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If you suffer from osteoarthritis, chances are you may have heard of Chondroitin Sulfate and Glucosamine Sulfate supplements to deal with the pain that accompanies this degenerative joint disease. But, are they effective? Can they stop or slow the progression of osteoarthritis? Do they have the capability to replace conventional medicine that doesn’t yet have a proven treatment to cure osteoarthritis? Let’s find out.
Also referred to as degenerative arthritis, Osteoarthritis (OA) is a chronic disease that affects the joints. Often also called as ‘wear and tear’ arthritis, this condition usually affects joints in the hands, fingers, hips, and knees. It causes pain, stiffness, swelling, and sometimes, even disability.
In normal joints, a firm, rubbery material known as ‘cartilage’ provides cushioning to each bone. Cartilage is responsible for providing a smooth, gliding surface for joint motion. This cushioning it provides absorbs the jarring impact that occurs when bones rub against each other.
Osteoarthritis results in the breakdown of this cartilage, causing pain, swelling and problems moving the joint. Aging, obesity, joint overuse and injury aggravate osteoarthritis symptoms, as cartilage starts to undergo wear and tear.
Glucosamine and chondroitin sulfate have emerged as an alternative treatment to alleviate pain that accompanies osteoarthritis. Available at pharmacies and health food stores without any prescription, both are well-tolerated and appear to be safe. It’s important to note that both glucosamine and chondroitin sulfate are components of normal cartilage. In the body, they are the building blocks for cartilage and appear to stimulate the body to make more cartilage.
As there is no known cure for osteoarthritis in conventional medicine, these supplements can play an important role in managing symptoms. A Korean study found that glucosamine and chondroitin sulfate may delay progression of osteoarthritis of the knee after daily administration for over 2 or 3 years.
A review paper published by The Arthritis Center, Boston University School of Medicine, Boston discussed the efficacy of glucosamine and chondroitin preparations for OA symptoms and found them as a worthy alternate treatment for osteoarthritis, though quality issues and likely publication bias necessitate the need for more research. A study done at Michigan State University provides a plausible explanation for the purported anti-inflammatory properties of glucosamine and chondroitin sulfate.
Based on results of recent randomized controlled trials, experts now believe there is evidence that these two supplements can be used as therapeutic agents to delay the progression of osteoarthritis.
Glucosamine is a natural compound found within healthy cartilage of our joints. It’s made from a chemical combination of proteins and sugars bound together. It gives healthy cartilage its natural shock-absorption and joint lubrication abilities, which facilitate joint movement. Glucosamine possesses natural anti-inflammatory and anti-aging properties.
There are different forms of glucosamine including glucosamine sulfate, glucosamine hydrochloride, and N-acetyl-glucosamine. These may sound like different chemicals but do have some similarities. However, they may not have the same effects when taken as a dietary supplement. Most of the scientific research done on glucosamine use for osteoarthritis has been done on glucosamine sulfate. Glucosamine sulfate occurs naturally in the human body, usually contained in the fluid surrounding joints.
For dietary supplements, it is harvested from shells of shellfish but can also be artificially made in labs. Glucosamine sulphate has anti-inflammatory properties and may help with cartilage regeneration. A study published in JAMA Internal Medicine found that long-term treatment with glucosamine sulfate can slow the progression of knee osteoarthritis.
Glucosamine sulfate functions as the primary building block for formation and repair of cartilage. When taken orally, glucosamine sulfate is absorbed readily into the system. Studies have proven that it’s as effective as ibuprofen for treating pain of osteoarthritis of the knee after 4 weeks.
More research is needed to understand if it may have the potential to help regenerate cartilage. Glucosamine is especially useful for providing pain relief for some patients with osteoarthritis of the knee, hip and spine.
Glucosamine has unique anti-inflammatory effects and has a protective effect on the cartilage. Studies suggest that glucosamine sulfate may inhibit the breakdown of cartilage associated with osteoarthritis.
A multi-center, randomized study in Germany that followed 252 patients with OA of the knee for 4 weeks reported similar findings. In the study, researchers found that glucosamine sulfate may be a safe and effective symptomatic ‘Slow Acting Drug’ for OA. Another study that combined evidence from two 3-year studies found that Glucosamine sulfate reduces progression of osteoarthritis in postmenopausal women with knee osteoarthritis. Scientists have found that long-term treatment with glucosamine sulfate retarded the progression of knee osteoarthritis, possibly determining disease modification.
Chondroitin occurs naturally in the body and is a building block of healthy joint tissue. It is a major component of cartilage and plays an important role in its growth and maintenance.
Chondroitin helps cartilage retain water, attracting fluid into the connective tissue surrounding the joint. This helps with shock absorption and also facilitates lubrication of joints.
