The theory behind
using GS is to rebuild and maintain the cartilage function. This has been
popular for some time as a treatment for OA. First, Glucosamine is the amino
sugar that is believed to support the formation and repair of cartilage to decrease swelling and possible breakdown. This
kind of medication is natural (found in seashells) . While researching
Glucosamine studies, I found many mixed reviews about Glucosamine, this website
(http://senior-health.emedtv.com/glucosamine-and-chondroitin/is-glucosamine-and-chondroitin-safe.html), I think gave overview of the
possible side effects of the supplement. Nevertheless it is still known that Glucosamine maybe effective in treating and perhaps
slow the progression of OA. (Another good article that disagrees with
Glucosamine Sulfate is by Dr. Stephen Barrett, Glucosamine and Chondroitin for
Arthritis: Benefit in Unlikely).
I
found one Clinical Study called, “A clinical study on Glucosamine Sulfate
versus Combination of Glucosamine Sulfate and NSAIDs in Mild to Moderate Knee
Osteoarthritis” (http://www.tswj.com/2012/902676/). The
aim of this study is to explore the differences between glucosamine sulfate
(GS) versus combination of GS and NSAIDs in patients with
mild-moderate knee OA. After the patients are diagnosised with mild or moderate
Osteoarthritis. They used two different methods to collect data via the,
“Western Ontario McMaster Universities Arthritis index (WOMAC) of
Osteoarthritis questionnaires and Visual Analog Scale (VAS).” WOMAC assesses pain,
stiffness, and physical function in patients with hip and / or knee
osteoarthritis and VAS assesses the body’s efficacy of pain management.
The results based on these test scores show that at first the combination of GS
with NSAIDs demonstrated better improvement in pain, stiffness and physical
function, in comparison with just GS. However, at their second review the
results revealed that GS group also showed great improved in pain, stiffness
and physical function, but not as well as GS and NSAIDs in that same time.
I
really enjoyed reviewing this study and even though the study suggested that
the “Glucosamine Sulfate has a carryover effect like disease modifying
agents.” Could the long-term treatment use
of GS reduce the need of NSAIDs? In the study, 18 of their
subjects did not go through with the experiment due to poor compliance, GI
problems, and Inadequate control of pain. What I found interesting is even
though the goal is to reduce the NSAIDs side effect and improve the patients
quality of life, the data shows that the pain treatment is better
much with combination of NSAIDs and GS, but they claim that glucosamine sulfate
may reduce the dependence of NSAID usage and delay the disease progression.
This doesn’t really solve the problem, but there have been many websites that
promote the combination of GS and NSAIDs… So does Glucosamine even matter? What
do you think?
I think glucosamine can be effective for some people, and an interesting argument for it's effectiveness can be seen in dogs. Oddly enough both my mom and my mom's dog take glucosamine daily. We started giving it to my dog because he was having a hard time jumping onto the couch or a chair. It seems to have really worked for him, and although he is older, he doesn't seem to have an issue with the pain as he did before. This website, http://www.glucosamine-osteoarthritis.org/glucosamine/glucosamine-for-dogs.html , discusses how the placebo effect isn't an issue here, as it is for most human medication, because the dog doesn't know what he/she is getting. I thought that was interesting, because it can be a good comparison, if you wanted to see how much the placebo effect really worked, not only for glucosamine, but other medications or supplements as well.
ReplyDeleteI came here to say the same thing that Kayla pretty much did, but most of my experience with GS comes from my family's black lab. He's been getting old and would occasionally whine/yelp when he got up from laying down, we assumed from achy joints. SO my mom started giving him GS and he hasn't had any real problems with it since. Now that is far from a scientific study, but it does go to show that GS can certainly be of help in some cases. And like Kayla pointed out, no placebo effect from the dog, he's lucky if he stops to smell what he eats. I do also like the idea of the GS with the NSAIDs as I feel that strikes a good middle ground that is more likely to be effective for more people.
ReplyDeleteMany of the scientific reviews of glucosamine seem to come to the conclusion that glucosamine has the potential to benefit osteoarthritis but there is still no certainty or "guarantee". A review published in 2009 entitled, The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation, compiled data from the years 1950-2008. These researchers came to the conclusion that glucosamine showed some clinical effectiveness in the treatment OA, but that "the biological mechanism of glucosamine sulphate and chondroitin remains uncertain". Therefore as you are questioning here, it would seem as though we aren't certain as to what is working out of the treatment process and/or is it that treatment singularly or a combination of multiple things such as the NSAIDs and the glucosamine.
ReplyDeleteAs the other responders have pointed out to your post, it would seem as though many of us know of some case where it would seem as though glucosamine did improve quality of life whether it was in animal or human. What was working... again we are not sure but something did. In the case of the combination of the NSAIDs with the glucosamine working "better" than the glucosamine alone and better still than no treatment, my best guess to this would be the following:
The NSAIDs relieve "some" of the pain. The glucosamine, as you stated in the initial post, "in theory is supposed to rebuild and maintain the cartilage function". With the reduced pain and "annoyance" a person should be able to be more physically active. Someone who is more physically active should have better/higher LBM and will typcially have better circulation and improved applicable blood values. Therefore the glucosamine could in theory do its job more efficiently (if taken regularly) and would be assisted by improved physical activity levels. This physical activity would at least maintain if not improve the muscle tone and support around the joint and therefore provide more stability and hence less pain.
So all together I personally feel it's the aspect of combining the right treatments along with the right "lifestyle". I personally take glucosamine + chodroitin + msm to assist with my joints through my hard physical activity. I think it helps me and as the others have said, I have also seen it help many of my aging pets over the years. So despite the research I am a fan of it and also feel that the NSAIDs have their place in the treatment of the joints...only the NSAIDs may be used more sporadically while the glucosamine may be used regularly.