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  • Chondroitin and Glucosamine: Current thinking and efficacy

    ey, i got a question what do you think of this product...
    i know some pro fighters use products like this and jj guys, i also remember you saying something a long time ago about chinese people eating joints for cartilage which they do in wonton soup you said it was "genius" or maybe im misquoting you..either way im curious now, what do you think about stuff like this or shark cartilage and other products with glucosamine and stuff
    Here's a description of the product:
    GLC 2000 is a 100% pure, full spectrum concentrate, available in a powerful powder or convenient capsule, to help lubricate and maintain healthy joint function.*

    Our specific combination of all four anion bound glucosamine forms: Glucosamine hydrochloride (+HCL) Glucosamine sulfate potassium (-2KClso4) Glucosamine sulfate sodium (+NaClso4), and N-Acetyl D-Glucosamine (GLcNAc) addresses all aspects of ester glucosamine conversion and utilization by the body.* The inclusion of ascorbate and manganese proteinate provides the active biocatalysts necessary to complete the glucosamine conversion cycle.*

    GLC 2000 combines the complete glucosamine profile with low molecular weight Chondroitin (A-4 Sulfate,R=so3H/R1=H), helping the body to maintain healthy secretion of metalloproteinase and other related catabolic enzymes.* This specific action helps neutralize enzymes within the synovium, and promote healthy joint function.*
    Well, at some time in the past I had made mention that I had thought the Chinese might have had decreased incidences of osteoarthritis because when it came to eating chicken, they ate the whole damn thing, cartilage and all. Well, it might have some effect; a lifetime of eating cartilage, in the amounts that they seem to eat it, might have some effect rebuilding their joint cartilage, but, then again, its a tough one. There are many other factors, including the fact that most Chinese seem to exercise far more than their western counterparts, and, without a doubt, weigh far less. Two major factors in the development of osteoarthritis. Also, considering the fact that cartilage in your joints has very poor blood perfusion, which dictates how many nutrients can get to it (and thus the ability to repair), and you have something that is not going to heal regardless of how many supplements you take. Now a lifetime of having these building blocks available in your system, readily available to provide some small degree of constant repair might be one thing; taking these pills for a week or two and expecting miraculous recovery of knee pain, well, I kind of doubt it.

    But let's look at some recent scientific studies. I'll paraphrase each to help make them more understandable. I think that after we're done here, you'll see that these supplements just make the people making them richer.
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  • #2
    February 22, 2010 — A 30-minute walk taken at least 3 days a week combined with glucosamine sulfate supplements may reduce symptoms of mild to moderate hip or knee osteoarthritis (OA), researchers report in a new study published online February 12 in Arthritis Research & Therapy.

    "Management of [OA] includes the use of non-pharmacologic and pharmacologic therapies," write Norman T. M. Ng, MD, from the University of Queensland, Brisbane, Australia, and colleagues. "Although walking is commonly recommended for reducing pain and increasing physical function in people with OA, glucosamine sulphate has also been used to alleviate pain and slow the progression of OA."

    The main goal of this feasibility study was to evaluate the combined effects of a progressive walking program and glucosamine sulfate intake on OA symptoms and physical activity participation in people with mild to moderate OA.

    In addition, the investigators compared the effectiveness of 2 frequencies of walking (3 vs 5 days per week) and 3 step levels (1500, 3000, and 6000 steps per day), combined with glucosamine sulfate supplements, and also examined compliance with supplement intake and the walking program.

    The study included 28 patients aged 42 to 73 years. All patients were given 1500 mg of glucosamine sulfate per day for 6 weeks and then began a 12-week progressive walking program while continuing to take glucosamine.

    Fifteen patients were randomly assigned to walk 5 days per week, and the remaining 13 were randomly assigned to walk 3 days per week. The participants received a pedometer to monitor their step counts. Step level of walking was gradually increased to 3000 steps per day during the first 6 weeks of walking and to 6000 steps per day for the next 6 weeks in both groups.

    Patients were assessed at baseline and at 6-, 12-, 18-, and 24-week follow-ups.

