Glucosamine sulfate and chondroitin sulfate

greenspun.com : LUSENET : About Joints : One Thread

After experiencing groin pain, from mild to severe for 12 years and thinking it was a muscle, or ligament problem, I was finally x-rayed and diagnosed on Nov. 1 as having mild, or mild to moderate osteoarthritis of the right hip. I have cartilage, but, it is worn at one point. The rheumatologist said that I would definitely need a hip replacement in the future, and asked if I wanted it done now. I said no and started to take glucosamine sulfate (1500mg), chondroitin sulfate (1200mg),MSM(1500mg), bromelain(1500mg),vitamin C(3 grams), fish oil capsules, a multivitamin and Brewer's yeast for its amino acids, vitamins and minerals. In addition, I began to eat a quart of chicken soup a day, because it contains collagen, and, when collagen, which is hard to digest in its normal state is heated, it unwinds and becomes easier to digest and absorb. Within a week, I began to experience a significant reduction in pain. Three weeks later I am pain free in all normal movements- walking, standing, sitting. I only feel some occasional minor discomfort which is fleeting. Rising from a chair produces little or no discomfort, whereas before it was accompanied by great stiffness and pain. In addition, there has been a signifificant increase in hip range of motion, although I have not yet regained some of the motion I have lost. And forcing my hip out does hurt. I am working on this with swimming, water exercise and yoga. This is a total approach to the problem. My rheumatologist discourages walking for exercise, saying that it causes microtrauma of the joint. Is this true?

My main question is, what can I look forward to in the future? Will there be further deterioration of my joint if I continue this regimen? How fast? Is it possible that I can manage my OA and avoid hip replacement surgery? I realize that this is a speculative question. What are the long-term results of taking GS and CS, not just the short-term? What for example is the European experience? My rheumatologist says that taking GS and CS does not produce new cartilage. Is he right? An article I read by Dr. Hangerford suggests otherwise. I would also like to know when the clinical trial on GS and CS at JHU began and will end. And finally, is hyaluronic acid injection a possible treatment for OA of the hip? Does it slow the progression of the disease? Where can I get more information about this treatment? Thankyou.

-- alan metz (malanmetz@aol.com), November 21, 2002

Answers

Part 1. You have a lot of questions. I am not sure I can provide answers to all of them. The regimen you are currently taking including glucosamine sulfate, chondroitin sulfate, MSM, bromelain, vitamin C, fish oil capsules, multivitamin, Brewer's yeast, and chicken soup is not one that has been studied in anyone of who I am aware. Of these supplements you mentioned, glucosamine and chondroitin have the longest available clinical data. MSM has nearly no clinical information in Index Medicus whatsoever. As far as what you can look forward to in the future, in general, osteoarthritis slowly progresses in man. There is some evidence in arthritis of the knee that glucosamine can prevent futher deterioration. Both of these studies have been published in the last two years. However, they were three year studies. There is no data available for a longer time frame than that. For chondroitin sulfate, one study looking at patients with osteoarthritis of the finger joints noticed less progression in the patients taking chondroitin than in those who were not. Again, this study was only a two year study.

-- Marc Hungerford, M.D. (mhunger@jhmi.edu), January 29, 2003.

Part 2. At this point, I would have to agree with your rheumatologist that glucosamine and chondroitin does not produce new cartilage. It seems it's best effect is preventing further loss of cartilage. To my knowledge there is no substance which has been shown to grow new cartilage in man. Some of the data that you are referring to is in cartilage culture where the cartilage cells have been able to produce more extracellular matrix when treated with glucosamine or chondroitin, but this is a far cry from growing new cartilage in adult human beings. The glucosamine and chondroitin study at Johns Hopkins University was terminated prior to completion because of difficulty enrolling patients and also the beginning of a nationally funded study at the University of Utah which would answer most of the questions we were trying to answer with our study. Finally, hyaluronic acid has not been approved for treatment of osteoarthritis of the hip. It is currently only approved for us in the knee.

-- Marc Hungerford, M.D. (mhunger@jhmi.edu), January 29, 2003.

I went through the same procedure for two years using the same GS, CS and MSM and had some relief from a bone on bone situation resulting indirectly from a football injury at age 16. I was also using intensive weight abnd flexibility exercises and water running since I was a runner, but I needed Viox to manage pain and finally became worried about that and stopped. I then felt that I had to do something. I have since had a hip resurfacing which is entirely successful and allows resumption of old activities even though I am 77 years old and an active athlete I think that this was the answer for me.

-- ernie mccullough (emccu@telusplanet.net), February 28, 2003.

Moderation questions? read the FAQ