Thoughts on Glucosamine and Chondroitin?

[Spartan74]

What's the concensus on using Glucosamine and Chondroitin as a preventative measure ? Never taken it myself but do have some friends that swear by it. Thanks.

[ccrn]

The Arthritis Research Center of Canada (ARC) has finished a six month double blind study that has shown no long term benifits of Glucosamine and chondroitin.

Also there has been a long term study of about two or three years called GAIT (Glucosamine/Chondroitin Arthritis Intervention Study) here in the USA that is being peer reviewed. I believe it might be the only true scientific study done besides the ARC study regarding these two supplements.

The EU has had studies that supposedly showed promising results however the doses used there are higher from what is used in American OTC doses. Also, no offense intended, at least one EU study has been discredited in the area of heart research recently.

Other problems with Glucosamine and Chondroitin are dose consistancy, label misrepresentation, and even impurities. Why it is that pharmaceuticals are held to such a high standard by the public yet these OTC's are not is beyond me.

On a personal level, as I type this, my wife who is a DC tells me that her subjective observations of her pt's are that neither of these two supplements are efficacious-

FWIW

[Spartan74]

Thank You CCRN.

[The Dave]

I've been taking Glucosamine & Chondroitrin for about 2 months now, maybe a little longer. It seems like it almost took me this long to feel any beneficial effects from it, and yet, its minimal. If you take a liquid dose of it, it supposedly works a bit faster than the pill form. I started taking it, because my knees were giving me some trouble.

I believe what I'll be doing, instead of continuing to take this, is just go see a physical therapist, and see whats wrong with my running form, if thats the cause of the pain. I'll see if I can find an interesting article I read on this when I get home, and post it up.

[ccrn]

Originally Posted by The Dave

I believe what I'll be doing, instead of continuing to take this, is just go see a physical therapist, and see whats wrong with my running form, if thats the cause of the pain. I'll see if I can find an interesting article I read on this when I get home, and post it up.

For sure see a sports physiologist about not only your running form but your feet. Some feet are very fliexible and need support and others are not and only need cushioning. Also some runners overpronate or underpronate and need some form of motion control shoe. Foot width will also be a consideration. An experienced physiologist who also runs will be familiar with shoe brands and will be able to recommend.

A physical therapist will be able to help you with asymmetries and muscle weakness and or stiffness.

All of these can hinder performance especially when trying to achieve a certain level within a certain time increasing risk of injury (mostly over use injury of the knees).

A good running shoe store with experienced runners as sales persons can be valuable too.

If all this is old hat my apologies

FWIW

[The Dave]

Originally Posted by ccrn

For sure see a sports physiologist about not only your running form but your feet. Some feet are very fliexible and need support and others are not and only need cushioning. Also some runners overpronate or underpronate and need some form of motion control shoe. Foot width will also be a consideration. An experienced physiologist who also runs will be familiar with shoe brands and will be able to recommend.

A physical therapist will be able to help you with asymmetries and muscle weakness and or stiffness.

All of these can hinder performance especially when trying to achieve a certain level within a certain time increasing risk of injury (mostly over use injury of the knees).

A good running shoe store with experienced runners as sales persons can be valuable too.

If all this is old hat my apologies

FWIW

Great info!! I appreciate it. I've already had some good luck with insoles, but it doesn't help all the way. So a physiologist is who I shall go see. Again, thank you.

[Bill Harsey]

Originally Posted by ccrn

The Arthritis Research Center of Canada (ARC) has finished a six month double blind study that has shown no long term benifits of Glucosamine and chondroitin.

Also there has been a long term study of about two or three years called GAIT (Glucosamine/Chondroitin Arthritis Intervention Study) here in the USA that is being peer reviewed. I believe it might be the only true scientific study done besides the ARC study regarding these two supplements.

The EU has had studies that supposedly showed promising results however the doses used there are higher from what is used in American OTC doses. Also, no offense intended, at least one EU study has been discredited in the area of heart research recently.

Other problems with Glucosamine and Chondroitin are dose consistancy, label misrepresentation, and even impurities. Why it is that pharmaceuticals are held to such a high standard by the public yet these OTC's are not is beyond me.

On a personal level, as I type this, my wife who is a DC tells me that her subjective observations of her pt's are that neither of these two supplements are efficacious-

FWIW

If my memory serves, these supplements were first proven on horses for whom which the placebo effect is kinda hard to make happen.

