Supplements for Osteoarthritis?

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Osteoarthritis (OA) is the most common form of arthritis in the United States and is also a major cause of disability, impaired quality of life and increased health care cost.1 It is typically treated with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDS). However, current drugs used to treat OA treat the symptoms; they do not slow its progression.2 NSAIDS can cause gastrointesinal bleeding and other adverse side effects.

Obesity, smoking and trauma to joints all appear to increase the risk of developing OA with increasing age. Women appear more susceptible to the development of OA than men and high-heels may increase the risk of OA of the knee.3

Glucosamine and chrondoitin sulfate are two promising nutraceutical agents that have been widely touted as treatments for OA. In animals both of these substances have been shown to help repair damage to cartilage.4, 5 These two building blocks of cartilage have also shown beneficial effects in reducing joint inflammation. In double-blind controlled human trials these two supplements have been shown to reduce joint pain at least as well as NSAIDS.6 The NIH is currently conducting a long-term study to determine if these supplements can slow the progression of the disease in humans and if they have any adverse side effects. The typical dose used is 500 mg of glucosamine 3X/d and 400 mg of chrondoitin 3X/d.

One other nutraceutical has shown some promise in treating OA. One small study found that 500 mg of niacinamide 6X/d for 12 weeks reduced inflammation and improved joint flexibility modestly compared to a placebo.7 It is clear that more research is needed before glucosamine, chrondoitin and/or niacinamide should be routinely used to treat people with OA. However, prelimiary research suggests that they may be modestly effective and appear to have less adverse effects than NSAIDS. For this reason they may be worth trying, particlarly in a patient that does not tolerate NSAIDS.

By Dr. James J. Kenney, PhD, RD, FACN.

1. Guccione AA, Felson DT, Anderson JJ, et al. Am J Public Health. 1994;84:351-8

2. Altman RD. Am J Med 1987;83:65-9

3. Keerigan DC, Todd MK, Riley PO. Lancet 1998;351:1399-1401

4. Setnikar I, Pacini MA, Revel L. Arzneimittelforschung 1991;41:542-5

5. Uebelhart D, Thonar EJ, Zhang J, Williams J. Osteoarthritis Cartilage 1998;6(suppl A):6-13

6. McAlindon TE, LaValley MP, Gulin JP, Felson DT. JAMA. 2000;283:1469-75

7. Jonas WB, Rapoza CP, Blair WF. Inflamm Res 1996;45:330-4

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