Question: I was taking chondroitin and glucosamine for my osteoarthritis and was told that chondroitin caused pain. I quit taking chondroitin but continued taking glucosamine, and the pain stopped! Why are the two still advertised together?
Dr. Hibberd's Answer:
More than 20 million Americas have osteoarthritis (with pain, stiffness, and sometimes swelling from associated age-related degenerative changes), and it is a frequent cause of disability in adults. Unfortunately, we have yet to discover any medicines that will adequately prevent or stop this degenerative process. We are left with agents that only relieve symptoms and have little, if any, effect on the progression of the condition.
Much misinformation regarding glucosamine and chondroitin needs clarification:
• As dietary supplements, they are not subject to the same FDA oversight, testing, or purity standards as prescription medications, and they are not FDA approved to treat any condition.
• There is NO evidence they regenerate cartilage.
• Also, there is NO evidence to support change in stiffness (of affected joints) seen with either supplement alone or in combination.
• Their use (alone or in combination) may be marginally effective in the relief of moderate to severe pain, but not significantly more than a placebo (sugar pill) for mild pain.
Data was recently published from a trial that was looking for a 20 percent reduction in pain from the use of chondroitin and glucosamine. (20 percent is the threshold for prescription drugs to be considered effective in reducing pain). The results came up significantly short with a "not significantly different from placebo" report.
For those who still wish to use supplements, take glucosamine sulphate (usual doses are 1500 mg daily), and for those with severe pain, chondroitin (usual doses are 1200 mg daily) may be added. If there is no benefit after 3 months, it is recommended they be discontinued. Side effects are usually mild and infrequent, and are also an indication for discontinuation as you have wisely done.
For those who wish to tout their effectiveness for pain relief, the hard (reproducible) response rates for pain control are: glucosamine 3.9 percent, and chondroitin 5.3 percent. When both supplements were used together, pain was reduced by 6.5 percent (only in cases of moderate to severe pain, not in mild cases). These rates hardly justify the significant financial costs of these supplements.
In addition, there appears to be a very significant difference in responses from one manufacturer to another, with Rotapharm reported to have demonstrated the most consistent response.
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