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Thread: Glucosamine and Chondroitin? page

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    gator70's Avatar
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    Question Glucosamine and Chondroitin?

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    My tendons sure are doing a lot of popping, creaking and slipping lately. Any advice? Anyone have any luck with Glucosamine or is that a rabbit hole?

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    slowcooker's Avatar
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    Here is a study that says: Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged. http://www.bmj.com/content/341/bmj.c4675.full

    I used something called Fast Joint Care + (plus).. for a couple months after it was recommended by my pain specialist. I have to admit it felt like it worked. But it was expensive ($1 a day), and the main ingredient was something that us primal people have lots of at home (egg shell membranes).. I just need to find a way to peel that membrane out of my egg shells, and then crush/grind it down to a usable (digestible) size.. each capsule had the equivalent of 8 membranes..

    http://www.genuinehealth.com/by-name...oint-care.html

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    I have severe osteoarthritis, and when glucosamine/chondroitin was first touted as the miracle cure (from a book, I believe it was called The Arthritis Cure), I took it faithfully for 2 years (at $100 a month!). It did absolutely nothing. I later read a report that said it would only work with 'mild' cases, and I suspect it was just a placebo effect.

    I've since controlled my pain and stiffness to a large extent by eating Primal and avoiding egg yolks and other inflammatory foods. I am able to mange with diet and exercise--no meds at all.

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    Yes! I used to hobble around on stiff feet every morning, and that disappeared within two weeks. If I remember correctly, it works on about 40% of the people who take it. Heck, it's not that expensive. Buy a bottle and try it. You'll know by the time the bottle is gone if it's working or not.

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    Here is some science "for"---

    Taken from a MEDSCAPE article:

    An Evidence-Based Assessment of Glucosamine Sulfate, St. John's Wort, and Echinacea

    Jack J. Chen, PharmD Disclosures

    An Evidence-Based Assessment of Glucosamine Sulfate, St. John's Wort, and Echinacea

    Jack J. Chen, PharmD, BCPS, FCPhA

    Case Study: Glucosamine Sulfate

    Joseph Pepping, PharmD, Pain Management and Nutritional Medicine Consultant for the Kaiser Moanalua Medical Center, Honolulu, Hawaii, reviewed 4 double-blinded, randomized clinical trials on the effect of glucosamine sulfate for the management of knee osteoarthritis (Table 8).[12-15] Particular attention was focused on a well-designed, randomized, double-blind, placebo-controlled trial investigating the long-term effects of glucosamine sulfate.[12] In this study, patients with severe osteoarthritis or morbid obesity were excluded. Symptoms were scored by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, a well-validated tool for measuring osteoarthritis-related outcomes such as pain, stiffness, and disability. Long-term progression of osteoarthritis was evaluated by measuring the change in width of the medial tibiofemoral joint space using digitized radiographs over a period of 3 years. Treatment with crystalline glucosamine sulfate (Dona, Viartril-S, Xicil, Rotta Research Group, Monza, Italy) 1500 mg once daily for 3 years (normally glucosamine sulfate is administered 500 mg 3 times daily) was well tolerated and associated with beneficial structure- and symptom-modifying effects in patients with mild to moderate osteoarthritis of the knee. The treatment period of 3 years is the longest to date of all studies of glucosamine in the management of osteoarthritis. This study is also remarkable in that the results suggest that oral glucosamine sulfate may act as a disease-modifying agent in patients with mild to moderate osteoarthritis of the knee.

    Based on the evidence, Dr. Pepping recommended that stabilized glucosamine sulfate administered at a dosage of 1500 mg/day has beneficial effects on osteoarthritis symptoms (Grade A recommendation) and that long-term treatment is well tolerated (with superior safety over nonsteroidal anti-inflammatory agents) and may slow the progression of cartilage degeneration. Glucosamine sulfate "can be responsibly offered as either a first-line or adjunctive agent in the treatment of osteoarthritis," Pepping said. A caveat is that these studies used the sulfate salt of glucosamine (stabilized with potassium chloride or sodium chloride), and other forms of glucosamine may not be as effective. When counseling patients on glucosamine sulfate, clinicians should emphasize that the product should be taken with meals and routinely (not as needed). Additionally, a trial of at least 4 weeks is necessary to assess benefits. Diabetic patients should be informed that there are case reports of glucosamine sulfate causing an increase in blood glucose levels and that blood glucose levels should be monitored. However, in the 4 large clinical trials that were reviewed, significant changes in blood glucose levels were not noted.

