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The Best and Worst Arthritis Foods

There are approximately 10 million people in the UK alone suffering from some form of arthritis. This disease of the musculoskeletal system presents itself in a wide range of form, with over 100 different classifications.

In general, arthritis symptoms include joint inflammation, stiffness, pain, and impaired function. There are a wide range of joints and surrounding tissues that can be affected, eventually leading to joint instability, deformation, and lack of mobility if not properly managed.

Unfortunately, at this stage there is no 100% cure for any type of arthritis, including the prevalent osteoarthritis and rheumatoid arthritis.

Nevertheless, there has been significant research into combination therapies that are making living with arthritis more manageable. In addition to medications, occupational therapy, and natural supplements, more people are subscribing to an arthritis diet consciously eating more of some foods and less of others.

How Important Is Diet For Arthritis?

Like many diseases, our diet affects our body’s ability to deal with arthritis. There are some foods which exasperate symptoms, while others can help to alleviate symptoms.  By paying attention to the types of foods consumed, it’s possible to better manage arthritis.

There are several key dietary recommendations for people with arthritis:

  • Maintain a well-balanced diet to support general health. A poor diet will not only negatively affect arthritis symptoms, it may also accelerate the progression of the disease and make the body more susceptible to other health problems.
  • Avoid fasting or crash diets that place added strain on the body
  • Increase calcium intake to minimise the risk of developing osteoporosis
  • Maintain healthy fluid intake, drinking plenty of water.
  • Keep bodyweight within a healthy range. Too much weight places extra stress on the joints, especially the hips and knees.

 

While these are good general guidelines, any arthritis diet should also focus on reducing inflammation, strengthening bones and cartilage, and reducing oxidative stress by elevating antioxidant intake.

The Problem With Inflammation

One of the key considerations in any arthritis diet plan is to avoid foods that promote inflammation. This especially applies to people already diagnosed with rheumatoid arthritis, psoriatic arthritis, gout, lupus, or ankylosing spondylitis.

OVERVIEW: Rheumatoid Arthritis, Gout, Psoriatic Arthritis, Lupus and Ankylosing Spondylitis

Rheumatoid Arthritis (RA) is an inflammatory type of arthritis that usually affects knees. Rheumatoid arthritis of the knee the auto immune disease. The body's immune system mistakenly attacks healthy tissue.

Rheumatoid Arthritis (RA) is an inflammatory type of arthritis that usually affects knees. Rheumatoid arthritis of the knee the auto immune disease. The body’s immune system mistakenly attacks healthy tissue.

Rheumatoid Arthritis

After osteoarthritis, rheumatoid arthritis is the most common form of arthritis in the UK, affecting approximately 400, 000 people. Symptoms of this disease usually start to present themselves when the patient is aged between 40 and 50, although adults of any age can be affected. Rheumatoid arthritis affects more women than men1.

Although the exact cause of rheumatoid arthritis is not fully understood, it’s known that the immune system has an abnormal response that promotes joint inflammation, attacking cartilage and other tissues around the joint. This progressively damages the joint and causes stiffness and discomfort, ultimately impeding function and movement

Gout

This form of inflammatory arthritis develops in response to an abnormal build-up of uric acid. The body is unable to effectively expel this substance, leading to crystallisation and deposition within the joints. Gout is typically associated with the big toe; however the ankles, insteps, fingers, knees, wrists, heels, and elbows may also be affected.

Psoriatic Arthritis

People that have the skin condition psoriasis are at risk of developing psoriatic arthritis. Although there are variations in symptoms, inflammation is very common and can cause significant pain and discomfort.

Lupus

There are several classifications of lupus, although they all related to tissue swelling associated with an abnormal auto-immune response. Systemic lupus erythematosus is especially detrimental to joint health.

Ankylosing Spondylitis

Predominately associated with the spine, ankylosing spondylitis is a chronic inflammatory arthritis characterised by back stiffness and pain. Over time it can lead to ankylosis. Often other parts of the body are also affected by inflammation including the hip, shoulders, ribs, and hand and feet joints.

What Causes Inflammation?

