Chondroitin
pill for osteoarthritis, is it better to use
chondroitin sulfate alone or in
combination with glucosamine sulfate?
Review the latest
studies and the benefits of glucosamine chondroitin combination for arthritis,
specifically osteoarthritis prevention and treatment
Chondroitin
supplement pills benefit for osteoarthritis 400 mg tablets, side effects
Chondroitin sulfate consists of repeating chains of molecules called glycosaminoglycans (GAGs). Chondroitin sulfate is a major constituent of cartilage providing structure, holding water and nutrients, and allowing other molecules to move through cartilagean important property, as there is no blood supply to cartilage. Chondroitin may work by acting as a building block for proteoglycan molecules, and may also have anti-inflammatory properties. See Consumer lab for chondroitin product testing. Commmercially available chondroitin is derived mainly from shark and cow cartilage.
Source Naturals
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Chondroitin Sulfate, 400 mg pill,
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Chondroitin Sulfate is a mucopolysaccharide found in cartilage, tendons
and ligaments, where it is bound to proteins such as collagen and elastin. In
our joints, it contributes to strength, flexibility and shock absorption.
Current research indicates that supplemental
Chondroitin Sulfate may help maintain proper joint
function.
Chondroitin for
osteoarthritis
In degenerative joint disease, such as
osteoarthritis, there is a loss of chondroitin sulfate as the cartilage erodes. Animal studies indicate that chondroitin
sulfate may promote healing of bone, which is consistent with the fact that the majority
of glycosaminoglycans found in bone consist of chondroitin sulfate. Chondroitin sulfate
has been shown, in numerous trials to relieve symptoms and possibly slow the progression
of, or reverse, osteoarthritis.
Commercially available chondroitin is derived mainly from shark and cow cartilage.
Chondroitin Research
Chondroitin at 800 mg a day was given in addition to naprosyn 500 mg a day for a
period of two years to a group of individuals with osteoarthritis of the hands. This group
was compared to another group who only received naprosyn. Those who took chondroitin were
found to have a slower rate of arthritis progression than those who only took naprosyn.
See bottom of page for more studies.
Back in the mid 1990s the America
public became aware of effective nutritional alternatives to standard medical
drugs for the treatment of osteoarthritis. Glucosamine was the first nutrient
that became popular. Since then, many other nutrients and herbs have been
promoted, including chondroitin. Chondroitin sulfate is a major constituent of
cartilage providing structure, holding water, and allowing other molecules to
move through cartilage—an important property, as there is no blood supply to
cartilage. In degenerative joint disease, such as osteoarthritis, there is a
loss of chondroitin sulfate as the cartilage erodes. But, few studies have
looked at the long-term benefit of oral chondroitin supplements. In a study
performed at University of Genova Medical School, in Italy, 12 individuals with
arthritis of the hands were treated with 800 mg/day of chondroitin sulfate plus
naproxen, and compared to 12 others who were given naproxen only. Naproxen is an
anti-inflammatory medicine similar to Motrin and sold over the counter as Aleve.
X-rays of the hands were done at the start of the study and again after 24
months. In both groups, degeneration of joints showed a general tendency to
increase over time, however, the damage was much lower in those treated with
chondroitin sulfate plus naproxen than in patients taking naproxen alone.
Comments: Although chondroitin by itself did
not stop the continuing damage to joints, it did slow the progression of the
arthritis. Glucsosamine supplements are known to enhance joint health in those
with arthritis, and it seems reasonable to take both supplements for the
treatment of arthritis. The most common dose of glucosamine is 1500 mg a day
while that of chondroitin is 500 to 1000 mg per day.
The pathobiology of osteoarthritis and the rationale for using the chondroitin
sulfate for its treatment.
Curr Drug Targets Immune Endocr Metabol Disord. 2004 Jun;4(2):119-27.
Volpi N.
Biological Chemistry Section, University of Modena and Reggio Emilia, Italy.
