Dietary Supplements for Healthy Joints
by Dr. Mark Hopkins
With the new fitness program we are pushing our joints to increased levels of activity. Certainly controlling you weight, doing strength and flexibility training go a long way toward healthy joints, but there are some of us who may have trouble starting a regimen because of an old injury or early arthritis. If joint pain persists it is important to have it diagnosed as there are many possible causes all with different types of treatment. As orthopedic surgeons we often divide joint pain in to one of three categories: arthritic, mechanical or tendinopathy/bursitis. Arthritic pain can come from either internal factors (heredity, diseases) or external factors (injuries, excess weight). Mechanical pain could be due to a meniscus (cartilage) tear, articular cartilage flap tear or a loose body. Tendinopathies and bursitis are often from overuse. A good example would be patellar tendonitis (jumper's knee) or IT, iliotibial band tendonitis (very common in runners). If you have joint pain and do not know what it is, get it diagnosed. If you are reading this and looking at the strange terms above trying to figure things out, let your doctor do it for you.
We will focus on those aches or pains that can be cured or alleviated with dietary supplements. These supplements can help pain due to arthritis, tendonitis and bursitis. Glucosamine and chondroitin are most effective on joint pain due to arthritis. There are two pharmaceutical means of treating arthritis. Non-steroidal anti-inflammatories treat the symptoms but do nothing to cure the arthritis or reverse it. Basically these medicines mask the symptoms while allowing the disease to progress unchecked. These medicines also have potential side effects such as kidney failure, hypertension, increased risk of heart attacks, etc. Common medicines that are used to treat arthritis include motrin, ibuprofen, naprosyn, etc. Certainly these medicines do have a purpose but sometimes you trade one symptom (knee pain) for another (kidney problems). The other medicines on the market used to treat arthritis are disease modifying. They can slow or even reverse the course of the disease or arthritis in the joints. Glucosamine and chondroitin are in the disease modifying category.
These dietary supplements are not FDA regulated, so buyer beware!! There are many different types of glucosamine and chondroitin compounds and they come in different purities, molecular weights and most importantly effectiveness. Low cost is not always better and the advertisers get very tricky with their wording.
Chondroitin sulfate and glucosamine work best synergistically. This means both agents have a greater effect when combined than when used separately. Chondroitin sulfate inhibits enzymes that break down cartilage and increases synthesis of hyaluronic acid which is a natural lubricant in joints. Glucosamine may be involved in the production of joint cartilage and synovial (joint) fluid. The combination may increase the ability of cartilage components to maintain and even improve articular cartilage under stress and may boost the natural protective response of cartilage and tissues under adverse environmental conditions. Data suggests that the combination of effects results from modulation of cellular gene expression that is responsible for the anabolic (building up) and anti-catbolic activity. The recommended dose per the NIH (National Institute of Health) is 1200 mg chondroitin sulfate and 1500 mg of glucosamine per day. The chondroitin levels build up gradually so it can take up to three months before any effect is felt. The GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) was a multicenter prospective study completed Nov 2005 sponsored by the NIH. It will provide a good source for information. For more detailed information about these products refer to hospitalprivileges.net and go to the dietary supplement link on the right side.
Mark Hopkins, M.D. is a board-certified orthopedic surgeon who has worked extensively in the past with the Olympic teams and has an avid interest in cartilage regeneration. He helped develop HLPR, Healthy Living Plan for Reservists.