Monday, November 9, 2009

Glucosamine, Chondroitin & MSM


I've had many of my patients ask me if they need to be taking any supplements. Some even tell me they swear by their daily glucosamine and chondroitin pills -the 2 supplements favored by most runners. My patients were all really convinced the supplements worked until I tell them the published evidence.

In some earlier studies, there seemed to be some evidence supporting the use of glucosamine (but not chondroitin, or MSM etc). Yes, that means you do not need anything else in your tablet or pill except glucosamine. But most if not all of those studies were sponsored by the companies who made the tablets.

Based on recent studies however, researchers looked the effects of glucosamine and/ or chondroitin on joint spaces in the knees of 572 subjects with known (x-ray evidence) osteoarthritis in their knees. At the end of the 2 year follow up, there were essentially no differences between the subjects who received a placebo (or dummy) tablet and those who received glucosamine and/ or chondroitin. It was a double blinded study, meaning both researchers and subjects didn't know who were getting the dummy tablets and who were getting the real deal.

So what's my take on this. For all those who are currently taking them and feel that they work, please carry on. If not you may feel uneasy stopping anyway. For those who are thinking of starting, well, you have the evidence before you.

Have a look at much stronger evidence not to take glucosamine here.


Reference

Sawitzke AD, Shi H, Finco MF et al (2009). The Effect of Glocosamine and/ or Chondroitin Sulphate on the Progression of Knee Osteoarthritis. International Society of Sports Nutrition.

8 comments:

  1. Interesting! I was just deciding on whether to start taking glucosamine or not.

    Am an avid runner who is currently taking for my first half marathon.

    ReplyDelete
  2. Thank you. well, consider the evidence presented and make your decision.

    ReplyDelete
  3. I am a septic, guess this tells I am not young, anyway glucosamine effects seems to be real. Not by me, but by the medical body. This is last 2 paragraph of a wiki article:
    However, currently OARSI (OsteoArthritis Research Society International) is recommending glucosamine as the second most effective treatment for moderate cases of osteoarthritis. Likewise, recent European League Against Rheumatism practice guidelines for knee osteoarthritis grants to glucosamine sulfate the highest level of evidence, 1A, and strength of the recommendation, A.[51]
    A 2009 small study has concluded that glucosamine reduces cartilage turnover in osteoarthritis patients in response to physical training.

    And the link:
    http://en.wikipedia.org/wiki/Glucosamine

    Ling SM

    ReplyDelete
  4. Hi Ling SM,

    thank you for reading and for your comments, I went to have a look at the Wiki link you provided and here is what I found.

    In the 2nd last paragraph the author of that article didn't do perform any clinical trials or research, it was simply a review article and he commented on results of trials done previously. Hence it was merely his own opinion.

    In the last paragraph, I went to look at the reference and the study had only 12 participants. The participants took either glucosamine, ibuprofen and a placebo together with exercise (or strength training) for 12 weeks. All the 3 groups improved though the group taking glucosamine improved the most. This to me is too small a sample size to draw conclusions.

    My personal opinion is based on interpreting results, analysis and comments done on large randomized clinical trials and I probably would not consider "wiki" as a reliable scientific source.

    ReplyDelete
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