Salisbury Press

Sunday, February 23, 2020

Healthy Geezer: Osteoarthritis supplements

Friday, March 22, 2019 by FRED CICETTI Special to The Press in Focus

Q. Are glucosamine and chondroitin good for arthritis?

Arthritis is inflammation of the joints. Osteoarthritis is the most prevalent form of the condition. An estimated 27 million adults in the United States live with osteoarthritis.

You get osteoarthritis when cartilage, the cushioning tissue within the joints, wears down. The disease affects both men and women. By age 65, more than 50 percent of us have osteoarthritis in at least one joint.

Osteoarthritis can affect any joint, but it usually strikes those that support weight. Common signs of osteoarthritis include joint pain, swelling and tenderness.

Treatments for osteoarthritis include exercise, joint care, dieting, medicine and surgery. For pain relief, doctors usually start with acetaminophen, the medicine in Tylenol, because the side effects are minimal. If acetaminophen does not relieve pain, then non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve) may be used.

Many people say glucosamine and chondroitin can relieve the symptoms of osteoarthritis. In the United States, glucosamine and chondroitin are sold as dietary supplements, which are regulated as foods rather than drugs. The annual sales of the supplements around the world are about $2 billion.

Glucosamine and chondroitin are two molecules in joint cartilage. Treatment with these supplements is based on the theory that consuming them may speed the formation of new cartilage. There is no proof that glucosamine and chondroitin help form new cartilage.

However, there are studies indicating that the supplements relieve pain better than placebos. The pain reduction found in these studies was similar to results obtained by NSAIDs. However, NSAIDS have side effects, including gastrointestinal bleeding. Glucosamine and chondroitin have few side effects.

While there are indications that glucosamine and chondroitin have pain-relieving qualities, the supplements have yet to pass a test that would qualify them to be a primary treatment for osteoarthritis. More research is needed.

In one study, the combination of glucosamine and chondroitin did not provide significant relief from osteoarthritis pain among all participants. There were 1,583 perons, with an average age of 59, who participated in the study.

For a subset of participants with moderate-to-severe pain, glucosamine combined with chondroitin provided statistically significant pain relief compared with the placebo. About 79 percent had a 20 percent or greater reduction in pain, compared to about 54 percent for the placebo. Researchers said these findings need to be confirmed in further studies because of the small size of this subgroup. The research was funded by the National Institutes of Health (NIH).

Researchers led by rheumatologist Daniel O. Clegg, M.D., of the University of Utah, School of Medicine, conducted a four-year study known as the Glucosamine-chondroitin Arthritis Intervention Trial (GAIT) at 16 sites across the United States.

The GAIT study included an additional inquiry to investigate whether these supplements could diminish structural damage from osteoarthritis of the knee. At the end of the ancillary study, the team had gathered data on 581 knees. After assessing the data, the researchers concluded that glucosamine and chondroitin appeared to do no better than a placebo in slowing loss of cartilage in osteoarthritis of the knee.

Another study was done by Dr. Peter Juni of the University of Toronto, and Dr. Andrew Sherman at the University of Miami. Investigators analyzed the results of 10 randomized clinical trials involving more than 3,800 patients with knee or hip osteoarthritis. They found no clinically-relevant effect of chondroitin, glucosamine or both taken together on joint pain.

“We need to look more closely at these over-the-counter medications that claim to be panaceas and may not be giving us our money’s worth,” Dr. Sherman said.

Should you try the supplements? Not without consulting a physician.

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All Rights Reserved © 2019 Fred Cicetti

The Times News, Inc., and affiliates (Lehigh Valley Press) do not endorse or recommend any medical products, processes, or services or provide medical advice. The views of the columnist and column do not necessarily state or reflect those of the Lehigh Valley Press. The article content is not intended as a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician, or other qualified health-care provider, with any questions you may have.