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    Study Raises New Questions About Glucosamine


    Many people who, like Betty Rindone, were dissatisfied with glucosamine, have had better results with the lesser known glucosamine-chondroitin combination. The two supplements are said to have a heightened effect when taken together. Brian Cole, MD, director of cartilage restoration at Rush-Presbyterian-St. Luke's Medical Center in Chicago, tells WebMD, "They seem to increase the amount of normal cartilage without toxicity or side effects." Cartilage is missing or destroyed in the joints of people with osteoarthritis.

    For many elderly people, cost is an important issue in choosing between the two supplement regimens. "The chondroitin combination is fairly pricey," says Rindone.

    He notes that a definitive study involving both supplements is on the way. This summer, the NIH is launching a major study of 1,000 patients to compare the effects of glucosamine, the glucosamine and chondroitin combination, and a placebo for treating osteoarthritis.

    "I guess you have to say the jury's still out [on glucosamine]," says Peter Sharkey, MD, who reviewed Rindone's study for WebMD. "I've got a lot of patients who say that it works. But the problem is you have a big placebo effect. Pain scores got better even for people taking the placebo." Sharkey is associate professor of orthopaedic surgery at the Rothman Institute at Thomas Jefferson University in Philadelphia.

    The way glucosamine works has not been studied, says Sharkey. "Doctors couldn't be surprised when studies show these things work or don't work, because we don't know how it benefits cartilage. It's like shooting in the dark; you just happen to hit something that works. Even results of the glucosamine-chondroitin combination don't knock your socks off. They show about 20-30% improvement."

    The only thing the supplements will harm is your wallet, Sharkey tells his patients. "It's probably a reasonable thing to try. There's no downside to taking it. If you can afford it, it may work. I also tell them my wife takes it; she believes that it helps. I even take it. Just don't spend your kids' college tuition money on it."

    For Betty Rindone, a glucosamine-chondroitin combination has improved her quality of life, to some extent. She still feels her arthritis some days worse than others. And she knows when she's been overdoing things. "If I use common sense, take a day off now and then, it helps. But I seem to be getting along OK. I just have to remember to slow down a bit," she tells WebMD.

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