LifeCare Chiropractic

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chondroitin

Natural Treatments for Arthritis Go Head to Head with Dangerous Drugs

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Natural Treatments for arthritis
Natural Treatments for arthritis

There are lots of claims about natural treatments for arthritis, but which ones work?

Without any good answers, all too many of us drop back on drugs for arthritis pain.  The list can include drugs like steroids and NSAIDs.  These drugs come with a list of side effects that you would not want to experience (if you’re really up to learning all about why NSAIDs are so bad for your health, feel free to check out my eBook on the topic by clicking here).

A few years back, the drug companies were able to come up with a new version of the most common class of anti-inflammatories, the cyclo-oxygenase inhibitors.  This NSAID class includes drugs like ibuprofen, and indomethacin.  The problem with this class of drugs is that one of the enzymes they block just so happens to protect the lining of the stomach.  This is why the big risk with these drugs is bleeding ulcers and why some 20,000 people per year die as a result of taking these drugs.

Because of this tiny little side effect, researchers developed a class of drugs that do not block the one version of the enzyme that protects the stomach lining.  Thus was born the selective cyclo-oxygenase inhibitors that rose to the top of the drug food chain to become one of the most financially successful blockbuster drugs of its time.

At least, until it was determined that, while this drug was a wee bit safer on the stomach,  unfortunately this drug DID block one enzyme that protected the heart, leading to some 100,000+ heart attacks and who knows how many deaths from Vioxx alone.  To make matters worse, Merck hid this data for years until it blew up in their face, resulting in hundreds of lawsuits from families that lost their loved ones.

Luckily (for the drug companies) the public has a short memory and Celebrex is still available on the market and prescriptions are still being written today for patients with arthritis pain who probably forgot about the entire Vioxx debacle.

So, if you happen to be one of those patients whose primary care doctor also has a short memory and wrote you a prescription for Celebrex, there may be an answer.

This particular article pits the natural combination of glucosamine and chondroitin up against Celebrex in 606 patients with knee arthritis and severe pain (Kellgren and Lawrence grades 2–3 knee osteoarthritis and moderate-to-severe pain based on the Western Ontario and McMaster osteoarthritis index-WOMAC-score ≥301 an a 0–500 scale).

Patients received either 400 mg chondroitin sulfate, 500 mg glucosamine combination three times a day or 200 mg celecoxib (Celebrex) every day for 6 months.  Here’s what they found:

  • The natural arthritis treatment group dropped 50.1% (WOMAC score).
  • The drug-known-to-kill group had a matched 50.2% decrease.
  • At 6 months, 79.7% of patients in the natural arthritis treatment group and 79.2% in the toxic arthritis drug (Celebrex, in case you’re not following along) group fulfilled OMERACT-OARSI criteria.
  • Both groups had more than a 50% reduction in joint swelling and effusion.

Sounds like a pretty even match, right?  Yeah–except that neither glucosamine nor chondroitin, in the history of its use, has been associated with even a single death (that I’m aware of–I’m sure there’s a patient or two who choked to death taking the supplements…), while Celebrex is in a class of drugs that is so bad for the heart that cardiology recommendations now state that NO heart disease patients should be on NSAIDs.

Oh..and it’s WAY cheaper.  So which one are YOU taking?

The Latest on Glucosamine / Chondroitin for Knee Osteoarthritis Symptoms

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knee osteoarthritis symptoms
Knee arthritis and vitamin D

The idea of using natural approaches for knee pain has been around for quite some time.  Glucosamine began to hit the scenes when I was still in school.

Yes indeed.  The first clinical trial, while I was in chiropractic school, was on a brontosaurus.  Sure, weight loss would’ve helped and the vegetarian diet was definitely anti-inflammatory, but the real problem was getting them into the MRI scanner for the imaging.

(And, for the paleontology geeks out there, I am aware that the brontosaurus was actually an apotosaurus…)

Ok…so maybe the research hasn’t been around quite THAT long, but there are times when it sure seems like it.  And quite frankly, the research over the years has been a blend of “OK” and negative (as in not helping at all).  Personally, I think this has happened for several reasons:

  1. Many patients put into trials do not have knee pain caused by arthritis.  Just because you have arthritis on imaging does NOT, I repeat–does NOT, mean that arthritis is causing your problems.  In many cases, the soft tissues surrounding the knee are the problem.  Glucosamine is not going to help a shred if this is the case.
  2. There are definitely issues of the quality of the supplements used.  You get what you pay for.
  3. The study length was not sufficient.  While there is some anti-inflammatory action of glucosamine, this is not likely its strong point.  Following up for 6 months is not likely to show much of a difference versus a study that lasts years.

