Benefits of Glucosamine and Chondroitin Sulfate for Osteoarthritis

According to the Glucosamine/ Chondroitin Arthritis Intervention Trial (GAITT), a study made by the National Institutes of Health (NIH), taking Glucosamine and Chondroitin sulfate food supplements is more effective than the pain medication Celebrex�® in treating moderate to severe osteoarthritis knee pain. The study was published in the February 23rd issue (2006) of The New England Journal of Medicine (NEJM).

The 14 million dollar study funded by the NIH is the largest placebo-controlled, double blind clinical trial to test the safety and effectiveness of glucosamine and chondroitin in reducing knee pain associated with osteoarthritis. A control group of 1258 patients, with ages 40 and above, were randomly given placebo, glucosamine (1500 mg.), chondroitin (1200 mg.), a combination of the glucosamine and chondroitin or celecoxib (Celebrex 200 mg.) daily for a period of 6 months. The study found that 79.2 percent of the patients, suffering from moderate to severe osteoarthritis, experienced a significant decrease in pain with the glucosamine/chondroitin combination as compared to 69.4 percent of those taking Celebrex. However, the study also concluded that glucosamine and chondroitin, alone or in combination, did not reduce pain effectively in patients with mild knee pain.

The study comes as a welcome relief to the estimated 21 million Americans suffering from osteoarthristis looking for a convenient alternative to expensive pain medications. Glucosamine and chondroitin also have fewer side effects compared to non steroidal anti-inflammatory drugs.

Glucosamine caught the public’s attention when the Lancet, a leading medical journal, reported that it had beneficial effects on osteoarthritis sufferers. Fuelled by the sudden interest, the numerous TV and newspaper reports that followed eventually lead to overstatements. Unfounded claims in the improvement or modification in the structure of affected joints was soon circulated. Although some clinical trials have shown that Glucosamine may help to prevent or slow down the loss of cartilage, the re-growth of cartilage is speculative. Drug companies, eager to cash in on public demand for the Glucosamine “cure” soon flooded the market with hundreds of products.

Glucosamine is an amino sugar normally produced in the human body. It is necessary for the construction and repair of connective tissue and healthy joint cartilage. Cartilage is the protein part of the fibrous substance that holds the joints. It is also used in the formation of tendons, membranes, heart valve, cornea, intervertebral disc, bones and other tissues

Chondroitin sulfate also occurs naturally in the body. It is an essential ingredient in the production of proteoglycans. Proteoglycans are large protein molecules that give cartilage elasticity. Chondroitin sulfate act by attracting fluid into the proteoglycan molecules. This synovial fluid also acts as a shock-absorber and lubricates the joints. Chondroitin sulfate also stimulates collagen production, an ingredient that forms part of the cushioning structure at the ends of the joints.

As we get older, the production of glucosamine and chrondroitin sulfate by the body tapers. Increased activity, damages to the body and degenerative diseases may overcome the rate at which it is produced and used affecting the production of proteoglycans. This in turn decreases synovial fluid that cushions and prevents the joints from rubbing together. Cartilage can begin to deteriorate and weaken (less collagen) producing damage, stiffness and pain.

The GAITT study, designed to test the safety and efficacy of glucosamine and chondroitin sulfate, has confirmed that the supplements reduced knee pain associated with osteoarthritis. Glucosamine and Chondroitin sulfate are much more affordable and safer compared to other pain medications. In the US they are classified as food supplements and can be bought over the counter. However, being food supplements they are not regulated and tested and it is advised to buy only from reputable manufacturers. It is recommended to consult a doctor before deciding to take these supplements, especially in pregnant women and diabetics. Dosages used in the study were 1500 mg. of Glucosamine and 1200 mg. of Chondroitin sulfate taken daily.

In-depth clinical studies currently being undertaken by the National Institutes of Health can offer definitive results on the other beneficial effects of these food supplements.

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