One of the underlying causes of these arthritic diseases is inflammation. When joints become inflamed they attract more inflammatory agents and white blood cells that cause further irritation. This causes the synovium (joint lining) to swell and leak into the surrounding tissues.

MEDICAL VIDEOS: Inflammation Explained

Medical videos

This is an excellent video explaining the body’s general inflammatory response:

And this is a technical video explaining in great detail specifically the pathology of joint inflammation:

illustration of joints most commonly affected by rheumatoid arthritisThis swelling causes the joints to become stiff, restricting movement and causing pain and discomfort. As a result the cartilage and bone can start to breakdown and thin, further aggravating the joints and leading to disease progression.

By gaining greater control over inflammation, it’s possible to reduce swelling. This will naturally reduce pain and discomfort, improving mobility and slowing joint degradation.

Controlling COX-1 & COX-2 with NSAIDs

One of the major underlying causes of joint inflammation are the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These enzymes trigger the release of prostaglandins, key hormones that elevate inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to block COX-2, acting as inhibitors to inflammation. However, long-term use of these drugs has detrimental side effects.

There is now a large shift towards natural compounds that can help reduce inflammation in combination therapies to treat arthritis.

Preventing Inflammation With An Arthritis Diet

The relationship between diet and arthritis inflammation is a very important consideration in any patient’s diet plan. Food contains different nutrients and other compounds that can impact inflammation both positively and negatively.

Some substances will aggravate inflammation, while others can help to minimise inflammation. Understanding which foods to avoid and which foods to include in your diet for arthritis can make a significant difference.

Foods That Reduce Inflammation

Foods That Reduce Inflammation

Omega-3 fatty acids

One key nutrient that is proving to be effective in reducing inflammation in sufferers of arthritis is omega-3 fatty acids. Many studies have confirmed that supplementation with this nutrient can help to ease inflammation of the joints without negative side effects2 3 4 5.

Fatty fish are the best sources of omega-3s. However, there are also vegetarian sources, especially nuts and seeds.

Omega-3-Rich Foods
• Flaxseeds • Walnuts • Sardines • Salmon • Beef • Soybeans • Tofu • Shrimps • Brussels Sprouts • Cauliflower

Fibre

Foods rich in fibre help to fight inflammation by reducing the concentration of c-reactive protein. This protein is a marker of acute inflammation. Not only are high levels of c-reactive protein associated with patients suffering from arthritis, studies show that this protein is an important predictive marker for diabetes and cardiovascular disease6.

For these reasons alone, it’s highly recommended to have a high fibre diet7. This will help to elevate arthritis symptoms, and it will also help to protect the body against other health problems.

Fibre-Rich Foods
• Whole grains • Apples • Bananas • Oranges • Strawberries • Pear • Beans • Pulses • Almonds • Broccoli

Vitamin B6

There has been a lot of research into the relationship between arthritis and B6. Also known and pyridoxine, this is one of eight B vitamins. The body is unable to store B vitamins because they are water soluble. Some studies have shown that people with rheumatoid arthritis have a higher requirement for B6 because inflammation reduces availablity8. Supplementation with vitamin B6 has been found to significantly reduce the levels of pro-inflammatory compounds tumor necrosis factor –alpha (TNF-alpha) and interleukin-6 (IL-6)9.

Vitamin B6-Rich Foods
• Pork • Beef • Fish • Turkey • Sunflower Seeds • Pistachio Nuts • Prunes • Bananas • Avocadoes • Spinach

These nutrients can all be sourced from high quality whole foods. However, foods supplements are more time-efficient and cost-effective at supplying the nutrients. Of course, patients should do their utmost to follow a healthy arthritis-friendly diet in any case.

 

Strengthening Bones and Joints

cheesesMany people that suffer from arthritis are also at risk of developing osteoporosis. Therefore, any arthritis diet foods should contain nutrients that support the strengthening of the joints and bones.

Calcium, vitamin K2 (menaquinone), vitamin D, phosphorus, magnesium, and manganese are all important nutrients that support healthy bones and joints.

Calcium is essential for maintaining bone mass. However, for the body to effectively utilise calcium it needs the support of other nutrients.

