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Glucosamine and Chondroitin

What is Glucosamine?

Glucosamine sulfate is an amino sugar necessary for the construction of connective tissue. It is a component of the mucopolysaccharides, which are integral in the formation of nails, tendons, skin, bone, ligaments, eyes, heart valves, and other body tissues.

Glucosamine is a major building block of proteoglycans (molecules that are essential for healthy cartilage, because they attract and hold many times their weight in water, which both lubricates and nourishes the cartilage).

Studies have shown that there is a direct relationship between the amount of glucosamine present and the amount of proteoglycans produced; when glucosamine levels are high more proteoglycans are produced which means that more water will be held in its proper place.

There also seems to be a direct correlation in reverse; if only small amounts of glucosamine are available then few proteoglycans will be produced which means less of the all important water will be held in that area. When cartilage is damaged, and these water attracting molecules (proteoglycans) are lost, it loses its ability to absorb shock, and becomes more susceptible to cracking, fissuring, and possibly even wearing through completely.

Glucosamine has also been shown to play an important role in the production of collagen. In addition, glucosamine normalizes cartilage metabolism, which helps to keep the cartilage from breaking down.

Studies have shown that glucosamine may do more than stimulate the production of cartilage; it may actually help reduce pain and improve joint function in those with osteoarthritis. And it doesn't seem to matter if it comes from the glucosamine manufactured by our bodies or from a supplement: it all seems to work the same.


The following are the dramatic results of studies involving glucosamine supplementation by patients suffering with osteoarthritis.

An early double-blind glucosamine study conducted in the Philippines involved 20 patients with osteoarthritis of the knee. Ten patients were given 500 mg. of glucosamine 3 times a day while the other 10 received a placebo. Within 6 to 8 weeks, the glucosamine group enjoyed significant reductions in pain, joint tenderness, and swelling.

About 80 to 100 percent of the patients taking glucosamine improved during the study, versus only 20 to 40 percent of the placebo group. And no side effects were reported.

In Portugal a study including 252 doctors and 1,208 patients was conducted to determine the effectiveness and tolerance of glucosamine to patients suffering with osteoarthritis.

Patients were given 3 daily doses, totaling 1.5 grams of glucosamine, over a 36 to 64 day period (with an average of 50 days). The results of this study are extremely positive:

Patients reported a steady reduction of pain throughout the treatment period.

Ninety-five percent of the patients in the study reported a sufficient or good clinical response.

The positive effects of glucosamine supplementation were evident from six to twelve weeks after the treatment had stopped.

Only a small number of patients reported any side effects (mainly gastrointestinal discomfort), but even these effects disappeared within one to three weeks.

The results of these studies and others clearly show that glucosamine supplementation can be of benefit to those suffering from osteoarthritis.


What is Chondroitin?

Chondroitin sulfates are long chains of repeating sugars that attract fluid into the proteoglycan molecules, which is important for the following two reasons:

1. The fluid acts as a shock absorber.

2. The fluid draws nutrients into the cartilage. Because articular (joint) cartilage has no blood supply all of its nourishment and lubrication comes from the fluids that are attracted into the proteoglycan molecules by the chondroitin sulfates. Without this precious fluid, cartilage would become malnourished, drier, thinner, and more fragile.


Chondroitin does more than attract fluid; it also does the following:

Protects existing cartilage from premature degeneration by inhibiting the action of certain cartilage chewing enzymes.

Inhibits other enzymes that try to starve cartilage by cutting off the transportation of nutrients.

Helps in the synthesis of new cartilage by stimulating production of proteoglycans, glycosaminoglycans, and collagen, (the cartilage matrix molecules that serve as building blocks for healthy new cartilage).


Works synergistically with glucosamine.

The following are examples of studies involving chondroitin supplementation on patients suffering from osteoarthritis:

A six month study conducted at the University of Naples in 1991, (involving oral and injectable chondroitin sulfates), on people with cartilage degeneration showed dramatic results. The 200 patients included in this study were between the ages of 52 and 75 and met at least five of the following criteria: radiological evidence of osteoarthritis, a typical clinical history of osteoarthritis, exclusion of other types of arthritis, swelling of at least one joint, redding of at least one joint, hypersensitivity to pressure of at least one joint, and pain when resting or moving of at least one joint.

The patients who received either 1,200 mg. of oral chondroitin sulfate or a 100 mg. injection of chondroitin sulfate showed positive effects within two weeks. When the study was completed, the researchers stated that the results showed a considerable improvement in both pain and mobility. No side effects were found.

A study conducted in France, on 50 patients suffering from osteoarthritis of the knee, in 1986 showed extremely encouraging results. Patients were given either 800 mg. or 1,200 mg. of oral doses of chondroitin sulfates of or 500 mg. of pain medication.

When cartilage taken after three months of supplementation were compared to samples taken at the beginning of the study, it was apparent that the damaged cartilage in the chondroitin group had improved significantly.


Why use Glucosamine and Chondroitin?

Because both Glucosamine and chondroitin sulfates work synergistically to stimulate the development of new cartilage while keeping cartilage damaging enzymes under control. They may be able to do what many other supplements and treatments for osteoarthritis can not; it may actually help the body heal itself while it reduces both pain and inflammation.


Are these supplements safe?

Yes, Studies have shown that glucosamine and chondroitin sulfates are safe even at amounts far above the recommended daily dosage. In fact, a six-year study tracking people taking chondroitin in doses of 1.5 to 10 grams per day has shown no toxicity.


How much should I take?

For best results, you should take one to two tablets daily; with food. It is recommended that you also supplement with Vitamin C and Manganese because they increase the effectiveness of both glucosamine and chondroitin sulfates and also have beneficial effects on joint functions. As with any dietary supplement, you should not exceed the recommended dosage.


References

1. Dovanti, A., Bignamini, A. A., and Rovati, A. L. Therapeutic Activity of Oral Glucosamine Sulfate in Osteroarthrosis: A Placebo-Controlled Double- Blind Investigation. Clinical Therapeutics 3(4):266-272,1980.
2. Pujalte, J. M., Llavore, E. P., and Yiescupidez, F. R. Double-blind Clinical Evaluation of Oral Glucosamine Sulphate in the Basic Treatment of Osteoarthrosis. Current Medical Research and Opinion 7 (2): 110-114, 1980.
3. Pujalte et al. Op. ct.
4. Tapadinhas, M. J., Rivera, 1. C., and Bignamini, A. A. Oral Glucosamine Sulphate in the Management ofArthrosiis: Report on a Multicentre Open Investigation in Portugal. Pharmatherapeutica 3(3):157-168,1982.
5. Caplan, A. 1. Cartilage. Scientific American 251(l):84-97, October 1994.
6. Soldanic G� and Romagnoli, J. Experimental and Clinical Pharmacology of Glycosaminoglycans (GAGs). Drugs in Experimental and Clinical Research 18(l):81-85,1991.
7. Rovetta, G. Galactosaminoglycuronoglycan Sulfate (Matrix) in Therapy of Tibiofibular Osteoarthritis of the Knee. Drugs in Experimental and Clinical Research 18(l):53-57, 1991.
8. Soldani and Romagnoli, Op. cit.
9. Oliviero, U., et al. Effects of the Treatment with Matrix on Elderly People with Chronic Articular Degeneration. Drugs in Experimental and Clinical Research 17(l):45-51,1991.
10. Popitone, V. R. Chrondroprotection with Chrondroitin Sulfate. Drugs in Experimental and Clinical Research 17(l):3-7, 1991.

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