Krysta McGinnis

Glucosamine Chondroitin

Glucosamine is an amino monosaccharide Synthesized from glucose in human tissue Most abundant in connective tissue & cartilage

Within the cartilage, it is most important for the formation of:1. Hyaluronic acid 2. Chondroitin sulfate3. Keratin sulfate

Stimulates the formation and repair of articular cartilage

3 forms: 1. Glucosamine sulfate2. Glucosamine hydrochloride3. N-acetyl glucosamine

Glucosamine

Found in and around the cells of the cartilage It prevents other body enzymes from degrading the building

blocks of joint cartilage

Helps cartilage retain fluid into the connective tissue

Blocks enzymes that break down cartilage

Provides the building blocks for the body to produce new cartilage

Chondroitin

Can be used together or separate Mechanism is unknown for either form Forms of glucosamine: tablets, capsules, & powder Forms of chondroitin: capsules & tablets

Supplements may help control pain & increase the aff ected joint mobility

There is no evidence that they help the joint grow new cartilage or keep osteoarthritis from getting worse

Supplementation may be benefi cial, especially when there is a disturbed balance between catabolic & anabolic processes

A doctor should be consulted before beginning supplementation

Glucosamine Chondroitin Supplementation

Osteoarthritis of the knee: It can reduce the pain as well as NSAIDs Difference between glucosamine chondroitin and these

drugs - the time it takes to reduce pain & relieve symptoms Isn’t effective for everyone who takes it

Long-term eff ect: might slow the breakdown of joints Hope that it might slow down the breakdown of cartilage Some evidence suggests that taking glucosamine

chondroitin supplements might decrease the need of a total knee replacement

Glucosamine Chondroitin is Likely Effective for

Temporomandibular joint (TMJ) arthritis: Affects a joint in the jaw Characterized by: jaw pain, chewing, yawning, & talking Relieving jaw pain: glucosamine chondroitin works just as

well as NAIDs Research has found in some people, pain relief appears to

continue for up to 90 days after glucosamine sulfate is discontinued

Possibly Effective for

Most common type of arthritis

Degenerative joint disease Characterized by:

increasing loss of cartilage remodeling of the periarticular bone inflammation of the synovial membrane

Predominate in weight bearing joints

Characterized by loss of cartilage in the joints resulting in friction between the bones Common causes: gradual wear

Osteoarthritis

http://nccam.nih.gov/research/results/gait/enlarged.htm

AgeOverweight & ObesityGenetic determinantsDevelopmental dysplasia of the joints

All lead to similar clinical symptoms: Cartilage destruction Bone remodeling Osteophyte formation Inflammation of the synovial membrane Pain Immobility

Risk Factors

Commonly focuses on the treatment of symptoms, but does not treat the cause

Main goal should be to delay cartilage degeneration

Doctors recommend: Acetaminophen NSAIDs Capsaicin

Glucosamine Chondroitin is now being recommended instead of the NSAIDs or in conjunction with Glucosamine chondroitin may decrease the side effects caused

by NSAIDs FDA doesn’t regulate supplements

Common Treatment of Osteoarthritis

Clinical trial to test the eff ects of glucosamine & chondroitin sulfate for the treatment of knee osteoarthritis Sponsored by:1. National Institute of Arthritis and Musculoskeletal and Skin Diseases2. The National Center for Complementary and Alternative Medicine

Purpose: to test the short-term eff ectiveness of glucosamine & chondroitin sulfate in reducing pain

Design of the study: Double-blinded with 5 treatment groups, 2 pain groups (mild & moderate-to-severe)1. Glucosamine alone 2. Chondroitin sulfate alone 3. Glucosamine & chondroitin sulfate combination 4. NSAIDs – positive control5. Placebo

Monitored: for improvement of symptoms or any possible adverse reactions

Glucosamine Chondroitin Arthritis Intervention Trial (GIAT)

Overall, there wasn’t a significant diff erence between the treatments tested & the placebo

Participants taking Celebrex experienced pain relief versus the placebo

Moderate-to-severe pain participants: combination of glucosamine & chondroitin had pain relief of 20%+

Mild pain subset participants: glucosamine & chondroitin together or alone didn’t provide statistically significant pain relief

Results of GIAT

2008: Study looked at participants who continued with the study for another 28 months.

Tested to see whether glucosamine or chondroitin slowed the loss of cartilage in their knees.

Results in 2010: No diff erence in cartilage loss compared with people who took placebo. All groups lost less cartilage than expected.

GIAT 2nd Phase

Drug-Nutrient Interactions: No known interactions

Drug-Drug Interactions: Major:

Warfarin (Coumadin): used to slow blood clotting Moderate:

Antimitoic chemotherapy: some medications for cancer work by decreasing how fast cancer cells can copy themselves

Minor: Acetaminophen: together might affect how well each works Antidiabetes drugs: might increase blood sugar & decrease how

well the medication works

Interactions

Likely safe when used appropriately by adults Not recommended for children

Side eff ects: nausea, heartburn, diarrhea, & constipation

Uncommon side eff ects: drowsiness, skin reactions, & headache

Special Precautions/Warnings: Pregnancy or Breast-feeding: not recommended Asthma: advised to be cautious Diabetes: appears to be safe, but blood sugar should be

monitored closely Shellfish allergy: no reports of allergic reaction

Safety Concerns

http://www.nlm.nih.gov/medlineplus/druginfo/natural/807.html

http://nccam.nih.gov/research/results/gait/qa.htm

http://orthoinfo.aaos.org/topic.cfm?topic=a00189

http://umm.edu/health/medical/altmed/supplement/chondroitin

http://www.ncbi.nlm.nih.gov/pubmed/22977594

http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000374.htm

http://www.ncbi.nlm.nih.gov/pubmed/22977594

Bibliography