    Glucosamine Alone Was Helpful


    The researchers found that during the first 6 weeks of the study, when patients were taking glucosamine supplements only, physical activity levels, physical function, and total Western Ontario and McMaster Universities scores improved (P < .05).

    These outcomes continued to improve through to the final follow-up, although most improvements were seen between weeks 6 and 12, the authors report.

    In addition, significant improvements were seen in patients' self-efficacy in managing arthritis pain and "other symptoms," in physical activity self-regulation, and in the number of perceived barriers to physical activity.

    Compliance with the walking program was the same for both groups.

    Walking Plus Glucosamine May Improve Symptoms of Osteoarthritis


    Walking 5 days per week was not more effective than walking 3 days per week in reducing pain and stiffness, increasing physical function, or improving most other measures used in the study, the authors report.

    Participants in the 3-day walking group walked 3 days per week, but participants in the 5-day walking group walked slightly less than 4 days per week, which suggests that it may be difficult to get people with hip or knee OA to walk more than 3 to 4 days a week, the authors write.

    Increased Activity Further Improved Results


    Increasing the number of steps from 1500 to 3000 steps per day, combined with glucosamine intake, resulted in a 125% increase in minutes of physical activity, a 17% reduction in pain scores, and improvements in physical function. Increasing the steps to 6000 steps per day resulted in a further 57% increase in physical activity participation and further improvements in physical function.

    The limitations of the study include the small sample size, the use of self-report data, the fact that joint space narrowing was not measured to assess the effectiveness of glucosamine supplementation, lack of a placebo control group, and lack of radiographic evidence to confirm the diagnosis and severity of OA.

    "Although the study included a small sample, the findings provide preliminary evidence that OA sufferers can obtain health-related benefits from the combination of glucosamine supplements and walking," the authors conclude. "If the benefits of this program are confirmed, it could be promoted to increase physical activity among people with hip or knee OA."

    Chris Morris, MD, a practicing rheumatologist at Arthritis Associates in Kingsport, Tennessee, commented on this study for Medscape Rheumatology, saying that it supports what many rheumatologists believe — that low- to no-impact exercise can make a difference in OA of the knee.

    Glucosamine a Red Herring?

    He questioned why glucosamine was added to the walking program, however. "I am perplexed as to why they included the glucosamine in the study. I think it is a bit of a red herring and is a flaw of the study, simply because they had no control group to see if exercise without glucosamine did as well. It is possible that they purposely did this to avoid questions related to glucosamine, using the use of the supplement as a way to standardize the patients," he said.

    Dr. Morris added that many patients have unrealistic expectations about the beneficial effects of exercise.

    "They expect immediacy in terms of results — they expect to be able to do everything they did 20 years (and often 50 pounds) earlier, and when their knees hurt, they just give up. Patients need to understand that they have to start out light and gradually work their way up — that any program takes time, and that they must commit to the activity long-term."

    The study by the Australian researchers "provides yet another study to help support the viewpoint that exercise can help arthritic symptoms and the patient's well-being," Dr. Morris said. "I encourage my patients to exercise and have recommended walking to those who do not have the resources or access to health clubs, wellness centers, water exercise programs. Most people live reasonably near an enclosed shopping mall, many of which are carpeted, and most of which open their doors early for walkers."
    Underline mine, and they demonstrate one thing; the use of glucosamine in this study really did not mean much. Why it was put in, well, who knows. But one thing is clear; exercise is beneficial, which we all knew before. The study does not prove that glucosamine does anything. You'll see this commonly in studies involving glucosamine.

    Another thing. There is a difficulty with respect to how you qualify pain, and how you have people qualify pain. Have them walk for a few weeks, take a few pills, have them expect that you expect them to feel better, and voila! They feel better.

    All this shows is that exercise is helpful. As I've said before, movement is life. Keep the joints moving, and they'll stay healthy. One of the beneficial effects of qi gong, when you think about it.
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    • #3
      Glucosamine and/or Chondroitin May Not Be Helpful for Osteoarthritis

      September 16, 2010 — Glucosamine and/or chondroitin may not be helpful for patients with osteoarthritis of the hip or knee, according to the results of a network meta-analysis reported in the September 17 issue of the BMJ.

