Glucosamine: A natural therapy for arthritis
Glucosamine is made in the body from glucose and the amino acid glutamine. It is used to make the cells in cartilage that hold water and give cartilage its elasticity. Glucosamine supplements are made from the shells of crabs, lobsters and shrimp. In Europe glucosamine has been used therapeutically and researched for 30 years. It has also been used for decades by veterinarians in the United States to treat ailing animal joints.
What It Does
One major European study found that glucosamine significantly reduced pain and swelling and improved mobility in patients with arthritis of the knee. Even more important was the finding that glucosamine prevented joint-space narrowing, indicating that it prevented progressive damage to the joint. Joint-space narrowing is an indicator of the degenerative process. The term refers to the thinning of cartilage tissue.
There has been speculation that glucosamine may rebuild cartilage. It has been found to stimulate the synthesis of cartilage in laboratory tests. Human trials to definitively answer this question are lacking. But the National Institutes of Health is sponsoring a four-year study that might yield an answer to the question. In this regard, it is relevant to note that in studies of glucosamine the reduction in pain and swelling and improvements in mobility brought about by this supplement can continue for weeks after treatment stops, suggesting that glucosamine does more than simply suppress symptoms.
Comparison With NSAIDs
The conventional approach to the treatment of arthritis is to suppress joint pain with drugs. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain by blocking the inflammatory process. Non-aspirin NSAIDs include ibuprofen (Motrin, Advil, Nuprin), indomethacin (Indocin), naproxen (Naprosyn, Aleve) and piroxicam (Feldene).
There is a growing body of evidence that shows that glucosamine eases osteoarthritis pain at least as well as NSAIDs. This is not of minor significance since glucosamine accomplishes the pain relieving effects of NSAIDs without the side effects of NSAIDs. These side effects are considerable, requiring FDA mandated labels that state in part: “Serious gastrointestinal toxicity such as bleeding, ulcerations and perforation can occur at any time with or without warning symptoms, in patients treated chronically with NSAID therapy.” NSAIDs can cause peptic ulcer, liver damage or kidney disease. These drugs have another, equally serious but less well-known side effect. They actually accelerate the destruction of cartilage. At least half a dozen studies dating from the early 1970s have shown that NSAID use is associated with acceleration of osteoarthritis and increased joint destruction.
A study in the Archives of Internal Medicine, March 27, 2000, linked NSAIDs and congestive heart failure in elderly patients with a history of cardiovascular disease. In December of 2004, a study sponsored by the National Institutes of Health to determine the effects of NSAIDs on Alzheimer’s disease found that subjects taking Aleve (naproxen) had a 50 percent greater rate of heart attacks and strokes than those given a placebo. Federal officials said that the entire class of painkillers known as NSAIDs, which include Aleve, Advil and Mobic, could have negative effects on the heart.
Then, of course, there are the Cox-2 inhibitors, a sub-class of NSAIDs that include Vioxx, Celebrex, and Bextra. All of these have been found to increase the risk of heart attacks and strokes. Vioxx has been removed from the market.
Next week’s article will compare the different kinds of glucosamine, the appropriate dosages, and the results that can be expected.
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.