The latest on glucosamine

Q:

Q: I HAVE osteoarthritis of the knee and have been taking a glucosamine and chondroitin supplement because I thought it had now been clinically proven to help. Then I heard someone from CHOICE on the radio saying that this is not the case. Am I wasting my money?

To answer this question, SuperLiving has consulted both the CHOICE article on this subject and asked the CEO of Arthritis Australia about their most recent guidelines.

A: There was much excitement among arthritis sufferers some years ago when the general scientific consensus seemed to be that a popular natural supplement, glucosamine – often teamed with another, chondroitin – showed promise as a pain reliever (with possible other benefits) for osteoarthritis.

A subsequent 2008 review of the evidence has put that early promise into question, but the jury is still well and truly out. Most experts are not recommending that it is necessarily cause to stop taking them if you feel they are doing you good.

The review of evidence from studies was brought to public attention by CHOICE magazine last month.

It states that: “scientific evidence for glucosamine or glucosamine/chondroitin makes it seem doubtful that it's effective at relieving the pain of osteoarthritis.”

“However, plenty of people who suffer from osteoarthritis think it's worked for them, so it's still worth giving glucosamine and chondroitin a try, even if the only result is the placebo effect. If you get any effect at all, it's likely to take four to six weeks. On the other hand, exercise and weight loss are likely to benefit you more.”

The CHOICE article then went on to detail the results of its own analysis of the major combined glucosamine and chondroitin supplements on the market to see if they do contain the amounts of active ingredients claimed; and if those amounts are in line with the dosages tested in the major clinical trials.

For chondroitin, an effective therapeutic dose is generally held to be 800-1000mg per day; while major studies that have found beneficial effect from chondroitin involves even higher doses of 1200mg.

Only three products in the CHOICE analysis provided 1200mg per day or more of chondroitin:

• Herron OsteoEze Active
• GNC Glucosamine 750 Chondroitin 600
• Enervite Super Joint & Arthritic Relief 1100mg.

Three of the products CHOICE tested did not contain enough glucosamine to match the dose levels used in clinical trials (generally 1500mg). The first two listed below did not contain the level of glucosamine levels claimed on the label (note the acceptable legal limit for accuracy of ingredients listings such as these is between 92.5% and 107% of what’s claimed on the label):

• Nutralife High Potency Joint Care Arthritis Formula with Glucosamine and Chondroitin (90% of the amount claimed on label)
• Wagner Joint Formula Glucosamine and Chondroitin (86% of the amount claimed on the label)
• Woolworths Select Glucosamine Complex 500mg

According to Ainslie Cahill, CEO of Arthritis Australia: “following the CHOICE article we have nothing further to add because their summary, as outlined above, reflects our views and the message being given to consumers.”

Arthritis Australia produces a fact sheet on glucosamine and chondroitin that reflects their position (link below). Among other things, they do warn about any treatment that promises a cure – and against investing large sums of money on treatments for which they are not noticing a benefit.

These fact sheets are prepared with the Australian Rheumatology Association and in consultation with a number of peak groups.

To broadly summarise Arthritis Australia’s position:

While their effectiveness remains unclear, it appears glucosamine and chondroitin are relatively safe treatment options for people with osteoarthritis (no other type of arthritis) to trial.

What is the recommended dose?

• Glucosamine sulfate: 1500mg per day
• Glucosamine hydrochloride: 1500mg per day (note,
  glucosamine sulfate is suggested to be more effective than glucosamine hydrochloride)
• Chondroitin sulfate: 800 -1000mg per day (note, the CHOICE findings regarding dose levels in major studies put this at 1200mg per day)

What are the possible risks?

Glucosamine:

• Shellfish allergies: glucosamine is often made from shellfish so you should talk to your doctor before taking glucosamine if you are allergic to shellfish.
• Diabetes: glucosamine is a type of sugar so check with your doctor before taking glucosamine if you have diabetes.
• Pregnant or breastfeeding women: there have not been enough long term studies to clearly say that glucosamine is safe for a developing baby. Pregnant women should talk to their doctor before taking glucosamine.
• Other side effects: upset stomach (for example,
  diarrhoea), headaches, and skin reactions. Talk to your doctor or pharmacist about possible side effects before taking glucosamine.

Chondroitin:

• Bleeding: people taking blood thinning medicines, such as warfarin, should talk to their doctor before taking chondroitin as it may increase the risk of bleeding.
• Other side effects: chondroitin may also occasionally
  cause stomach upsets.

Where to find out more

For more arthritis information visit www.arthritisaustralia.com.au or call 1800 011 041.

To download a copy of the CHOICE article including the comparative table of supplements (which also includes price per dose information) go to < a href=http://www.arthritissa.org.au/asp/latestnews.asp#269 target=_blank>www.arthritissa.org.au

The George Institute, affiliated with the University of Sydney, is recruiting people with painful knees for the LEGS Study. This study, funded by the National Health and Medical Research Council, will evaluate the effects of glucosamine, with and without chondroitin, on pain and cartilage loss. If you're aged 45 to 75, have chronic knee pain and live in or near the Sydney region, further information and contact details can be found at www.thegeorgeinstitute.org

Reader Comments

I have had a displaced kneecap for over four (4) years which, for two years, made my knee and leg swell. Since I started using glucosamine, the swelling has completely subsided and the knee does not pain me as it used to.

Whether this is a “placebo” effect doesn’t worry me in the least – the result means I can walk normally and, although my knee does occasionally hurt, it is nothing compared to when the kneecap first displaced.
Kerry

Found Glucosamine Sulphate a waste of time and money. Glucosamine Chondritin works! Dr John O'Neill's is the best. Expensive, but brilliant!
Paul