      "Osteoarthritis of the hip or knee is a chronic condition mostly treated with analgesics and non-steroidal anti-inflammatory drugs, but these drugs can cause serious gastrointestinal and cardiovascular adverse events, especially with long term use," write Simon Wandel, from the University of Bern in Bern, Switzerland, and colleagues. "Disease modifying agents that not only reduce joint pain but also slow the progression of the condition would be desirable. Throughout the world for the past 10 years, the cartilage constituents chondroitin and glucosamine have been increasingly recommended in guidelines, prescribed by general practitioners and rheumatologists, and used by patients as over the counter medications to modify the clinical and radiological course of the condition."

      The goal of the study was to assess the impact of supplementation with glucosamine and/or chondroitin on joint pain and on radiologic progression in patients with osteoarthritis of the hip or knee. Using a Bayesian model allowing synthesis of multiple time points, the investigators combined direct comparisons within trials with indirect evidence from other trials. The primary study endpoint was pain intensity, and change in minimal width of the joint space was the secondary endpoint. When a 10-cm visual analog scale was used, the prespecified, minimal clinically important difference between preparations and placebo was -0.9 cm.

      The investigators searched electronic databases and conference proceedings from their beginnings to June 2009, and they also contacted appropriate experts and searched relevant Web sites. Inclusion criteria were large-scale, randomized controlled trials enrolling more than 200 patients with knee or hip osteoarthritis and comparing glucosamine, chondroitin, or their combination vs placebo or head to head.

      Ten trials meeting eligibility criteria were identified, enrolling a total of 3803 patients. The overall difference in pain intensity vs placebo was -0.4 cm (95% credible interval, -0.7 to -0.1 cm) on the 10-cm visual analog scale for glucosamine, -0.3 cm (95% credible interval, -0.7 to 0.0 cm) for chondroitin, and -0.5 cm (95% credible interval, -0.9 to 0.0 cm) for the combination. The 95% credible intervals crossed the boundary of the prespecified, minimal clinically important difference for none of the estimates. Compared with commercially funded trials, industry-independent trials showed smaller effects (P = .02 for interaction).

      For changes in minimal width of joint space, the differences were all very small, with 95% credible intervals overlapping zero.

      "Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space," the study authors write. "Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged."

      Study Limitations

      Limitations of this study include use of different instruments to measure joint pain, which made it necessary to calculate effect sizes as a common measure of effectiveness so that outcomes assessed with different instruments would be comparable. Differences in responsiveness of different instruments could potentially threaten the validity of results. In addition, many patients included in the trials may have had radiologic disease too severe to benefit from supplementation or pain too minimal to benefit from analgesic effects.

      Conclusion

      "Our findings indicate that glucosamine, chondroitin, and their combination do not result in a relevant reduction of joint pain nor affect joint space narrowing compared with placebo," the study authors note. "Some patients, however, are convinced that these preparations are beneficial, which might be because of the natural course of osteoarthritis, regression to the mean, or the placebo effect."

      "We are confident that neither of the preparations is dangerous," the study authors conclude. "Therefore, we see no harm in having patients continue these preparations as long as they perceive a benefit and cover the costs of treatment themselves."
      Here they tackled it a different way. Instead of the usual "do your knees feel better" ("Why yes doctor, I feel great..." bullshit), they looked at the repair qualities of the actual joints, and the thickness of the cartilage. They found no increase in cartilaginous thickness. Which demonstrates tha the supplements did not alter the cartilaginous cushion of the joints. Therefore, there could be no improvement in joint pain.