 

Key nutrients that support calcium absorption

Nutrients Needed To Absorb Calcium

Vitamin K2

This vitamin plays a key role in calcium metabolism, with several studies confirming that menaquinone is important for protecting bone health10,11,12. Menaquinone is found in certain animal foods and fermented foods. Unfortunately, K2-rich foods are typically high in fat. So while it is important to included foods containing K2 in an arthritis diet, they should be consumed in moderation.

Vitamin D

This pseudo-vitamin is needed to help increase the absorption rate of calcium within the gastrointestinal tract. Without vitamin D, calcitriol cannot be formed, preventing the insufficient calcium availability and weakening of the bones.

Phosphorus

The second most abundant mineral in the body after calcium, phosphorus also plays an important role in building strong bones and teeth. Most people get sufficient phosphorus in their diet.

Magnesium and Manganese

The trace elements magnesium and manganese are needed to absorb calcium. Studies show that deficiencies in these nutrients cause bone degradation and can increase the risk of osteoporosis13,14.

Foods that promote strong bones & joints

Foods for Strong Bones and Joints

Calcium

While most people associated dairy foods with calcium, many leafy greens, legumes, fruit, and seafood also contain this important mineral.

Calcium-Rich Foods
• Collard greens • Broccoli • Kale • Soy beans • Bok Choy • Figs • Oranges • Sardines • Salmon • Shrimp • Ricotta • Yogurt • Milk • Mozzarella • Cheddar cheese • Feta cheese • Cottage cheese • Parmesan cheese

Vitamin K

The primary sources of this vitamin are meat derived, especially organ meat. This is because animals have the ability to synthesise this vitamin from vitamin K1 they aquire from eating grass. Consequently, meats, dairy and eggs derived from grass-fed animals have a richer concentration of vitamin K2 compared with animals that are grain fed15.

Natto is the only vegetarian source of vitamin K2. The only reason natto contains vitamin K2 is due the bacterial strain used during the fermentation process. Vegetarians and vegans may need to take a dietary supplement to ensure that they are gaining enough vitamin K2 in their diet.

Since the richest sources of vitamin K2 also have a high concentration of saturated fat it’s important not to eat excessive amounts of these foods. This is another reason why a dietary supplement may be a better alternative.

Vitamin K2-Rich Foods
• Natto (fermented soybeans) • Hard cheese • Soft cheese • Egg yolk • Butter • Chicken liver • Salami • Chicken breast • Ground beef

Vitamin D

The body produces vitamin D when exposed to sufficient sunlight. There are also some food sources of vitamin D, but this is largely restricted to fish.

Vitamin D-Rich Foods
• Salmon • Tuna • Mackerel • Fish liver oil • Mushrooms • Beef liver • Cheese • Egg yolks

Phosphorus

Fortunately phosphorus is found in just about all foods, so rarely are any changes needed in an arthritis diet to account for a deficiency.

Phosphorus-Rich Foods
• Salmon • Pumpkin Seeds • Shellfish • Cheese • Brazil Nuts • Pork • Beef • Veal • Pulses • Sardines • Soya Beans

Magnesium & Manganese

Seafood and plant-based foods tend to be the best sources of the trace elements magnesium and manganese.

Manganese & Magnesium-Rich Foods
• Shellfish • Nuts • Seeds • Tofu • Whole Gains • Beans • Fish • Spinach • Kale • Bananas • Yogurt

These nutrients can all be sourced from high quality whole foods. However, foods supplements are more time-efficient and cost-effective at supplying the nutrients. Of course, patients should do their utmost to follow a healthy arthritis-friendly diet in any case.

 

Increasing Antioxidant Availability

we have compared the best joint supplements with antioxidants for youResearch shows that there is increasing evidence that oxidative stress plays a major role in the degradation of joints affected by rheumatoid arthritis16. Chronic inflammation is closely linked to elevated reactive oxygen species (ROS) that cause cellular damage17.

Not only does oxidative stress promote inflammation, it also has a direct impact on the joints by attacking important components of the structural tissue, such as proteoglycans, and stoping their synthesis18. Therefore, any rheumatoid arthritis diet plan should include plenty of antioxidants to try and reduce free radical activity.