Chondroitin sulfate supports the health of the joints. As a supplement, chondroitin sulfate is made from the cartilage of cows, pigs or sharks, but it can also be manufactured artificially in the laboratory. In fact, a study done at University of Maryland School of Medicine, Baltimore shows evidence that chondroitin sulfate is effective for slowing progression of disease in knee osteoarthritis.
Chondroitin sulfate can provide additional pain relief for some people with knee and hand osteoarthritis. A study published in the Journal of Rheumatology found that Chondroitin sulfate is effective in treating OA when used for 3 months. The benefits are rather modest, offering 8-10% improvement.
However, it can be the ideal alternative to nonsteroidal anti-inflammatory drugs (NSAIDs) for patients who cannot take NSAIDs but need a long-term treatment plan. A 1996 study compared the anti-inflammatory efficacy of chondroitin sulfate with diclofenac sodium in patients with knee osteoarthritis. The study, which was published in The Journal of Rheumatology, found that treatment with chondroitin sulfate may be slower, but more effective in the long run. Patients treated with the NSAID showed prompt and plain reduction of clinical symptoms, which, however, reappeared after the end of treatment. On the other hand, in patients treated with chondroitin sulfate, therapeutic response appeared later in time but lasted for up to 3 months after the end of treatment.
In a 1-year, randomized, controlled pilot study which included 42 patients of both sexes, scientists found that oral chondroitin 4- and 6-sulfate is an effective and safe symptomatic slow-acting drug for the treatment of knee OA.
While current scientific data offers no conclusive evidence that glucosamine sulfate or chondroitin sulfate prevents or reverses the process of joint degeneration that leads to osteoarthritis, they can slow down the progression of the disease. These supplements can be a part of your osteoarthritis treatment, especially if you want to limit dependence on NSAIDs.
Typical dosage is 1500mg for glucosamine sulfate and 1200mg for chondroitin sulfate, taken once daily. The larger dosage of glucosamine sulfate can be attributed to the fact that glucosamine sulfate doesn’t survive the digestive tract too well to reach the joints. This is why, topically applied products that bypasses digestion may be worth looking into as they will easily achieve targeted delivery.
A clinical trial studying the effects of using a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee found that topical use brought relief from pain of osteoarthritis in 4 weeks.
Bear in mind – chondroitin and glucosamine supplements alone or in combination may not work for everyone with osteoarthritis. Many patients find it is best to use these nutritional supplements in conjunction with other non-surgical treatments like NSAIDs, stretching exercises and water therapy.
Doctor’s haven’t determined the duration of treatment with glucosamine sulfate and chondroitin sulfate as yet. It’s best to talk to your healthcare provider and ask for suggestions on which brands may have the highest quality supplements and to chart out a treatment plan based on your specific needs.
Structure-modifying effects of chondroitin sulfate in knee osteoarthritis: an updated meta-analysis of randomized placebo-controlled trials of 2-year duration – https://www.ncbi.nlm.nih.gov/pubmed/20399895?dopt=Abstract
Glucosamine Sulfate Use and Delay of Progression of Knee Osteoarthritis – http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/213562
Glucosamine and Chondroitin Sulfate as Therapeutic Agents for Knee and Hip Osteoarthritis – https://link.springer.com/article/10.2165/00002512-200724070-00005
A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee – http://www.jrheum.org/content/30/3/523.short
Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis – https://link.springer.com/article/10.1007/s00296-009-0969-5
Glucosamine and chondroitin sulfate regulate gene expression and synthesis of nitric oxide and prostaglandin E2 in articular cartilage explants – http://www.sciencedirect.com/science/article/pii/S1063458405000191
Glucosamine sulfate in osteoarthritis of the knee – http://www.sciencedirect.com/science/article/pii/S1063458405800068
Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies – http://journals.lww.com/menopausejournal/Abstract/2004/11020/Glucosamine_sulfate_reduces_osteoarthritis.4.aspx
Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee – http://www.sciencedirect.com/science/article/pii/S106345840580007X
Chondroitin sulfate in osteoarthritis of the knee: a prospective, double blind, placebo controlled multicenter clinical study – http://www.jrheum.org/content/28/1/173.short
Clinical review of chondroitin sulfate in osteoarthritis – http://www.sciencedirect.com/science/article/pii/S1063458408002008
Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study – http://www.sciencedirect.com/science/article/pii/S1063458498800113
Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis – http://europepmc.org/abstract/med/8856618
Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial – https://www.ncbi.nlm.nih.gov/pubmed/11214126?access_num=11214126&link_type=MED&dopt=Abstract
Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study – https://www.ncbi.nlm.nih.gov/pubmed/12374520?access_num=12374520&link_type=MED&dopt=Abstract