All of this brings us to this particular study.  In it, researchers set up the details in a slightly different manner than previous studies.  Specifically, they followed 600 patients with knee osteoarthritis for 6 years and determined whether or not they were taking prescriptions (anti-inflammatory drugs, analgesics) and/or a glucosamine/chondroitin supplement.  They then looked at structural changes of the knee (loss of joint space width and cartilage volume).  Here’s what they found:

  • In the group NOT taking analgesic/NSAIDs, those who were taking the glucosamine / chondrotin lost less cartilage volume after 2 years (over the medial central plateau).
  • This protective effect of Glu/CS occurred in participants with more severe osteoarthritis.
  • In the group who were taking the analgesic/NSAIDs, those taking Glu/CS also lost less cartilage volume (global plateau at 12 months and the central plateau at 24 months.

Overall, this study did NOT look at how much knee pain the participants had, but rather looked objectively at how the knee joint itself was responding to the glucosamine and chondroitin.  And the results are very heartening.

Even more so when you consider that the drugs used to treat knee osteoarthritis symptoms are well-known to actually destroy the lining of the joint you are trying to prevent.  Despite this underlying damage from the medications, this natural approach to joint health was powerful enough to protect.

 

Some Manganese Supplements May Exceed Safe Intake Levels – (02-15-01)

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Some Manganese Supplements May Exceed Safe Intake Levels

When it comes to vitamins and minerals, most have a wide range of effective and safe doses. Manganese is one of the minerals that does not and can cause problems at high enough levels. High levels have been linked to Parkinson’s like symptoms. Aslo, a few years back a research article was released that strongly tied hair manganese levels and persons incarcerated for violent behavior ( Entrez-PubMed http://www.medscape.com/viewarticle/411197). Of an interesting note–infant formulas have much higher levels of manganese than breast milk.

(article) ConsumerLab.com issued an alert on Monday that that some glucosamine and chondroitin products, used for osteoarthritis, exceed newly established upper intake levels for manganese. According to the Institute of Medicine’s newly-released guidelines, the tolerable upper intake level (UL) for manganese in adults is 11 milligrams per day. Neurologic adverse effects, similar to symptoms caused by Parkinson’s disease, have been observed in individuals who have consumed high amounts of manganese, and iron absorption by the gut may be inhibited.Two products evaluated in ConsumerLab.com’s Glucosamine and Chondroitin Product Review last year claim to contain, respectively, 25 mg and 30 mg of manganese per suggested daily serving. These amounts far exceed the recommended UL of 11 mg per day, which includes all dietary and supplement intake. One of these products had already failed ConsumerLab.com’s initial testing for not having its claimed amount of chondroitin. The other product initially passed the review, but has now been removed from ConsumerLab.com’s list of Quality Approved Products in light of the new recommendations. Manganese is an essential nutrient involved in bone formation and in protein, fat, and carbohydrate metabolism. Nuts, legumes, tea, and whole grains are rich sources of manganese. The recommended adequate intake of manganese for adults is approximately 2 milligrams per day, which is similar to the intake levels from typical American diets.

 

CARTILAGE BREAKDOWN A MARKER FOR OSTEOARTHRITIS PROGRESSION – (04-10-06)

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Molecular markers of cartilage breakdown and synovitis at baseline as predictors of structural progression of hip osteoarthritis

This study evaluated the use of markers of cartilage breakdown as marker for osteoarthritis progression.

The markers used were effective, but I would like to see this same type of study done on natural approaches such as glucosamine and chondroitin instead of instead of an anti-inflammatory compound like diacerein. Granted, diacerein does not inhibit the metabolism of chondrocytes like other NSAIDs, but we all know my bent towards natural compounds..

Read entire article here

MAKE SURE YOU TAKE THIS TO PROTECT YOUR JOINTS

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There has been much controversy over the use of joint support supplements like glucosamine, chondroitin and methysulfonylmethane (MSM) and their effectiveness for osteoarthritis.  Some studies find a protective effect, some do not.  This is yet another article supporting the use of chondroitin sulfate in osteoarthritis, demonstrating a protective effect on bone cartilage loss and bone erosions within 6 months of use for the knee.

The bottom line is that these supplements are very safe to try on a trial basis.  There is a wide variation in price, however, and, as the adage goes, you get what you pay for.  I always recommend to patients that they start with the more expensive brands, and one that contains a combination of all three compounds mentioned above.  After at least 3 months, if you find that it is effective for you, then you can try to substitute for a less expensive brand.  This way, you have established that it works for you and it was not a matter of quality.

And of course, couple this supplementation with an evaluation by a chiropractor that has a strong soft tissue focus–many times “arthritis” pain is NOT coming from the joint, but rather the soft tissues surrounding the joint itself.  Address this aspect of the problem and the pain goes away or gets significantly better.

http://ard.bmj.com/content/70/6/982.abstract