Q: How effective are the various supplements advertised to relieve osteoarthritis symptoms?
A: Many arthritic individuals (particularly
those suffering from osteoarthritis-the
"wear and tear" form of arthritis resulting
from degeneration of the articular cartilage
lining the joints) use supplements to try and
manage their pain, swelling, stiffness and/or
limited movement.
Glucosamine, chondroitin sulfate, SAM-e
(s-adenosylmethionine) and MSM (methyl
sulfonylmethane) are supplements that have
gained a great deal of attention due to their
potential for alleviating symptoms of osteoarthritis
with minimal side-effects. These
supplements are believed to work by the following
mechanisms (which have yet to be
scientifically proven):
Glucosamine, a natural substance derived
from crab, lobster or shrimp shells, is
believed to provide the building blocks
needed to support the growth, repair and
maintenance of cartilage within joints. As a
result, glucosamine may prevent or slow
the progression of osteoarthritis by helping
to rebuild the damaged cartilage. It may
also have a possible anti-inflammatory
effect on arthritic joints. (Note: Individuals
with diabetes, taking blood-thinning drugs,
or who are allergic to shellfish should check
with their doctors before taking glucosamine.)
Chondroitin sulfate, found naturally in
cartilage, is believed to protect articular
cartilage from the deterioration caused by
destructive enzymes. It may also help to
prevent the formation of microscopic blood
clots, leading to improvement in circulation
to joint tissues. (Note: Individuals taking
blood-thinning drugs or who are allergic to
shellfish should check with their doctors
before taking chondroitin sulfate.)
SAM-e (pronounced "sammy") is a naturally
occurring compound produced from
methionine, an amino acid, and adenosine
triphosphate (ATP), a compound responsible
for producing energy within the body.
SAM-e is believed to improve joint mobility
and relieve pain by raising levels of ATP
and stimulating the production of cartilage
within the joints. Getting sufficient folic
acid in the diet (found in dark leafy green
vegetables and fortified cereals) may help
the body produce SAM-e naturally.
MSM is a naturally occurring sulfur compound
found in small amounts in many foods
(such as meat, fish, vegetables, grains and
certain fruits). It is believed to have antiinflammatory
properties that help relieve
arthritis symptoms.
Despite their popularity in some circles, the
jury is still out regarding the effectiveness of the
aforementioned supplements as research findings
have been mixed. While more research has
been conducted on glucosamine than on chondroitin
sulfate, SAM-e or MSM, long-term, wellcontrolled
studies are still lacking on all four
supplements. Chondroitin sulfate is frequently
used in combination with glucosamine, but it
has yet to be determined if they work better
together or separately. Individuals with mild-tomoderate
osteoarthritis tend to report experiencing
greater benefits from the use of these supplements
than individuals with severe arthritis.
Despite the lack of solid scientific evidence
regarding their effectiveness, many doctors
may still recommend that their patients try
glucosamine and chondroitin sulfate. If individuals
do not experience noticeable improvement
after three months, most doctors recommend
that they stop taking the supplements because
any beneficial effect from taking them typically
occurs within that time frame. In addition,
these supplements may lose their effectiveness
after six to 12 months of use, after which the
supplement should be discontinued.
SAM-e usually produces its effect after
approximately one week of use. Again, if no
noticeable improvements in symptoms occur,
individuals should stop taking the supplement.
Little or no scientific evidence exists to support
the effectiveness of MSM and, therefore, it
tends not to be recommended by physicians.
All of these supplements appear to be generally
well-tolerated. They do, however, have
some side effects, including diarrhea or constipation,
nausea, heartburn, mild gastrointestinal
distress, headache and fatigue.
Finally, individuals with other health or
medical conditions requiring medication should
keep in mind that these supplements may
interact with any current medication they may
be taking. As with all supplements, individuals
should consult their physicians before taking
any of these four supplements.
Source: Dr. Cedric X. Bryant, ACE's Chief Science Officer; ACE FitnessMatters, Nov/Dec 2007.
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