11.26.04 -- Study Finds Glucosamine and MSM Better for Joints When Taken Together
|
|
|
By Greg Arnold, DC, CSCS, October 14, 2004, abstracted from “Randomized, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination” in a 2004 issue of Clinical Drug Investigations
Osteoarthritis (OA) is now considered a serious public health concern in the United States. Doubling from 35 million sufferers to 70 million in 2002 (including 300,000 children), osteoarthritis is second only to heart disease as a cause of work disability and costs the U.S. economy more than $86.2 billion each year (www.arthritis.org)
Two of the most popular alternative treatments for OA include glucosamine sulfate (GS) and Methylsulfonylmethane (MSM). GS provides the raw materials to build cartilage2 while blocking pain-producing prostaglandins.3 Even a review of research on GS published in one of the most respected medical journals in the world4 stated GS’s effectiveness in treating OA.
MSM, a natural painkiller, helps treat OA by blocking the inflammatory process while simultaneously stimulating the body’s natural anti-inflammatory hormone, cortisol. MSM also helps increase the synovial fluid level in joints and protects cartilage from being broken down.5 Recent research has shown daily intakes of 2,250 mg of MSM to reduce OA pain in as little as six weeks.6
Although this past research demonstrates the effectiveness of GS and MSM for OA when taken separately, a new study7 has found that GS and MSM are more effective for arthritis when they are taken together. Researchers studied 118 subjects with mild to moderate OA and had them receive 500 mg of GS, 500mg MSM, or both GS and MSM, or placebo three times daily for three months. Patients were evaluated at weeks 2, 4, 8, and 12 while measuring pain, swelling and a 15m walking time.
At the end of 12 weeks, the GS/MSM combination “significantly improved” signs and symptoms of OA compared with either taking them separately or placebo, resulting in the researchers concluding that “combination therapy showed better efficacy in reducing pain and swelling and improving the functional ability of joints than the individual agents.”
Reference:
1 “The Facts about Arthritis” from the Arthritis Foundation website www.arthritis.org
2 Setnikar, I., Antireactive properties of "chondroprotective" drugs. Int J Tissue React, 1992. 14(5): p. 253-61
3 Reichelt, A., et al., Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study. Arzneimittelforschung, 1994. 44(1): p. 75-80
4 McAlindon, T.E., et al., Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. Jama, 2000. 283(11): p. 1469-75
5 Parcell, S., Sulfur in human nutrition and applications in medicine. Altern Med Rev, 2002. 7(1): p. 22-44
6 Lawrence, RM. Methylsulfonylmethane (MSM): a double-blind study of its use in degenerative arthritis. Int J Anti-Aging Med 1998; 1(1): 50
7 Usha, P., Randomized, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination. Clin Drug Invest, 2004. 24(6): p. 353-363
Glucosamine and Chondroitin
To understand how chondroprotective agents work, one must first understand how joints work. The key element in human joints is articular cartilage, the shock-absorbing tissue that connects two bones together and allows pain-free movement. Articular cartilage is comprised of two different molecules, collagen and proteoglycans, with the remainder composed primarily of water (65-85%). Collagen, a protein that binds tissue together, provides elasticity. Proteoglycans, composed of sugars and protein, absorb water, which provides lubrication and resiliency, nature's shock absorber for your joints. Both compounds are produced by chondrocytes, caretaker cells responsible for the formation and maintenance of cartilage. A deficiency in any one of the above constituents will increase the likelihood of wear and tear on articular cartilage, which can eventually lead to compromised joint function. Glucosamine and chondroitin are safe, natural and effective nutrients that support healthy joint function by supplying the materials needed to produce collagen and proteoglycans.
