16 replies to this topic

[sUper GeNius]

Doesn't surprise me.

http://www.usatoday....pplements_N.htm

[Mind]

The second part of a long-awaited study of how well the dietary supplements glucosamine and chondroitin sulfate slow cartilage loss in patients with arthritis reaches the same conclusion as the first part: The pills didn't work.

The two-year study, conducted at eight universities, found that the popular supplements didn't do any better than sugar pills in slowing the rate of cartilage loss in the knees of patients with arthritis.

This was the second part of a very large study funded by the National Institutes of Health called GAIT (Glucosamine/chondroitin Arthritis Intervention Trial). The first, published in 2006 in The New England Journal of Medicine, found that the supplements had no effect.

[Mind]

So what is effective against arthritis? Or is it just as simple as a good diet and exercise staving it off in older age.

[Zenob]

Doesn't surprise me.

http://www.usatoday....pplements_N.htm

I'm not surprised. I used to be really heavy(over 300 pounds). My knees used to KILL me. I was to the point that I was pretty sure I'd have to end up getting surgery. I had some friends that swore by glucosamine and chondritin. I tried it and it didn't do a thing for me. I finally started eating right and exercising. Lost 130 pounds and strengthened my legs\knees with running(usually run a 5k 3-4 times a week). Now my knees don't hurt at all. They still creak and pop like crazy when I squat down, but no pain.

[niner]

Haven't there been some decent studies saying that glucosamine reduced pain in OA? My recollection is that it's about as good as ibuprofen. As I recall, chondroitin was never shown to do much of anything.

[kismet]

Haven't there been some decent studies saying that glucosamine reduced pain in OA? My recollection is that it's about as good as ibuprofen. As I recall, chondroitin was never shown to do much of anything.

Yep, zero proof for chondroitin. However, I'm not sure if pain reduction is worth mentioning, it needs to stop disease progression.

Recently there have been quite a lot large, well-carried out studies debunking glucosamine... I can't believe there are still so many positive studies out there if it doesn't work. Sometimes I'm wondering how we can believe any study at all.
Hydrochloride may have lower bio-availability than sulphate regardless, so I'm not sure what to think about the GAIT.

The only recent trial leading to a positive outcome was sponsored by Rottapharm it seems. [1]

[1] Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, Blanco FJ, Benito P, Martín-Mola E, Paulino J, Marenco JL, Porto A, Laffon A, Araújo D, Figueroa M, Branco J. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007 Feb;56(2):555-67. Rheumatology Department, Fundación Jiménez Díaz-Capio, Madrid, 

[stephen_b]

Was it expected to work in OA more than in RA?

Edited by stephen_b, 30 September 2008 - 06:05 PM.

[mustardseed41]

You cant tell me Glucosamine is not effective. Millions of other folks would say so also. My knees pain is much improved since taking it.

[spacetime]

Glucosamine did nothing for me except screw up my leptin levels and make me fat. Results differ widely and with levels of pain a greta deal could be placebo effect. But FWIW Cissus worked quite well even though I had my doubts.

[maxwatt]

So what is effective against arthritis? Or is it just as simple as a good diet and exercise staving it off in older age.

For osteo-arthritis, COX inhibitors: aspirin, ibuprofen, other NSAIDS. Also nf-Kappa Beta inhibitors: reducing levels of nf-Kappa B reduces inflammation, and the subsequent tissue damage. Diet is probably not a significant factor. I once saw a paper that found no correlation with diet, but the focus was on meat, poultry, dairy and wheat.

Sirt1 agonists such as resveratrol inhibit nf-Kappa B.

Other Sirt1 agonists than resveratrol include Milk Thistle (Silymarin) and EGCG in green tea. Besides reducing arthritis symptoms, nf-kappa B inhibition kills nf-Kappa B dependent cancers, such as breast cancer and leukemia, at least in vitro. Impurities such as emodin in 50% resveratrol extracts may aggravate arthritis symptoms (see resveratrol forum.) These impurities can be present in some 98 and 99% extracts, so large resveratrol doses of nearly pure resveratrol may have enough emodin or other things to worsen rather than improve symptoms. Stick to high quality, tested extracts if you are going to mega-dose resveratrol.

