Glucosamine ineffective

[greyowl]

Yet another high-priced supplement promoted by shills and quacks in the alternative health industry bites the dust.


Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis
Daniel O. Clegg, M.D., Domenic J. Reda, Ph.D., Crystal L. Harris, Pharm.D., Marguerite A. Klein, M.S., James R. O'Dell, M.D., Michele M. Hooper, M.D., John D. Bradley, M.D., Clifton O. Bingham, III, M.D., Michael H. Weisman, M.D., Christopher G. Jackson, M.D., Nancy E. Lane, M.D., John J. Cush, M.D., Larry W. Moreland, M.D., H. Ralph Schumacher, Jr., M.D., Chester V. Oddis, M.D., Frederick Wolfe, M.D., Jerry A. Molitor, M.D., David E. Yocum, M.D., Thomas J. Schnitzer, M.D., Daniel E. Furst, M.D., Allen D. Sawitzke, M.D., Helen Shi, M.S., Kenneth D. Brandt, M.D., Roland W. Moskowitz, M.D., and H. James Williams, M.D.


ABSTRACT

Background Glucosamine and chondroitin sulfate are used to treat osteoarthritis. The multicenter, double-blind, placebo- and celecoxib-controlled Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) evaluated their efficacy and safety as a treatment for knee pain from osteoarthritis.

Methods We randomly assigned 1583 patients with symptomatic knee osteoarthritis to receive 1500 mg of glucosamine daily, 1200 mg of chondroitin sulfate daily, both glucosamine and chondroitin sulfate, 200 mg of celecoxib daily, or placebo for 24 weeks. Up to 4000 mg of acetaminophen daily was allowed as rescue analgesia. Assignment was stratified according to the severity of knee pain (mild [N=1229] vs. moderate to severe [N=354]). The primary outcome measure was a 20 percent decrease in knee pain from baseline to week 24.

Results The mean age of the patients was 59 years, and 64 percent were women. Overall, glucosamine and chondroitin sulfate were not significantly better than placebo in reducing knee pain by 20 percent. As compared with the rate of response to placebo (60.1 percent), the rate of response to glucosamine was 3.9 percentage points higher (P=0.30), the rate of response to chondroitin sulfate was 5.3 percentage points higher (P=0.17), and the rate of response to combined treatment was 6.5 percentage points higher (P=0.09). The rate of response in the celecoxib control group was 10.0 percentage points higher than that in the placebo control group (P=0.008). For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo (79.2 percent vs. 54.3 percent, P=0.002). Adverse events were mild, infrequent, and evenly distributed among the groups.

Conclusions Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. (ClinicalTrials.gov number, NCT00032890

 

[*Hawk]

Interesting. My mother is currently supplementing these two at similar dosages.

What would be a better alternative?

 

[roadkill]

B.s.

Manipulation by the pharmaceutical industry to get people off a cheap alternative that works so they pay through the nose for drugs. They want to take over the 20 billion a year supplement industry and squash your right to choose safe alternative supplements that do in fact work.

 

[greyowl]

Manipulation by the pharmaceutical industry to get people off a cheap alternative that works so they pay through the nose for drugs. They want to take over the 20 billion a year supplement industry and squash your right to choose safe alternative supplements that do in fact work.

This was an independent, double-blind study published in a peer-reviewed medical journal. You are a brainwashed dupe of the snake-oil merchants in the supplement racket.

 

[*Hawk]

hmmmm.... So basically there are more studies that says it works, than studies that say it doesn't work????

 

[DaneGer]

well which is it?!?......

 

[greyowl]

hmmmm.... So basically there are more studies that says it works, than studies that say it doesn't work????

This is an exhaustive, state-of-the-art study involving 1583 subjects, which is a hell of a lot more people than any study paid for by shills in the supplemement industry. The results clearly show that glucosamine, either by itself or stacked with chondriatin, is ineffective for pain relief of arthritic knees, and from that we can safely extrapolate, for any other type of arthritis pain.

