample of individuals with moderate to severe pain from arthritis, there was statistical improvement of joint pain but they concluded that more studies were needed. In addition, since the source of glucosamine in supplements is often the shells of shellfish, individuals with shellfish allergies should check with a physician before use. In addition, glucosamine is not recommended for women who are pregnant or breastfeeding since safety has not been established in children.
Interestingly, hyaluronic acid is a major component of synovial fluid, the material found in a joint that acts as a lubricant during movement. Both the American College of Rheumatology and the American College of Occupational and Environmental Medicine recommend hyaluronic acid injections into the joint for pain relief for osteoarthritis.
There are a large number of herbal preparations that are marketed to consumers for reducing pain and promoting joint health but more studies are needed to establish their effectiveness with osteoarthritis. In addition to glucosamine and chondroitin, other supplements that may support joint health include methylsulfonylmethane (MSM), and a range of vitamins. Most joint health supplements are available in pill, capsule, gel caps and chewable forms, but some are also available as supplement drinks and as topical creams. However, consumers need to know that more studies are necessary to establish the safety and effectiveness of any herbal preparation for osteoarthritis. Talk to your doctor before beginning a course of supplements to make sure you are doing what is best for you. Be sure to discuss all current prescription and herbal medications to ensure that there are no drug interactions. Be aware of potential side effects and make sure you use supplements safely. Make sure that you discuss use of supplements during pregnancy or breastfeeding.
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