Page 93 - Athletic Health Handbook
P. 93
Laboratory Studies or affiliated with the industry and from any governmental agency that
are published in journals that are controls and regulates manufacturing
There are several studies that suggest considered to have a less stringent practices for these supplements. An
potential positive effects from these peer-review compared to other analysis of some available preparations
supplements. In vitro studies have professional journals. In an attempt has shown that the actual content
shown some direct positive effects on to evaluate these factors, a recent of glucosamine and/or chondroitin
chondrocytes and their metabolism. meta-analysis concluded that the sulfate can differ significantly from
Animal models also have been shown treatment effects are probably exag- those listed on the label. More
to benefit from supplementation in gerated but some efficacy in terms of expensive preparations were generally
osteoarthritis and synovitis models. pain relief appears to be present. The more accurate, although this is not
However, it is important to remember effectiveness seems similar to that universally true.
that the results in animal models resulting from NSAIDs or over-the-
and certainly in vitro studies cannot counter analgesics. There are some Patients interested in using chon-
be automatically extrapolated to data that suggest that glucosamine droitin sulfate and/or glucosamine
effectiveness in humans. sulfate slows the progression of radi- may expect mild to moderate pain
ographic changes in osteoarthritis relief in osteoarthritis and no other
Clinical Studies of the knee and therefore, may effects have been definitively docu-
have disease-modifying properties. mented in humans. The preparations
Several studies have examined the However, larger, long-term, double can be quite expensive and may need
clinical efficacy of glucosamine and blind controlled trials are necessary to be taken for several months before
chondroitin sulfate. Recently, 15 and are currently underway to better maximum effect is obtained. It is
placebo-controlled trials were identi- assess the benefits and safety of recommended that patients take
fied. Virtually all investigated knee the supplements. glucosamine 1,500 mg/day with or
osteoarthritis. Overall, it appeared without chondroitin 1,200 mg/day,
that the supplements resulted in some There are no clinical studies avail- the doses used in most clinical trials.
improvement in pain and function. able that support the use of these If there is no change in symptoms
Chondroitin sulfate may result in supplements in inflammatory arthritis, after an eight-week trial, it is unlikely
somewhat larger effects compared following surgery or as prophylaxis. that these supplements will be of
to glucosamine. There are no studies Any use in these clinical settings is any benefit. Although theoretical
available that investigate the efficacy purely speculative. In addition, there side effects such as elevation of
of the combination versus the single are no data that suggest these supple- blood glucose, interaction with anti-
use of the supplements. There are ments can promote regeneration of coagulants, and allergies have been
several factors that qualify the results already degenerated or lost cartilage mentioned, there are no reported
of the reported studies. First of all, as is suggested by some manufacturers. cases that document these problems.
the studies evaluated only short-term
use and most studies did not evaluate Practical Considerations
the effects beyond four to eight weeks
of use. Secondly, the vast majority of Patients and physicians should
the studies are company-sponsored understand that there is no oversight

Suggested Reading

Adebowale AO, Cox DS, Liang Z, Addington ND. Analysis of glucosamine and chondroitin sulfate content in marketed products 93
and the Caco-2 permeability of chondroitin sulfate raw materials. J Am Nutraceut Assoc. 3:37-44, 2000.
McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin treatment for osteoarthritis. A systematic quality
assessment and meta-analysis. JAMA. 283: 1469-1475, 2000.

© AMERICAN ORTHOPAEDIC SOCIETY FOR SPORTS MEDICINE, 2008, ALL RIGHTS RESERVED

GLUCOSAMINE AND CHONDROITIN SULFATE
   88   89   90   91   92   93   94   95   96   97   98