Structure-modifying osteoarthritis (OA) drugs are agents that reverse,
retard, or stabilize the pathology of OA, thereby providing symptomatic relief
in the long-term treatment. The objective of this review is to evaluate the
literature on chondroitin sulfate with respect to the pathobiology of OA to
ascertain whether this agent should be classified as a symptomatic slow-acting
drug (SYSADOA), a compound that has a slow onset of action and improve OA
symptoms after a couple of weeks. Chondroitin sulfate exhibits a wide range of
biological activities and from a pharmacological point of view it produces a
slow but gradual decrease of the clinical symptoms of OA and these benefits last
for a long period after the end of treatment. Many literature data show that
chondroitin sulfate could have an anti-inflammatory activity and a
chondroprotective action by modifying the structure of cartilage. These
properties are also related to the oral adsorption of chondroitin sulfate as
high-molecular mass compounds having clusters of sulfate groups and high charge
density capable of exert their chondroprotective activity in vivo.
Joint Power Rx with
chondroitin and glucosamine
has many nutrients found to be
helpful in arthritis.
These Include:
Boswellia serrata
supplement.
Chondroitin sulfate
Glucosamine sulfate
MSM nutrient
Omega 3 fatty acids, DHA or
fish oils
Stinging nettle
herb
Turmeric root extract,
curcumin is very popular
Is chondroitin necessary if someone is already
taking glucosamine?
The research with chondroitin is not as consistent and
extensive as it is with glucosamine. If you have arthritis, one option is to start with
glucosamine 500 mg three times a day for a month. If, after a month, you haven't been
helped, double your dose of glucosamine. If, after another month, you need additional
relief, you can try chondroitin at 500 mg three times a day.
Another option is to start taking both together along with a few other nutrients
and herb found through research to be helpful for arthritis.
Are there recent studies saying chondroitin cannot be
absorbed into our bodies through oral consumption?
The studies I have come across show that chondroitin does
get absorbed.
Can a diabetic take chondroitin?
Yes. One study providing a combination of glucosamine and chondroitin for a
period of 90 days did not find any change in blood sugar levels.
Are there recent studies saying chondroitin cannot be
absorbed into our bodies through oral consumption?
The studies we have come across show that chondroitin does
get absorbed quite well.
Can a diabetic take chondroitin?
Yes. One study providing a combination of glucosamine and chondroitin for a
period of 90 days did not find any change in blood sugar levels.
Side effects
No major adverse effects have been published in medical journals.
Vegan or vegetarian
chondroitin?
Q. I'm on the way to renew my cartilage
and looking for a vegan chondroitin. Do you know a company, which has that kind
of product on stock so i could take advantage of chondroitin sulfate for my
arthritis.
A. Chondroitin is made from extracts of cartilaginous cow and pig
tissues along with shark, and fish cartilage. As of March 2009, we are not aware
of a vegan source of chondroitin.
Chondroitin study
The pathobiology of osteoarthritis and the rationale for using the chondroitin
sulfate for its treatment.
Volpi N.
Biological Chemistry Section, University of Modena and Reggio Emilia, Italy.
Curr Drug Targets Immune Endocr Metabol Disord. 2004 Jun;4(2):119-27.
Structure-modifying osteoarthritis (OA) drugs are agents that reverse,
retard, or stabilize the pathology of OA, thereby providing symptomatic relief
in the long-term treatment. The objective of this review is to evaluate the
literature on chondroitin sulfate with respect to the pathobiology of OA to
ascertain whether this agent should be classified as a symptomatic slow-acting
drug (SYSADOA), a compound that has a slow onset of action and improve OA
symptoms after a couple of weeks. Chondroitin sulfate exhibits a wide range of
biological activities and from a pharmacological point of view it produces a
slow but gradual decrease of the clinical symptoms of OA and these benefits last
for a long period after the end of treatment. Many literature data show that
chondroitin sulfate could have an anti-inflammatory activity and a
chondroprotective action by modifying the structure of cartilage. These
properties are also related to the oral adsorption of chondroitin sulfate as
high-molecular mass compounds having clusters of sulfate groups and high charge
density capable of exert their chondroprotective activity in vivo.
