The joint supplements glucosamine and chondroitin provide marginal benefit, but are considered safe. They may be worth considering if you can justify the expense. Other supplements such as Omega 3 oils and Vitamin C/E may be worth considering.
1 Glucosamine and chondroitin
Chondroitin is an important component of joint cartilage and glucosamine is building block for other joint structures. Both chondroitin and glucosamine taken orally reach the joint space. There have been over 500 studies of glucosamine and chondroitin, and analysis of the best of the studies show only a marginal benefit or provide benefit only to a subgroup of suffers. These benefits do not meet the requirements to be generally considered clinically important. However, given the safety of these supplements, they may be worth considering if your income is sufficient.
Doses of less than 800 mg/day of chondroitin or less than 1500 mg/day of glucosamine are considered sub-therapeutic, but there is no indication of appropriate dose. The Mayo Clinic suggest 500mg Glucosamine sulfate three times a day or 20mg per Kg body weight and 200-400mg chondroitin 2-3 times daily. These doses are based on those commonly used in studies.
I found glucosamine and chondroitin available online for about $10/month. Look carefully at the ingredients to check how many capsules make up the stated dose when calculating the daily cost.
3 Food for joints
There have been over 2,000 studies of related to nutrition and Osteoarthritis, but only 53 are of sufficient quality to be useful. Some options that may be worth considering include:
- Methylsulfonylmethane (MSM) is a less well known joint supplement than glucosamine and chondroitin, with far less studies available. There is some support for MSM helping with joint pain, but not enough to give confidence as to its effectiveness or safety. MSM does cross the blood/brain barrier and may cause headaches. (I believe MSM was a trigger for my migraines.)
- The supplement "avocado/soybean unsaponifiables" has shown positive results in studies. However, this supplement has not been widely studies for effectiveness or long term safety.
- There is some suggestion that Omega 3 oils may help with Osteoarthritis. Given the other health benefits of Omega 3 oils, supplementation should be considered.
- Higher Vitamin C intake may reduce Osteoarthritis and 1000mg/day of Vitamin C reduced joint pain, though by less than half what would be expected from NSAIDs. Like Omega 3 there may be other benefits to Vitamin C supplementation that make this worthwhile.
- Some, but not all studies have shown benefit from Vitamin E supplementation. Like the above two supplements, Vitamin E should be considered as there may be other health benefits.
- Devil's Claw, a South African plan extract, may help with joint pain (60mg harpagoside). However, there is little known about its safety.
- ↑ Biochemical and pharmacokinetic aspect... [Arzneimittelforschung. 1995] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/7575762
- ↑ Anti-inflammatory activity of chond... [Osteoarthritis Cartilage. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/9743814
- ↑ Synovial and plasma glucosamine con... [Osteoarthritis Cartilage. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17353133
- ↑ JAMA Network | Archives of Internal Medicine | Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee OsteoarthritisA Comprehensive Meta-analysis http://archinte.jamanetwork.com/article.aspx?volume=163&issue=13&page=1514
- ↑ 5.0 5.1 5.2 Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941572/
- ↑ Meta-analysis: chondroitin for osteoarthritis... [Ann Intern Med. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17438317
- ↑ Glucosamine for pain in osteoarthritis: why ... [Arthritis Rheum. 2007] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17599746
- ↑ Glucosamine, chondroitin sulfate, and the two i... [N Engl J Med. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/16495392
- ↑ Glucosamine: Dosing - MayoClinic.com http://www.mayoclinic.com/health/glucosamine/ns_patient-glucosamine/dsection=dosing
- ↑ Chondroitin sulfate: Dosing - MayoClinic.com http://www.mayoclinic.com/health/chondroitin-sulfate/NS_patient-chondroitin/DSECTION=dosing
- ↑ Arthritis Research & Therapy | Full text | Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidence http://arthritis-research.com/content/8/4/R127
- ↑ 12.0 12.1 Efficacy of methylsulfonylmethane (... [Osteoarthritis Cartilage. 2006] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/16309928?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Randomised, Double-Blind, Parallel, Place... [Clin Drug Investig. 2004] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/17516722
- ↑ Systematic review of the nutritiona... [Osteoarthritis Cartilage. 2008] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/18417375
- ↑ Detection of dimethyl sulfone in the huma... [Magn Reson Imaging. 2000] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/10642107?dopt=Abstract
- ↑ Accumulation of methylsulfonylmethane in the hu... [Toxicol Lett. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/pubmed/11641045?dopt=Abstract
- ↑ Structural effect of avocado/soybean unsapon... [Arthritis Rheum. 2002] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11932878?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Efficacy and safety of avocado/soybean unsa... [Rev Rhum Engl Ed. 1997] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/9476272?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Symptoms modifying effect of avocado/soybe... [Scand J Rheumatol. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11578021?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Symptomatic efficacy of avocado/soybean unsa... [Arthritis Rheum. 1998] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/9433873?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3176911/
- ↑ Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee: the MOST study http://www.oarsijournal.com/article/S1063-4584%2812%2900060-X/abstract
- ↑ Do antioxidant micronutrients protect agains... [Arthritis Rheum. 1996] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/8630116?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Reduced pain from osteoarthritis in hip joint... [Ugeskr Laeger. 2003] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/12854267?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Tocopherol in Osteoarthritis: a controlled ... [J Am Geriatr Soc. 1978] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/350940?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Clinical effectiveness of Sp... [Z Orthop Ihre Grenzgeb. 1986 May-Jun] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/3529677?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ High dosage vitamin E therapy in patien... [Z Rheumatol. 1990 Nov-Dec] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/2085059?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Vitamin E is ineffective for symptomatic relie... [Ann Rheum Dis. 2001] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/11557651?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Supplementary vitamin E does not affect the loss... [J Rheumatol. 2002] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/12465157?dopt=Abstract&holding=f1000,f1000m,isrctn
- ↑ Harpgophytum procumbens for osteoa... [BMC Complement Altern Med. 2004] - PubMed - NCBI http://www.ncbi.nlm.nih.gov/sites/entrez/15369596?dopt=Abstract&holding=f1000,f1000m,isrctn