Tuesday, April 17, 2007

Chondroitin for Arthritis - save your money

I'll give you the take away summary first: A new study from the Annals of Internal Medicine shows that chondroitin sulfate does not work to relieve arthritis pain. Before you fire off a comment that mentions how much it helped Aunt Tilly....the postscript is that there were no frequent or severe adverse affects so go ahead and take it if you think it helps you.

Osteoarthritis affects millions of adults and the most popular OTC (over the counter) supplement for pain relief is glucosamine plus chondroitin. Chondroitin alone is a $1 billion/year market in the U.S. It is a large molecule that is only 12% absorbed into the bloodstream. It is not incorporated into the cartilage and arthritis affects the entire joint anyway, not just the cartilage. Inflammation plays a large role in arthritis pain and numerous past trials have suggested that chondroitin may act as an antiinflammatory. Some past trials showed benefit and one even showed it worked better than joint replacement!!

This meta-analysis trial looked at all past studies and found that the quality of many trials was poor. Some did not blind the investigators and others did not publish results that showed no good effect. After reviewing all the studies, these researchers identified the high quality scientific trials and they tried to find convincing evidence of the effectiveness of chondroitin. They found no benefit greater than placebo. A large multicenter NIH study in 2006 also showed glucosamine and chondroitin sulfate alone or in combo was not better than placebo.

Orthopedic doctors recommend this combo and there are hundreds of liquid, topical and pill forms of glucosamine/chondroitin on the market. Pure science would say it is a waste of money but it does not appear to have adverse effects. Despite the lack of science, we all know that different people respond differently so even if it is a placebo effect, if you think it works for you there is no reason to stop.

Evidenced based medicine is what we are all striving for. This is a good study and the evidence does not bear out the claims of chondroitin for relief of osteoarthritis hip or knee pain.

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