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Easing Arthritic Pain

How a supplement often used on animals is helping humans, too.

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How might they work? Osteoarthritis results from a breakdown of cartilage, the protective coating around the bones at the joints, Clegg says. Without this smooth and springy substance, the bones scrape against each other, which can cause chronic pain and limit range of motion.

Both glucosamine and chondroitin are synthesized by the body and are naturally found in cartilage. Clegg and other researchers theorize that glucosamine somehow helps create new cartilage, while chondroitin may slow cartilage destruction. Taken together, some experts say, the combination offers a one-two punch against the wear-and-tear of osteoarthritis. NSAIDs, in contrast, primarily mask the symptoms.

Also unlike NSAIDs, glucosamine and chondroitin don't cause symptoms such as stomach upset, nor do they carry the risk of ulcer formation. Although some people have experienced mild gas, the side effects from the supplements are negligible, according to the Arthritis Foundation's position statement. If you're thinking about trying glucosamine and chondroitin, the Foundation advises a few precautions, however. Patients who are taking the blood-thinning medication heparin -- whose molecular structure is similar to chondroitin -- should have their blood clotting activity monitored if they add chondroitin. Taking both at the same time could increase the risk of bleeding. Diabetic patients wanting to try glucosamine (an amino sugar) should consider potential effects on their blood sugar control. If you're allergic to shellfish, avoid taking glucosamine, which is made from crab, lobster, or shrimp shells. (Chondroitin is manufactured from cow cartilage.) And before you rush out to buy either of them, make sure that osteoarthritis is the cause of your pain; glucosamine and chondroitin don't seem to help other forms of the disease, such as rheumatoid arthritis. Of course, it's always a good idea to talk to your doctor first.

And be prepared: the supplements aren't cheap. A month's supply of glucosamine alone (at 1500 milligrams a day, the amount used in most studies) can run from $30 to $60 per month. And you should choose a brand that's been used in a scientific study; researchers at the University of Maryland School of Pharmacy in Baltimore recently tested several brands and found that some didn't contain as much glucosamine and chondroitin as their labels indicated. No matter the brand you purchase, insurance will not typically cover the cost, because these substances are considered to be foods, not drugs.

Arbenz, who is on Medicare, admits that she finds the cost of the supplements frustrating, but she'll continue to take her glucosamine for as long as she needs to. "Sure, I know that they don't really know if it works and all of that science stuff. But it's working for me. And for me that's enough."

To Sign Up for the NIH Study:

To be eligible to participate in the study, you should have both knee pain and X-ray evidence of osteoarthritis. Contact Diana Kucmeroski, study coordinator, at the University of Utah School of Medicine, Rheumatology Division, 50 North Medical Drive, Salt Lake City, UT 84132; or call (801) 585-6468. You will be directed to one of nine study centers (in Wichita, Cleveland, San Diego, San Francisco, Indianapolis, Philadelphia, Omaha, Salt Lake City, or Seattle).

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