Glucosamine and Chondroitin

 

Glucosamine and Chondroitin are well known for providing the building blocks for the restoration of cartilage structure in joints. BE ADVISED! These items provide minimum to no benefit if the rest of your nutritional program aren’t in order. The formation of proteoglycans is severely inhibited by the destructive processes from inflammation and lack of supporting nutrients. Many things need to be present in the joint in order for spontaneous repair to occur. Most people forget this. They believe that taking a supplement will cure all ills. Supplements are exactly that, supplementing proper practices. That being said, don’t waste your money unless you are eliminating saturated fats, replacing them with essential fats and getting plenty of high quality vitamins and minerals and antioxidants from fresh fruits and vegetables.

 

          Here is an excerpt from an article picked up recently by Dr. Michael Colgan of the Colgan Institute as published in his Nov 15, 1996 issue of the Chronicles

 

          Many of us weekend warriors are familiar with the pain and discomfort of torn ligaments, pulled tendons and torn cartilage. Then, to add to further insult to our injuries, arthritis starts creeping insidiously into our lives as we grow older.

          To stop this pain and discomfort, many people use over-the-counter anti-inflammatories such as aspirin or ibuprofen, much touted by drug companies as the only answer. But there is mounting evidence that these anti-inflammatories inhibit the body’s ability to produce cartilage. In fact the common anti-inflammatories used by many physicians to treat knee pain are now suspected to be a major cause of ligament and cartilage destruction.

          In the knee, for example, much of the pain, inflammation and eventual arthritis occurs because of damage to the cartilage cushion, which leaves the heads of the leg bones, the femur and the tibia, grinding on each other.

          A good study on subjects with arthritic knees was done at St. John’s Hospital in Oporto, Portugal. Dr. Antonio Vaz randomly divided a group of 68 patients, giving the first group a daily dose of 1.5 grams of glucosamine sulfate, and the second group 1.2 grams of ibuprofen (Motrim). Results showed that by the end of the study, the glucosamine group has significantly less pain that the ibuprofen group.1

          Another double-blind study divided 30 patients with chronic arthritis into two groups. One group received 500 mg of glucosamine sulfate per day for 14 days. The other group received a placebo. Total symptom scores, including pain swelling, tenderness, and loss of function, improved by 71% in the glucosamine group, but were little changed in the placebo group.2

          A study with young athletes reported even more spectacular findings. 51 male and 17 female athletes with cartilage damage of the knee were given 1500 mg of glucasamine sulfate daily for 40 days, and then 750 mg for 90-100 days. Of the  68 athletes, 52 had complete disappearance of their symptoms and resumed full athletic training. A follow-up 12 months later showed no signs of cartilage damage in any of the athletes.3

          To understand the mechanism of glucosamine, we need to look at the biochemistry of the connective tissue that makes up your ligaments, cartilage, tendons, and spinal discs. There are two main components of these tissues. The first is collagen. The second is a long chain made up mainly of sugars called glycosaminoglycans (GAGs). These GAGs are the tissue framework that collagen holds onto. Collagen and GAGs together continuously construct and reconstruct your tendons and ligaments.

          This is where glucosamine comes in. Glucosamine is the major precursor of GAGs. But even more important, the making of glucosamine from glucose and glutamine is your body’s rate limiting step in GAG production, and hence the rate limiting step in re-modelling your connective tissue.

          Following connective tissue injury, such as a cartilage tear, this limit does not allow the body to make sufficient glucosamine for optimal healing. And, as we age, the body’s ability to convert glucose and glutamine to glucosamine declines because of reductions in the level of the converting enzyme glucosamine synthetase. This is where oral glucosamine comes in. Taking glucosamine supplements can increase GAG levels by up to 170%.4,5

          There are many companies selling various glucosamine supplements on the market. Many of the formulas display a complete lack if knowledge of human biochemistry. So, avoid the supplements that contain condroitin sulfate. The molecule of chondroitin sulfate is too big to pass through the lining of the gut. It is only effective if used as an injection. For those of you with a “need to know” penchant, chondroitin sulfate has a molecular weight of 50,000; glucosamine sulfate has a molecular weight of 211.

          Then there is n-acetyl-glucosamine (NAG). By itself, NAG is almost useless because it is only one of the sugars in GAGs and does not stimulate GAG synthesis alone. It requires glucosamine sulfate to bypass the rate-limiting step and trigger GAG production. NAG should be only taken in combination with glucosamine sulfate.

