Glucosamine/Chondroitin
by Phillip Treadwell, PharmD

Arthritis is an extremely common disease. Estimates of the incidence of this problem typically range around 60 million affected Americans. Many types of arthritis exist, but the vast majority of cases of arthritis are the osteoarthritis type. With a problem that is this common, many potential remedies will be touted. Some of the most popular products for osteoarthritis right now are glucosamine/chondroitin combinations. Many products also exist containing glucosamine alone or chondroitin alone. We will talk about the evidence that exists for these products and any concerns that may accompany them.

Chondroitin is a naturally occurring component of cartilage. Chondroitin sulfate is the form that is typically available and is derived from animal cartilage. The product is purified (more or less) and packaged for sale. Some concern existed about the ability of the intestines to absorb chondroitin, but these have been laid to rest. Chondroitin is delivered to the joint where it may be used by the body to improve the cartilage in the joint. In studies, chondroitin has been shown to improve arthritis symptoms, but this typically occurs over four weeks to four months. No studies have yet shown any improvement in the structure of the joint with chondroitin, but better studies will be required to give a fair picture of this product’s effect on joint structure. Side effects from chondroitin include nausea, diarrhea, abdominal pain and allergic reactions in some individuals. Discontinue use of this product if you notice swelling in the face or airway or a rash.

Glucosamine is a precursor for the formation of components of cartilage. It is derived from natural sources such as marine exoskeletons. Glucosamine is available as two different salts, glucosamine hydrochloride and glucosamine sulfate. Glucosamine sulfate is the better studied of the two salts. Glucosamine has been shown to improve joint symptoms in arthritis and may even improve the structure of the joint in these patients. Evidence is not yet complete, but it is likely that glucosamine may partially reverse, or at least slow, the damage done by osteoarthritis. No other chemical can make this claim. Some adverse effects of glucosamine include nausea, diarrhea, and heartburn along with increased blood sugar in diabetics. If you have diabetes, you should only take glucosamine under the advice of a physician. Some experts feel that this product may cause allergic reactions in people allergic to shellfish, but this is unproven.

Combinations of glucosamine and chondroitin are logical products but have very little data to show that they are effective. I believe that they will be beneficial, but that is one man’s opinion and not scientific. We will have to wait to see what on-going, government sponsored clinical trials say about combination products before making a final decision.

Because of the potential adverse effects of this product and other diseases that can mimic osteoarthritis, I recommend asking a healthcare professional if glucosamine, or chondroitin, or a combination of the two, is right for you. For some people, they may be safer than prescription anti-inflammatory medications. Remember, pills are only one component for the care of arthritis. Talk to your healthcare provider about what is right for you.