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General Glucosamine Information

Glucosamine has been studied for well over 40 years in humans1 and it has been used in prized thoroughbred horses, cats, dogs and even exotic animals. When it comes to safety, some clinical studies have reported more side effects in a sugar pilled placebo than with Glucosamine! Remember, Glucosamine is found naturally in the body and is a natural nutraceutical product. According to the Institute of Medicine and National Academies, “in Europe in approximately 1960, physicians introduced the use of glucosamine sulfate as an injectable therapeutic agent in the treatment of osteoarthritis2.” Hundreds of thousands of people have used Glucosamine, and many have found it extremely effective to not only effectively ease their arthritis pain but to also to provide them with far more than just long lasting pain relief. Glucosamine has been shown in clinical studies to regrow cartilage3, slow the progression of arthritis, and possibly even modify the disease itself with almost no side effects. The most common reaction when you have mild pain or a headache or the like is to turn to a bottle of your favorite over the counter medication, such as aspirin or ibuprofen. The New England Journal of Medicine reports that “anti-inflammatory drugs (prescription and over-the-counter, which include Advil®, Motrin®, Aleve®, Ordus®, Aspirin, and over 20 others) alone cause over 16,500 deaths and over 103,000 hospitalizations per year in the US”, according to a review article published in the New England Journal of Medicine4 Everything from stomach bleeding to intestinal damage to liver failure can result from the long term use and interactions with what are known as NSAIDS, or Non-Steroidal Anti-Inflammatory Drugs. Fortunately, Glucosamine not only safely and effectively eases the pain of arthritis while working to do something that NSAIDS cannot do – rebuild cartilage. Don’t just treat the symptoms and cover up the pain, get more at the root of the problem and don’t neglect your body in an attempt to just cover the pain. In the U.S., baby boomers (who started turning 50 in 1996) are doing so at a rate of 300,000 per month5. Even if you have not reached 50 yet, it is important to take steps now to slow down the effects of arthritis. Arthritis has no cure and it will not get better on its own, but a daily regimen of Glucosamine can help to keep your joints strong and maintain your cartilage for years to come.

Also, if you are taking or plan to begin taking Glucosamine for your arthritis, then you need to check the bottle. If you see (Glucosamine Sulfate * KCl) or (Glucosamine Sulfate * NaCl) or Glucosamine Sulfate as a Salt, then you should be aware that up to 30% or more6 of the Glucosamine is being bound up in salts. But the manufacturers can legally say that they are giving you whatever dosage is listed on the bottle but the active, bioavailabile amount of actual Glucosamine is going to be much smaller than the reported dosage because it has to be carried by the salts. Generally you will only find these deceptive (but unfortunately legal) practices in the very cheap glucosamine products, but you should be aware that you get what you pay for, and when it comes to important things like your body, one shouldn’t skimp. Your car can break down and you can fix it if you had to, but you only get one body. References: 1. Current Medical Research and Opinion. Vol. 7, No. 2, 1980 2. Institute of Medicine of the National Academies 3. Archives of Internal Medicine. 162(18):2113-23, 2002 Oct 14 4. Wolfe MM, et. al. NEJM 1999;340(24):1888-99 5. http://www.agr.gc.ca/food/nff/ffnmarket/ffnmrket.html 6. Institute of Medicine of the National Academies 7. Physicians Desk Reference, Page 1542