GLUCOSAMINE
Glucosamine is composed of glucose (a sugar) and glutamine (an amino acid). It is utilized by chondrocytes to form glycosaminoglycans (GSG) and proteoglycans (PG). Both of these constituents attract and bind water into cartilage, increasing resiliency. Research indicates that glucosamine may actually help your body repair damaged or eroded cartilage. A number of studies have been conducted on glucosamine sulfate and glucosamine hydrochloride, with a preponderance of positive results. Glucosamine sulfate is considered the more effective of the two. One study from the University of Liege in Liege, Belgium studied the effects of glucosamine sulfate on 212 patients with knee osteoarthritis. Participants took either 1,500 mg glucosamine or a placebo once daily for three years. The study compared joint-space width at enrollment, one year, and at the study’s conclusion. The 106 patients on placebo had a progressive joint-space narrowing, while participants taking glucosamine experienced no significant joint-space loss, indicating glucosamine may beneficially modify cartilage structure.3 A study published in the journal Osteoarthritis and Cartilage in 1998 investigated the in vitro effects of glucosamine sulfate on proteoglycan and collagen production by chondrocytes taken from osteoarthritic articular cartilage. The results showed “a statistically significant stimulation of PG production by chondrocytes from human osteoarthritic cartilage cultured for up to 12 days in 3-dimensional cultures.” 4 Another study from Italy enrolled eighty inpatients with established OA. They received either 1,500 mg of glucosamine sulfate or placebo daily for 30 days. The patients treated with glucosamine sulfate experienced a reduction in symptoms almost twice as large and twice as fast as those receiving placebo. Researchers also used electron microscopy of patient’s articular cartilage to support this hypothesis. Patients who received glucosamine sulfate showed a picture more similar to healthy cartilage. The researchers concluded that glucosamine sulfate tends to rebuild damaged articular cartilage and restore articular function.5
CHONDROITIN
Chondroitin is classified as a glycosaminoglycan. It bonds with collagen to form the basis of connective tissue. Chondroitin helps attract fluid into proteoglycans, thereby bringing nutrients into cartilage and providing shock absorption. While glucosamine helps manufacture and maintain cartilage, chondroitin keeps cartilage from becoming malnourished. Chondroitin works synergistically with glucosamine, and these two nutrients form the basis of most joint health supplements on the market today. A 6-month randomized, multi-center, double-blind, double-dummy study published in 1996 compared the effectiveness of chondroitin versus a popular non-steroidal anti-inflammatory drug (NSAID) in patients with knee osteoarthritis (OA). One hundred and forty-six patients with knee OA were recruited and separated into two groups; an NSAID group and a chondroitin sulfate (CS) group. The NSAID group was given the NSAID and a placebo for the first month, then placebo alone for months 2-3. The CS group was given the NSAID and CS for the first month, and then CS alone for months 2-3. Both groups were then given 1200mg of CS for months 4-6. “Patients treated with the NSAID showed prompt and plain reduction of clinical symptoms, which, however, reappeared after the end of treatment; in the CS group, the therapeutic response appeared later in time but lasted for up to 3 months after the end of treatment. CS seems to have slow but gradually increasing clinical activity in OA; these benefits last for a long period after the end of treatment.” 6
NOW® Foods is your source for natural joint support products. Our Extra Strength Glucosamine & Chondroitin is one of our best-selling products, and we also have combination supplements that include MSM, Concentrace® minerals, and more. We also carry both glucosamine and chondroitin as separate products, as well as in powder and lotion forms.
References:
1) Balch, James F. et. al. ; Prescription For Nutritional Healing 3rd Edition; Avery; Penguin Putnam; 2000
2) Benedikt, H.; Glycosaminoglycans And Derivatives For Treatment Of Arthritis; Chiropractic Products, May 1997, pp. 92-95
3) Reginster, Jean Yves et. al.; Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial; The Lancet, 2001, Vol. 357, No. 9252
4) Bassleer, C. et. al.; Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro; Osteoarthritis and Cartilage, 1998, 6, 427-434
5) Drovanti, A. et. al.; Therapeutic Activity of Oral Glucosamine Sulfate in Osteoarthritis: A Placebo-Controlled, Double-Blind Investigation; Clinical Therapeutics, Vol. 3, No. 4, 1980, pp. 260-272
6) Morreale, P. et. al.; Comparison of the Antiinflammatory Efficacy of Chondroitin Sulfate and Diclofenac Sodium in Patients with Knee Osteoarthritis; Journal of Rheumatology, 1996, 23:8, pp. 1385-1391