Glucosamine and Chondroitin Slow Joint Deterioration and Ease Arthritis Pain

Q:  What do you think of glucosamine and chondroitin? Do they really build cartilage?

A:  Both glucosamine and chondroitin act as substrate for the synthesis of a healthy joint matrix. In other words they help form a backbone for the fluid materials that cushion the joint. There have been enough short-term studies that suggest that they are much better than placebo (fake pills) for osteoarthritis and about equal with anti-inflammatory medicines like ibuprofen. They usually result in about a 50% improvement in pain and stiffness. Some studies used glucosamine alone, chondroitin alone, or a combination of both.

The first long-term study on glucosamine, which involved 212 patients in Belgium, reports that glucosamine protected against further joint damage in osteoarthritis. After 3 years, x-rays showed joint space narrowing and deterioration in 38% of the patients who were taking a placebo. But only 22% of patients taking glucosamine (1500 mg a day in a powder prescription form available in Europe) showed further joint deterioration. Patients on glucosamine also had improvement in pain, stiffness and physical functioning.

Should you rush out and get a prescription? First of all, glucosamine and chondroitin are "nutritional supplements" in the US and not prescription drugs, so they are not regulated by the FDA. You can buy them at any health food store. I saw them at Pick 'n' Save for $15.88 for 100 pills. Some studies have shown that preparations claiming to contain certain doses of glucosamine or chondroitin have lots less or even NONE of the dosages described! Another cautionary note is that there is little data available on long-term toxic effects.

Does a person take one or both of these? Glucosamine appears to be effective taken alone, but we'll know the answer better in a few years. The US National Institutes of Health is due to launch a big study in March, 2000 that will compare glucosamine alone or in combination with chondroitin for knee arthritis. Usual dosages are 1500 mg daily of glucosamine and 1200 mg daily of chondroitin.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.