Glucosamine for Arthritis

In the beginning, conventional medicine found little that could cope with arthritis pain. Then along came NSAIDS – Non-Steroidal Anti-Inflammatory Drugs. These now household names were once new drugs, with common names like Aspirin and Ibuprofen and later Naproxen Sodium. They were pretty good at covering up arthritis pain. However, they had some pretty severe side effects if taken for long periods of time at the dosages needed to cover up the ever increasing pain. Everything from stomach bleeding to the breaking down of your lower digestive tract to liver failure is possible if not inevitable if NSAIDs are taken long enough. Little did we know at the time that we might be making arthritis worse with NSAID use. The first generation of pre COX-2 drugs, the NSAIDS worked largely to inhibit an enzyme known as COX-1. This is in part why they work for pain relief because COX-1 partially mediates pain receptors. Unfortunately, COX-1 is a non-specific molecule. It also affects several other important body systems, such as blood clotting and digestion. That is why you can get an upset stomach or you bruise easier due to thinning of the blood when you are taking daily aspirin or ibuprofen or naproxen because those systems (as well as pain or inflammation) are being disrupted. Along came COX-2 Inhibitors, the supposedly more “selective” medications. Generally available only with a prescription (and costing far more than over the counter NSAIDS), brands such as Vioxx® and quickly rose to “stardom” in the arthritis pain relief realm. In fact they are one of the most heavily prescribed drugs. That is all changing now. As a result of some of the potentially fatal side effects of COX-2 and high cost and inability to do anything but cover up arthritis pain, continual research on glucosamine and its effectiveness for arthritis in humans and animals has been in progress for more than 20 years both in America and abroad in places such as much of Europe, Germany, Italy, Portugal, and Spain. Glucosamine is different than NSAIDs or COX 2 drugs. Glucosamine works in a much different way than NSAIDs or COX-2 drugs because it is natural. Glucosamine builds and maintains cartilage, tendons and other connective tissues in the body by acting as a building block for these materials and inhibiting enzymes that destroy cartilage. When the body does not have an adequate supply of glucosamine, arthritis – most commonly osteoarthritis – can develop. This debilitating condition that afflicts millions of people worldwide is characterized by a breakdown in the “shock absorbers” of the joints, particularly weight bearing ones such as the hip or knee. Glucosamine works by preventing the cartilage destruction, joint pain, swelling and loss of flexibility in a natural way and without the harmful side effects that are associated with NSAIDs or COX-2 drugs. Not to mention the fact that glucosamine is far cheaper (about a dollar a day) and derived from natural sources. Glucosamine cannot cure your arthritis, but it will do wonders for your arthritis and joint pain. Because glucosamine works from within, bathing your joints in a proverbial warm and protective solution and working to heal your joints instead of merely cover up pain, results take a little bit longer than NSAIDs or COX-2 drugs. Once you have achieved relief, however, glucosamine works to protect your joints from further damage while continuing to stave off further damage. Contrasted to glucosamine, there is evidence that many of the NSAIDs can actually work against your arthritic joints, to cause your arthritis pain to become even worse by breaking down your joints. If you need immediate pain relief, glucosamine can be taken with traditional NSAIDS (aspirin, ibuprofen, etc) if you need temporary pain relief while the glucosimine gets to work rebuilding your cartilage and reducing your pain. You should ensure that you are taking a full 1,500 mg of glucosamine a day for your arthritis pain as that is the dosage tested in dozens of clinical trials to be effective. Also, many people find Chondroitin Sulfate and MSM to be helpful for their arthritis pain, so consider a product that contains them as well, if possible. Be sure to explore the Glucosamine Product Guide for a fair comparison of the leading glucosamine products available today.



How does Glucosamine and Chondroitin Work

By: Richard Stenlake, Compounding Chemist Article used with permission.

Richard Stenlake is a registered pharmacist who owns the largest compounding pharmacy in Australia. Over many years he has pioneered the introduction of innovative medication ideas to the Australian market. Arthritis is a degenerative joint disease that causes pain, inflammation and limited joint movement. In osteoarthritis the joint that is affected has degenerated cartilage. As this is the cushion between the joints, one gets bone rubbing against bone and thus pain, inflammation and lack of mobility follows. Up until now the only relief from this pain was by way of treatment with nonsteroidal anti-inflammatory drugs (e.g. brufen, orudis) or by injection with steroids (e.g. cortisone). However, these only mask the symptoms and relieve the pain, and the disease continues to get worse. Thus, the spiral continues increasing the dose as the pain worsens. However here we create another problem as these drugs have deleterious side effects and may in fact cause certain features of osteoarthritis to progress faster. Thus over the years the only relieve that may be obtained is by joint replaced by your surgeon. Even with artificial joints, the problem is not solved as these too have a finite life and will have to be replaced further down the track.