      But xrays can be difficult to interpret and are subject to operator opinion. But, with a standardized way of looking at them, and measuring certain points in the joint over a respectable period of time, you can get a very good idea if there are changes after the supplements were given. This study shows that the use of supplements are not helpful.
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      • #4
        Glucosamine and Chondroitin, for Hip or Knee Osteoarthritis

        Abstract

        Alone or in combination, the supplements do not reduce joint pain or limit joint-space narrowing.
        Introduction

        Randomized trials on the effectiveness of glucosamine and chondroitin for osteoarthritis (OA) have yielded mixed results; the largest trial showed no benefit for these agents, used alone or in combination for knee OA (JW Gen Med Mar 15 2006, p. 45, and N Engl J Med 2006; 354:795). Now, researchers have conducted a meta-analysis of 10 randomized controlled trials in which about 3800 patients (68% women; median age, 62) with OA of the hip or knee received glucosamine, chondroitin, both supplements, or placebo; all patients were evaluated for joint pain — and some for radiological progression of disease — during follow-ups that ranged from 1 to 36 months.

        On a 10-cm visual analog pain scale, the difference in pain intensity (compared with placebo) was –0.4 cm for glucosamine, –0.3 cm for chondroitin, and –0.5 cm for the combination. These results were of borderline statistical significance, but they did not approach the researchers' prespecified minimally important clinical difference of 0.9 cm. Six trials contributed data on radiological joint-space narrowing. Glucosamine, chondroitin, and the combination had no effect on joint-space narrowing. The supplements, either alone or in combination, however, caused no reported adverse effects
        Here's an abstract I found that basically confirms the study from above. It's pretty clear. Italics are mine.

        However, it makes mention that there are no harmful side effects to taking these supplements. We'll see in a bit that that is not true....
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        • #5
          Why doesn't it work?

          This study offers some insight as to why glucosamine and chondroitin don't have significant effects on joint cartilage:

          Supplements deliver little glucosamine to serum

          Boston, MA - Osteoarthritis (OA) patients in large numbers began taking glucosamine supplements in the wake of randomized studies showing delayed radiographic progression with glucosamine compared with placebo [ 1 , 2 ]. Subsequent studies cast some doubt on this effect [ 3 ], and Dr Beth Anne Biggee (Tufts-New England Medical Center, Boston, MA) and colleagues have now published data showing that the amount of glucosamine in the serum after oral dosing is far below that needed for the chondroprotective mechanisms proposed to account for glucosamine's apparent benefits in OA [ 4 ].

          My knowledge of the way that chondroitin sulfate is formed has made me highly skeptical that providing glucosamine orally can have any direct function on cartilage.

          Senior author Dr Jeremiah E. Silbert (Harvard Medical School and Brigham and Women's Hospital, Boston, MA) tells rheuma wire that the data were not a complete surprise.

          "My knowledge of the way that chondroitin sulfate is formed has made me highly skeptical that providing glucosamine orally can have any direct function on cartilage. We have previously published two articles showing that mouse chondrocytes in culture and human chondrocytes in culture make their own glucosamine from glucose, with less than 0.2% coming from glucosamine added to the culture medium at the levels we find in serum," says Silbert, who has spent most of his research career studying glucosamine and chondroitin sulfate.



          1500 M oral glucosamine, but only 11.5 M gets into serum

          In this study 18 OA patients fasted overnight, then took 1500 M of commercial glucosamine sulfate. Silbert's team then used a new high-sensitivity method to measure glucosamine concentrations in serum samples drawn at baseline and every 15 to 30 minutes over three hours and additionally from two subjects at five hours and eight hours. The new method measures serum glucosamine concentrations as low as 0.5 M, much lower than possible in previous studies.

          Biggee et al found that none of the subjects had detectable glucosamine levels at baseline. Of the 18 patients, 17 had detectable glucosamine after taking the oral supplement. Serum concentrations began to rise within 30 to 45 minutes after dosing and reached maximums of 1.9 to 11.5 M after 90 to 180 minutes.

          "This maximum concentration of 11.5 M has previously been shown to contribute less than 2% of the galactosamine incorporated into chondroitin sulfate in incubations of glucosamine with cultured human chondrocytes and is a much lower concentration than the glucosamine concentrations claimed by other investigators to have various significant in vitro effects," the authors write.

