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Fighting arthritis with glucosamine

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Cell stimulation
According to Theodosakis, glucosamine stimulates production of new cartilage cells in the joints, while chondroitin breaks down old cartilage. Within two weeks of taking the supplements, he claimed he was so much better that he abandoned his conventional medication.

His book was a bestseller and millions of people with arthritis who have tried glucosamine, either with or without chondroitin, claim almost miraculous improvements. Rheumatologists (doctors who specialise in arthritis) put such stories down to the placebo response - a person believes a treatment works and so feels better - but the sheer volume of reports obliged them to carry out clinical trials.

The most recent studies in top medical journals suggest that Theodosakis and his followers are right. In March 2000, the prestigious Journal of the American Medical Association reviewed trials of dietary supplements of glucosamine and chondroitin and concluded that 'some degree of efficacy appears probable.' Then in January 2001 a major three-year Belgian study of 212 patients with knee osteoarthritis was published in The Lancet. It found that glucosamine not only relieved symptoms but actually slowed cartilage deterioration.

Research programme
Meanwhile the US National Institutes of Health is running a US$14 million four-year investigation of glucosamine and chondroitin. It is said that researchers faced a challenge in finding 1,200 subjects with osteoarthritis of the knee who were not already taking the supplement.

Some experts suspect that glucosamine may work in a similar way to an antibiotic, doxycycline, which is the subject of trials at a number of American universities. This is thought to protect joints and slow down the progression of osteoarthritis by blocking enzymes involved in the breakdown of joint cartilage, but the long-term use of antibiotics raises more problems. Glucosamine could offer a safe and natural alternative.

2007 has seen something of a setback for the glucosamine story. A recent publication appeared in the July issue of the journal 'Arthritis and Rheumatism'. A team from Boston University Medical Centre reviewed the evidence from 15 previous trials on Glucosamine and concluded that 'its benefits have been overstated'.

In the UK, a spokeswoman from the Arthritis Research Campaign said, 'results from trials of glucosamine sulphate have certainly been very mixed, and the evidence base to show that it relieves pain and stiffness remains inconclusive. Nevertheless, many people with osteoarthritis find that glucosamine is effective, and as it appears to have no side-effects and is quite cheap, osteoarthritis sufferers will continue to take this supplement.'

Professional recommendation
Many doctors now recommend glucosamine to patients with osteoarthritis, although it is not available on the NHS. It seems to take about a month to have full effect and so far no adverse side effects have been reported. Dosages vary and nobody as yet knows the optimum daily amount, but the Belgian researchers used 1500 mg a day. Many preparations on the market come as 500 mg capsules of glucosamine sulphate, sometimes in combination with chondroitin.

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Created: 12/11/2001  Updated: 17/08/2007

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