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Other natural treatments for arthritis
Glucosamine
Note early studies showed a benefit in taking glucosamine
for the treatment of osteoarthritis. However most recent studies show little
or no benefit. Two large research studies over the last 10 years that
compared all the major studies of glucosomine and glucosamine / chondroitin
supplements showed no real benefit.
This does not mean that you should not try it. Millions of
people who take it claim to receive a benefit.
Warning if you are allergic to shell
fish most glucosamine products come from shell fish. There are non-shellfish
products on the market.
Description of Glucosamine
glucosamine, which occurs naturally in the body, plays a key role in the
construction of cartilage -- the tough connective tissue that cushions the
joints. Glucosamine stimulates the production of glycosaminoglycans (the key
structural components of cartilage) as well as the incorporation of sulfur
into cartilage. Sulfur is necessary for making and repairing cartilage.
Glucosamine may be effective in treating and possibly slowing the
progression of osteoarthritis. This is a type of arthritis caused by
continuous wear and tear on the joints leading to inflammation, breakdown,
and eventual loss of cartilage. The tissues most affected by osteoarthritis
are the weight bearing joints, such as the knees and hips, as well as the
joints in the hands.
Studies suggest that glucosamine may be at least as effective as some of
the medications frequently used to treat this joint condition, but with
fewer gastrointestinal side effects. The medications used to treat
osteoarthritis are known as nonsteroidal anti-inflammatory drugs (NSAIDs),
such as ibuprofen and piroxicam. NSAIDs may cause stomach upset, cramps,
constipation, diarrhea, and in some cases, stomach ulcers.
Glucosamine is often taken with chondroitin, another supplement thought
to be effective in treating arthritis. These substances are often combined
with manganese as well, a trace metal that is also needed for building
cartilage.
General use of Glucosamine
Glucosamine works to stimulate joint function and repair. It is most effective in
treating osteoarthritis, the most prevalent type of arthritis. A number of studies over
the last 20 years have shown this. For example, a 1982 clinical study compared usage of
the NSAID ibuprofen with glucosamine sulfate, for osteoarthritis of the knee. During the
first two weeks, ibuprofen decreased pain faster, but by the fourth week the glucosamine
group was well ahead in pain relief. The overall results showed 44% of the glucosamine
group had pain relief compared to 15% for ibuprofen. Because glucosamine is not an
anti-inflammatory drug, it takes longer to start working, but it works equally well.
Another 1982 open trial study with 252 doctors and 1,506 patients conducted in Portugal
provided good clinical information on appropriate dosage and usage of glucosamine sulfate
for osteoarthritis. For 50 days, patients took 500 mg of glucosamine sulfate three times a
day. The results showed 95% of the patients benefited from the supplement, as it reduced
their pain whether they were resting, standing, or exercising. This study also showed the
effects of glucosamine on obese patients, however, they may require higher dosages to
offset the joints' reaction to the stress from obesity. Those patients also taking
diuretics or suffering from peptic ulcers were also studied regarding the effect of, and
their tolerance to, glucosamine. The former might require higher dosages and the latter
need to take glucosamine with food.
In a more recent 2000 study at the Assaf Harofeh Medical Center, in Ziffrin, 57
patients with osteoarthritis in the knee were treated randomly for four weeks with
glucosamine sulfate intravenously combined with an 800 mg of chondroitin sulfate daily, or
with a placebo. As in the 1982 study, a record was kept of their knee pain when at rest,
standing, or moving. No reduction of symptoms occurred with the placebo group, but the
glucosamine/chondroitin sulfate group showed much reduction of symptoms in all
activity/nonactivity functions. This latter group also showed no negative reactions or any
change in their blood tests. The study concluded that glucosamine sulfate is safe for
long-term osteoarthritis treatment.
Another osteoarthritis study of the knee, in 1999 at the University of Liege in
Belgium, involved 212 patients worldwide. These patients were randomly given either
glucosamine or a placebo for three years. The patients' pain was measured every four
months and x rays were taken of their knees. The placebo group had more pain and narrowed
joints, while the glucosamine group had no narrowing of joints and their condition
improved. This was one of the first studies to show how glucosamine works by stopping the
joints from narrowing. It was also the first long-term study conducted.
Since then, the University of Utah received a $6.6 million grant (September 1999) from
the National Institutes of Health for another major ongoing glucosamine study.