A NEW APPROACH

In the last few years, excellent results have however best achieved with a combination of natural nutritional supplements. In many cases these have been able to slow and eventually eliminate disease. This approach includes a combination of glucosamine and chrondroiton sulphate. These are substances we already consume and are produced in small amounts in our bodies and as such have no known side effects. There has been extensive study done on them, which has proved that both glucosamine and chondroitan work in both animals and humans.

WHAT IS GLUCOSAMINE AND HOW DOES IT WORK?

Firstly healthy cartilage needs three things: water for lubrication and nourishment, proteoglycans to attract and hold the water, and collagen to keep the proteoglycans in place.

Proteoglycans are like a rope that threads itself through the collage and are essential as they hold many times their own weight of water, which both lubricates and nourishes the collagen. If the cartilage is damaged the thread of rope becomes weak and ‘leaks’ out and thus the collagen loses its nourishment as the proteoglycans lose their grip and float away. Thus the cartilage cannot withstand shocks, cracks and may wear out completely. Glucosamine is a major building block of the water – loving proteoglycans. Besides being a building block for the synthesis of proteoglycans, its mere presence acts as a stimulus to the cells that produce proteoglycans – in fact glucosamine is a key factor in determining how many proteoglycans are produced by the cells.

Glucosamine has been shown to speed up production of both proteoglycans and collagen and it normalises cartilage metabolism which helps keep cartilage from breaking down. Thus because of the affect of glucosamine on cartilage metabolism it can in fact help the body to repair damaged or eroded cartilage. In other words, glucosamine strengthens your body’s natural repair mechanisms. Besides stimulating cartilage production, glucosamine also reduces joint pain and inflammation.

CHRONDROITON SULPHATE

Where glucosamine helps form the proteoglycans that sit within the space in the cartilage, chrondroiton sulphate acts like ‘liquid magnets’. Chrondroiton is a long chain of repeating nigans that attracts fluid into the proteoglycan molecules. This is important for two reasons:

the fluid acts as a spongy shock absorber the fluid sweeps the nutrients into the cartilage. Joint cartilage has no blood supply thus all of its nourishment and lubrication comes from the fluid that ebbs and flows as pressure is applied and released to the joint. Without this fluid, cartilage would become malnourished, drier, thinner and more fragile.

HOW CHRONDROITON SULPHATE WORKS

Chrondoiton Sulphate is a long chain molecule with a negative charge attached to it. As these chains wrap around proteoglycans they repel each other and thus create spaces between each proteoglycan. These are what are known as matrixes within the cartilage and this is where the fluid flows. There may be as many as 10,000 of these chains on a single proteoglycan molecule – thus we have a super water retainer as these chains make sure all these molecules are away from each other and cannot clump together. Besides drawing in precious fluid, chrondroiton: protects cartilage and stops it from breaking down and inhibits certain ‘cartilage chewing’ enzymes interferes with the metabolism of other enzymes that will starve the cartilage of fluid stimulates production of proteoglycans, glucosamine and collagen.



Nutraceuticals and Osteoarthritis

Nutraceuticals as Therapeutic Agents in Osteoarthritis. The Role of Glucosamine, Chondroitin Sulfate, and Collagen Hydrolysate.

Article Summary:

A review of the literature related to studies that examine the effectiveness of glucosamine and chondroitin in the treatment of osteoarthritis. A total of 13 studies were investigated in this meta analysis. Some design flaws were identified in many of the studies, however, all the studies examined showed a large effect for the use of glucosamine and chondroitin in the treatment of osteoarthritis. Glucosamine sulfate was evaluated and found to be more effective than a placebo in all trials examined and equal to or better than ibuprofen in other trials. Chondroitin sulfate was also examined for its effectiveness and found in all trials to be more effective at alleviating pain than the placebo. Although different products vary with respect to how much glucosamine and chondroitin is in the product, the preferred amount appears to be 1500 mg of glucosamine and 1200 mg of chondroitin. The expected amount of cost should be from $30-$45 a month for the product. While extensive reviews of the the side effects of the products are limited, most studies have participants who tolerate the glucosamine and chondroitin well and report few side effects.