An easy way to naturally increase dietary antioxidant intake is to eat an assortment of colourful vegetables and fruits each day. These foods are rich in anti-inflammatory antioxidants such as vitamin E, A, and C.

Other key antioxidant is the trace element selenium, which can be found in lean meats, seafood, poultry, peas, beans, eggs, seeds, and nuts. Copper, zinc, manganese, and iron are also important nutrients that can have antioxidant benefits due to their associated enzymatic activity with superoxide dismutases.

Threating rheumatoid arthritis with antioxidant therapy

Antioxidant Therapy

cruciferousThe use of antioxidant therapy for the treatment of rheumatoid arthritis has been a subject of many recent studies. Antioxidants such as vitamin E and superoxide dismutase have been successfully used in therapy to treat inflammation in animal experiments19,20.

In human clinical studies, high doses of vitamin E over several months have been shown to support better disease control in patients suffering from rheumatoid arthritis21.

Other research has demonstrated that combination therapies using antioxidants together with conventional drugs22, or with omega-3 fatty acids23 can reduce the symptoms of inflammation and offer relief to people affected by rheumatoid arthritis.

While patients participating in these studies were given antioxidants via supplements, there is also evidence that natural dietary intakes of antioxidants can also help with the treatment of rheumatoid arthritis. For example, patients that adopt a Mediterranean-type diet naturally increase antioxidant intake and subsequently experience less rheumatoid arthritis activity24.

Other studies have also found that a healthy dietary antioxidant nutrient intake can reduce free radical formation and enhance the antioxidant activity in rheumatoid arthritis patients25. Certain micronutrients, such as beta-cryptoxanthine and zinc, together with a diet rich in cruciferous vegetables and fruit can have a protective role against the development of rheumatoid arthritis26.

Dietary Supplements

In addition to eating antioxidant rich foods there are plenty of supplements available that are enriched with essential nutrients that can reduce oxidative stress and associated inflammation. These joint care supplements are an important aspect of an rheumatoid arthritis diet plan.

 

What Foods Should You Avoid With An Arthritis Diet?

Everybody will react differently to various foods and there is no “perfect” arthritis diet. However, many people with arthritis should foods that are known to irritate inflammation.

Arthritis Diet Foods To Avoid
• Sugar • Refined Carbohydrates • Alcohol • Saturated & Trans Fats • Gluten • Nightshades

Watch this short video for the 5 worst foods for arthritis

References

 