Some resveratrol users have reported an increase in arthritic symptoms, perhaps due to such impurities. Individual biochemical variability may be a factor. Some people achieve much higher or lower blood levels of resveratrol from the same dose. I am speculating that for some individuals resveratrol blocks Sirt1 instead of activating it, but I also think this would only apply to a small unfortunate subset of people.

Autoimmune diseases such as rheumatoid arthritis can be aggravated by Sirt1 and those so afflicted should probably avoid Sirt1 agonists.

Feverfew contains Parthenolide, which inhibits nf-Kappa B apparently by a different mechanism from Sirt1 agonists like resveratrol. Unfortunately, most feverfew supplements probably do not contain enough Parthenolide to be effective. .

FWIW, I take between two and three grams of a quality tested resveratrol extract daily, and find it highly effective for the pain and stiffness in my fingers and toes. I used to take much-too-much ibuprofen, 800 mg four times a day under a rheumatologist's supervision. Resveratrol is much more effective for me. I may experiment with feverfew extracts, when I can find a source with enough Parthenolide that meets other requirements for safety.

I found chondroitin ineffective for me, and though glucosamine provided mild relief (placebo?), it was insufficient when the disease progressed. My understanding of glucosamine's mode of action is that it increases the amount of synovial fluid, lubricating the joints, rather than regenerating cartilage as was once thought. This could account for the inconsistent results show in studies. I would expect lubrication to help in mild arthritis, or in the early stages, but to be ineffective when you lose too much cartilage. A possible down-side to glucosamine is that it may increase insulin resistance by another mechanism than does glucose, at least as was shown in some studies.

When I first saw a rheumatologist, he told me if you live long enough, you will get arthritis. Over-use can predispose a joint. The first symptom is often pain in one's big toe. There is no cure, and treatments deal with limiting pain and maintaining range of motion. I am hopeful inhibiting nf-Kappa B will slow or halt progression, and perhaps allow some level of healing to occur.

[HighDesertWizard]

So what is effective against arthritis? Or is it just as simple as a good diet and exercise staving it off in older age.

Would you believe Boswellia?

Notice in the study below that Boswellia actually reduced MMP-3 in synovial fluid. That's not just pain reduction.

MaxWatt above notes the usefulness of Cox-2 inhibitors. Boswellia is a 5-Lipoxygenase Inflammatory Pathway inhibitor. The implication? Other 5-Lo inhibitors are likely to be somewhat effective against arthritis as well.

For example, here's a link to a study of the effect of Pycnogenol.

http://www.ncbi.nlm....pubmed/18386255

It's the 5-lo we're after for arthritis, crohn's cancer, atherosclerosis, depression, ADHD, brain fog, etc. See a helpful page about the science concerned with 5-lo with a Boswellia twist here:

http://www.truebotan...ia_science.html



Finally... here's the Boswellia-osteoarthritis study link and abstract....

A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin® for treatment of osteoarthritis of the knee

=================================
Introduction

5-Loxin® is a novel Boswellia serrata extract enriched with 30% 3-O-acetyl-11-keto-beta-boswellic acid (AKBA), which exhibits potential anti-inflammatory properties by inhibiting the 5-lipoxygenase enzyme. A 90-day, double-blind, randomized, placebo-controlled study was conducted to evaluate the efficacy and safety of 5-Loxin® in the treatment of osteoarthritis (OA) of the knee.
Methods

Seventy-five OA patients were included in the study. The patients received either 100 mg (n = 25) or 250 mg (n = 25) of 5-Loxin® daily or a placebo (n = 25) for 90 days. Each patient was evaluated for pain and physical functions by using the standard tools (visual analog scale, Lequesne's Functional Index, and Western Ontario and McMaster Universities Osteoarthritis Index) at the baseline (day 0), and at days 7, 30, 60 and 90. Additionally, the cartilage degrading enzyme matrix metalloproteinase-3 was also evaluated in synovial fluid from OA patients. Measurement of a battery of biochemical parameters in serum and haematological parameters, and urine analysis were performed to evaluate the safety of 5-Loxin® in OA patients.
Results