Chondroitin Useful in Osteoarthritis
Back in the mid 1990s the America
public became aware of effective nutritional alternatives to standard medical
drugs for the treatment of osteoarthritis. Glucosamine was the first nutrient
that became popular. Since then, many other nutrients and herbs have been
promoted, including chondroitin. Chondroitin sulfate is a major constituent of
cartilage providing structure, holding water, and allowing other molecules to
move through cartilage—an important property, as there is no blood supply to
cartilage. In degenerative joint disease, such as osteoarthritis, there is a
loss of chondroitin sulfate as the cartilage erodes. But, few studies have
looked at the long-term benefit of oral chondroitin supplements. In a study
performed at University of Genova Medical School, in Italy, 12 individuals with
arthritis of the hands were treated with 800 mg/day of chondroitin sulfate plus
naproxen, and compared to 12 others who were given naproxen only. Naproxen is an
anti-inflammatory medicine similar to Motrin and sold over the counter as Aleve.
X-rays of the hands were done at the start of the study and again after 24
months. In both groups, degeneration of joints showed a general tendency to
increase over time, however, the damage was much lower in those treated with
chondroitin sulfate plus naproxen than in patients taking naproxen alone.
Comments: Although chondroitin by itself did
not stop the continuing damage to joints, it did slow the progression of the
arthritis. Glucsosamine supplements are known to enhance joint health in those
with arthritis, and it seems reasonable to take both supplements for the
treatment of arthritis. The most common dose of glucosamine is 1500 mg a day
while that of chondroitin is 500 to 1000 mg per day.
Chondroitin sulfate in erosive osteoarthritis of the hands.
Rovetta G, Monteforte P, Molfetta G, Balestra V.
Department of Rheumatology, DISEM, University of Genova Medical School, Italy.
Int J Tissue React. 2002;24(1):29-32.
The aim of this study was to evaluate the joint count for erosions in patients
with erosive osteoarthritis (EOA) of the hands treated with 800 mg/day of orally
administered chondroitin sulfate plus naproxen, compared with that of patients
administered naproxen only. Twenty-four consecutive patients (22 women and two
men, mean age 53.0 +/- 6) suffering from symptomatic OA and with radiographic
characteristics of EOA were studied. The patients were divided into two groups
of 12 patients each. The first group took naproxen 500 mg/day only. The second
group was treated with chondroitin sulfate 800 mg/day orally plus naproxen 500
mg/day. Radiological hand examinations were performed at baseline and again
after 12 and 24 months. In both groups, the joint count for erosions showed a
general tendency to increase over time. Progression of erosions at 24 months was
lower in patients treated with 800 mg/day chondroitin sulfate plus naproxen than
in patients taking naproxen only (p <0.05). Chondroitin sulfate failed to stop
the usual time-associated progression in the number of finger joints presenting
erosions in EOA of the hands. It was, however, associated with a lower increase
in the number of finger joints with erosions detected after 2 years of
radiological observation.
A randomized double-blind clinical trial of the effect of chondroitin sulfate
and glucosamine hydrochloride on temporomandibular joint disorders: a pilot
study.
Nguyen P, Mohamed SE, Gardiner D, Salinas T.
Louisiana State University Health Sciences Center, New Orleans, USA.
Cranio. 2001 Apr;19(2):130-9.
Previous studies have shown chondroitin sulfate and glucosamine hydrochloride
have beneficial effects on symptoms of osteoarthritis of the knee. Our aim was
to study the effect of a daily dose of 1500 mg of glucosamine hydrochloride (GH)
and 1200 mg of chondroitin sulfate taken for twelve weeks on subjects
diagnosed with capsulitis, disk displacement, disk dislocation, or painful
osteoarthritis of the temporomandibular joint (TMJ). Forty-five subjects were
enrolled in the study and were randomly assigned to either an active medication
group or a placebo group. Eleven subjects were lost from the study for various
reasons, resulting in fourteen subjects remaining in the active medication group
and twenty subjects remaining in the placebo group. Subjects taking chondroitin
sulfate-GH had
improvements in their pain as measured by one index of the McGill Pain
Questionnaire, in TMJ tenderness, in TMJ sounds, and in the number of daily
over-the-counter medications needed. Subjects taking the placebo medication had
improvements in their pains as measured by the visual analog scale and by four
indices of the McGill Pain Questionnaire. Additional studies are required to
evaluate the clinical effectiveness of chondroitin sulfate-GH and to determine the exact
mechanism by which chondroitin sulfate-GH affects the articular cartilage of synovial joints.
