News & Perspectives

Glucosamine Effective for Arthritis

Doctors and patients have long wished for a treatment for osteoarthritis, a degenerative joint disease that now afflicts some 21 million Americans. What everyone has been hoping for was a remedy that would not only relieve the pain, but one that could also prevent the condition from getting worse. The dietary supplement glucosamine sulfate has been a leading candidate. Now, in its January 27, 2001 issue, the esteemed medical journal The Lancet reports that indeed this natural remedy appears to protect against joint destruction, just as promised.

The results of this major three-year Belgian study are impressive. As in previous trials that lasted a shorter time, patients taking glucosamine reported far greater improvements than those who went without the remedy. But in this study Belgian researchers at the University of Liege found an effect that had not been seen with glucosamine before--or, for that matter, with any other osteoarthritis treatment. Glucosamine prevented knee joints from narrowing, a sign that the shock-absorbing cartilage that normally cushions the bones remained intact. In other words, glucosamine stopped the disease in its tracks.

"For the first time, we have shown that a compound may be able to at least slow down the progression of osteoarthritis," reported the lead investigator, Dr. Jean-Yves Reginster, when the study results were first calculated. The comments were made late in 1999 at a meeting of the prestigious American College of Rheumatology in Boston.

A well-designed study
To make sure the glucosamine findings would be taken seriously, the investigators followed strict scientific guidelines. They recruited 212 people who suffered worn-down knees due to years of osteoarthritis--a fairly large group by research standards. The diagnosis was confirmed by X rays. Next, the patients were asked how much pain and stiffness they had and how well they could get around. Their symptoms were rated on a scale ranging from mild to moderate, the same type of criteria used by U.S. researchers.

In a random fashion, half the volunteers were then given 1,500 mg of glucosamine sulfate a day, and the others received a placebo. Three years later, patients who took glucosamine sulfate reported feeling roughly 20 percent better than before, but the placebo group said they felt about 8 percent worse. X rays taken after three years also showed that the knee joints of glucosamine users were spaced nearly as evenly as when the study began. By contrast, the knee joints of those who took a placebo had narrowed considerably.

Building cartilage--and respect
Not everyone is convinced that patients should rush out and take the remedy. "The glucosamine waters unfortunately remain pretty muddy," says Dr. Daniel Clegg of the University of Utah, who is heading up a National Institutes of Health (NIH)–sponsored study on glucosamine. Critics say that the Belgian study was not large enough to draw firm conclusions, and that the X-ray evidence is hard to interpret.

But a growing chorus of believers feel that the recent findings lend greater credibility to the already popular supplement. "I have recommended it to patients before," says Dr. William Arnold, who advises the Arthritis Foundation on alternative health issues. "Now I’m even more convinced that it works."

Indeed, glucosamine appears to offer certain advantages over such standard arthritis treatments as Tylenol and ibuprofen. These drugs can quickly relieve osteoarthritis pain and stiffness, but they do nothing to stop joint damage. There is at least some evidence that glucosamine does--and it's inexpensive and safe.

The Arthritis Cure, revisited
The body uses glucosamine to build proteoglycans, compounds that act as natural construction workers to give cartilage its shape and resilience. Some contend that it restores joint health best when taken with other supplements.

Dr. Jason Theodosakis, who helped propel glucosamine to fame in his best-selling book, The Arthritis Cure (St. Martin’s, 1997), recommends that glucosamine be taken along with the cartilage-building compound chondroitin sulfate. No one really knows if this combination of glucosamine and chondroitin works better than glucosamine alone, but researchers are looking at this question and answers should be available soon.

Although studies are lacking, other supplements may also be worth trying along with glucosamine if that compound alone is not effective. These include the supplement MSM (750 mg, 3 times a day); the B vitamin niacinamide (1,000 mg, 3 times a day; at this high dose, use only under a doctor’s supervision); the herb boswellia (1 pill, standardized to contain 150 mg boswellic acid, 3 times a day); and SAMe (400 mg twice a day for two weeks, then 200 mg twice a day). Several times a day, you can also apply pain-relieving topical cayenne cream to affected joints.

Getting the right supplement
In the current Belgian study, glucosamine alone proved to be an effective arthritis fighter. The project used a special patented version of glucosamine sulfate, which can be purchased only by prescription in Europe. In the U.S., glucosamine is widely available in pharmacies and health-food stores. In fact, Americans spend some $400 million on glucosamine products every year. The trick is to find a reliable brand.

Dr. Theodosakis has found plenty of bad glucosamine products among the 100 or so brands on the market. As with other supplements, some did not contain what was stated on the label. "It's really buyer beware," he says. His findings underline the importance of sticking with brands you trust from reliable manufacturers.

If you’re thinking of trying glucosamine, it may be best to use glucosamine sulfate rather than glucosamine hydrochloride or glucosamine chlorohydrate. The latter forms may also be effective, but the sulfate form of glucosamine has been tested most extensively.

Suggested dose: Take 500 mg of glucosamine sulfate 3 times a day, for a total daily dose of 1,500 mg. The supplement is slow to act, so up to a month may pass before you start to feel better. You can also take Tylenol or another pain reliever for two weeks or so, and then just glucosamine if pain and stiffness subside. Glucosamine can also be combined with other supplements (see above). Consult your doctor before discontinuing prescription drugs.

Interested in how you can help arthritis by eating healthfully? Check out our Healing Kitchen Food Remedies.

Date Posted: 09/01/2002

Date Published: 08/31/2002
> Printer-friendly Version Return to Top