Seventy patients completed the study. At the end of the study, both doses of 5-Loxin® conferred clinically and statistically significant improvements in pain scores and physical function scores in OA patients. Interestingly, significant improvements in pain score and functional ability were recorded in the treatment group supplemented with 250 mg 5-Loxin® as early as 7 days after the start of treatment. Corroborating the improvements in pain scores in treatment groups, we also noted significant reduction in synovial fluid matrix metalloproteinase-3. In comparison with placebo, the safety parameters were almost unchanged in the treatment groups.
Conclusion

5-Loxin® reduces pain and improves physical functioning significantly in OA patients; and it is safe for human consumption. 5-Loxin® may exert its beneficial effects by controlling inflammatory responses through reducing proinflammatory modulators, and it may improve joint health by reducing the enzymatic degradation of cartilage in OA patients.
=================================

and from the text of this arthritis study...

=================================

In OA patients, MMPs such as MMP-3 are over-expressed and abundant in fluids of the synovial cavity, and cause degeneration of cartilage tissue. 5-Loxin® was able to reduce the elevated MMP-3 level in synovial fluid. This finding indicates that reduction in synovial fluid MMP-3 level by 5-Loxin® is consistent with improvements in abnormal joint physiology in OA. Therefore, these data together demonstrate that 5-Loxin® potentially has effects in terms of reducing the pain and improving physical ability and joint health; it is most likely that these improvements occur through downregulation of cartilage degrading enzymes such as MMP-3.

 BoswelliaArthritisMMPl.jpg   49.82KB   41 downloads
=================================

Edited by wccaguy, 01 October 2008 - 03:10 PM.

[E.T.]

Look at all the responses to the USA Today article: some 500 or so responses, and about 85% said that glucosamine/chondroitin greatly helped their joint pain, while the prescription stuff didn't help or made things worse. Many posters claimed they think this study was paid for by drug companies. Less and less people are trusting FDA/drug companies/mainstream physicians.

[johnblaze]

Many years ago I suffered sever trauama of the spine, fracturing some lower and mid vertabrae. About 8 months ago I was in a car accident and suffered severe trauma on both of my feet with multiple fractures as well. I also have been diagnosed with osteoarthritis of the spine, around the shoulder area. I started taking NOWs Glucosamine/Chonroitin/MSM supplement with the goal of slowing down the degeneration in my spine, aiding the recovery from the car accident, and to replace pharmacuetical NSAIDs. I had thought that even if the regeneration of cartilage was dubious that the analgesic effects, even if they took a month to achieve, would be worth the relaitvely cheap price and side effect profile. Well let me tell you, it didn't do ANYTHING noticable for me. I was not able to taper off tylenol at any sort of accelerated rate, and ended up taking both side by side. I have been taking G/C/M for almost a year now and it has not eliminated the need for NSAIDs. I also take NOWs D-Flame which contains 5-LOX and COX-2 enzyme inhibitors, and I would say tha it provides little more reliefe than G/C/M but still I have to rely on NSAIDs for breakthru pain. To conlcude I think that G/C/M at best provides a bit of relief, and is at worst a placebo, and I will continue to take it barring any discoveries that it contains adverse effects - it is cheap. I would also reccomend D-Flame, but I would like to see it's formula updated to reflect new research.

EDIT: D-Flame contains boswellia extract, resveratrol(50%) extract, and EGCG extract as mentioned in this thread, along with half a dozen other anti-inflammatories.

Edited by johnblaze, 08 October 2008 - 08:00 PM.

[yoyo]

So what is effective against arthritis? Or is it just as simple as a good diet and exercise staving it off in older age.

s-adenosylmethionine

[zorba990]

There are more than a few posts in bodybuilding forums claiming good
results with cissus quadrangularis for joint pain. Perhaps this is another
herb that Anthony will produce a high quality extract for.

[zorba990]

There are more than a few posts in bodybuilding forums claiming good
results with cissus quadrangularis for joint pain. Perhaps this is another
herb that Anthony will produce a high quality extract for.

And don't forget Arnica!

http://www.bio-pro.d...2747/index.html

[OneScrewLoose]

A lot of my joints creak and crack, although it is painless. I have found a HUGE difference between quality in different Glucosamine and Chondroitin supplements. The worst one's I've taken were from Costco and NOW. Midrange was Trader Joe's. The best I've used is the G&C /w MSM from Pure Encapsulation (very expensive though). Apparently, it makes a difference if it's sourced from animals or not.