  1. “Crowson, C. et.al. (2011). The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases. Arthritis and Rheumatology, Volume 63, Issue 3, (pp. 633-9).”
  2. “Artemis, P. and Simopoulos, M. (2002). Omega-3 fatty acids in inflammation and autoimmune diseases. Volume 21, Issue 6.”
  3. “Geusens, P. et.al. (2005). Long-term effect of omega-3 fatty acid supplementation in active rheumatoid arthritis. Volume 37, Issue 6, (pp. 824-9).”
  4. “Yan, Y. et.al. (2013). Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity, Volume 38, Issue 6, (pp. 1154-63).”
  5. “Calder, P. (2013). Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? British Journal of Clinical Phamacology. Volume 75, Issue 3, (pp. 645-62).”
  6. “Yunsheng, M. et.al. (2006). Association between dietary fiber and serum C-reactive protein. The American Journal of Clinical Nutrition. Volume 83, Issue 4, (pp. 760-6).”
  7. “Ajani, U. et.al. (2004). Dietary fiber and C-reactive protein: findings for national health and nutrition examination survey data. Volume 134, Issue 5, (pp. 1181-5).”
  8. “Friso, S. et.al.(2001). Low circulating vitamin B(6) is associated with elevation of the inflammation marker C-reactive protein independently of plasma homocysteine levels. Circulation. Volume 103, Issue 23, (pp. 2788-91).”
  9. “Huang, et.al. (2010). Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis. European Journal of Clinical Nutrition, Volume 64, (pp. 1007-13).”
  10. “Kanpen, M. et.al. (2013).Three-year-low-dose menaquinone-7 supplementation helps decrease bone lose in healthy postmenopausal women. Osteoporosis International. Volume 24, Issue 9, (pp. 2499-507).”
  11. “Cockayne, S. et.al. (2006). Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Achieves of Internal Medicine, Volume 166, Issue 12, (pp. 1256-61).”
  12. “Ishida, Y. (2008). Vitamin K2. Clinical Calcium, Volume 18, Issue 10, (pp. 1476-82).”
  13. “Strause, L. and Saltman, P.(1987). “Role of Manganese in Bone Metabolism.” In: Nutritional Bioavailability of Manganese. American Chemical Society, (pp. 46-55).”
  14. “Castiglioni, S. et.al. (2013). Magnesium and Osteoporosis: Current State of Knowledge and Future Research Directions. Nutrients. Volume 5, (pp. 3022-33).”
  15. “.Rheaume-Bleue K. (2011). Vitamin K2 and the Calcium Paradox: How a Little-Known Vitamin Could Save Your Life. 1st ed. Ontario, Canada; Wiley.”
  16. Wruck, C. et.al. (2011) Role of oxidative stress in rheumatoid arthritis: insights from the Nrf2-knockout mice. Annuals of Rheumatoid Diseases, Volume 70, Issue 5, (pp. 844-50).”
  17. “Altidag, O. et.al. (2007). Increased DNA damage and oxidative stress in patients with rheumatoid arthritis. Clinical Biochemistry, Volume 40, Issue 3-4, (pp.167-71).”
  18. “Hadjigogos, K. (2003).The role of free radicals in the pathogenesis of rheumatoid arthritis. Panminerva Med. Volume 45, (pp. 7-13).”
  19. “Mazzon, E. et.al. (2001). Amelioration of Joint disease in a rat model of collagen induced arthritis by M40403, a superoxide dismutase mimitic. Arthritis Rheum, Volume 44, (pp.2909-210.
  20. “Behaska, A. et.al (2002). Mechanism of vitamin E inhibition of Cyclooxygenase activity in mocrophage from old mice: role of peroxynitrite. Free Radical Biology Medicine, Volume 32, (pp. 503-11).”
  21. “Helmy, M. et.al, (2001). Antioxidants as adjuvant therapy in rheumatoid disease. A preliminary study. Arzneimittel-Forschung, Volume 51, Issue 4, (pp. 293-298).”
  22. “Jaswal, S. et.al. (2003). Antioxidant status in rheumatoid arthritis and role of antioxidant therapy. Clinica Chimica Acta International Journal of Clinical Chemistry, Volume 338, Issue 1-3, (pp. 123-9).”
  23. “Darlington, L. and Stone, T. (2001). Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders. British Journal of Nutrition, Volume 85, Issue 3, (pp. 251-269).”
  24. “Hagfors, L. et.al. (2003). Antioxidant intake, plasma antioxidants an oxidative stress in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis. Nutrition Journal, Volume 30, (pp. 2-5).”
  25. “Bae, S. et.al. (2003). Inadequate antioxidant nutrient intake and altered plasma antioxidant status of rheumatoid arthritis patients. Journal of American College of Nutrition. Volume 22, Issue 4, (pp. 311- 15).”
  26. “Cerhan, J. et al. (2003). Antioxidant micronutrients and risk of rheumatoid arthritis in a cohort of older women. American Journal of  Epidemiology. Volume 157, (pp. 345-54).”
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Glucosamine

Summary: glucosamine and osteoarthritis

Glucosamine is a naturally occurring substance (amino sugar) in the joints. Multiple studies have shown that when glucosamine is consumed for a minimum of two to six months, it seems to have anti-inflammatory and cartilage-building effects.

The effects are significantly improved when glucosamine is combined with chondroitin and omega-3 fatty acids. In addition, several other other natural micro nutrient remedies such as pine bark extract and vitamins can help the body fight inflammation and improve the metabolism of cartilage.

Generally, glucosamine as well as other natural micro nutrient joint foods have no side effects. They can and should be taken over a long period of time. Glucosamine is generally considered an essential element of a natural complimentary food therapy for the treatment of osteoarthritis and arthritis.

What is glucosamine?

What is glucosamine?

glucosamineGlucosamine belongs to the class of amino sugars. Chemically it only differs from the glucose molecule by one amino group, which is not present in glucose.

