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Glucosamine Gets New Validation As a Way to Relieve Arthritis Pain
People with arthritis who take glucosamine have said it makes their joints feel better; and some studies have confirmed these reports. Now a three-year study at the Prague Institute of Rheumatology has confirmed that glucosaraine appears to stop the narrowing of the space in the knee joint that typically occurs with arthritis. More than one hundred men and women with mild to moderately severe knee arthritis for at least a decade took 1,500 mgs of glucosamine sulfate or a placebo once a day for three years. X-rays of participants' knee joints, taken when they began the study and every year thereafter, showed that the critical space where the bones of the leg meet was more likely to narrow in those taking the placebo than in those taking glucosamine. In arthritis, the cartilage that normally covers the ends of the bones is damaged so the bones can rub together. At three years, fourteen of the fifty-six people taking placebos had severe narrowing, a sign that arthritis has become worse, compared with five of the sixty-six taking the supplement. from Earth Star Magazine, March 03 |
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| | | From: Rene | Sent: 12/14/2005 3:57 PM |
Supplement Combo as Good as Prescription for OA Knee Pain By Alan R. Gaby, MD Healthnotes Newswire (November 17, 2005)—The results of a new clinical study presented at the Annual Scientific Meeting of the American College of Rheumatology (Nov. 14, 2005) suggest that the combination of glucosamine and chondroitin sulfate is at least as effective as the prescription drug celecoxib (Celebrex) in treating pain caused by moderate to severe osteoarthritis (OA) of the knee. Glucosamine is a naturally occurring molecule that the body uses to build joint cartilage. Most studies have shown that glucosamine (usually given as glucosamine sulfate) can relieve OA pain and slow progression of the disease, presumably by helping to repair damaged joint tissue. Chondroitin, another component of joint cartilage, has also been found to slow OA progression and to have an anti-inflammatory effect. In the new study, 1,258 people with OA of the knee were randomly assigned to receive one of the following for 24 weeks: 500 mg of glucosamine (in the form of glucosamine hydrochloride) three times a day; 400 mg of chondroitin sulfate three times a day; 500 mg of glucosamine and 400 mg of chondroitin sulfate, each three times a day; 200 mg per day of celecoxib, a prescription anti-inflammatory medication; or a placebo. The response rate was defined as the proportion of patients in each group who experienced at least a 20% improvement in pain. Among people with moderate to severe symptoms, the response rates were 79% with combination therapy, 69% with celecoxib, 66% with glucosamine, 61% with chondroitin sulfate, and 54% with placebo. Only the response rates in the combination-therapy and celecoxib groups were statistically significant compared with the placebo group. However, in the study as a whole, and in the subset of people with mild OA, celecoxib was the only treatment found significantly more effective than the placebo. All treatments were well tolerated. The results of this study suggest that the combination of glucosamine and chondroitin sulfate is more effective than a placebo, and at least as effective as celecoxib, for moderate to severe OA of the knee, although this combination did not appear to be effective for milder arthritis. Combination treatment was also more effective than glucosamine or chondroitin sulfate alone, but it was not clear whether these differences were statistically significant. It should be noted that previous research has suggested that glucosamine sulfate is more effective than glucosamine hydrochloride, the form of glucosamine used in the new study, so additional research is needed to determine whether combination therapy is more effective than glucosamine sulfate alone. An expert in nutritional therapies, Chief Medical Editor Alan R. Gaby is a former professor at Bastyr University of Natural Health Sciences, where he served as the Endowed Professor of Nutrition. He is past-president of the American Holistic Medical Association and gave expert testimony to the White House Commission on Complementary and Alternative Medicine on the cost-effectiveness of nutritional supplements. Dr. Gaby has conducted nutritional seminars for physicians and has collected over 30,000 scientific papers related to the field of nutritional and natural medicine. In addition to editing and contributing to The Natural Pharmacy (Three Rivers Press, 1999), and the A–Z Guide to Drug-Herb-Vitamin Interactions (Three Rivers Press, 1999), Dr. Gaby has authored Preventing and Reversing Osteoporosis (Prima Lifestyles, 1995) and B6: The Natural Healer (Keats, 1987) and coauthored The Patient's Book of Natural Healing (Prima, 1999). From: http://www.publix.com/wellness/news/Article.do?id=2181&childId=2281 |
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| | | From: Rene | Sent: 7/17/2006 8:03 PM |
The Truth Behind the Glucosamine and Chondroitin Study One of the most widely used natural remedies is a combination of glucosamine and chondroitin to ease the pain of aching joints for arthritis sufferers. Interest was high when a major study investigating the supplements' effectiveness reported little impact. While previous small studies had shown positive results, this study was big -- 1,583 patients in a double-blind, multi-center investigation that included both a placebo control group and a prescription painkiller to measure against. The study results came in a few months ago, but the researchers' conclusions and the resulting negative headlines have served up confusion instead of clarity. It was no surprise that when I asked Mark Stengler, ND, editor of Bottom Line's Natural Healing about the study, he had an opinion on the results. Here's what he had to say... STUDY RECAP Here is a quick recap of the study, managed by the University of Utah. It included five groups of people who had symptomatic knee osteoarthritis and took pills over the six-month study period in the following way... - Group one -- 1,500 mg of glucosamine daily
- Group two -- 1,200 mg of chondroitin sulfate daily
- Group three -- a combination of glucosamine (1,500 mg daily) and chondroitin (1,200 mg daily)
- Group four -- 200 mg of celecoxib (Celebrex) daily
- Group five -- a placebo pill daily.
