Supplements for Knee Osteoarthritis

Glucosamine and Chondroitin

Glucosamine and Chondroitin may slow down the progression of osteoarthritis, in addition to relieving the symptoms.

Glucosamine and chondroitin are both manufactured by the body. They are substances found in and around the cells of cartilage. Cartilage has a limited ability to regenerate (possibly because it has no blood supply.) However, many researchers believe that GLUCOSAMINE supplements can help slowly repair and rebuild some cartilage. CHONDROITIN is believed to promote water retention and elasticity of the cartilage, and inhibit enzymes involved in cartilage breakdown.

Glucosamine and chondroitin are also believed to reduce inflammation. There have been many studies that show glucosamine is as effective as anti-inflammatory medications for knee pain relief in the majority of knee osteoarthritis sufferers - with fewer side effects.

NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT)

Many studies done so far on the effects of glucosamine and chondroitin are believed to be inadequate and incomplete. However, a large clinical trial funded by the NIH (National Institutes of Health), the Glucosamine and Chondroitin Arthritis Intervention Trial (GAIT), tested whether or not glucosamine and/or chondroitin have a beneficial effect for people with knee osteoarthritis. This study (ClinicalTrials.gov Identifier: NCT00032890) began in April 2000 and completed in November/2005.

Updated Questions and Answers: NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) including key results (NCCAM's official site)

Key Results of Study: "For a subset of participants with moderate-to-severe pain, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared to placebo--about 79 percent had a 20 percent or greater reduction in pain versus about 54 percent for placebo. According to the researchers, because of the small size of this subgroup these findings should be considered preliminary and need to be confirmed in further studies.
For participants in the mild pain subset, glucosamine and chondroitin sulfate together or alone did not provide statistically significant pain relief. "

"GAIT includes an ancillary study, which is still ongoing, that will assess whether glucosamine and chondroitin sulfate can reduce or halt the progression of knee osteoarthritis following additional treatment."

Feb 22/2006 Press Release - last modified 2012.
The New England Journal of Medicine article.

Glucosamine and Chondroitin Precautions

You should tell your doctor about supplements you are taking as even 'natural' supplements may interact with medication you are on or affect other conditions you may have. If you are diabetic, you should carefully monitor your blood sugar. There are concerns that glucosamine may have some effect on insulin resistance, though no effect on glucose tolerance was seen during the GAIT clinical trial. Though glucosamine is a sugar, your body can't convert glucosamine into glucose. Chondroitin may not be appropriate for patients on blood thinners.

If you wish to try glucosamine and chondroitin supplements, make sure you buy it from a reputable manufacturer, as dietary supplements are not strictly regulated (contents are not checked). You want to make sure you are getting what's on the label. Glucosamine is extracted from the shells of shellfish. Do not take it if you have an allergy to shellfish. Chondroitin is made from animal cartilage - usually cow or shark.

Be patient, it can take a couple of months to notice any changes.

Although glucosamine is usually well tolerated, it can cause nausea, indigestion, heartburn, flatulence, and diarrhea or constipation. Chondroitin can also cause gastrointestinal complaints.

SAMe (S-Adenosylmethionine)

The body manufactures SAMe. It is not found in significant amounts in foods. SAMe supplements appear to be as effective as anti-inflammatory medication in relieving the pain of osteoarthritis and increasing functional ability, although it takes longer to work. It is not yet known if it actually slows down the progression of osteoarthritis.

SAMe was first being studied as a depression treatment when it was discovered that it reduced the symptoms of osteoarthritis.

*SAMe has antidepressant effects and should not be taken with antidepressant medication unless recommended by a physician. SAMe may cause a mild upset stomach.

It can take up to a month to obtain full benefits of SAMe supplements.

SAMe is a very expensive supplement, which may be why is not used by as many people as glucosamine and/or chondroitin. There also seems to be more public awareness of glucosamine and chondroitin as a treatment for osteoarthritis. Additionally, there have been more studies on glucosamine and chondroitin than SAMe.

Other Supplements For Knee Osteoarthritis

OMEGA-3 fatty acids: Omega-3 has some anti-inflammatory properties and in a study at Cardiff University in Wales, people taking 1000 mg cod liver oil capsules twice daily for 3 months had significantly reduced levels of enzymes that cause cartilage break down. Good sources of omega-3 are fish oil or flaxseed oil.

MSM: Methylsulfonylmethane: An organic sulfur compound that is found in most fresh foods - fruits, vegetables, grains, milk, and animal products. Sulfur is needed to form connective tissue and is found in every cell in the body. Though scientific studies on the effects of MSM on osteoarthritis have been few, it is believed that MSM may reduce the pain and inflammation of knee osteoarthritis. There are no known side effects. Sometimes glucosamine, chondroitin, and MSM are combined in one supplement.

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