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Do Glucosamine Supplements Work?

Can joint health supplements with glucosamine or chondroitin help you rebuild cartilage and reduce joint pain?

By
Monica Reinagel, MS, LD/N, CNS
July 26, 2010
Episode #101

Do Glucosamine Supplements Work?

Glucosamine and chondroitin are popular dietary supplements that are promoted as a natural treatment for joint pain and arthritis. I recently got an email from a reader asking whether they really work. If you had asked me that question ten years ago, I would probably have given you a different answer than the one I’m going to give you today.

But first, let me give you a little background on what these supplements are and how they are supposed to work.

What Causes Joint Pain?

Sooner or later, almost everyone is going to have to put up with a little joint pain. Often, it’s because the spongy tissue, or cartilage, that cushions your joints has gotten worn away—by sports injuries, overuse, or just a lifetime or wear-and-tear. Osteoarthritis is more common in older people, whose joints have had more time to wear out. But young people can have joint pain, too. In fact, for reasons I’ll get to in a moment, it’s getting more common among younger folks.

The most common treatments for joint pain are over-the-counter pain killers like ibuprofen or prescription drugs like Celebrex. Like most drugs, these anti-inflammatory drugs come with a variety of side effects and risks. Some of the risks are fairly serious—and osteoarthritis is usually a long-term condition requiring ongoing treatment. So, a lot of people want to know if there’s anything they can do to ease joint pain naturally.

How Do Glucosamine and Chondroitin Work?

Glucosamine and chondroitin are both natural substances produced by your body. Glucosamine is thought to stimulate cartilage production in the joints and chondroitin is a component of cartilage tissue. It’s thought to attract water to the tissue, which helps the cartilage stay elastic, and also to block the action of enzymes that break down cartilage tissue.

The idea is that taking extra glucosamine and chondroitin in supplement form helps your body replace damaged or worn away cartilage more quickly. And the early studies were very promising. In 2000, for example, an article in the Journal of the American Medical Association reviewed 37 different studies on glucosamine and chondroitin. Twenty of the studies had design flaws that the authors felt made the results unreliable. But of the 15 that met their criteria, most showed moderate to large benefits.  The authors expressed some doubts that the results would be quite as impressive in a large-scale, tightly-controlled experiment. Nevertheless, they concluded that the supplements were probably effective to some degree. 

Sales of these supplements sky-rocketed. After all, promoters could cite published scientific evidence that they worked. Doctors began recommending them to patients.

But, as so often happens, as more and more studies were conducted and published, the evidence for glucosamine seemed to get weaker and weaker.

Glucosamine No Better Than Placebo?

In 2006, a large, carefully-controlled study overseen by the National Institutes of Health tested the effects of glucosamine and chondroitin, alone or in combination, on joint pain. People taking glucosamine did get some relief—about a 20% reduction in pain—but that was no more than they got from taking a dummy pill.

At this point, the official take on glucosamine and chondroitin supplements is that they are a waste of money. But I’m not quite ready to throw in the towel on these. The fact is that many people do report substantial improvement in their joint pain when they take these supplements. And I’m not sure that it’s entirely due to a placebo effect. In fact, the authors of the 2006 study hinted that certain people seem to get more benefit than others.

The problem is that the only way to know whether you’re one of those people is to try it yourself. And if you do notice some improvement, there’d be no way to guarantee that you weren’t imagining it. But, hey, feeling better is feeling better! And, unlike arthritis drugs, glucosamine supplements appear to be exceedingly safe and well-tolerated.

Can Glucosamine Supplements Help You?

Glucosamine supplements are made from shellfish and chondroitin is usually derived from cow’s cartilage, so these supplements will not be acceptable to most vegans.

My fellow quick-and-dirty tipster, The House Call Doctor, recently wrote about the causes and treatments for osteoarthritis in a pair of articles, What Is Osteoarthritis? and What Are the Treatments for Osteoarthritis? Dr. Rob and I agree that if you’d like to see whether glucosamine or chondroitin supplements could help you, there’s no harm in doing your own personal experiment. 

How to Take Glucosamine Supplements

Here’s how to give it the best possible test:

  1. Look for a supplement containing glucosamine sulfate. The evidence for this form is slightly stronger than for supplements containing the glucosamine hydrochloride form. 

  2. Don’t bother with chondroitin.  Chondroitin supplements do not seem to work. For people with severe pain, a combination formula with glucosamine and chondroitin may be worth trying.

  3. Use the effective dosage. Regardless of what it says on the bottle, the effective dosage appears to be 1500mg of glucosamine sulfate per day. Most products contain 500mg per pill, so you’d take one, three times a day.

  4. Take it for three months. It may take up to three months for any improvement in stiffness or pain to become noticeable so, if you decide to try it, make sure you give it a fair trial.

If after three months you notice an improvement in your joint pain, congratulations! In that case, you’ll just have to decide whether the improvement is worth the cost of the supplement on an ongoing basis. If you don’t notice any improvement, there’s no pointing wasting your money: you’re unlikely to get any benefit from continuing.

I should mention that glucosamine supplements are made from the shells of shellfish and chondroitin is usually derived from cow’s cartilage, so these supplements will not be acceptable to most vegans.

Foods that Fight Inflammation

What if the supplements don’t work for you? Is there anything else you can try? As many of you know, I’ve written a lot on the topic of anti-inflammatory diets, including a book called the Inflammation Free Diet Plan. An anti-inflammatory diet can’t prevent or cure osteoarthritis but reducing inflammation could definitely help with symptoms. For more on this, see my article Foods that Fight Inflammation

And finally, if you suffer from joint pain, carrying around a lot of extra weight is a sure way to make it worse. Obesity is a risk factor for osteoarthritis because of the extra stress it puts on your joints. (That’s why we’re starting to see more arthritis in young people.) For some tips on losing weight, see my five-part series Creating Your Own Best Diet and my article on Keeping Your Diet on Track

And if joint pain keeps you from exercising, Get Fit Guy’s has a terrific article on workouts you can do in the water, which he says is a great form of exercise for people with joint pain.

Reminder: These tips are provided for your information but they’re not intended as medical advice. Please work with your health care professional to determine what’s right for you.

Keep in Touch

If you have a suggestion for a future show topic or would like to find out about having me speak at your conference or event, send an email to nutrition@quickanddirtytips.com

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Have a great week and remember to eat something good for me!

RESOURCES: 

Glucosamine and Chondroitin for Arthris: Benefit is Unlikely

Knee image courtesy of Shutterstock

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