Spending Money on Chondroitin Might Be a Bad Idea- Study - Mercedes-Benz Forum

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post #1 of 4 (permalink) Old 04-17-2007, 09:23 AM Thread Starter
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Spending Money on Chondroitin Might Be a Bad Idea- Study

A new study suggests that the use of chondroitin supplements in treating osteoarthritic pains is as ineffective as the placebo.

According to the statistical data provided by the authors of the research, frequent knee pain affects about 25% of adults, at least half of whom have osteoarthritis. Persons with knee and other joint pain often take over-the-counter nutritional supplements available in grocery stores, in drug stores, or online for treatment of their joint pain. The most popular supplement is a pill containing a combination of glucosamine and chondroitin. The demand for the chondroitin component of this pill alone constitutes a $1 billion-per-year market in the United States.

Glucosamine is an amino acid sugar produced by the body and present in cartilage. There are no serious side effects with glucosamine. It is extracted from shells of shellfish so if a patient is allergic to shellfish he/she should avoid it. If a patient is diabetic, since glucosamine is an amino acid sugar, it can impact on the blood sugar level.

Chondroitin is a carbohydrate compound and is present in cartilage. It gives the cartilage elasticity. Articular surface of joints are protected by cartilage (articular cartilage) and this cartilage is a tough smooth gristle that reduces friction and protects the underlying bone from wear. Damage and wear of the cartilage is seen on an x-ray as loss of joint space. Cartilage contains both glucosamine and chondroitin.

Due to the popularity of the glucosamine-chondroitin supplement and the lack of reliable information about its usefulness in treating osteoarthritis, the National Institutes of Health had previously funded a study to test the effects of chondroitin and glucosamine on osteoarthritis of the knee. This multicenter, placebo-controlled, double-blind, six month long trial found that glucosamine plus chondroitin had no statistically significant effect on symptoms of osteoarthritis. The results indicated that glucosamine and chondroitin do not effectively relieve osteoarthritic pain. Although the study found no overall effect for the supplements, a secondary analysis of a subgroup of patients suggested that the supplements taken together helped people with more severe pain.

The conclusions of the aforementioned research are now confirmed by a new study, published in the Annals of Internal Medicine by a team led by Stephan Reinbach, which looked at data from 20 clinical trials encompassing 3,846 patients.

According to the scientists, the logic of those who believe that by ingesting pills containing molecules of chondroitin (Chondroitin sulfate, a glycosaminoglycan, is a constituent of a large macromolecule in the knee’s cartilage called aggrecan) they relieve their pains is misleading. The rationale for the use of chondroitin and glucosamine as treatment of arthritis is that these two drugs, according to some, will improve the health of affected articular cartilage. Both chondroitin and glucosamine are manufactured by the body.

But scientists argue that because chondroitin is a large macromolecule, only about 12% to 13% of ingested chondroitin is absorbed intact into the bloodstream. Second, while chondroitin therapy supposedly targets cartilage, osteoarthritis affects the whole joint, not just cartilage. Pathologies include bone sclerosis, remodeling and deformity, ligamentous stretching and loss of integrity, muscle atrophy, joint capsular stretching, and even synovial inflammation. A molecule targeted only at constituents of cartilage is unlikely to affect all manifestations of osteoarthritis. Also, any treatment targeting cartilage alone would be unlikely to alleviate pain, the predominant symptom of osteoarthritis, because cartilage is aneural.

"People had the idea that this could be the magic bullet for osteoarthritis, but it cannot be," said Dr. Peter Juni, a medical epidemiologist at the University of Bern in Switzerland and one of the authors of the study.

Out of the 20 trials, the researchers focused on three of the largest and most complete studies, which included 1,553 patients. They found virtually no difference in pain reduction between the chondroitin and placebo groups. The researchers also looked at X-rays of the patients' joints and found little difference between the two groups.

Juni said the three studies included more patients with advanced osteoarthritis than low-grade osteoarthritis.

Because several smaller studies had shown an improvement for low-grade sufferers, Juni acknowledged that some patients could benefit from chondroitin.

He also noted that if patients don’t manifest any side effects from taking the supplement, they should be allowed to take it: "If patients say they benefit from chondroitin, I see no harm in encouraging them to continue taking it."

However, chondroitin, in the United States at least, is almost always sold in a combination pill with glucosamine. The meta-analysis by Reichenbach and colleagues included studies of chondroitin alone, not combined with glucosamine; therefore, the results of their meta-analysis might not apply to the combined product.

"Chondroitin is rarely used in this country by itself," said Mark David, a nutritional biochemist and spokesman for Pharmavite, a California-based company that sells a combination chondroitin-glucosamine supplement under the Nature Made brand. "It looks as if the combination does better than either of them alone."

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post #2 of 4 (permalink) Old 04-17-2007, 01:53 PM
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I am one who suffers from knee pain. A personal friend and client who has held the position of Assistant Surgeon General of the United States and who was the senior medical advisor to one of the U.S. Cabinet agencies as well as to a military organization told me exactly the same thing you have written above, but 5 years ago (based on earlier studies). Her advice to me was to use glucosamine alone for my kind of knee pain, which is caused by a decrease in synovial fliud (the body's natural jiount lubricant) - unless you have conditions that indicate you should not use it at all. And she said that chondroitin, which really increases the expense of medicine when combined with glucosamine, is no better than a placebo, even when used in combination with glucosamine.


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post #3 of 4 (permalink) Old 04-17-2007, 06:15 PM
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As a fifty one year old who refuses to stop playing full court basketball I must say I swear by glucosamine (not sure whether my latest jar has condroitin in it - sometimes it doesn't). That and lots of Advil. Who's got game?

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post #4 of 4 (permalink) Old 04-18-2007, 03:37 AM
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As a fifty two year old house painter, my daily swallowing of a few capsules containing Glucosamine & Chondroitin (plus other support ingredients) has become routine over the last year. I stopped for about a month, but the knee and joint pain came back, but has near disappeared again - from about two weeks after I resumed the routine. Whatever the research results, the combination I take works for me, and I'll continue with them.
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