Six months is not a very long study for soft tissue damage repair.

My next question is "peer reviewed" by whom? Think about this one before answering.

An observation I would make is this, because one area of study by the EU has been discredited then all areas of study by same are no longer valid? We could then throw out much of what any given area of science has concluded.

That last word is kinda big for a knifemaker...

[CPTAUSRET]

I have sustained various injuries over the years, broken neck, broken back, GSW's, a few edged weapon wounds, etc, etc. Traumatic Arthritis is what I am told I now have...I take the stuff (G and C), and Nancy does too. Is it subjective that I feel better, who knows?

But I used to take 800mg Motrin 4 times daily, I did so for maybe 20 years, now I do not. Ibuprofen is not good for you at that level over the long term, in fact that is now an illegal dosage for long term use.

Terry

[Bill Harsey]

Originally Posted by CPTAUSRET

I have sustained various injuries over the years, broken neck, broken back, GSW's, a few edged weapon wounds, etc, etc. Traumatic Arthritis is what I am told I now have...I take the stuff (G and C), and Nancy does too. Is it subjective that I feel better, who knows?

But I used to take 800mg Motrin 4 times daily, I did so for maybe 20 years, now I do not. Ibuprofen is not good for you at that level over the long term, in fact that is now an illegal dosage for long term use.

Terry

Terry, Is this after you got married?

I can't quite match that pedigree but have had some pretty good injuries from the 10 seasons I spent logging here in Oregon. All I know about the stuff is that before I started taking it, I couldn't sleep thru the night because of knee pain, for several years. (all this after a major surgery to try and repair several things at once) If I stop for a period of time, the pain creeps back in and I start waking up in the middle of the night thinking "this sucks". I just returned from a 15 mile bicycle ride in below freezing weather and my knees are fine at the moment. I can't prove the stuff works but like you I've quit buying advil by the case.

[CPTAUSRET]

Originally Posted by Bill Harsey

Terry, Is this after you got married?

I can't quite match that pedigree but have had some pretty good injuries from the 10 seasons I spent logging here in Oregon. All I know about the stuff is that before I started taking it, I couldn't sleep thru the night because of knee pain, for several years. (all this after a major surgery to try and repair several things at once) If I stop for a period of time, the pain creeps back in and I start waking up in the middle of the night thinking "this sucks". I just returned from a 15 mile bicycle ride in below freezing weather and my knees are fine at the moment. I can't prove the stuff works but like you I've quit buying advil by the case.

"Terry, Is this after you got married?"



Bill, that's funny!

Nancy has had two spinal fusions of her lower back so she is also lives with pain, and subjectively she feels better with the G and C.

Terry

[Ambush Master]

Originally Posted by Bill Harsey

Terry, Is this after you got married?
If I stop for a period of time, the pain creeps back in and I start waking up in the middle of the night thinking "this sucks". I can't prove the stuff works but like you I've quit buying advil by the case.

Same here. Close to 1K Parachute Jumps and being seriously pounded into the ground way too many times, I'm amazed that I can still walk. What got me started taking it was my thumb joints started to lock up on occasion. A friend suggested it because they had been giving it to their Lab Retriever and he had improved dramatically after about a month. I've been taking it for about 10-12 years and everything works fine !!! Like Bill, if I lay off of it for a few days I start to feel things that are not pleasant.

Martin

Originally Posted by Bill Harsey

If my memory serves, these supplements were first proven on horses for whom which the placebo effect is kinda hard to make happen.

...

I should probably stay out of this..... Mr Harsey you are correct.

I have seen Glucosamine and Chondroitin used and the success rate was questionable. Some people swear by it. I think it depends on the degeneration, bone changes, amount of work etc. All of which would apply to a human as well.

Usually we continued to include Aspirin and Phenylbutazone (nonsteroidal anti-inflammatory drug, no idea the human equiv) and steroid cortozone injections. The use of G&C generally reduced the frequency of injections, but did not eliminate them.

DMSO - I try to avoid using it. A few years ago vets were saying this was a cancer causing agent and it was also connected to blindness. Now it is all the rage in cancer treatment. Generally I only use it for applying steriods and breaking down calcification. Anything mixed with it is absorbed into the bloodstream. I know the local feed store sells more for human use than farm use.....

my .02

[Bill Harsey]

Originally Posted by ghuinness

I should probably stay out of this..... Mr Harsey you are correct.