          They add, "This raises questions regarding current biologic rationales for glucosamine usage that were based on in vitro effects of glucosamine at much higher concentrations."

          The extra amount is changing the miniscule into miniscule-plus-an-additional-miniscule and would still be far below any concentration that has been shown to have an effect on chondrocytes.

          "The amounts in the serum are far lower than the amounts used experimentally by others to show effects. It is possible that there could be these other effects, but they need to be demonstrated at the concentrations found in serum to have validity. I doubt that this will be seen, but I keep an open mind," Silbert says.

          The data also show an interesting divergence between subjects who had previous exposure to glucosamine and those who were glucosamine-naive. Those who had previously used glucosamine had significantly faster appearance of glucosamine in the serum after oral ingestion, slower rate of rise to serum maximum levels, and higher serum maximum levels.

          Silbert speculates that previous chronic glucosamine usage has modified liver cells in some undefined way, perhaps causing low-level liver damage, so that the uptake of glucosamine is lessened, which then allows more to spill out into the peripheral circulation. "However," he points out, "the extra amount is changing the miniscule into miniscule-plus-an-additional-miniscule and would still be far below any concentration that has been shown to have an effect on chondrocytes."
          Underline mine.

          This demonstrates that the pills you take, really don't get into the bloodstream in any significant amounts. And as I said before, given the small blood perfusion to cartilage, well, it's like putting a hostess twinkie on a train to California to feed the people of Los Angeles, and have the train lose nine out of it's ten cars in Las Vegas. What you eat, does not get to the joints in any appreciable amount.

          What's curious about this study, is that there is the suggestion of liver damage with people who take it chronically. The liver sucks this stuff out of the bloodstream and metabolizes it; people who take it on a regular basis end up with higher amounts in their bloodstream. The suggestion that the liver is eventually damaged, or just overwhelmed by glucosamine and chondroitin, can't be discarded.
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          • #6
            The possible negative effects of taking chondroitin and glucosamine:

            Study Suggests Glucosamine Sulfate May Promote Development of Insulin Resistance

            New York (MedscapeWire) Apr 18 — A research study presented at the annual Experimental Biology scientific meetings in San Diego, California, cautioned that consumption of the popular dietary supplement glucosamine sulfate may actually increase the risk of developing insulin resistance and may worsen control of diabetes in patients with this disease. Glucosamine sulfate is widely used to relieve the pain of osteoarthritis and other chronic joint conditions.

            "Somewhat to our surprise, we found that taking glucosamine sulfate supplements may promote insulin resistance. Our data, from a preliminary 15 subject study, suggest that taking glucosamine sulfate could decrease the metabolic actions of insulin, already a potential concern in obese patients or people with high risk factors such as high blood pressure, genetic predisposition to diabetes or heart disease. Our data also suggest that glucosamine sulfate may aggravate blood sugar control in diabetic patients," said Anthony L. Almada, MSc, president and chief scientific officer of IMAGINutrition, sister company of MetaResponse Sciences, one of the institutions that conducted the study.

            The double-blind, placebo-controlled randomized 12-week study involved 15 patients and was conducted by scientists at Los Angeles College of Chiropractic in addition to those at MetaResponse Sciences. Since injections of glucosamine produce an "acute" form of type II diabetes in animals the scientists wondered if this would occur in humans taking glucosamine sulfate orally. Previous clinical studies have measured only blood glucose but not blood insulin, the hormone from the pancreas that is underproduced or "under-effective" in diabetics.

            Almada added, "We recognize the limits of our study. More research, with a larger number of subjects and more rigorous assessment methods, is needed to replicate and confirm our findings. We are planning an additional clinical study investigating if the combination of another dietary supplement with glucosamine sulfate would offer all of the joint benefits without the risk of developing insulin resistance."

            "I have seen blood sugar levels rise in a few of my diabetic patients who are taking glucosamine sulfate," cautioned Chris Foley, MD, director of integrative health for HealthEast, a healthcare system in St. Paul, Minnesota. "Diabetics who are taking glucosamine sulfate supplements should check with their physicians and look for a possible worsening of their blood sugar control."

