17 replies to this topic

[bigtourist]

I am personally not taking it, but know a lot of people who do. From my very limited reading on the topic previously, this does not surprise me.
Any thoughts on this? Should MSM have been included?
article here

[nameless]

Saw that article too.

Buy I also know people who swear by it, including my Mom. Her fingers, which are arthritic, actually look a lot better than they used to since she started glucosamine/chondtroitin/msm.

Perhaps it's the MSM that is helping?

I've considered trying it myself, but haven't as of yet.

Edited by nameless, 17 September 2010 - 08:42 PM.

[niner]

Aren't there a zillion decent trials that find glucosamine to have some efficacy, but not chondroitin? The Swiss study was pretty big, but I haven't seen it so can't comment. The authors say it shouldn't be covered by insurance. I'd say that people shouldn't buy the kind of overpriced ripoff formulations that you would need insurance for. Glucosamine is a commodity compound. It shouldn't be expensive.

The media just loves these "supplement doesn't work" stories, don't they?

[adamh]

I see this article and study or one exactly like it about 2x per year each and every year. The pharma industry pays for them, IMO. They use doses known to be ineffective and other tricks to discredit it. What is the difference between a hooker and most scientists and researchers? There are some things a hooker won't do. OK, that was a bad joke and don't beat up on me if you are an honest researcher.

The reason I'm so sure is because it works for me. The placebo effect is not a possibility here because I've used it for years and it works. Placebos work fine for a while and then seem to fade out. If I forget to take it, I get reminded by the discomfort. Or if I take too low a dose. I believe chondroitin works too and I've tried just gluco by itself and it didn't seem to work as well. The stuff works but you have to take a big enough dose over enough time. Usually you notice a difference in a few days with the right dose but it may take weeks. Half the right dose may do nothing at all. 3/4 of the right dose might do a little.

[OneScrewLoose]

My mom just started taking G&C w/ MSM and it seems to work for her and doses above a gram each. I have been thinking that it might be placebo because of seeing these studies, but if it keeps working I see no reason to stick with it.

[Ark]

Cissus is where it is at!

That stuff work!~

[smithx]

I recall looking at this before and noticing that studies using glucosamine in any form except sulfate seem not to work.

Can anyone confirm or deny this? I think it's the glucosamine HCL that is useless.

[adamh]

Smithx, I'm no expert on the subject, I'm just a satisfied user who knows a lot of other satisfied users. But I've heard that the hcl form works as well as any other. There is absolutely no question in my mind that it works for me. I pay no attention to whether it's sulphate or hcl when I buy it and I believe I've used both but don't recall for certain.

This is like those other studies "debunking" vitamins and supplements that many of us know and find effective. I say follow the money and you will find someone or some corporation with an axe to grind at the end of the trail. And the media always trumpets these "debunking" stories like they were the gospel and endlessly repeat them. Pressure from advertisers? Who knows?

[kismet]

Aren't there a zillion decent trials that find glucosamine to have some efficacy, but not chondroitin? The Swiss study was pretty big, but I haven't seen it so can't comment. The authors say it shouldn't be covered by insurance. I'd say that people shouldn't buy the kind of overpriced ripoff formulations that you would need insurance for. Glucosamine is a commodity compound. It shouldn't be expensive.

The media just loves these "supplement doesn't work" stories, don't they?

Not exactly, the effect size has been declining as more studies were published/good qual. show no effect/independent studies show no sig. effect. and/or there is evidence of publication bias/great heterogenity. Since the GAIT was published another study found no effect from glu sulphate. There is really not much upside other then, yes, it seems safe (and prolly ineffective) in the short/mid term.

Chondro. may in fact have better efficacy data for joint space narrowing as all 4 (industry-funded) trials show some effect, but GAIT and others are rather negative on pain.

There is no "siwss study" - it is merely a meta-analysis reported by reuters, which I have not read (no access to BMJ but if you could upload it...):

BMJ. 2010 Sep 16;341:c4675. doi: 10.1136/bmj.c4675.
Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.
Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle S.

I see this article and study or one exactly like it about 2x per year each and every year. The pharma industry pays for them, IMO.
If you read them you would know that independent health authorities regularly perform those meta-analyses/sys. reviews...

The reason I'm so sure is because it works for me. The placebo effect is not a possibility here because I've used it for years and it works. Placebos work fine for a while and then seem to fade out. If I forget to take it, I get reminded by the discomfort. Or if I take too low a dose. I believe chondroitin works too and I've tried just gluco by itself and it didn't seem to work as well. The stuff works but you have to take a big enough dose over enough time. Usually you notice a difference in a few days with the right dose but it may take weeks. Half the right dose may do nothing at all. 3/4 of the right dose might do a little.

The quick onset of action that you report from what is commonly known as a modestly effective SYSDOA, "symptomatic slow-acting drugs in osteoarthritis", is very consistent with placebo.

Edited by kismet, 18 September 2010 - 08:53 PM.

[adamh]

It's very easy to say placebo when you haven't used it and are easily swayed by a meta analysis based on the same types of studies I spoke of. I know for a fact it's not placebo. Not because I'm not susceptible to that effect, but because placebos do not keep working over a long period of time. Not when you have considerable discomfort and it keeps on working with no diminishment. Just today, I noticed more discomfort and when I looked, I saw I had not taken my second batch of supplements yesterday. Placebos don't work like that. I have pill holders with a compartment for each day.

You may think you know the answer but I do know the answer. It works for me beyond a doubt and works for many others.

