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Good News on Glucosamine

Cartilage cushions human joints, and when it wears down over time and the body's ability to replace it slows or ceases, the result is osteoarthritis, the most common form of arthritis. This painful and potentially disabling condition often goes along with aging.

Pain relievers, over-the-counter and prescription, are the chief medical treatment. But nearly all of these drugs increase the risk of gastrointestinal bleeding. And they do nothing to halt the advance of arthritis. Indeed, some researchers believe that these drugs can make it worse.

In European countries medicinal glucosamine has been prescribed for arthritis for many years, and more recently it has appeared on the American market as a dietary supplement. It is often taken with chondroitin sulfate. Both substances occur naturally in the body and contribute to the formation of cartilage. We haven't recommended them as supplements, alone or in combination, because the scientific evidence has been unclear, and not much is known about their long-term safety. While it has been shown that glucosamine can be absorbed and attaches to cartilage, many researchers believe that chondroitin sulfate supplements cannot be absorbed. Some think that glucosamine may make it harder for the body to process blood sugar and thus may be a problem for diabetics. Furthermore, since supplements are unregulated in this country, what's sold here may contain less glucosamine or chondroitin sulfate than stated on the label, or even none at all.

A new era for arthritis?

But a new study may be good news for glucosamine. Published in the Lancet, the study was well designed, lasted three years, and included more than 100 people. It found that people with mild-to-moderate knee arthritis who took 1,500 milligrams of purified, standardized glucosamine once a day for three years had, on average, 20 to 25% less pain and disability than those taking a placebo (dummy pill). X-ray exams showed that in those taking glucosamine, arthritis progressed slowly or not at all, while the placebo group continued to lose cartilage at the expected rate. Moreover, glucosamine produced no adverse side effects. And it did not affect blood glucose over the three-year period.

Since people in the study had only mild-to-moderate arthritis, no one knows if glucosamine would help those with severe pain. Also, the glucosamine they took was a standardized prescription medication, of consistent quality. There's no supplement here that you can count on to supply a 1,500-milligram dose.

Nevertheless, the study showed that glucosamine helped slow deterioration of cartilage and relieved pain. A large study on these supplements is underway at the National Institutes of Health, with results expected in two or three years. Meanwhile, if you want to try glucosamine, it may help and seems safe, particularly if you don't have diabetes. It's fairly inexpensive—unless combined with chondroitin sulfate, which we don't recommend. If you do decide to take it, tell your doctor.


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