I see a lot of different health issues in practice, and these can broadly be divided into what you might call ‘primary’ and ‘secondary’ concerns. I see primary concerns as the sort of things that cause individuals to make appointments to see me. Common example include fatigue, irritable bowel syndrome, asthma and eczema. On the other hand, secondary concerns tend not to be volunteered, and may only come out while I’m doing a review of all health issues. One common secondary issue relates to the joints. For example, I see may individuals who have a tendency to pain and stiffness in one or more joint, generally as a result of ‘wear and tea’ or what is known as ‘osteoarthritis’. Many of these individuals have sustained sporting injuries, after which they may find the joint never was ‘quite right’.
Of all the joints to be affected in this way, I find the knee to be the most common. Not only is this one of the major weight-bearing joints in the body, but it is also prone to injury during the twisting and turning and abnormal forces induced by, say, skiing, rugby, football, squash or tennis.
Appropriate physical therapy (e.g. physiotherapy, osteopathy, biomechanical assessment and management) has its part to play in such cases. However, from a ‘nutritional’ perspective, a mainstay of the management I advise is the agent ‘glucosamine sulphate’. This substance is a basic building block in cartilage and other ‘soft tissues’ such as ligament and tendon. While not all research is utterly consistent, there is evidence that supplementation with glucosamine sulphate can be effective in the relief of osteoarthritis, including that affecting the knee [1-4]. In practice, I find glucosamine to be generally very effective in improving the function of the knee joint and reducing discomfort. It can be a critical factor in allowing individuals to retain active, productive lives.
I was therefore interested to read a recent study which looked at the relationship between supplementation with glucosamine sulphate and risk of requiring a subsequent knee replacement [5]. Knee replacements surgery is usually the final option for individuals suffering from osteoarthritis of the knee who have been unable to find appropriate relief using other means. In theory at least, glucosamine sulphate may enhance the health of the joint, including its cartilage, and this may lead to someone being spared surgery.
In this study, 275 individuals were followed through time. For the purposes of the analysis, individuals were divided into two groups:
1. Those who in previous studies had taken glucosamine sulphate for at least 1 year and up to 3 years
2. Those who in previous studies had taken a placebo (inactive medication)
The participants in this study were followed for an average of 5 years following the time that they discontinued the medication/placebo.
The results of this study found:
Those who had previously taken glucosamine were 57 per cent less likely to have knee replacement compared to those who had taken placebo.
Those who had previously taken glucosamine used less medication and health resources generally compared to those who had taken placebo.
This study supports the use of glucosamine sulphate for the treatment of ‘wear and
tear’ and osteoarthritis of the knee. In particular, this agent seems to help keep people off the operating table.
References:
1. Pujalte JM, et al. Double blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980;2:110-114
2. Dovanti A, et al. Therapeutic activity of oral glucosamine sulphate in osteoarthritis: a placebo-controlled double-blind investigation Clinical Therapeutics 1980;3(4):266-272
3. Noack W, et al. Glucosamine sulphate in osteoarthritis of the knee. Osteo and Cart 1994;2:51-59
4. Muller-Fabbender H, et al. Glucosamine sulphate compared to ibuprofen in osteoarthritis of the knee Osteo and Cart 1994;2:61-69
5. Bruyere O, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthritis Cartilage, 2008;16(2):254-60.
I think combining the glucosamine with MSM and chondroiton increases its effectiveness. Is that right?
The best thing I did for my knees was to stop eating bread. I made the link when I went from eating almost no bread at all to having a little bit at every meal while on holiday in France. My knee pain, which had abated in recent months came back with a vengeance. I got back home; knees were okay. I added a little bread to my diet—ouch. I’ve always been a bit skeptical about alternative medicine, but conventional medicine hasn’t been doing too well lately in my books. Maybe the leaky gut people are on to something (though I think that in the interests of marketing they might come up with a better name).
Me too.
I have MS and last year decided to stop eating foods that are implicated in the ‘leaky gut’ thing. No pulses or grains or potatoes (there is a theory that nightshade plants can increase inflammation and I’m still thinking about that one) and only a little dairy.
When I say ‘only a little’ that means no milk and being sparing with cheeses, but I’m very fond of natural yoghourt, although I limit that to a dessertspoon per day.
My knees, through bad design are a mess. Made worse by the MS, as the pain messages weren’t getting through and exercising really screwed up the right one.
So, to the point. Since following this diet, my joint pain and knee pain are far lower.
With a low GI diet, I don’t get such terrible fatigue and my ‘brain fog’ is much better as well.
I have also found a cheap video called ‘Tai Chi for Arthritis’ which has done wonders for my knee pain. After each group of the exercises, my muscles complain, but it is almost impossible for me to injure myself. Which is HUGE as this happens with any new activity for me – even knitting!
I’m just about to move house and we are packing up ourselves. Lifting boxes was causing dreadful pain, but after a week of learning these exercises, my mobility was much improved and my knee pain is now bearable. I’ve been doing them for 3 weeks now and can actually bend my knees further than I imagined was possible.
Also – orthotics. They have helped enormously. It takes quite a while for the body to adapt to the orthotics, but then it’s had many years to develop bad habits. I found a good podiatrist (private, ouch!) and he also showed me some helpful exercises to help with the ‘retraining’.
Isn’t glucosamine hydrochloride meant to be better, easier to absorb, than glucosamine sulphate?
I’m convinced about the benefits of Glucosamine and Chondroitin but I’m not convinced about the need to take expensive supplements (although I see why the research has focused on the profitable health shop products). The natural sources are bones and connective tissue and the shells of crustaceans. We don’t often eat bones, but bone broth and jellies are extremely cheap to make and were regarded as important health foods for centuries. I’ve started having a cup of soup based on broth every day with my lunchtime salad and making sure I eat any jelly that comes with meat dishes.
My marathon running career ground to a halt 8 years ago (when I was 54) due to an accumulation of knee problems. Surgery helped, but only when I combined gentle running with daily doses of glucosamine did I manage any signficant improvement. My knees have got better and better – 4 years ago I resumed “competitive” road running and last year managed 12 marathons with no problems (that’s tempting fate!). Incidentally, I have tried glucosamine combined with MSM and chondroitin – seemed to make no difference.
11 years ago I had knee surgery and was told there was virtually no cartiledge, that I would need the same op. every 18 months to 2 years until eventually having knee replacement surgery to both knees (but not until I’d turned 60). I began taking Glucosamine & Chrondoitin, though was sceptical (and the consultant wouldn’t endorse it back then). I am now 62, still taking G&C and have had no further knee surgery OR replacement op. I’m not saying my knees are better, but they haven’t deteriorated any further; ditto the arthritis in my spine & neck. I have recommended it to many people but always with the advice to PERSEVERE, it is not a short-term solution.
I work as an Osteopath for the NHS and we routinely use Glucosamine Sulphate in addition to ‘physical therapy’.
1500mg OD for a 3 month course PLUS treatment in primary care is getting real results.
JH
glucosamine works well in the supportive treatment of arthritis. but dont forget to use other supplements that supports the join. in particular, chondroitin, niacinamide and vitamin-C
I have tried several brands of glucosamine (with and without MSM) over the past five years, and Dr. Max Powers ‘Joint Support + Vitamin B12 ( http://www.drmaxpowers.com/ ) is the best product and the best value I have found.
I recommend taking the full dose as stated on the bottle, daily, if like me you have experienced osteoarthritis, with the accompanying pain and loud popping of joints while climbing stairs, for instance.
I have full relief from those symptoms since taking this product, and I believe the potency speaks for itself in this result. My only regret is that I didn’t know about this simple solution many years earlier.