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In the medical community, there has been much debate over the effectiveness of glucosamine and chondritin for relief of arthritis pain.  According to the Arthritis Foundation website, they state that ‘Glucosamine and Chondritin maybe not effective for Arthritis’ and that ‘Major study suggests that placebo works just as well.’  However, segments of patients continue to experience reduced arthritis pain after taking Glucosamine / Chondritin.  Why is there such a discrepancy between the results of research studies and actual results?  Is there any difference between what kind of glucosamine you buy?  We will attempt to discuss some of these questions.

First, let us briefly review arthritis, specifically osteoarthritis and how glucosamine factors into this condition.  Osteoarthritis pain, not rheumatoid arthritis, has been attributed to the loss of the smooth cartilage that covers the surface of bones.  The function of this smooth (articular) cartilage is to provide a cushion effect between bones.  Glucosamine supplements are intended to give the body a key ingredient for reproducing lost smooth cartilage associated with arthritis.

Why does glucosamine work for some but not others?

 a. Severity of Arthritis:  Glucosamine is not as effective in severe arthritis

In a study published by the Osteoarthritis Research Society International, it was reported that glucosamine supplementation was beneficial in reducing the progression of mild or moderate knee arthritis over a 3 year period.   However, no notable difference was noted in subjects with severe arthritis.  As a result, if you want to try glucosamine & chondritin, start using it early.

 b.  Pre-existing conditions

Do you have type 2 diabetes or elevated cholesterol as well as arthritis?  Recent studies have now shown that some types of glucosamine supplements can actually increase cholesterol and further increase insulin resistance.  In theory, this could contribute to weight gain, adding additional strain on arthritic joints and possibly reducing the effects of the glucosamine.

 Are some glucosamine better than others?

In 2011, a study was released in the Journal of Pharmacy & Pharmaceutical Sciences and it tested 14 different glucosamine products in the Canadian market.  It showed that the bio-availability of glucosamine was <80% of the dosage shown on the label in 12 out of 14 products.  Specifically, they ranged from only 41-66%.  A generous estimate says you’re probably getting at most 2/3 of the glucosamine the labels says.

The new Challenger: N-Acetyl Glucosamine

Some data is now showing that N-Acetyl Glucosamine may actually deliver the intended dosage.  Some manufacturers of N-acetyl Glucosamine say that it is a more stable form because it doesn’t require salts in its formulation.  They also claim that it does not interfere with insulin resistance.  This product is still very new on the market and very little research has been done to compare it against traditional glucosamine products.  It remains to be seen whether it can support its claims down the road.  However, it may be safer to try N-Acetyl Glucosamine especially if you also have diabetes or have borderline diabetes.

If you have any questions regarding glucosamine supplements, please do not hesitate to contact Dr. Kevin Ho.

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