Joint Supplements
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The joint supplements glucosamine and chondroitin provide marginal benefit, but are considered safe. They may be worth considering if you can justify the expense. Other supplements such as Omega 3 oils and Vitamin C/E may be worth considering.
1 Glucosamine and chondroitin
Chondroitin is an important component of joint cartilage and glucosamine is building block for other joint structures. Both chondroitin and glucosamine taken orally reach the joint space[1][2][3]. There have been over 500 studies of glucosamine and chondroitin[4], and analysis of the best of the studies show only a marginal benefit[5][6][7] or provide benefit only to a subgroup of suffers[8]. These benefits do not meet the requirements to be generally considered clinically important[5]. However, given the safety of these supplements, they may be worth considering if your income is sufficient.
1.1 Dosage
Doses of less than 800 mg/day of chondroitin or less than 1500 mg/day of glucosamine are considered sub-therapeutic[5], but there is no indication of appropriate dose. The Mayo Clinic suggest 500mg Glucosamine sulfate three times a day or 20mg per Kg body weight[9] and 200-400mg chondroitin 2-3 times daily[10]. These doses are based on those commonly used in studies.
2 Cost
I found glucosamine and chondroitin available online for about $10/month. Look carefully at the ingredients to check how many capsules make up the stated dose when calculating the daily cost.
3 Food for joints
There have been over 2,000 studies of related to nutrition and Osteoarthritis, but only 53 are of sufficient quality to be useful[11]. Some options that may be worth considering include:
- Methylsulfonylmethane (MSM) is a less well known joint supplement than glucosamine and chondroitin, with far less studies available. There is some support for MSM helping with joint pain[12][13], but not enough to give confidence as to its effectiveness or safety[14]. MSM does cross the blood/brain barrier[15][16] and may cause headaches[12]. (I believe MSM was a trigger for my migraines.)
- The supplement "avocado/soybean unsaponifiables" has shown positive results in studies[17][18][19][20]. However, this supplement has not been widely studies for effectiveness or long term safety.
- There is some suggestion that Omega 3 oils may help with Osteoarthritis[21][22]. Given the other health benefits of Omega 3 oils, supplementation should be considered.
- Higher Vitamin C intake may reduce Osteoarthritis[23] and 1000mg/day of Vitamin C reduced joint pain, though by less than half what would be expected from NSAIDs[24]. Like Omega 3 there may be other benefits to Vitamin C supplementation that make this worthwhile.
- Some[25][26][27], but not all[28][29] studies have shown benefit from Vitamin E supplementation. Like the above two supplements, Vitamin E should be considered as there may be other health benefits.
- Devil's Claw, a South African plan extract, may help with joint pain (60mg harpagoside)[30]. However, there is little known about its safety.
4 References
- ↑ Biochemical and pharmacokinetic aspect... [Arzneimittelforschung. 1995] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/7575762
- ↑ Anti-inflammatory activity of chond... [Osteoarthritis Cartilage. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/9743814
- ↑ Synovial and plasma glucosamine con... [Osteoarthritis Cartilage. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17353133
- ↑ JAMA Network | Archives of Internal Medicine | Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee OsteoarthritisA Comprehensive Meta-analysis http://archinte.jamanetwork.com/article.aspx?volume=163&issue=13&page=1514
- ↑ 5.0 5.1 5.2 Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941572/
- ↑ Meta-analysis: chondroitin for osteoarthritis... [Ann Intern Med. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17438317
- ↑ Glucosamine for pain in osteoarthritis: why ... [Arthritis Rheum. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17599746
- ↑ Glucosamine, chondroitin sulfate, and the two i... [N Engl J Med. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/16495392
- ↑ Glucosamine: Dosing - MayoClinic.com http://www.mayoclinic.com/health/glucosamine/ns_patient-glucosamine/dsection=dosing
- ↑ Chondroitin sulfate: Dosing - MayoClinic.com http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin/DSECTION=dosing
- ↑ Arthritis Research & Therapy | Full text | Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence http://arthritis-research.com/content/8/4/R127
- ↑ 12.0 12.1 Efficacy of methylsulfonylmethane (... [Osteoarthritis Cartilage. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/16309928?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Randomised, Double-Blind, Parallel, Place... [Clin Drug Investig. 2004] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17516722
- ↑ Systematic review of the nutritiona... [Osteoarthritis Cartilage. 2008] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/18417375
- ↑ Detection of dimethyl sulfone in the huma... [Magn Reson Imaging. 2000] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/10642107?dopt=Abstract
- ↑ Accumulation of methylsulfonylmethane in the hu... [Toxicol Lett. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/11641045?dopt=Abstract
- ↑ Structural effect of avocado/soybean unsapon... [Arthritis Rheum. 2002] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11932878?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Efficacy and safety of avocado/soybean unsa... [Rev Rhum Engl Ed. 1997] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/9476272?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Symptoms modifying effect of avocado/soybe... [Scand J Rheumatol. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11578021?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Symptomatic efficacy of avocado/soybean unsa... [Arthritis Rheum. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/9433873?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176911/
- ↑ Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee: the MOST study http://www.oarsijournal.com/article/S1063-4584%2812%2900060-X/abstract
- ↑ Do antioxidant micronutrients protect agains... [Arthritis Rheum. 1996] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/8630116?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ [Reduced pain from osteoarthritis in hip joint... [Ugeskr Laeger. 2003] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/12854267?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Tocopherol in Osteoarthritis: a controlled ... [J Am Geriatr Soc. 1978] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/350940?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ [Clinical effectiveness of Sp... [Z Orthop Ihre Grenzgeb. 1986 May-Jun] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/3529677?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ [High dosage vitamin E therapy in patien... [Z Rheumatol. 1990 Nov-Dec] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/2085059?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Vitamin E is ineffective for symptomatic relie... [Ann Rheum Dis. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11557651?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Supplementary vitamin E does not affect the loss... [J Rheumatol. 2002] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/12465157?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Harpgophytum procumbens for osteoa... [BMC Complement Altern Med. 2004] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/15369596?dopt=Abstract&holding=f1000,f1000m,isrctn