 

[roadkill]

conflicting view

Even JAMA admits glucosamine is effective against osteoarthritic pain.
A 2000 study (1) published in the Journal of the American Medical Association (JAMA) showed that glucosamine and chondroitin, 2 food supplements, do appear to help with symptoms of osteoarthritis. The authors of the study analyzed 15 previously published studies on the effects of glucosamine and chondroitin on osteoarthritis.


The findings of the study, adjusted for variability and quality in the supplements, showed a significant benefit from glucosamine supplements as well as from chondroitin supplements.

In March 2000, the study in the Journal of the American Medical Association (JAMA) concluded:

"Trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects, but quality issues and likely publication bias suggest that these effects are exaggerated. Nevertheless, some degree of efficacy appears probable for these preparations." (1)



The reason why this study is so important is that it was published in the largest medical journal in the world, JAMA. When JAMA reports that an alternative treatment works, you'd better believe that it works, because they only reluctantly publish findings which promote natural treatments.

In 2001, the "Lancet" published the results of a 3-year double-blind clinical trial involving 212 people with osteoarthritis who took either glucosamine or a placebo. The researchers found that symptoms improved 20% to 25% in the glucosamine group but worsened slightly in the placebo group. The x-ray examinations showed that serious narrowing of the knee-joint space - a sign of progression of the disease - occurred in only 50% as many patients taking glucosamine as in those receiving the placebo. (2)

However, it is important that one use high quality products. There is evidence showing that these cartilage precursors do help with osteoarthritis (not rheumatoid arthritis). The likely explanation for some of the conflicting previously-published research likely has to do with the quality of the supplements which were used.

Glucosamine is an amino sugar, which chondroitin - a carbohydrate - is a cartilage component which promotes water retention and elasticity and inhibits the enzymes which break down cartilage. Both compounds are manufactured by the body.

Glucosamine supplements are derived from shellfish shells, while chondroitin supplements are generally made from cow cartilage. Human studies have shown that either one may help with arthritis pain and stiffness with fewer side effects than conventional arthritis drugs.



Osteoarthritis and glucosamine
Chronic joint problems and arthritis affect close to 1/3 of American adults according to a self-reported survey conducted in 2001 (1). Osteoarthritis, the most widespread type of arthritis, is a degenerative disease of the joints. Although sometimes capable of causing acute inflammation, osteoarthritis is most commonly a 'wear-and-tear' disease involving degeneration of joint cartilage and the formation of bony spurs within various joints. When cartilage becomes worn, exposed bones can rub together and the painful symptoms of osteoarthritis may appear.


Osteoarthritis can affect any joint, including those throughout the spine. Repetitive occupational usage, trauma to the joints, and obesity are risk factors.

Most people over 60 years of age suffer from osteoarthritis to some extent. Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis. Traditional medical treatment includes drug therapy to control the pain associated with osteoarthritis.

NSAIDs, non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, naproxen (Aleve), and ketoprofen (Orudis) are the traditional drug solutions for arthritis.

Glucosamine is the subject of research in numerous double-blind, placebo-controlled studies.

Many companies use medium grade glucosamine so you must be careful to look for the highest quality. Look for the highest quality form of glucosamine, pharmaceutical grade.

Because dietary supplement manufacture is not regulated, product quality (especially of chondroitin products) is not assured. You want to make sure you choose a high quality supplement.

As far as dosage is concerned, if you choose to take glucosamine in capsule form, you will need at least 1500mg per day. If taking glucosamine in liquid form, because of the reported higher absorption rate, you will likely not need a full 1500mg. 1000-1250mg per day of high quality glucosamine in liquid form is optimal.

Also crucial to the effectiveness of the glucosamine supplement is the other ingredients which may be included in the product. I would recommend you look for products which combine glucosamine with other arthritis-fighting ingredients such as chondroitin. The synergy between these different compounds makes for a more effective supplement.