I have seen Glucosamine and Chondroitin used and the success rate was questionable. Some people swear by it. I think it depends on the degeneration, bone changes, amount of work etc. All of which would apply to a human as well.

Usually we continued to include Aspirin and Phenylbutazone (nonsteroidal anti-inflammatory drug, no idea the human equiv) and steroid cortozone injections. The use of G&C generally reduced the frequency of injections, but did not eliminate them.

DMSO - I try to avoid using it. A few years ago vets were saying this was a cancer causing agent and it was also connected to blindness. Now it is all the rage in cancer treatment. Generally I only use it for applying steriods and breaking down calcification. Anything mixed with it is absorbed into the bloodstream. I know the local feed store sells more for human use than farm use.....

my .02

Thanks for checking in, What I get from your post is this is complicated science with many factors to consider and measure. I have only one lifetime to work with and am willing to take the chance this stuff works. If I and others are proven wrong maybe the next generation won't have to go thru the same mistakes.

[ccrn]

I dont want to offend anyone here nor is it my intent to dismiss the subjective experience of the vetaran members whos opinions I value.

It is and always will be my intent to question and discriminate without prejudice any treatment , practice, or medication's efficacy. This is essential in nursing which is a practice that should be based on specific and measurable criteria defendable by science, research, and observation.

This is a practice that I carry into my personal life as well as my professionl one. If its not effective or efficient then it should be at least candidate for the chopping block.

A professional example is the Amiodarnone vs Lidocaine debate in the advanced cardiac life support arena. Lidocaine has been the big gun for certain arrhythmias for years. Then along came Amiodarone which was put in favor by the AHA. Their favor was so lop sided that it became a joke. People accused the AHA of being paid off. Now in 2004 their new ACLS recommendations dont necessarily favor amiodarone anymore.In fact the latest research is showing that none of the ACLS medications we are using show efficacy over placebo. Not very comforting is it?

My subjective experience is otherwise. Ive seen these meds save peoples lives in the ER and ICU.. In 2005 AHA will supposedly come out with radical changes in ACLS protocols based upon research.

As far as glucosamine and chondroitin the verdict is still out from my perspect.

Ive seen research that supports it, mostly that done by the manufacturer. Ive seen the 25 horse study that supports glucosamine/chondroitin. It apparently was done via measurable criteria ie lameness grade, flexion test and stride length. However it wasnt a double blind study with a placebo control group and the trainers knew their animals were on the supplement. Also that study involved Cosamine DS and Cosequin which are much stronger than OTC supplements available for human consumption here in the USA so cannot be extrapolated to other glucosamine/chondroitin products. It was for six weeks compared to the six month ARC study.

Speaking of which it is my understanding the studies in the EU involve prescription strength products not the comparitively lower strength OTC supplements available here.

Which leads to another issue. My searching reveals there have been studies of products for human and equine use here in the US and dose strength, consistancy, and impurities are an issue also.

One study claims that neither product is absorbed by the human GI tract, Another claims it is. Yet another claims that only 20% of the product is absorbed at all. If it is in fact absorbed at all how does having an overabundance of a molecule found naturally in the body effect the matrix of cartilage if at all?

Some of the claims of product manufacturers are tainted with studies that involve IM injections as opposed to oral administration, and injections directly into joints. This is all in the fine print to be read freely on product websites.

Much of the manufacturer based research states that their products have regenerative properties. Independent double blind placebo research does not duplicate this at this point to my knowledge. There does appear to be some anti inflammotory properties which in itself would be valuable especially with the inherent hazards of NSAID use.

"As of May 2004, the data from the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) were being analyzed, with the results to be published in a peer-reviewed medical or scientific journal." I do not know which one and I dont understand why I have to be careful at all regarding this issue Mr Harsey (respecfully), it might be a peer review by the allopathic medicine community or other scientific body.

My position is that I hope they find out exactly what the actions of glucasamine HCI, glucosamine sulfate, or chondriotin are. At the very least it would be fantastic to know exactly what results are achivied by its therapy. Other medications actions are unkown and so too may be gl/ch. But if its efficacy can be known and side effects as well as complications it would aide persons taking this supplemt as well as other supplents andmedications. At the very least it would be nice to have label regulations applied to both.

The medical community and general population has everything to gain if this can be done-

ccrn

[DoctorDoom]

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