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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.
=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<ref name="JointChAbs"/><ref name="JointChAbs2"/><ref name="JointGluAbs"/>. There have been over 500 studies of glucosamine and chondroitin<ref name="JointAIM"/>, and analysis of the best of the studies show only a marginal benefit<ref name="JointBMJ"/><ref name="JointAnnIM"/><ref name="JointArthRheum"/> or provide benefit only to a subgroup of suffers<ref name="JointNEJM"/>. These benefits do not meet the requirements to be generally considered clinically important<ref name="JointBMJ"/>. One review noted that the benefit of these suppliments is confused by a high rate of response to placebos<ref name="DiNubile2018"/>, suggesting that the belief in their efficacy is important. However, given the safety of these supplements, they may be worth considering if your income is sufficient.
==Dosage==
Doses of less than 800 mg/day of chondroitin or less than 1500 mg/day of glucosamine are considered sub-therapeutic<ref name="JointBMJ"/>, 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<ref name="GlucosDose"/> and 200-400mg chondroitin 2-3 times daily<ref name="ChondDose"/>. These doses are based on those commonly used in studies.
=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.
=Cancer Risk=
One study found a small reduction in the rates of colorectal cancer from glucosamine and chondroitin based on the review of two large groups of healthcare professionals<ref name="KantorZhang2016"/>. Another study of found reduced rates colorectal cancer from glucosamine<ref name="KantorNewton2018"/>. One theory is that glucosamine and chondroitin act as an anti-inflammatory.
=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<ref name="JointNutra"/>. Some options that may be worth considering include:
* There is some suggestion that [[Omega 3]] oils may help with Osteoarthritis<ref name="JointO3GPig"/><ref name="JointO3Most"/>. Given the other health benefits of [[Omega 3]] oils, supplementation should be considered.
* Higher Vitamin C intake may reduce Osteoarthritis<ref name="JointVitCFraming"/> and 1000mg/day of Vitamin C reduced joint pain, though by less than half what would be expected from [[NSAIDs and Running|NSAIDs]]<ref name="JointVitC1g"/>. Like [[Omega 3]] there may be other benefits to Vitamin C supplementation that make this worthwhile.
* Some<ref name="JointVitEP1"/><ref name="JointVitEP2"/><ref name="JointVitEP3Scherak-1990"/>, but not all<ref name="JointVitEN1Brand-2001"/><ref name="JointVitEN2"/> 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)<ref name="JointDevilCGagnier-2004"/>. However, there is little known about its safety.
=References=
<references>
<ref name="ChondDose">Chondroitin sulfate: Dosing - MayoClinic.com http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin/DSECTION=dosing </ref>
<ref name="GlucosDose">Glucosamine: Dosing - MayoClinic.com http://www.mayoclinic.com/health/glucosamine/ns_patient-glucosamine/dsection=dosing </ref>
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Doddrell, Detection of hip or knee: network meta-analysis http://wwwdimethyl sulfone in the human brain by in vivo proton magnetic resonance spectroscopy.ncbi, Magn Reson Imaging, volume 18, issue 1, pages 95-8, Jan 2000, PMID [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941572pubmed/ 10642107 10642107]</ref><ref name="JointAnnIMJointMSM3">Meta-analysis: chondroitin for osteoarthritis... [Ann Intern Med. 2007] PR. Usha, MU. Naidu, Randomised, Double- PubMed Blind, Parallel, Placebo- NCBI http:/Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis., Clin Drug Investig, volume 24, issue 6, pages 353-63, 2004, PMID [http://www.ncbi.nlm.nih.gov/pubmed/17438317 17516722 17516722]</ref><ref name="JointArthRheumJointMSM2">Glucosamine for pain in osteoarthritis: why LS. Kim, LJ.Axelrod, P.Howard, N. 