Safety considerations for glucosamine
No study so far has found any serious side effects from either glucosamine or chondroitin. The most common side effects are increased intestinal gas and soft stools.

However, an editorial in the British publication the "Lancet" (Volume 354, Number 9176 July, 31 1999) suggested that glucosamine might contribute to insulin resistance in diabetics or those at risk for diabetes. Insulin resistance - a decrease in the body's response to the blood sugar-regulating hormone insulin - is a condition which is a precursor to type-2 (adult-onset) diabetes. Increasing insulin resistance may result in more difficult to control blood sugar levels.(3)

So it would seem prudent to monitor blood sugar levels in anyone taking glucosamine regularly who is at risk for diabetes. A simple fasting blood sugar test will show whether there is a need for concern. The normal should be 87. Any values over 100 are suspicious of pre-diabetes. Any value over 120 is generally considered to be diabetes. Of course, following the healing diet and exercise recommendations on this site will be helpful in moderating any effect on insulin resistance which glucosamine might have.

There have been no reports of allergic reactions to glucosamine. But since glucosamine is made from shellfish shells, people who are allergic to seafood should use it cautiously, watching for reactions. As for chondroitin, it can cause bleeding in people who have a bleeding disorder or take a blood-thinning drug.

I spend a lot of time researching the best prices for high quality supplements on the internet. In my opinion, the lowest price for high quality glucosamine/chondroitin supplements in capsules form is here. I also like Puritan Pride's special "Buy 2 Get 3 FREE" promotions on glucosamine.

Another glucosamine supplement which has a particularly good reputation for its high quality is Syn-Flex. It comes in liquid form, and it also contains chondroitin as well as other arthritis-fighting compounds. Syn-Flex is available here.

It may take up to 2 months for glucosamine to produce any significant improvement. If you see no effect by then, it's probably best to try a different approach. Some people obtain relief from joint pain with the organic sulfur MSM.










References

(1) McAlindon TE and others. Glucosamine and chondroitin for treatment of osteoarthritis: A systematic quality assessment and meta-analysis JAMA 283:1469-1475, 2000.

(2) Reginster JY and others. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomized, placebo-controlled trial. Lancet 357:251-256, 2001.

(3) Experimental Biology 2000 Conference San Diego April 18, 2000





disclaimer: Throughout this website, statements are made pertaining to the properties and/or functions of food and/or nutritional products. These statements have not been evaluated by the Food and Drug Administration and these materials and products are not intended to diagnose, treat, cure or prevent any disease.

2002 by Marc Leduc

 

[greyowl]

Even JAMA admits glucosamine is effective against osteoarthritic pain.
A 2000 study (1) published in the Journal of the American Medical Association (JAMA) showed that glucosamine and chondroitin, 2 food supplements, do appear to help with symptoms of osteoarthritis. The authors of the study analyzed 15 previously published studies on the effects of glucosamine and chondroitin on osteoarthritis.


The findings of the study, adjusted for variability and quality in the supplements, showed a significant benefit from glucosamine supplements as well as from chondroitin supplements.

In March 2000, the study in the Journal of the American Medical Association (JAMA) concluded:

"Trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects, but quality issues and likely publication bias suggest that these effects are exaggerated. Nevertheless, some degree of efficacy appears probable for these preparations." (1)



The reason why this study is so important is that it was published in the largest medical journal in the world, JAMA. When JAMA reports that an alternative treatment works, you'd better believe that it works, because they only reluctantly publish findings which promote natural treatments.

In 2001, the "Lancet" published the results of a 3-year double-blind clinical trial involving 212 people with osteoarthritis who took either glucosamine or a placebo. The researchers found that symptoms improved 20% to 25% in the glucosamine group but worsened slightly in the placebo group. The x-ray examinations showed that serious narrowing of the knee-joint space - a sign of progression of the disease - occurred in only 50% as many patients taking glucosamine as in those receiving the placebo. (2)

However, it is important that one use high quality products. There is evidence showing that these cartilage precursors do help with osteoarthritis (not rheumatoid arthritis). The likely explanation for some of the conflicting previously-published research likely has to do with the quality of the supplements which were used.

