The Cost of Cartilage Health: maintenance better than surgical repair?

Glucosamine and chondroitin are widely taken to help relieve knee pain from osteoarthritis but do they work?

The GAIT Study:

     Double blind
The study, like most good medical studies, was done ‘double blind’, that is neither the patients nor the people administering to them knew which treatment the patient was on.

     MORE cf link below
But when results of the group of patients with moderate to severe pain was analysed the investigators found that the combination of glucosamine and chondroitin sulphate WAS significantly effective for pain relief!
ie. a healthy dynamic life style may be pursued?
(This is true in my case - Add my experience to the study -Chondrosulf alone 400mg x 3 per day.)
The GUIDE finding Both glucosamine sulphate and acetaminophen were more effective in reducing pain than placebo. Patients taking glucosamine sulphate exhibited more relief than patients on acetaminophen.

It was concluded that once-daily 1500 mg oral doses of glucosamine sulphate may be the preferred treatment for knee osteoarthritis.

Note
It must be noted that unlike the GAIT study that was publicly funded the GUIDE study was sponsored by the manufacturers of the glucosamine compound that was used in the trial.


In both the GAIT and GUIDE studies 1500mg of glucosamine daily was used and in the GAIT study 1200mg of chondroitin daily was used. However, some manufacturers suggest that glucosamine and chondroitin sulphate supplements should be taken in two phases, for example -

* A loading phase of a month of increased levels of glucosamine (up to 2250mg) and 1200mg of chondroitin sulphate.

* A maintenance phase of 1500mg of glucosamine and 800mg of chondroitin sulphate.

Other suggestions are that glucosamine and chondroitin sulphate doses should be calculated based on a person’s body weight. One recommendation is 20mg of glucosamine for every 1kg of body weight, whilst another suggestion is as follows:

* If body weight is less than 54.5kg take 1,000mg glucosamine and 800mg chondroitin sulphate.
*
* If body weight is between 54.5 and 91kg take 1,500mg glucosamine and 1,200 mg chondroitin sulphate.
*
* If body weight is more than 91kg take 2,000mg glucosamine and 1,600mg chondroitin sulphate.
(sounds reasonably logical start point from a materials engineering stand point) Are these ploys by supplement companies to sell more of their product or is there a scientific basis for these recommendations? Well, at present the evidence for doses and schedules is fairly sparse and that is one of the reasons why daily doses of 1500mg of glucosamine and 1200mg of chondroitin sulphate are common recommendations.

What about the source of these products-QC-AC-TQM?

Chondroitin sulphate is usually produced from cow (bovine) cartilage but can be produced from pig (porcine), chicken and even shark cartilage. Glucosamine on the other hand is derived from shellfish, usually shrimp, lobster or crab shells.


An important and informative discussion followed cf link
en référence à :

"Other factors   Chondroitin sulphate production in the body can be hindered if there is a deficiency of some key vitamins and minerals, in particular manganese, vitamin C and vitamin A. As participants in the GAIT study didn’t appear to undergo a dietary analysis prior to the start of the trial it is possible that some individuals may have had deficiencies in these key substances."
- Cartilage Health - Glucosamine and Chondroitin Supplement (afficher sur Google Sidewiki)

COMMENT:

Although I have no information on the cost of "wide-spread full life-cycle cost of surgery, It would appear obvious to an industrial R&D person such as I that the low risk relatively easy to extend chemical route is the road to take and ought to be introduced before serious pain results. In my case knee pain was reaching the handicapping stage whereby X-Rat readily detected near absence of cartilage on one side of th knee joint. The chemical supplement has been working well for several years and I am sorry not to have discovered in a simple X-Ray check-up! Not only has knee pain practically totally disappeared improvement in back-pain and disc slip has also greatly improved by my Chondroitin suppliment intake