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Weisman, Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis., N Engl J Med, volume 354, issue 8, pages 795-808, Feb 2006, doi [http://dx.doi.org/10.1056/NEJMoa052771 10.1056/NEJMoa052771], PMID [http://www.ncbi.nlm.nih.gov/pubmed/16495392 16495392]</ref><ref name="JointAIM"> Florent Richy, Olivier Bruyere, Olivier Ethgen, Michel Cucherat, Yves Henrotin, Jean-Yves Reginster, Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee Osteoarthritis, Archives of Internal Medicine, volume 163, issue 13, 2003, pages 1514, ISSN [http://www.worldcat.org/issn/0003-9926 0003-9926], doi [http://dx.doi.org/10.1001/archinte.163.13.1514 10.1001/archinte.163.13.1514]</ref><ref name="JointBMJ"> S. Wandel, P. Juni, B. Tendal, E. Nuesch, P. M. Villiger, N. J. Welton, S. Reichenbach, S. Trelle, Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis, BMJ, volume 341, issue sep16 2, 2010, pages c4675–c4675, ISSN [http://www.worldcat.org/issn/0959-8138 0959-8138], doi [http://dx.doi.org/10.1136/bmj.c4675 10.1136/bmj.c4675]</ref><ref name="JointAnnIM">S. Reichenbach, R. Sterchi, M. Scherer, S. Trelle, E. Bürgi, U. Bürgi, PA. Dieppe, P. Jüni, Meta-analysis: chondroitin for osteoarthritis of the knee or hip., Ann Intern Med, volume 146, issue 8, pages 580-90, Apr 2007, PMID [http://www.ncbi.nlm.nih.gov/pubmed/17438317 17438317]</ref><ref name="JointArthRheum">SC. Vlad, MP. LaValley, TE. McAlindon, DT. Felson, Glucosamine for pain in osteoarthritis: why do trial results differ?, Arthritis Rheum, volume 56, issue 7, pages 2267-77, Jul 2007, doi [http://dx.doi.org/10.1002/art.22728 10.1002/art.22728], PMID [http://www.ncbi.nlm.nih.gov/pubmed/17599746 17599746 ]</ref><ref name="KantorZhang2016">Elizabeth D. Kantor, Xuehong Zhang, Kana Wu, Lisa B. Signorello, Andrew T. Chan, Charles S. Fuchs, Edward L. Giovannucci, Use of glucosamine and chondroitin supplements in relation to risk of colorectal cancer: Results from the Nurses' Health Study and Health Professionals follow-up study, International Journal of Cancer, volume 139, issue 9, 2016, pages 1949–1957, ISSN [http://www.worldcat.org/issn/00207136 00207136], doi [http://dx.doi.org/10.1002/ijc.30250 10.1002/ijc.30250]</ref><ref name="KantorNewton2018">Elizabeth D. Kantor, Christina C. Newton, Edward L. Giovannucci, Marjorie L. McCullough, Peter T. Campbell, Eric J. Jacobs, Glucosamine use and risk of colorectal cancer: results from the Cancer Prevention Study II Nutrition Cohort, Cancer Causes & Control, volume 29, issue 3, 2018, pages 389–397, ISSN [http://www.worldcat.org/issn/0957-5243 0957-5243], doi [http://dx.doi.org/10.1007/s10552-018-1003-6 10.1007/s10552-018-1003-6]</ref><ref name="DiNubile2018">Nicholas DiNubile, Glucosamine and Chondroitin Sulfate: What Has Been Learned Since the Glucosamine/chondroitin Arthritis Intervention Trial, Orthopedics, volume 41, issue 4, 2018, pages 200–207, ISSN [http://www.worldcat.org/issn/0147-7447 0147-7447], doi [http://dx.doi.org/10.3928/01477447-20180511-06 10.3928/01477447-20180511-06]</ref> <ref name="DiNubile2018">Nicholas DiNubile, Glucosamine and Chondroitin Sulfate: What Has Been Learned Since the Glucosamine/chondroitin Arthritis Intervention Trial, Orthopedics, volume 41, issue 4, 2018, pages 200–207, ISSN [http://www.worldcat.org/issn/0147-7447 0147-7447], doi [http://dx.doi.org/10.3928/01477447-20180511-06 10.3928/01477447-20180511-06]</ref>
</references>