Conventional treatment focuses on pain relief until the joints are bad enough to warrant replacement surgery. The usual pain killers are non-steroidal anti-inflammatory drugs. Some of these drugs may have a deleterious effect on cartilage and should only be used after trying acetaminophen says Dr. Barry Koehler , associate professor of rheumatology at the University of British Columbia.
More alarming is the fact that in Canada on average there are 20,000 gastrointestinal bleeds and 1,400 deaths every year due to the side effects of these ant-inflammatory drugs. Dr. Edward Keystone of the Arthritis Society quoted these astounding statistics to CTV reporter Avis Favaro during a story on glucosamine aired September 1996.
Glucosamine sulphate, a naturally occurring compound necessary for the formation of proteins that comprise cartilage is one of the cornerstones of the complementary medical treatment of osteoarthritis. Most promising is the fact that it has none of the serious side effects of the anti-inflammatory drugs.
More than a dozen studies in Europe have shown that glucosamine sulphate is helpful in treating arthritic symptoms. In one study, forty patients with osteoarthritis of one knee received either glucosamine sulphate or ibuprofen (motrin, advil, etc) for eight weeks. Pain decreased faster with the ibuprofen in the first two weeks, but by the eighth week glucosamine was significantly more effective than ibuprofen.
Researchers at the University of Pavia in Italy confirmed the value of glucosamine in a double blind study. They also biopsied cartilage from affected joints and examined them under the electron microscope. Patients taking glucosamine showed structural improvement in their cartilage, while those taking placebo did not.
An open trial involving 252 doctors and 1,506 patients in Portugal examined the results of giving 500mg of glucosamine sulphate three time a day for an average time period of 50 days. Doctors found good results in 59 percent of patients and adequate results in a further 36 percent. Painful symptoms improved steadily throughout the treatment period. A significant number of these patients got good results who had not responded to any other medical treatment.
Dr. Joseph Houpt, Chief of Rheumatology at Mount Sinai Hospital in Toronto, became intrigued by patients claiming good pain relief from glucosamine. He set up the first North American double blind trial on glucosamine and its effect on osteoarthritis of the knee.
Since glucosamine in not patentable, Houpt initially had to fund the study out of his own pocket. Eight months later, Wampole Canada, a vitamin manufacturer, supplied funding.
Side effects of glucosamine, when they occur, are minimal (light to moderate nausea, indigestion, heartburn, and diarrhea) and are usually eliminated if the supplement is taken with meals.
In a true complementary medical approach to osteoarthritis there is no magic bullet. Besides taking glucosamine, it also involves an elimination diet to determine food allergies, exercise, and a complete nutritional programme including B-vitamins, Vitamin-E, vitamin-C, niacinamide, and herbal remedies. Other essential nutrients include the essential fatty acids both omega-3 (found in flax seed oil and fish oil) and omega-6 (found in evening primrose oil).
Jane Brody said, in a recent article in the New York Times, "rebuilding damaged cartilage has long been the holy grail of orthopedics and rheumatology." Whether glucosamine is the holy grail remains to be proven, but a few experts are already saying that glucosamine may safely replace the use of anti-inflammatories in osteoarthritis.
Meanwhile, should you wait for official sanction and deprive yourself of the considerable potential benefits of glucosamine? I think, in view of a large safety margin, an eight week trial of glucosamine should be recommended. Glucosamine capsules are available at any health food store. Since the effect may take four weeks to develop, and doesn't work for everyone, it's best to wean off pain killers slowly.
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