In chemistry, an amino group is a functional group, which includes a nitrogen atom and two hydrogen atoms. An organic compound that contains an amino group is called an amine, as in glucosamine.

A large part of joint cartilage is composed of various glucosamine compounds. Glucosamine therefore plays a major part in the protection of joint cartilage. The effect of additional dietary glucosamine on arthritic changes in joints is intensively under examination.

In order to ensure the chemical stability of glucosamine and to improve its uptake in the body, it is frequently consumed in the chemical form of either glucosamine sulphate or glucosamine hydrochloride.

TIP 1: Glucosamine sulphate is preferable over glucosamine hydrochloride, because it provides the joint with more sulphur (sulphate).

What does the body need glucosamine for? Are there side effects?

Currently, glucosamine is one of the most promising natural substances in the support of healthy joints. It is also naturally made in the body, which is why very few, if any, side effects are expected as a result of taking glucosamine. In the human body, glucosamine plays an important role in the development of supporting and connective tissue, which includes the joint cartilage. Glucosamine also supports the production of mucous substances and secretions.

Do glucosamine and glucosamine sulphate help to alleviate arthritic complaints?

Glucosamine for pain relief and cartilage development

 

Arthrosis SurgeryGlucosamine is thought to relieve pain and inflammation and help in the formation of new cartilage tissue. This has been confirmed by many orthopaedists in practice.

However, joint cartilage heals very slowly. While skin is regenerated in around seven days, even small amounts of damaged cartilage requires two to three months to recover. As a result, clinical studies tend to last a minimum of six to eighteen months. Several studies have shown positive effects on patients with osteoarthritis or arthritis. And in addition to this, there have been some very promising approaches in which glucosamine has been combined with other substances such as omega-3 fatty acids and chondroitin.

Although pain relief has often been observed in association with glucosamine, no studies have been able to conclusively prove the regeneration of joint cartilage through glucosamine.

This is likely due to two reasons:

  1. The exact condition and thickness of the cartilage can only be measured using expensive procedures and
  2. the actual regeneration takes several years. Since glucosamine is not a nutrient protected by patents, there is no economic incentive to produce evidence, which is likely very expensive.

We present here a number of clinical studies on glucosamine sulphate and its effects on pain and mobility in osteoarthritis.

Results of studies on glucosamine

Studies on glucosamine

Glucosamine: to be taken alone or in combination with anti-inflammatory drugs?

glucosamin sulfat for arthrosisIn 2012 Selvan and colleagues tested the influence of glucosamine sulphate and a combination of glucosamine sulphate with anti-inflammatory drugs. Their subjects suffered from mild to moderate osteoarthritis 1. In total, 43 participants were given glucosamine sulphate, and a further 39 participants were treated with the combination therapy. All patients were treated for 30 days, and were subsequently assessed for a further three months.

Interestingly, mobility of the affected joints improved in both groups and in general the subjects reported that they felt less pain. As expected, the effect on the level of pain (reduction) felt was greater in the group given the combination therapy. Here the painkillers used specifically targeted and reduced the severe inflammation. This reduced the major swellings, which increased the mobility of the joints. If less inflammation occurs in a joint, the pain is naturally reduced.

As natural anti-inflammatories, omega-3 fatty acids, vitamin E, pine bark extract and willow extract are particularly effective. They complement glucosamine very well.

Glucosamine inhibits inflammation

effect of glucosamin on knee painIf glucosamine is used at an early stage and over a long period of time, it can potentially reduce the need to take anti-inflammatory medication (NSAIDs). Importantly, this means that the side effects of pain killers are reduced. Ultimately, this improves the quality of life of those affected.

Interestingly, glucosamine itself seems to have a weak anti-inflammatory effect. As a consequence, it reduces inflammation and swelling. This could possibly contribute to joint damage progressing at a much slower rate.

