ikkainogakusei

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.

Resch KL, Hill S, Ernst E. Use of complementary therapies by individuals with 'arthritis'. Clin Rheumatol 1997;16:391-5.

Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9.

Setnikar I, Pacini MA, Revel L. Antiarthritic effects of glucosamine sulfate studied in animal models. Arzneimittelforschung 1991;41:542-5.

Rindone JP, Hiller D, Collacott E, Nordhaugen N, Arriola G. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med 2000;172:91-4.

Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.

Delafuente JC. Glucosamine in the treatment of osteoarthritis. Rheum Dis Clin North Am 2000;26: 1-11.

Qiu GX, Gao SN, Giacovelli G, Rovati L, Setnikar I. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung 1998;48:469-74.

McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000;283:1469-75.

Towheed TE, Anastassiades TP, Shea B, Houpt J, Welch V, Hochberg MC. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2001;1:CD002946.

Lopes Vaz A. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr Med Res Opin 1982;8: 145-9.

Bourgeois P, Chales G, Dehais J, Delcambre B, Kuntz JL, Rozenberg S. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 x 400 mg/day vs placebo. Osteoarthritis Cartilage 1998;6(suppl A):25-30.

Leeb BF, Schweitzer H, Montag K, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol 2000;27:205-11.

Morreale P, Manopulo R, Galati M, Boccanera L, Saponati G, Bocchi L. Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol 1996;23:1385-91.

Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev 1998;3:27-39.

Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med 1999;164: 85-91.

McCarty MF. The neglect of glucosamine as a treatment for osteoarthritis-a personal perspective. Med Hypotheses 1994;42:323-7.

The review of natural products. Drugs Facts and Comparisons. St. Louis, Mo.: Facts and Comparisons, 1996.

Di Padova C. S-adenosylmethionine in the treatment of osteoarthritis. Review of the clinical studies. Am J Med 1987;83:60-5.

Bradley JD, Flusser D, Katz BP, Schumacher HR Jr, Brandt KD, Chambers MA, et al. A randomized, double blind, placebo controlled trial of intravenous loading with S-adenosylmethionine (SAM) followed by oral SAM therapy in patients with knee osteoarthritis. J Rheumatol 1994;21:905-11.

Barcelo HA, Wiemeyer JC, Sagasta CL, Macias M, Barreira JC. Effect of S-adenosylmethionine on experimental osteoarthritis in rabbits. Am J Med 1987;83:55-9.

Konig B. A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. Am J Med 1987;83:89-94.

Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypotheses 1992;39:342-8.

Muller-Fassbender H. Double-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis. Am J Med 1987;83:81-3.

Vetter G. Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. Am J Med 1987; 83:78-80.

Maccagno A, Di Giorgio EE, Caston OL, Sagasta CL. Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. Am J Med 1987;83:72-7.

Caruso I, Pietrogrande V. Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease. Am J Med 1987;83:66-71.

Glorioso S, Todesco S, Mazzi A, Marcolongo R, Giordano M, Colombo B, et al. Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis. Int J Clin Pharmacol Res 1985;5:39-49.

Bliddal H, Rosetzsky A, Schlichting P, Weidner MS, Andersen LA, Ibfelt HH, et al. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage 2000;8:9-12.

Swanson BN. Medical use of dimethyl sulfoxide (DMSO). Rev Clin Basic Pharm 1985;5:1-33.

Santos L, Tipping PG. Attenuation of adjuvant arthritis in rats by treatment with oxygen radical scavengers. Immunol Cell Biol 1994;72:406-14.

Eberhardt R, Zwingers T, Hofmann R. DMSO in patients with active gonarthrosis. A double-blind placebo controlled phase III study [in German]. Fortschr Med 1995;113:446-50.

Newnham RE. Essentiality of boron for healthy bones and joints. Environ Health Perspect 1994; 102(suppl 7):83-5.

Travers RL, Rennie GC, Newnham RE. Boron and arthritis: the results of a double-blind pilot study. In: British Society for Nutritional Medicine. Journal of nutritional medicine. Vol 1. Abingdon, Oxfordshire, U.K.: Carfax, 1990:127-32.

Little CV, Parsons T. Herbal therapy for treating osteoarthritis. Cochrane Database Syst Rev 2001; 1:CD002947.

Petrella RJ. Is exercise effective treatment for osteoarthritis of the knee? Br J Sports Med 2000; 34:326-31.

Acupuncture. NIH Consens Statement 1997;15:1-34.

Berman BM, Swyers JP, Ezzo J. The evidence for acupuncture as a treatment for rheumatologic conditions. Rheum Dis Clin North Am 2000;26:103-15.

Aaron RK, Ciombor DM, Jolly G. Stimulation of experimental endochondral ossification by low-energy pulsing electromagnetic fields. J Bone Miner Res 1989;4:227-33.

Baker B, Spadaro J, Marino A, Becker RO. Electrical stimulation of articular cartilage regeneration. Ann N Y Acad Sci 1974;238:491-9.

Zizic TM, Hoffman KC, Holt PA, Hungerford DS, O'Dell JR, Jacobs MA, et al. The treatment of osteoarthritis of the knee with pulsed electrical stimulation. J Rheumatol 1995;22:1757-61.

Trock DH, Bollet A-, Dyer RH Jr, Fielding LP, Miner WK, Markoll R. A double-blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. J Rheumatol 1993;20:456-60.