Glucosamine is an amino sugar, which chondroitin - a carbohydrate - is a cartilage component which promotes water retention and elasticity and inhibits the enzymes which break down cartilage. Both compounds are manufactured by the body.

Glucosamine supplements are derived from shellfish shells, while chondroitin supplements are generally made from cow cartilage. Human studies have shown that either one may help with arthritis pain and stiffness with fewer side effects than conventional arthritis drugs.



Osteoarthritis and glucosamine
Chronic joint problems and arthritis affect close to 1/3 of American adults according to a self-reported survey conducted in 2001 (1). Osteoarthritis, the most widespread type of arthritis, is a degenerative disease of the joints. Although sometimes capable of causing acute inflammation, osteoarthritis is most commonly a 'wear-and-tear' disease involving degeneration of joint cartilage and the formation of bony spurs within various joints. When cartilage becomes worn, exposed bones can rub together and the painful symptoms of osteoarthritis may appear.


Osteoarthritis can affect any joint, including those throughout the spine. Repetitive occupational usage, trauma to the joints, and obesity are risk factors.

Most people over 60 years of age suffer from osteoarthritis to some extent. Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis. Traditional medical treatment includes drug therapy to control the pain associated with osteoarthritis.

NSAIDs, non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, naproxen (Aleve), and ketoprofen (Orudis) are the traditional drug solutions for arthritis.

Glucosamine is the subject of research in numerous double-blind, placebo-controlled studies.

Many companies use medium grade glucosamine so you must be careful to look for the highest quality. Look for the highest quality form of glucosamine, pharmaceutical grade.

Because dietary supplement manufacture is not regulated, product quality (especially of chondroitin products) is not assured. You want to make sure you choose a high quality supplement.

As far as dosage is concerned, if you choose to take glucosamine in capsule form, you will need at least 1500mg per day. If taking glucosamine in liquid form, because of the reported higher absorption rate, you will likely not need a full 1500mg. 1000-1250mg per day of high quality glucosamine in liquid form is optimal.

Also crucial to the effectiveness of the glucosamine supplement is the other ingredients which may be included in the product. I would recommend you look for products which combine glucosamine with other arthritis-fighting ingredients such as chondroitin. The synergy between these different compounds makes for a more effective supplement.



Safety considerations for glucosamine
No study so far has found any serious side effects from either glucosamine or chondroitin. The most common side effects are increased intestinal gas and soft stools.

However, an editorial in the British publication the "Lancet" (Volume 354, Number 9176 July, 31 1999) suggested that glucosamine might contribute to insulin resistance in diabetics or those at risk for diabetes. Insulin resistance - a decrease in the body's response to the blood sugar-regulating hormone insulin - is a condition which is a precursor to type-2 (adult-onset) diabetes. Increasing insulin resistance may result in more difficult to control blood sugar levels.(3)

So it would seem prudent to monitor blood sugar levels in anyone taking glucosamine regularly who is at risk for diabetes. A simple fasting blood sugar test will show whether there is a need for concern. The normal should be 87. Any values over 100 are suspicious of pre-diabetes. Any value over 120 is generally considered to be diabetes. Of course, following the healing diet and exercise recommendations on this site will be helpful in moderating any effect on insulin resistance which glucosamine might have.

There have been no reports of allergic reactions to glucosamine. But since glucosamine is made from shellfish shells, people who are allergic to seafood should use it cautiously, watching for reactions. As for chondroitin, it can cause bleeding in people who have a bleeding disorder or take a blood-thinning drug.

I spend a lot of time researching the best prices for high quality supplements on the internet. In my opinion, the lowest price for high quality glucosamine/chondroitin supplements in capsules form is here. I also like Puritan Pride's special "Buy 2 Get 3 FREE" promotions on glucosamine.