The participants were also categorized into two groups determined by level of pain, mild or moderate to severe. All participants were allowed to take up to 4,000 mg of acetaminophen daily as "rescue" analgesia. The results: Glucosamine reduced knee pain by 3.9 percentage points over placebo... chondroitin sulfate by 5 percentage points... and Celebrex by 10 percentage points. That's not much for the supplements, but wait. For patients whose pain was moderate to severe and who took the combined therapy of glucosamine and chondroitin sulfate, the results were impressive -- 79.2% pain reduction versus 54.3% for those taking placebo. The study's other good news was that adverse side effects were mild and evenly distributed over all groups. One would think a 79.2% reduction in pain for people with moderate to severe knee pain would be something to trumpet, but that's not what happened. The report concluded that the two supplements alone or in combination "did not reduce pain effectively in the overall group of
patients"... although it did add that "exploratory analyses suggest" the combination might help the subgroup. WHY THE NEGATIVE PRESS? Dr. Stengler's analysis: He says this study is interesting and that it would be a mistake to be misled by the negativity surrounding it. He points first of all to the fact that it confirms findings from 50 previous studies that showed glucosamine by itself or combined with chondroitin sulfate is effective when taken for osteoarthritis. The announced "ineffectiveness" of the supplements in this study had to do with the larger numbers of participants in the mild-pain group. Even the study authors admit that the relatively low level of pain these volunteers experienced may have limited the effect of the supplements. In other words, it's hard to notice relief of pain when there isn't much pain to address in the first place. (And really, Dr. Stengler adds, isn't it good to have something we know relieves moderate-to-severe pain even if it doesn't work as well for mild pain?) Further evidence for the effectiveness of the combined supplements was a study result the media, oddly enough, did not report. The pharmaceutical drug Celebrex was not as effective for treating moderate-to-severe pain as was the combination of glucosamine and chondroitin sulfate. Yet another overlooked and important finding: Chondroitin sulfate treatment was associated with a significant decrease of joint swelling, effusion (fluid seeping from inflammation) or both. Dr. Stengler makes several other observations having to do with the supplements used in the study. Patients took glucosamine hydrochloride rather than glucosamine sulfate, the form that has been most widely studied and found to be effective. This type might have been more helpful in this study as well had it been used. Often people do better on the combination of glucosamine and chondroitin, which, of course, only one group was on in this study. Finally, there is that nagging issue of conflict of interest. Not to point fingers, but some of the study authors have had ties with pharmaceutical houses that sell arthritis drugs. ADVICE Given that this study in fact underscores the usefulness of these supplements, Dr. Stengler continues to typically recommend 1,500 mg of glucosamine sulfate and 1,200 mg of chondroitin daily for his patients with osteoarthritis. People who weigh more than 200 pounds are often advised to take a dosage of up to 2,000 mg of glucosamine sulfate. A small percentage of his patients found that the supplements caused them some digestive upset, and in that case they stopped taking it. Also, patients who are allergic to shellfish are advised to be cautious about taking them. Other common recommendations and reminders given to people with osteoarthritis... - Methylsulfonylmethane (MSM) is a natural anti-inflammatory. Typical dose: 2,000 to 5,000 mg daily.
- Fish oil, frequently 1,000 to 2,000 mg daily, that combines EPA and DHA, helps reduce inflammation and lubricate joints.
- Get to and maintain a normal weight.
- Eat few simple sugars because they can aggravate pain.
- Acupuncture, for additional pain relief.
There is yet one more way in which this study is helpful in addition to providing positive evidence about the effectiveness of glucosamine and chondroitin for osteoarthritis. It is a useful reminder to always look beyond the headlines. You never know what you might find. Be well, 
Carole Jackson
Bottom Line's Daily Health News,
Sources: The Truth Behind the Glucosamine and Chondroitin Study - Mark A. Stengler, ND, associate clinical professor, National College of Naturopathic Medicine, Portland, Oregon. He practices naturopathic medicine at the La Jolla Whole Health Clinic, La Jolla, California and editor of Bottom Line's Natural Healing
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