[maxwatt]

Glucosamine never did much for me, neither HCL nor sulfate.

[OneScrewLoose]

Cissus is where it is at!

That stuff work!~

I had thought about that but worry about giving something to my mom that boosts testosterone.

[bobman]

It's found ineffective for osteoarthritis, which is a chronic, immune disease. It is a largely separate pathology from arthritis caused by wear and tear, just like eating glass and perforating your intestinal tract calls is separate from Chron's. So in the end this doesn't say much for the uses it is commonly recommended for.

[Logan]

It's found ineffective for osteoarthritis, which is a chronic, immune disease. It is a largely separate pathology from arthritis caused by wear and tear, just like eating glass and perforating your intestinal tract calls is separate from Chron's. So in the end this doesn't say much for the uses it is commonly recommended for.

Are you thinking of rheumatoid arthritis? I believe osteoarthritis is simply the result of the breakdown of cartilage, resulting in bone on bone contact, and it is not an autoimmune disorder.

[maxwatt]

It's found ineffective for osteoarthritis, which is a chronic, immune disease. It is a largely separate pathology from arthritis caused by wear and tear, just like eating glass and perforating your intestinal tract calls is separate from Chron's. So in the end this doesn't say much for the uses it is commonly recommended for.

I don't have the citation at hand, but I think while most studies found glucosamine did not result in cartilage regeneration, there was at least one study that found glucosamine increased the amount of hylauronic acid and thus synovial fluid in joints. Better lubrication equals less joint pain?

There was a report that glucosamine increases insulin resistance by a different mechanism/pathway than does sugar (not GLUT4?) which would not be a good thing. This result may not have been replicable in later papers, and I don't know the current thought on that, and I don't have time to research it right now.

[bobman]

It's found ineffective for osteoarthritis, which is a chronic, immune disease. It is a largely separate pathology from arthritis caused by wear and tear, just like eating glass and perforating your intestinal tract calls is separate from Chron's. So in the end this doesn't say much for the uses it is commonly recommended for.

Are you thinking of rheumatoid arthritis? I believe osteoarthritis is simply the result of the breakdown of cartilage, resulting in bone on bone contact, and it is not an autoimmune disorder.

Osteoarthritic cartilage experiences both a loss of NMDAR mediated, mechanotransduction induced anabolism, and an up-regulation of catabolic cytokines, resulting in an overall catabolic process. Yes Rheumatoid arthritis is an autoimmune disease, but in many ways so is osteoarthritis: your body catabolizes the cartilage through profound dis-regulated immune response. Yes the differential immune response occurs post trauma, but normal cartilage responds to that trauma by repairing, increasing the deposition of proteoglcyans binding fibrils & collagen genesis, while in osteoarthritic cartilage for some reason the same initial response cascades into something far worse. So you won't be able to tell if chondroitin and glucosamine are beneficial to cartilage by looking at osteoarthritic cartilage. Most likely glucosamine sulfate is beneficial to cartilage simply through donation of a sulfur to proteoglcyan sulfation.

edit: Since I always get dogged about links: http://books.google....epage&q&f=false
http://iospress.meta...61jqbh4e5yfrgn/
http://www.journals....0033-8/abstract

I don't have the link on hand, but whereas MK-801 completely inhibits mechanotransduction induced hyperpolarization of chondrocytes in normal cartilage (and actually in response to IL-4 as well) (and thereby proliferation), it has no effect on osteoarthritic chondrocytes (osteoarthritic cartilage depolarizes in response to IL-4), caused possibly by disrupted or otherwise altered integrin signalling, suggesting that osteoarthritic chondrocytes essentially lose the ability to respond to stress. This is obviously talked about in the first link as well.

Edited by bobmann, 22 September 2010 - 04:47 AM.

[bobman]

It's found ineffective for osteoarthritis, which is a chronic, immune disease. It is a largely separate pathology from arthritis caused by wear and tear, just like eating glass and perforating your intestinal tract calls is separate from Chron's. So in the end this doesn't say much for the uses it is commonly recommended for.

I don't have the citation at hand, but I think while most studies found glucosamine did not result in cartilage regeneration, there was at least one study that found glucosamine increased the amount of hylauronic acid and thus synovial fluid in joints. Better lubrication equals less joint pain?

There was a report that glucosamine increases insulin resistance by a different mechanism/pathway than does sugar (not GLUT4?) which would not be a good thing. This result may not have been replicable in later papers, and I don't know the current thought on that, and I don't have time to research it right now.

From what I've read glucosamine sulfate has some effects on cartilage, but I also doubt that it "regenerates" cartilage, any more than Vitamin C "regenerates" skin; the cartilage has a certain regenerative ability, so as long as it is not rate limited by a lack of the nutrients glucosamine provides nothing will happen after ingestion. Up to a certain point glucosamine sulfate may increase the durability of cartilage, and maybe provides for increased "sub-clinical" regeneration. The notion that cartilage is "static" or "inert" tissue is nonsense, and its ability to heal is fairly well documented, so providing some additional nutrients into the sinovium is always a good idea. I don't know about the hyalaronic acid increase. Of course if your body spends all day catabolizing its own tissue, giving the cartilage some nutrients to boost proteoglcyan deposition won't really matter.

[bobman]

Cissus is where it is at!

That stuff work!~

I had thought about that but worry about giving something to my mom that boosts testosterone.

It's also mutagenic, but it does seem to work for joints, at the very least it is an analgesic.

http://www.ncbi.nlm..../pubmed/1769715