Harvard Medical School conducted a somewhat unorthodox study where patients scheduled
for hip surgery were given ground chicken bone supplements. After two weeks of taking
these supplements, their pain was reduced considerably.
Glucosamine supplements can also aid in treating sports injuries, bursitis, food and
respiratory allergies, asthma, osteoporosis, tendonitis, vaginitis, some skin problems,
and candidiasis.
Uses of the three types of Glucosamine
Although commercially prepared glucosamine comes in three formats: glucosamine sulfate,
glucosamine hydrochloride, and N-acetyl-glucosamine (NAG), not all three work the same.
There are also differing opinions on which is better.
One claim states that glucosamine hydrochloride works 50% better than glucosamine
sulfate because hydrocholoride is the main stomach acid helping the digestive system to
put more active ingredients into the body. Another prefers glucosamine sulfate because of
its high absorption rate of 98% documented in human studies and its sulfur content.
Studies as far back as the 1930s show that people with arthritis usually have low levels
of sulfur.
N-acetyl-glucosamine (NAG) can be beneficial to individuals with Crohn's disease or
ulcerative colitis. Individuals with these diseases cannot change glucosamine to NAG as
fast as those without the diseases. In one study, cells from patients' intestines were
soaked in a solution with a 10:1 ratio of radioactive NAG to glucosamine. These cells
consolidated more NAG than did the cells from the intestines of patients without Crohn's
disease or ulcerative colitis.
Glucosamine is also sold mixed in formulas with devil's claw, pregnenolone,
methylsulfonylmethane (MSM), and chondroitin sulfate. Chondroitin sulfate is one of the
main glycosaminoglycans (GAGs) that is contained in shark cartilage and sea cucumber.
Although studies show that chondroitin sulfate has benefits, it is hard to absorb because
it contains large molecules.
Further confusion can arise because glucosamine is classified and sold as a dietary
supplement, meaning it has not gone through the FDA approval process. As with any
supplement, it is best to consult a health practitioner. Glucosamine is sold at health
food stores and drug stores, and is available with or without salt.
The standard dosage is 500 mg three times daily. Obese people may need to take higher
dosages based on their weight.
Side Effects and Warnings
about glucosamine
- In most human studies, glucosamine sulfate has been well
tolerated for 30 to 90 days.
- Side effects may include upset stomach, drowsiness, insomnia,
headache, skin reactions, sun sensitivity, and nail toughening.
There are rare reports of abdominal pain, loss of appetite,
vomiting, nausea, flatulence (gas), constipation, heartburn, and
diarrhea. Based on several human cases, temporary increases in blood
pressure and heart rate, as well as palpitations may occur with
glucosamine/chondroitin products. Based on animal research,
glucosamine theoretically may increase the risk for eye cataract
formation.
- It remains unclear if glucosamine alters blood sugar levels.
Several human studies suggest no effects on blood sugar, while other
research reports effects on insulin. Preliminary studies show no
effect on mean hemoglobin A1c concentrations in patients with type 2
diabetes mellitus. Caution is advised in patients with diabetes or
hypoglycemia, and in those taking drugs, herbs, or supplements that
affect blood sugar. Serum glucose levels may need to be monitored by
a healthcare provider, and medication adjustments may be necessary.
- In theory glucosamine may increase the risk of bleeding.
Caution is advised in patients with bleeding disorders or taking
drugs that may increase the risk of bleeding. Dosing adjustments may
be necessary.
- In several human cases, abnormal increased amounts of protein
were found in the urine of patients receiving glucosamine/chondroitin
products. The clinical meaning of this is unclear. Glucosamine is
removed from the body mainly in the urine, and elimination of
glucosamine from the body is delayed in people with reduced kidney
function. Increased blood levels of creatine phosphokinase may occur
with glucosamine/chondroitin, which may be due to impurities in some
products. This may alter certain laboratory tests measured by
healthcare providers.
- Preliminary data suggest that glucosamine may modulate the
immune system, although the clinical relevance of this is not clear
Interactions
Glucosamine should not be taken with heart medications or insulin. Those taking
diueretics may require higher amounts of glucosamine on a daily basis.
For more information on Glucosamine try visiting this site
The Arthritis and
Glucosamine Information Center
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