Authors: Deal CL. Moskowitz RW. Institution: Division of Rheumatology, Case Western Reserve University School of Medicine, University Hospitals, Cleveland, Ohio, USA. Country of Publication: United States Source: Rheumatic Diseases Clinics of North America. 25(2):379-95, 1999 May.









Glucosamine and NSAIDS

The Absolute TRUTH about NSAIDS and Glucosamine Why you shouldn’t take them for long term arthritis relief and what your alternatives are. Grab a recent bottle of your favorite NSAIDS such as aspirin, ibuprofen, naproxen, acetaminophen or even branded products such as Tylenol? or Advil?. Check the label. Do you see how it instructs you to take for NO LONGER than 10 days? This is a problem for people with arthritis, because your pain is constant and only grows worse with time. How are you supposed to follow the label and yet get pain relief at the same time? There is a very good reason that warning label of 10 days is FINALLY on the label. The New England Journal of Medicine reports that “anti-inflammatory drugs (prescription and over-the-counter, which include Advil®, Motrin®, Aleve®, Ordus®, Aspirin, and over 20 others) alone cause over 16,500 deaths and over 103,000 hospitalizations per year in the US”, according to a review article published in the New England Journal of Medicine1. While they may be effective in the short term, NSAIDS are not exactly safe in the long term. Stomach bleeding, acute toxicity, liver failure, fatalities…. not exactly something that is worth a little pain reduction over a long period time. Fortunately, there is a better solution when it comes to some of the effects of osteoarthritis. Keep in mind that with NSAIDS, you are only covering up your pain. Your arthritis is free to progress and get worse. The worst part of all – and this is the MOST important information you will ever read about arthritis – NSAIDS have been clinically shown to INCREASE and ACCELERATE articular damage, inhibit chondroitin synthesis and suppress proteoglycans synthesis by the chondrocyte2. This is extremely bad for your joints because while you are covering up your pain, your osteoarthritis is getting worse and because you are numbing yourself to your pain, you are not aware of how your joints are deteriorating until it becomes so severe that standard over the counter NSAIDS are no longer effective for you. Because glucosamine has been shown to be at least as effective if not more (because it has less side effects compared to NSAIDS), it is highly recommended for osteoarthritis. Glucosamine has been shown to stall the effects of osteoarthritis (some even claim it may halt its progression) as well as to reduce pain and inflammation. We all know that unfortunately osteoarthritis (right now) has no cure and left untreated arthritis will only get worse but with glucosamine your joints now have a fighting chance. In a nutshell, glucosamine gets to the root of the problem and starts the repair process while NSAIDS only mask pain and degrade your cartilage – making your osteoarthritis worse! But hey, NSAIDS are a bit cheaper right? They do temporarily reduce your pain right? Consider what else they can do. NSAIDS also can kill you if you overdose on them. Acetaminophen alone is one of the most common drugs associated with both intentional and accidental poisoning. Don’t forget the 16,500 or so deaths a year and many more hospitalizations to the common “harmless” NSAID. It is time to change all of that. If you have osteoarthritis, we implore you to - if nothing else - add glucosamine to your current daily life. Even if you are taking NSAIDS now, you will likely notice that you need to take less and less to reduce your pain. Eventually it is possible that you may be able to eliminate your NSAID dosages completely and continue with your healing glucosamine. Modern science is working at a feverish pace to deal with osteoarthritis pain but can you guess where the money really is? If we cured arthritis, the pharmaceutical companies would not be able to make money on every new drug. Instead the pharmaceutical companies continue to come up with patentable new drugs that are slightly better than the last ones, but remember that the drugs you buy today have been in development for over 10 years if not more. They are not exactly cutting edge technology. Glucosamine is a natural supplement and nobody can patent it. Its effectiveness has been proven both in and out of the lab. Glucosamine costs about a dollar a day rather than several hundred dollars a month like some prescription drugs. Lastly, glucosamine has helped hundreds of thousands of people get more active, get healthier and get more from their lives.

References: 1. Wolfe MM, et. al. New England Journal of Medicine 1999;340(24):1888-99 2. American Journal of Medicine. 1987 Nov 20;83(5A):29-34