          Always buy glucosamine sulfate rather than straight glucosamine. Research indicates that sulfer is an essential part of the molecule during tissue remodelling.5 In fact, sulfer is a major component of your body.

          Glucosamine sulfate has been shown to be virtually non-toxic to animals even at 8 grams per kg bodyweight per day. The human studies discussed above reported no side-effects at the Colgan Institute. Dosage should depend on the severity of the problem.

          As with all supplements, please read the references carefully, and always take a complete supplement. Remember that nutrients work synergistically, never on their own, so always make sure you are taking a good quality multi-vitamin and mineral supplement along with any other special nutrients.

 

References:

1.     Vaz AL. Double blind evaluation of the relative efficacy of glucosamine sulfate in the management of osteoarthritis of the knee in out-patients. Curr Med Res Opin 1982;8:145-149.

2.     D’Ambrosio E, Casa B, Bompani R, Scali G, Scali M. Glucosamine sulfate: a controlled clinical investigation of arthritis. Pharmatherapeutica 1981;2(80):504-508.

3.     Bohmen D et I. BrachtN, Prokopl, (eds). Treatment of chondropathia patellae in young athletes with glucosamine sulfate. Current Topics in Sports Medicine, Vienna: Urban and Schwarzenberg, 1984.

4.     Setnikar I, Giachetti C, Zanola G. Absorption, distribution and excretion of radioactivity after a single intravenous or oral administration of glucosamine to the rat. Pharmatherapeutica 1984;3(8):538-550.

5.     Setnikar I, Giachetti C, Zanola G. Pharmacokinetics of glucosamine in the dog and man. Arneimittelforschung, 1991;36(2):729-736.

 

 

New Meta-Analysis published in the Archives of Internal medicine:

          A recent review of clinical studies carried out over the last 22 years shows Glucosamine and Chondroitin to be effective in reducing pain, and joint damage. See the article here. A Comprehensive Meta-Analysis

 

Excerpt from the January/February issue of Nutrition Action Newsletter published by the Center for Science in the Public Interest

 

Glucosamine is a simple molecule that the body make from sugar and uses as a major building block of cartilage. In test tubes, it stimulates cartilage cells to synthesize the ingredients for more cartilage.

          In a handful of good studies in Europe, osteoarthritis sufferers who took 1500 mg of glucosamine each day for one to three months reported less pain, swelling, or tenderness than those who took a (inactive but look alike ) placebo. Many experienced as much relief as those who tool painkilling drugs.

          In one study of 200 people with arthritis of the knees, glucosamine matched the popular painkiller ibuprofen, the active ingredient in Advil and Motrin. Each relieved symptoms in about half of the 100 people who took it. But after four weeks, those in the ibuprofen group were six times more likely than those on glucosamine to report side effects like heartburn stomach pain, and nausea or to stop taking their medication.

          “The good studies show that glucosamine relieves the pain of osteoarthritis as effectively as the other things we’re using now,” concludes Felson. Which is why many doctors tell their patients that glucosamine is worth a try.

          Rheumatologist Marc. C. Hochberg of the University of Maryland School of Medicine in Baltimore, an expert on how to gauge the effectiveness of osteoarthritis treatments, is one of them.

          “If patients are interested, I suggest that they try 500 mg three times a day for a month, “ he says. “If they notice an improvement in symptoms they can continue for as long as it seems to work and there are not uncomfortable side effects.”

          If there’s no relief after four weeks-and studies report that from 20 to 50 percent of people get none-Hochberg recommends that his patients stop taking glucosamine.

 

…end of article

 

Glucosamine is best absorbed in the sulfate form. The HCl is less effective and less costly. That’s why you will often see mixtures of the two forms. Dosage is optimally 1500 mg of glucosamine sulfate per day in divided doses.  Chondroitin is notoriously difficult to put in a supplement effectively and at reduced cost. In fact, of the many chondroitin-only supplements tested, only 1 passed the independent lab tests. To me, although the mixtures passed, this puts them in question. I would prefer you either stick to a reputable brand of mixtures, or purchase them as separate supplements. Notice that in the included list of supplements, all mixtures of glucosamine and chondroitin are also mixes of glucosamine HCl and glucosamine sulfate. Again, this is to reduce cost. In my opinion, NOW foods is consistent in quality, are generally less expensive, are available everywhere, and offer both glucosamine sulfate and chondroitin as individual supplements. I might consider those on a cost/quality basis first. From there, you will have to make a cost analysis, as I don’t know the retail cost of all of these items.