Chondroitin sulfate questions
Q. I read on a website that there does not seem to be a risk of mad cow disease
regarding the use of chondroitin sulfate from bovine cartilage. Would you please
do a Google search with the terms - chondroitin sulfate BSE. Number six on the
list after the scholarly articles says Caution - Know The Risk Of Your
Chondroitin. The website talks about its product of chondroitin sulfate from
shark cartialge. To your knowledge, are there
any differences in the effects of shark cartilage versus bovine cartilage
chondroitin sulfate on the human body?
A. There is some debate regarding the risk of mad cow disease and
chondroitin sulfate consumption from a bovine source and not all questions have
been completely answered. Thus far there have not been any cases of mad cow
disease diagnosed in anyone who has consumed chondroitin sulfate, and it appears
tens of millions of people have over the past few years. Furthermore, the risk
of mad cow disease in the USA is so small that one would have a higher risk of
injury or death by just getting in the car and taking a trip to the shopping
mall, yet few people think of this risk when they get in their car but worry
about extremely small and extremely unlikely scenarios such as mad cow disease.
Therefore, at this point, for practical purposes, it appears that the use of
chondroitin sulfate from bovine sources is acceptable and appears to be safe.
Since human studies comparing shark cartilage derived chondroitin sulfate has
not been compared to bovine source of chondroitin sulfate, we cannot say which
form is better. Chances are they are similar.
Q. I have read that chondroitin sulfate is such a large
molecule that it is mostly unabsorbable in the small intestine being over 35,000
angstrom and the intestinal lining only allowing 25,000-32,000 angstrom as the
largest molecule
to pass through. Additionally, there was a study done a few summers ago that
showed the blood levels increased an hour afterward to be only 4%, whereas
glucosamine sulfate was elevated 400% in the same time frame. If this is true
than chondroitin seems to be worthless as an oral supplement and rather should
be injected.
A. There is a great deal of controversy regarding the benefit of
oral chondroitin sulfate supplement. Reasonable people looking at the research
may come to different conclusions. In our opinion, having reviewed the published
studies, it appears to us that there is more research pointing to the benefit of
chondroitin sulfate for joint health, particularly when combined with
glucosamine.
I was just looking at the physician formulas
website and noticed you are a retail source of the Source Naturals brand Chondroitin. I have been taking this supplement for at least 9 or 10 years. This
summer, when I went to purchase replacement bottles, I notice the ingredient
list on the bottles available locally had an additional stamp on them "CONTAINS
WHEAT" added over the regular list of ingredients. What wheat, and therefore
gluten, is doing lurking in the chondroitin formulas which say they contain
dibasic calcium phosphate, sorbitol, stearic acid, mod. cellulose gum, colloidal
silicon dioxide, and magnesium stearate, is totally beyond me. Let me make an
assumption,
the manufacturer is using some sort of filler from Who Knows What Grain Source,
possibly from another country, or there's a big batch that got contaminated. The
question is, is this a permanent state of affairs or just a temporary one?
This has really left me scrambling to try to find a replacement which does not
have WHEAT nor other starches. I have my routine, I don't combine the
chondroitin. and the glucosamine. but take them separately, and that's what has
worked for me, very consistently. I've experimented with going off of them for a
few months, and I can really tell the
difference. I've tried taking just the glucosamines, which does not work as
well. Can you tell me if Source Naturals is going to start making a non wheat
contaminated Chondroitin soon again?
The best people to ask is Source Naturals since they are the
ones making the chondroitin product.
I am looking for a high-quality chondroitin
supplement, preferably from a non-bovine source such as shark or a bovine
product that certifies the following: Only U.S. cows are used. The trachea of
the cow is used, which is not a significant reservoir for Mad Cow Disease, as is
the brain or spinal cord. The processing involves enzymatic digestion of all
proteins. Please provide more information about your chondroitin sulfate, 400
mg, product relative to these requirements.
