Glucosamine: A natural therapy for arthritis (Part II)
Last week’s article compared glucosamine and non-steroidal anti-inflammatory drugs. Glucosamine achieves its effects without the side effects of NSAIDs. These side effects include gastrointestinal bleeding, ulcerations, perforations, peptic ulcer, liver damage, kidney disease, and negative effects on the heart. The most ironic side effect of NSAIDs is the destruction of cartilage: NSAID use is associated with the acceleration of osteoarthritis and increased joint destruction. In contrast, glucosamine may rebuild cartilage: glucosamine has been found to stimulate the synthesis of cartilage in laboratory tests. Non-aspirin NSAIDs include ibuprofen (Motrin, Advil, Nuprin), indomethacin (Indocin), naproxen (Naprosyn, Aleve), and piroxicam (Feldene). The Cox-2 inhibitors, a sub-class of NSAIDs, include Vioxx, Celebrex, and Bextra. All of these have been found to increase the risk of heart attack and stroke. Vioxx has been removed from the market.
Glucosamine Sulfate vs. Glucosamine Hydrochloride
Glucosamine supplements are available in two forms – sulfate or hydrochloride. Which works better? There are three possible answers to this question: glucosamine sulfate is more effective; glucosamine hydrochloride is more effective; they perform equally well. There are authorities to support each of these opinions. The argument I think is the strongest is the argument fro glucosamine sulfate. Sulfur is a mineral that helps provide the protein links necessary for cartilage repair. Individuals with arthritis are commonly deficient in this essential nutrient. Restoring sulfur levels has brought about significant benefit to patients with arthritis.
Further evidence of the effect of sulfur on arthritis is the tradition of hot sulfur springs in the treatment of the disease. Throughout history, arthritis sufferers around the world have made pilgrimages to these sulfur-rich mineral springs, reporting less pain and increased mobility of stiffened joints. A scientific study done in 1966 indicated that sulfur extracted from mineral baths passes through the skin of both human and lower animals, confirming an earlier study that had come to the same conclusion. Because one of the primary functions of glucosamine sulfate is to promote the manufacture of chondroitin sulfate in cartilage, a lack of the sulfur molecule may mean less cartilage synthesis when another form of glucosamine is used.
Dosage and length of time for results
Recommended dosages of glucosamine sulfate are determined by body weight: for those weighing less than 120 pounds, 1,000 milligrams a day divided into two doses; for those between 120 and 200 pounds, 1,500 milligrams a day divided into two or three doses; for those above 200 pounds, 2,000 milligrams a day divided into two or three doses. As pain decreases, gradually decrease the dosage. Results can take weeks to develop. Because glucosamine does not simply relieve pain but works on the cartilage to achieve its results, it takes longer to achieve maximum effect. Allow eight weeks to see results and a minimum of four or five months before abandoning the effort. The effects are cumulative and long lasting.
In assessing the effectiveness of this supplement, its quality is of crucial importance. Some supplements have been found to contain substantially less of the active ingredients than claimed on their labels. Food supplements are not subject to FDA regulation. Therefore, it is important to buy supplements from reputable companies.
Glucosamine is a natural supplement. But supplements can have side effects, too. Just because something is natural doesn’t mean that it is safe. People have been known to die of natural causes. Next month’s article will be on the side effect of glucosamine.
Mary Lou Williams, M. Ed., is a lecturer and writer in the field of nutrition. She welcomes inquiries. She can be reached at 267-6480.