Another glucosamine supplement which has a particularly good reputation for its high quality is Syn-Flex. It comes in liquid form, and it also contains chondroitin as well as other arthritis-fighting compounds. Syn-Flex is available here.

It may take up to 2 months for glucosamine to produce any significant improvement. If you see no effect by then, it's probably best to try a different approach. Some people obtain relief from joint pain with the organic sulfur MSM.










References

(1) McAlindon TE and others. Glucosamine and chondroitin for treatment of osteoarthritis: A systematic quality assessment and meta-analysis JAMA 283:1469-1475, 2000.

(2) Reginster JY and others. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomized, placebo-controlled trial. Lancet 357:251-256, 2001.

(3) Experimental Biology 2000 Conference San Diego April 18, 2000





disclaimer: Throughout this website, statements are made pertaining to the properties and/or functions of food and/or nutritional products. These statements have not been evaluated by the Food and Drug Administration and these materials and products are not intended to diagnose, treat, cure or prevent any disease.

2002 by Marc Leduc

Your point is invaid because you are citing relatively small studies that are at least five years old to dispute the findings of a much larger, recent study.

The debate is over. Glucosamine doesn't work.

 

[roadkill]

slanted studies and paid off researchers

The Latest Medical Bullsh** about the Glucosamine Arthritis Study Results

Following closely on the heels of media bullcrap about echinacea and Vitamin E, the New York Times, the Washington Post, ABC, CNN and others got it totally wrong again. Why? Because they lazily believed the spoon-fed garbage they got from the medical media.

The actual results of a recent so-called GAIT study published in the NEMJ indicate that a combination of two popuilar natural supplements was more effective than Celebrex for the worst arthritis pain...79% percent of the patients using glucosamine and chondroitin experienced pain reduction from moderate to severe pain...meanwhile only 69% of the moderate to severe arthitis patients benefited from Celebrex!

So what did the major media report?

For instance the online edition of Medical News Today quoted the lead author from the New England Journal of Medicine: "For the study population as a whole, supplements were found to be ineffective," said rheumatologist Daniel O. Clegg, M.D. Clegg was the principal investigator for the national trial.

Clegg further embarrassed himself by saying, "As we expected, patients who took celecoxib [Celebrex] showed significant improvement in pain relief." In other words, Clegg thinks 69% is better than 79%! Idiot.

Then there were these farcical headlines:

“2 Top-Selling Arthritis Drugs Are Found to Be Ineffective” from the New York Times

“Glucosamine, chondroitin not much help for arthritic knees” from Forbes

“Study: supplements fail to ease arthritis” from the Houston Chronicle

“Study: supplements fail to ease arthritis” from the Washington Post.
Note how the lazy dailies, the Houston Chronicle and the Washinton Post came up with identical headlines.

To make matter worse, the Clegg study used a form of glucosamine that isn't the same as the one used by most consumers...the one found to be the most effective for arthritis in other studies. Why would they do that? It's as if they wanted the glucosamine to fail!

Despite the researchers choosing the inferior form of glucosamine, their pet drug still got whupped.

The culpability of the New England Journal of Medicine should not be overlooked. Those rat bastards made no mention in their "Results" section of how the natural supplements out-performed Celebrex.

Their behavior shames them...absolutely shames them. For starters, Dr. Clegg has received payments from 12...count'em...12 drug companies.

 

[greyowl]

Give it up bro', you're just making yourself look silly.

 

[roadkill]

Truth

I will leave it at this. Given the over-hype of the supplement companies and the corruption of the pharmaceutical giants the truth lies somwhere in between.

 

[pupeye]

I take glucosamine, and my joints still ache and crack. Doesn't seem to offer any benefit.

 

[HeadDoc]

if you've got serious knee issues, consider synvisc.

http://www.synvisc.com/aboutsynvisc/ussyn_reimburse.asp