Kevin Wilbanks wrote:
I am skeptical about the claims that the glucosamine/chondrotin supplements actually slow deterioration of cartilage, or promote repair. If it were truly proven via scientific studies, there would be a medical protocol for it and - given the fact that there are almost no side effects - it would be the first line of treatment in arthritis management.
Anecdotally, I've taken Glucosamine and it (along with rehab) was the greatest improvement to my joint problems (had rehab W/o and I didn't improve nearly as well). I have stopped taking GS and kept stable in terms of the rehab level, but if I wanted to really start training daily again, I'd start on the GS again and it'd help (no GS and my training wouldn't progress so quickly due to inflamation etc).
I've also Taken SAMe and it seemed to help but not so much, my mood was great though.
I've had a Chinese Herbalist (who was also a western pharmacist) give me Dit Da Joa which I guess means "Hit and Fall" medicine and it really helped in the short term but only as a stop gap measure.
As for scientific study, I have read of studies where they took a population of osteoarthritis patients and gave them NSAIDS only, NSAIDS and Glucosamine Sulfate, and GS only. They found that the NSAIDS/GS combo improved more quickly, but that the GS only population improved most overall. It'll take some digging to find that old study (circa '96) but I'll try.
Most recently, I've been told of a study (haven't found it yet, but I'll look) on the anti-inflammatory effect in people who continue to train. What they assert is that the inflammation has a minor cushioning effect so when one takes this away, you've got hard stuff grinding against hard stuff. In addition it has been held by most of the Athletic Trainers that I know that if a person takes too many NSAIDS, they don't know what kind of damage they're doing, because they can't feel the pain.
As for the bits and pieces...According to Morelli (et al) in the Jan 2003 issue of the American Family Physician
"In vitro studies have shown that glucosamine stimulates cartilage cells to synthesize increased amounts of glycosaminoglycans and proteoglycan ground substance...High dosages of glucosamine have been shown to have mild anti-inflammatory effects in animal models...Research suggests that the supplement must be taken for at least one month before improvement in symptoms can be expected to occur.
Chondroitin sulfate also has demonstrated efficacy in improving the symptoms of osteoarthritis by acting as a building block of proteoglycan molecules....Like glucosamine, chondroitin's mechanism of action in osteoarthritis may involve both anti-inflammatory properties and substrate provision for proteoglycan synthesis...Comparison of chondroitin with NSAIDs has shown that patients with osteoarthritis have fewer gastrointestinal side effects with chondroitin. Chondroitin is well tolerated; it appears to have a slower onset of action but to work longer than NSAIDS
The use of glucosamine and chondroitin together for the treatment of osteoarthritis has become extremely popular; however, there is little evidence that this combination is any more effective than either supplement alone.
S-adenosylmethionine (SAMe) is a naturally occurring compound found in all living cells that is commercially produced in yeast-cell cultures. A methyl donor, it is important in methylation reactions that aid in the production of cartilage proteoglycans. SAMe has been available by prescription in Europe since 1975, where it is used to treat arthritis and depression. A number of studies have found SAMe to be more effective than placebo in improving pain and stiffness related to osteoarthritis. However, many of these studies were nonrandomized, uncontrolled, and unblinded, and some were flawed statistically."
Glucosamine Sulfate, Chondroitin, and SAMe all have the potential to cause Gastro intestinal problems. GS may have the potential to raise blood glucose levels.
'Medical protocol' (note as a dietary supplement it is a suggestion as opposed to a perscriptive dose):
GS 1500mg in three doses per day
CS 1200mg in three doses per day
SAMe 400 to 1,200 mg per day
As for scientific references here are a few. There are a few meta-studies which should be addressed with a grain of salt as they were sponsored by the supplement industry. Please read with a critical mind.
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