 

 

isted alphabetically below are the products that passed ConsumerLab.com's independent testing of glucosamine, chondroitin, and glucosamine/chondroitin dietary supplements.

CONSUMERLAB.COM APPROVED QUALITY GLUCOSAMINE AND CHONDROITIN PRODUCTS

Product Name and Declared Concentration of Main Ingredient(s) Per Pill

 

Manufacturer or Distributor

 


Glucosamine & Chondroitin Sulfate Combined Products:

 

ArthxDS™ Glucosamine Chondroitin, 500 mg glucosamine HCl, 400 mg chondroitin sulfate per capsule*

Dist. by Medtech (Mfd. By PECOS Pharmaceuticals)

ArthxDS™ Once Per Day Time Release Formula Glucosamine 1500 mg Chondroitin 1200 mg, 750 mg glucosamine HCl, 600 mg chondroitin per caplet*

Dist. by Medtech (Mfd. By PECOS Pharmaceuticals)

Double Strength Cosamin®DS, 500 mg glucosamine HCI, 400 mg chondroitin sulfate, 5 mg manganese per capsule*

Nutramax Laboratories, Inc.

Glucosamine / Chondroitin Double Strength, 500 mg glucosamine HCl and 400 mg chondroitin per capsule

Walgreens

Maximum Strength Flex-A-Min® Glucosamine, Chondroitin, MSM, 500 mg glucosamine sulfate — 2KCI and 400 mg chondroitin per tablet*

Arthritis Research Corp.

Maximum Strength Glucosamine/Chondroitin, 500 mg glucosamine HCl and 400 mg chondroitin per tablet

CVS

Move Free (formerly Pain Free in caplet form), 500 mg Glucosmaine (sulfate,HCL, and N-acetyl), 400 mg Chondroitin, Joint Support Formula tablets

Schiff

Nature's Bounty Chondroitin Complex with Glucosamine, 250 mg glucosamine HCl, 200 mg chondroitin per capsule

Nature's Bounty

Osteo-Bi-Flex Glucosamine / Chondroitin, 250 mg glucosamine HCl, 200 mg chondroitin tablets

Sundown

Spring Valley Glucosamine/Chondroitin Max. Strength, 500 mg glucosamine HCl, 400 mg chondroitin tablets

Wal-Mart / Manf. By Park-Taft Laboratories

Triple Flex™ Maximum Strength Glucosamine Chondroitin Plus MSM Supplement, 500 mg glucosamine HCl, 400 mg chondroitin sulfate per tablet*

Nature Made Nutritional Products


Glucosamine-Only Products:

 

Aflexa Glucosamine (sulfate), 340 mg/tablet*

McNeil Consumer Healthcare, Inc.

Enzymatic Therapy GS-500, Glucosamine Sulfate, 500mg/capsule*

Enzymatic Therapy

Fields of Nature Glucosamine Sulfate 500 mg, Natural Joint Nutrient capsules

Fields of Nature

GNC Glucosamine (sulfate), 600 mg/capsule

GNC

Natrol Glucosamine Complex (sulfate, HCl, and N-acetyl), 500 mg/capsule

Natrol

Nature Made Glucosamine (sulfate and HCl) 500 mg/tablet

Nature Made

Nature Made® Joint Action™, 500 mg glucosamine HCl per tablet*

Nature Made Nutritional Products

Now Glucosamine Sulfate 750 mg Complex, 750 mg/capsule*

Now Foods

Nutrilite Glucosamine HCl with Boswellia, 375 mg/caplet

Access Business Group International LLC

One A Day Joint Health (with Glucosamine and Vitamins C & E), 500 mg glucosamine sulfate/tablet*

Bayer

OsteoJoint Triple Formula for Healthy Joints, 500 mg glucosamine sulfate/caplet

Your Life

Osteokinetics 467 mg glucosamine HCl /capsule

Shaklee (Formulas)

PhytoPharmica Glucosamine Sulfate, 500mg/capsule*

PhytoPharmica

Puritans' Pride Glucosamine Sulfate, 1000 mg/capsule

Puritans' Pride

Spring Valley Glucosamine Complex (sulfate and HCl), 500 mg/tablet

Wal-Mart / Manf. By Leiner Health Products


Chondroitin Sulfate-Only Products:

 

NOW Chondroitin Sulfate 600 mg/capsule*

Now Foods