            "A recent editorial in the British medical journal The Lancet suggested that glucosamine sulfate could produce insulin resistance, but before this study, no one had examined this important question. We used a minimally invasive, validated method to see if insulin resistance indeed manifests," added Mr. Almada.

            According to Nutrition Business Journal, retail sales of glucosamine sulfate in the United States are estimated to be between $230 to $300 million a year. More than 21 million Americans suffer from osteoarthritis, according to the National Institutes of Health. It is unknown how many diabetics take glucosamine sulfate. According to the American Diabetes Association, there are 15.7 million people (5.9% of the population) in the United States who have diabetes.
            Well, it could just be a coincidence. Fat people get osteoarthritis. Period. Fat people get diabetes. People with osteoarthritis take chondroitin and glucosamine. Are you starting to see the association? It may not be a direct cause and effect.

            But then again, it might. This has to be looked at in the future.
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            • #7
              An overview of the current thoughts on chondroitin and glucosamine:

              Current Role of Glucosamine in the Treatment of Osteoarthritis

              Objectives: To evaluate the interest of using the various preparations of glucosamine for symptomatic and structural management of osteoarthritis (OA).

              Methods: A critical analysis of the literature based on an exhaustive search (Medline, PubMed and manual search within the bibliography of retrieved manuscripts) from 1980 to 2005.
              Results: Despite multiple controlled clinical trials of the use of glucosamine in OA (mainly of the knee), controversy on efficacy related to symptomatic improvement continues. Differences in results originate from the differences in products, study design and study populations. Symptomatic efficacy described in multiple studies performed with glucosamine sulphate (GS) support continued consideration in the OA therapeutic armamentarium. The most compelling evidence of a potential for inhibiting the progression of OA is also obtain with GS.

              Conclusions: GS has shown positive effects on symptomatic and structural outcomes of knee OA. These results should not be extrapolated to other glucosamine salts [hydrochloride or preparations (over-the-counter or food supplements)] in which no warranty exists about content, pharmacokinetics and pharmacodynamics of the tablets.



              Glucosamine is an aminosaccharide, acting as a preferred substrate for the biosynthesis of glycosaminoglycan chains and, subsequently, for the production of aggrecan and other proteoglycans of cartilage.[6] Because of the essential role aggrecans play in giving the cartilage its hydrophilicity, compounds enhancing synthesis of aggrecans may be beneficial in cases of OA, a disorder characterized by an increase in matrix structural protein turnover, with catabolism being predominant over synthesis.[7]

              In vitro, glucosamine sulphate (GS) has been demonstrated to reduce prostaglandin E2 (PGE2) production and interfere with nuclear factor kappa B (NFaB) DNA binding in chondrocytes and synovial cells.[8,9]

              Glucosamine inhibits gene expression of OA cartilage in vitro.[10] It was suggested that since glucosamine inhibits both anabolic and catabolic genes, the therapeutic effects of glucosamine might be due to anti-catabolic activities, rather than due to anabolic activities. GS is a stronger inhibitor of gene expression than glucosamine hydrochloride.[11]


              1. In North America, glucosamine hydrochloride or sulphate and chondroitin sulphate are considered nutraceuticals, whereas in most European countries these are marketed as pharmaceuticals. Therefore, production and marketing of glucosamine are more closely monitored in Europe. In North America, varying quantities of glucosamine have been noted in a survey of several nutraceuticals.[38]

              2. Most of the negative clinical trials were performed with glucosamine hydrochloride 500 mg three times daily, whereas most of the positive trials were performed with the GS powder for oral solution at the dose of 1500 mg once daily. This obviously raises the question, so far unanswered, of the importance of sulphate and of its contribution to the overall effects of glucosamine. Although the sulphate is readily hydrolysed from the glucosamine in the gastrointestinal tract, there are suggestions that sulphate is in itself clinically relevant.[39,40]