The chondroitin sulfate product we have available is made by
Source Naturals, and you may wish to contact them for these details.
Eagle Laboratories, Inc. is a manufacturer of Low Molecular Weight Chondroitin Sulfate. All cartilage comes from US federally inspected plants to ensure the quality of our product. I would be interested in talking with you to discuss the benefits of using a low molecular Chondroitin in your formulations. Mark den Hollander, Eagle Laboratories, Inc.
Can a
tongkat ali herbal pill be taken together with chondroitin supplement
products?
We don't see any untoward effects since chondroitin is a safe
supplement.
I take chondroitin for arthritis and was wondering
whether the occasional use of yohimbe herb
would interfere with the benefits
of the osteoarthritis supplement.
We don't think there would be a problem with the combination.
is there any chondroitin research regarding the use of
this nutrient with
tribulus terrestris
extract
herb as a treatment for arthritis?
We are not aware of any such studies with
chondroitin sulfate. See more health
articles at
new chondroitin benefits.
Chondroitin analysis
A single laboratory validation (SLV) of a method to quantify chondroitin sulfate
in raw materials and dietary supplements has just been completed by David Ji at
Analytical Laboratories in Anaheim. Chondroitin sulfate is a negatively charged
polymeric glycosaminoglycan (GAG) consisting of alternating uronic acid and N-acetylhexosamine
residues connected by beta 1-3 hexuronidic and beta 1-4-N-acetylhexosaminidic
bonds, and is a major component of connective tissue. Dietary supplements
containing chondroitin sulfate are widely available and are often used to
maintain joint health, and there is some clinical evidence that chondroitin
sulfate might help treat symptoms of osteoarthritis. Quantitative analysis of
chondroitin sulfate in chondroitin sulfate raw materials and dietary supplement
raw materials has been extremely challenging owing to the wide molecular weight
variation of chondroitin sulfate polymers, its poor UV absorbance, and strongly
ionic nature. Other related GAGs may be present as impurities or adulterants in
chondroitin sulfate materials, and thus any analytical methodology designed to
quantify chondroitin sulfate must be selective for chondroitin sulfate in the
presence of these other GAGs. Carbazole reaction, cetyl pyridinium chloride
(CPC) titration, and size exclusion chromatography have been used to
characterize chondroitin sulfate, however these methods can not distinguish
between chondroitin sulfate and related GAGs, and are subject to interferences
in dietary supplement finished products. CPC titration, in particular, has
become a popular method for determining chondroitin sulfate purity, however this
method not only can not distinguish between chondroitin sulfate and other GAGs,
but will give positive results for any large moleculer anion, such as
carrageenan, proteins, and surfactants, thus making economic adulteration
possible. In the method developed by Ji, the chondroitin sulfate is first
extracted in water, then selectively hydrolyzed by chondroitinase ACII enzyme to
form unsaturated disaccharides; the resulting disaccharides are then quantified
by ion-pairing HPLC with UV detection and summed to yield the amount of
chondroitin sulfate in the material. A total of 6 disaccharides are quantified,
each differing in either their degree of sulfonation and/or position of
sulfonation. The single laboratory validation work determined the repeatability,
accuracy, selectivity, LOD/LOQ, ruggedness and linearity of the method, with
very good results. In addition to being able to quantify chondroitin sulfate in
raw materials and dietary supplements, the profile of the resulting
disaccharides may be used to help identify the source of the chondroitin
sulfate, which typically comes from bovine trachea, porcine cartilage, or shark
cartilage. Development and validation of the method was funded by NIH-ODS. The
SLV manuscript will be submitted to the Journal of AOAC International for
publication. David Ji and Dr. Mark Roman from Tampa Bay Analytical Research will
then co-direct the AOAC collaborative study involving twelve international
laboratories on this method. If results from the collaborative study are
acceptable, the method will be recommended for adoption as an AOAC official
method. It is anticipated that the collaborative study will be completed by
Spring of 2007.