    Table 8. Evidence Table: Glucosamine Sulfate in the Long-term Treatment of Osteoarthritis

    Study Subjects (N) Results Control LOE Limitations

    Reginster[12] 212 Positive Placebo I Minor

    Noack[13] 252 Positive Placebo I Minor

    Muller-Fassbender[14] 200 Equivalent Ibuprofen I Minor

    Qiu[15] 178 Equivalent Ibuprofen II Major

    LOE = level of evidence

    Conclusions

    As scientific evidence on dietary supplements and botanical products become increasingly available, clinicians should use the evidence-based medicine process to objectively evaluate the data and to formulate appropriate recommendations. Based on the available evidence to date, the following recommendations can be made: Echinacea purpurea is effective for reducing the duration of symptoms of the common cold (but not for prevention), St. John's wort is effective for treating mild to moderate depression, and glucosamine sulfate is beneficial for treating osteoarthritis of the knee.

    1. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomized, placebo-controlled clinical trial. Lancet. 2001;357:251-256.

    2. Noack W, Fischer M, Forster KK, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2:51-59.

    3. Muller-Fassbender H, Bach GL, Haase W, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2:61-69.

    4. Qiu GX, Gao SN, Giacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. 1998;48:469-474.
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    I was just researching this. From what I found most of hte research that is 'for' the supplement was done on Dona brand suppelments, notice in the copied informaiton above the name of hte research group, Rotta Research? Well, they are the makers of Dona supplements. Not so sure that is a reliable resource.

    The most recent research says it is no more beneficial than the placebo and can cause insulin resisitance, not something I would be willing to mess with personally.

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    I can't see any reason it would cause insulin resistance, NutMeg. Did anyone discuss the mechanism?

    I don't like buying stuff in capsules in bottles (like probiotics or glucosamine) if it is present in food in much larger quantities for much less money, and probably has cofactors present as well.

    Connective tissue, bony soups made in a crock pot on low, there's the ticket. Ironic that you would take a bottled supplement, Slowcooker, when your nickname shows you the way. Bony soups help heal a leaky gut, as well. Ham hocks, oxtails, shoulder roasts (lamb and pork), leg of lamb, lamb shank, all the cuts which are too tough and full of gristle and/or complicated joints and bones to cook like steak. My understanding is that the jelly which comes out of such meat in the crock pot (aspic if it's cooled down, a rich stock if it's warm) if chockful of glucosamine and chondroitin.

    If I'm wrong about this, let me know.

    As for why it helps some people and not others, I suspect that those it doesn't help also need some other nutritional factor. There's the principle of the Limiting Factor -- whatever is the most lacking of a group of substances in a chemical reaction is what limits how fast that reaction can go. If your limiting factor is glucosamine, then taking it will help the arthritis. If it's something else instead, then you'll need to find out what.

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    Gator's Avatar
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    Nutmeg: valid point about the research being funded by the producer of the product. Unfortunately, that is the case for ALL research on drugs and supplements. Very rare for the research to be funded by someone not involved in the distribution and sale of the researched item. In that case the research usually is funded by someone who wants to sell you a different product.
    Ultimately, I believe that it can be shown that just about all research in drugs and supplements is funded by pharmaceutical companies who want to sell you their wonderful item or detract from a competitor's wonderful item.

    If an 'independent' lab wishes to continue receiving contracts and grants, they had best seek ways to 'prove' the expected results.

    .
    Piano-Doctor-Lady: The final paragraph of your post hits the nail on the head. Clearly, succinctly, and completely.

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    The study linked above is a meta-analysis, it seems the resaerchers there had a reason to find it works sinc ehteir grant came from:
    he study was funded by grants from the Swiss National Science Foundation’s National Research Program 53 on musculoskeletal health (PJ and SR) (No 4053-0-104762/3). PJ was a senior research fellow in the Program for Social Medicine, Preventive and Epidemiological Research funded by the Swiss National Science Foundation (grant No 3233-066377
    I would think they would want an alternative to work.

    Glucosamine and IR:
    http://altmedicine.about.com/cs/arth...lucosamine.htm

    Then there is this from quack watch, which I don't know much about. I did think it was a funny name though!
    http://www.quackwatch.com/01Quackery...ucosamine.html

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    When I started having problems with osteoarthritis my sports medicine doctor recommended tgat I try it. She warned that it only works for a percentage of people and if it's going to work for you it will do so within 3 months. It did nothing for me. I recently read the research about insulin resistance and wonder if it would be working at cross purposes with a primal diet.

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