              3. Interestingly, the most clinically relevant results in GAIT were seen when sodium chondroitin sulphate was taken with glucosamine hydrochloride; whether this may be explained by an increase in the bioavailablity of sulphates together with glucosamine requires further study. It is of note that several of the glucosamine preparations contain other salts that could potentially influence uptake and utilization of glucosamine.[41]

              4. The placebo response for many clinical trials with oral agents in treatment of knee OA has traditionally been around 30%[42] and these usual figures were replicated in the GUIDE study. The high placebo response in the GAIT (60.1%) is of unknown significance.
              A few things:

              There seems to be some interaction between the sulphate form of these agents, and efficacy seen. So, it might not be the glucosamine or the chondroitin, but the sulfates that these agents introduce into the body. Or it might be that the sulfates make these agents more effective.

              Second, the beneficial effects found with these agents consistently parallel the beneficial effects found with placebo. The placebo effect can be quite the strong one.

              Third, glucosamine / chondroitin might work, not as a healing agent or as a nutritional building block to help repair the joints, but in a far different way, by inhibiting genetic breakdown of the cartilage tissues. This has to be explored.

              Lastly, and probably more important, the study hints at the possibility that the shit that is sold in the US and sold to millions and millions of people is just that. Garbage. This stuff is not regulated by the FDA, and therefore, it's caveat emptor. Buyer beware. In Europe, these agents are prescribed, and therefore, the chemical components of the drugs are well known and regulated. Here in the US, each formulation from each company could be different, inaccurate, and even, bogus.
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              • #8
                There is a rather large NIH study in the works, but the results are not in yet. Here are some early comments on what the study is showing. I've shown two sides of the story here, which basically proves only one thing. There are believers, and there are non believers. The jury is still out...

                Edgewood, MD - Although the results haven't even been officially presented yet, findings from the large US National Institutes of Health study of glucosamine and chondroitin in knee osteoarthritis are already being debated. The online release of an abstract [ 1 ], due to be presented next month at the annual meeting of the American College of Rheumatology (ACR), prompted one supplement manufacturer to issue a statement about its success, highlighting the finding that the combination of glucosamine and chondroitin produced greater relief of moderate to severe knee OA pain than celecoxib (Celebrex, Pfizer).

                However, OA expert Dr David Felson (Boston University, MA), who acts as an editorial consultant to www.jointandbone.org, points out that this finding comes from a subgroup of patients. "The main results are negative," he tells rheumawire . "This is a null study for glucosamine and chondroitin." He points out that the main results showed that neither glucosamine alone, nor chondroitin alone, nor glucosamine and chondroitin in combination were significantly better than placebo for the primary outcome. "This will be disappointing to many patients who had hoped that supplements would provide an alternative treatment."

                "Disappointing? Not for the patients who have moderate to severe pain from knee osteoarthritis," says Dr Jason Theodosakis (University of Arizona, Tucson), a long-time advocate of supplements in OA on his own website, www.drtheo.com, and a member of the oversight steering committee for the trial. "These are the very patients who are seeking intervention because of their pain," he comments. "In this subgroup of patients, the combination of glucosamine and chondroitin was the only thing that had a significant effect, and the effect was very significant, both statistically and clinically." The combination was superior to celecoxib, he points out, adding that all anti-inflammatory drugs carry the risk of side effects, whereas supplements have shown long-term safety. "It's clear that it may become malpractice to use anti-inflammatory drugs as first-line therapy unless the patients has failed six months of therapy with a good-quality combination glucosamine/chondroitin product," he tells rheumawire . This has always been his position, he maintains, but now the "data have caught up."
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                • #9
                  yea i read similar things aswell but this is good info, basically just no lol

                  i dont really have knee pain either..im just always looking for ways to make me super human...its to bad i dont live in the future when the nano tech will make everyone crazy...ah well.

                  and i think that joint mobility exercises and dynamic chi kung(i think taiji is better then dynamic chi kung exercises) are good for joints aswell, the former being more localized and better imo, i usually do warm up my joints before i stretch or lift or anything
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