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Chondroitin
Author/s: Rebecca Frey
Description of Chondroitin
Chondroitin is a substance found in human and animal cartilage that is used to treat
several physical disorders, most importantly arthritis, psoriasis, and cancer. It is the
most plentiful type of glycosaminoglycan (GAG) found in cartilage. Glycosaminoglycans
(GAGs) are complex carbohydrates that are found in the various types of connective tissue
in the body. GAGs account for 5-20% of cartilage tissue. Chondroitin occurs in connective
tissue as a sulfate composed of repeating disaccharide units; the first unit is either
glucosamine or galactosamine; the other unit is glucuronic acid.
General use for Chondroitin
Chondroitin has been studied in humans for over 30 years as a treatment for psoriasis,
cancer, and arthritis. It is also used by veterinarians to treat animals for arthritis.
These different applications are derived from different properties of chondroitin. At
present chondroitin is under investigation to determine if it is the active ingredient in
preparations made from cartilage.
Psoriasis
Studies have been conducted in the United States since 1990 to determine whether
chondroitin from shark cartilage can speed up wound healing in psoriasis and related
conditions. No conclusive findings have been reported.
Cancer
The use of cartilage products to treat cancer is based on the popular belief that
cartilaginous fish (sharks, skates, and rays) do not get cancer. Samples of these fish
indicate, however, that they do in fact develop a variety of tumors, mostly soft-tissue
cancers.
There are several theories as to why chondroitin and cartilage products containing it
might be useful in treating cancer. One theory is that they slow down or stop the
formation of blood vessels that supply the cancer with oxygen and nutrients. Another
theory is that chondroitin blocks the formation of certain enzymes that tumors produce to
invade surrounding tissue. The third theory suggests that cartilage products stimulate the
immune system. As of late 1999 the National Cancer Institute was conducting a multicenter
clinical trial of liquid cartilage extract.
Osteoarthritis
Chondroitin is best known to the general public as a remedy for osteoarthritis, which
is a form of arthritis caused by wearing away or degeneration of the cartilage that
cushions the ends of bones. In particular, it is thought that the drying of cartilage
tissue in osteoarthritis is a major cause of tissue destruction. Chondroitin sulfate is
given together with glucosamine, a building block of GAGs. The chondroitin helps to
attract and hold fluid within cartilage tissue. Tissue fluid keeps cartilage healthy in
two ways: it acts as a shock absorber within the joints of the body, thus protecting
cartilage from being worn away by the bones; and it carries nutrients to the cartilage.
The cartilage in the joints of the human body has no blood vessels, so it must receive its
nutrients from tissue fluid.
In addition to drawing tissue fluid into cartilage, chondroitin is also thought to
protect cartilage by:
- Anti-inflammatory activity.
- Inhibiting the activity of enzymes that break down cartilage.
- Counteracting enzymes that interfere with the transport of nutrients to the cartilage.
- Stimulating the production of proteoglycans, glycosaminoglycans, and collagen. These
complex molecules are the building blocks of new cartilage.
Several randomized double-blind studies of chondroitin in osteoarthritis patients were
conducted in France and Italy in 1998. The European studies demonstrated that oral as well
as injected chondroitin helps to increase joint mobility and reduce pain. American
practitioners, including naturopaths as well as allopathic physicians, tend to be
skeptical about the usefulness of chondroitin taken by mouth.
Preparations
The normal (non-vegetarian) adult diet already contains a certain amount of
chondroitin; it is found in most animal tissues, particularly the gristle attached to
bones.
Chondroitin sulfate can be taken orally as a pill, powder, or liquid. It can also be
administered by injection. Oral preparations of chondroitin, by itself or in combination
with glucosamine, are available in the United States as over-the-counter (OTC) dietary
supplements. They can be purchased over the internet, at pharmacies, health food stores,
or even some grocery stores. Because they are marketed as dietary supplements, they do not
require testing or approval by the Food and Drug Administration (FDA). At present, there
are no specific quality control requirements or good manufacturing process (GMP) standards
for these products.
There are at present no standard patterns of administration for chondroitin as a
treatment for psoriasis or cancer. When chondroitin is used together with glucosamine as a
treatment for osteoarthritis, the daily dosage is based on the patient's weight. Suggested
dosages are: 1000 mg glucosamine + 800 mg chondroitin sulfate for 120 lbs or less; 1500 mg
glucosamine + 1200 mg chondroitin sulfate for 120-200 lbs; and 2000 mg glucosamine + 1600
mg chondroitin sulfate for greater than 200 lbs.
For maximum effectiveness, patients are advised to divide their daily dosage into 2 to
4 doses and take them throughout the day with food. They are also encouraged to take
vitamin C and manganese supplements on the grounds that these substances increase the
effectiveness of the chondroitin.
Precautions
There are two important precautions to take regarding chondroitin as a dietary
supplement for osteoarthritis. The first is to avoid self-diagnosing and self-medicating.
Persons with stiff or sore joints should consult a medical doctor (M.D.), osteopathic
physician (D.O.), or naturopathic physician (N.D.) for an evaluation to be sure that the
problem is indeed osteoarthritis. Gout, bursitis, rheumatoid arthritis, fibromyalgia, and
several other conditions can also cause pain and stiffness in the joints. These conditions
are not helped by chondroitin.
The second precaution is to purchase chondroitin made by a reliable manufacturer. The
lack of government regulation of products sold as dietary supplements means that that
there is no guarantee that claims made on the label are accurate. Thus a product that
claims to contain chondroitin may not actually contain it, may not contain the amount that
it claims to, or may not be free from contamination and safe to use. One helpful guideline
is to look for the words pharmaceutical grade on the label. This standard ensures
that the product is pure and that it contains the stated amount of chondroitin. A table of
laboratory-tested chondroitin or glucosamine/chondroitin products and their manufacturers
can be found in The Arthritis Cure by Jason Theodosakis, et al. listed in the
resources section below.
With regard to potential overdose problems, chondroitin sulfate appears to be nontoxic.
One six-year study of people taking doses of 1.5-10 grams per day of chondroitin found no
toxicity in the subjects.
Side effects
Chondroitin sulfate has no known significant side effects. Some people report having a
bad taste in the mouth or mild nausea when taking large doses of oral chondroitin on an
empty stomach. A few people who have received chondroitin by injection report a mild
soreness around the injection site.
Interactions
Chondroitin sulfate is not known to cause any significant interactions with other
medications. A paper presented at the 1999 annual meeting of the American Academy of
Orthopaedic Surgeons, however, suggests that because the chondroitin sulfate molecule is
similar to the heparin molecule, its use together with anticoagulant drugs is
questionable. |