Glucosamine and chondroitin are effective treatments in cases of severe osteoarthritis

A French study was conducted in 2006 involving more than 1,500 patients with osteoarthritis of the knee. This study investigated the impact of various osteoarthritis treatments on the different patient complaints2:

  • Glucosamine sulphate
  • Chondroitin sulphate
  • A combination of glucosamine and chondroitin
  • Painkiller (celecoxib)

In cases of mild osteoarthritis, the difference between glucosamine and placebo treatment was only small. However, patients with more severe osteoarthritis had statistically significant improvements compared to the placebo (the results were clearly measurable and did not occur by chance). 70% of patients that were given the combination preparation of glucosamine and chondroitin had less pain and better mobility.

Effectiveness of glucosamine sulphate in combination with other substances

Glucosamine sulphate affects the pain in the joints and also down the progression of arthritis. Very frequently, however, results differ between experiments in cell cultures and studies in people.

The direct comparison between the quality individual papers is further complicated by the use of different glucosamine dosages and different measurement systems.

Very generally it can be said that glucosamine offers pain relief particularly in cases of mild pain 3.

Combination with Omega-3 and vitamins is recommended

glucosamin and omega-3The combination of glucosamine with other substances frequently leads to an altered effect. For example, when glucosamine sulphate is administered in combination with omega-3 fatty acids or vitamins, its effect seems to be stronger 4. Similarly, the same effect has also been described for glucosamine sulphate and chondroitin.

The nutrient combination is therefore consistently more effective than the individual substance 5.

ALSO CRITICS OF GLUCOSAMINE PRESENT NO ALTERNATIVES

There are also some clinical studies, which could not show any evidence of the effectiveness of glucosamine. A review paper by Burdett and McNeil in 2012 takes a critical view of the previous studies investigating the effects of glucosamine sulphate in patients with osteoarthritis 6.

The authors specifically point out that there are clearly promising in-vitro (laboratory) experiments, but the effectiveness in humans (in-vivo) is very different.

Very often, a modified study design means that the work cannot be directly compared with other investigations. Perhaps most importantly, the actual mechanism of how glucosamine works in the cartilage continues to remain unknown.

The two scientists concluded that glucosamine sulphate may at best cause a mild improvement in pain. However, they do not offer an alternative form of medication instead. The bottom line remains: a product that is consistently able to stop and reverse arthritis has not been found, and on the basis of risk-benefit analyses, glucosamine sulphate remains a recommended basic therapy.

Glucosamine can reduce the side effects of pain killers

In addition to this, it has been demonstrated that a glucosamine protects against stomach damage, which occurs when the painkiller indomethacin is prescribed. Similarly, the use of multi-nutrient combination therapy has shown a considerable reduction in the symptoms of arthritis in mice.

The authors finally highlight that the combination of painkillers and glucosamine could offer a way of saving on painkillers for patients with arthritis in the future. This provides a way of reducing the possible side effects of the medication in the gastrointestinal tract.


Therefore many orthopaedists recommend taking glucosamine and other nutrients:

TIP: Combine glucosamine with chondroitin and omega-3 fatty acids from fish oil (DHA and EPA). Omega-3 fish oil does not only help to protect your joints against inflammation, but it helps you improve the health of your blood vessels and cholesterol levels at the same time!

Osteoarthritis in animals: dogs and horses

Glucosamine in osteoarthritis in horses

An interesting question asked was whether glucosamine, when taken orally, arrives in the cartilage of joints at all? To determine this a few studies were conducted with animals, which had been given glucosamine sulphate or glucosamine hydrochloride.

Subsequently the blood and synovial fluid of the animals was tested in order to determine the concentration of glucosamine. In this way, Meulyzer and colleagues investigated the levels of the nutrient in horses, which were given 20mg glucosamine per kilogram of body weight orally or intravenously (equivalent to a human dose of 1500 mg in a person weighing 75kg)7.

After 5 to 720 minutes blood samples were taken from the animals at regular intervals. A sample of synovial fluid was taken 48 hours before the experiment, in addition to being taken 1, 6 and 12 hours after glucosamine was consumed.

In the case of oral administration of glucosamine, the concentration of glucosamine rose to 1 µg/ml. The concentration in the synovia was significantly higher after 1 and 6 hours than the initial value.

Additionally, glucosamine sulphate had a significantly higher level of bioavailability than glucosamine hydrochloride. However the authors could not comment upon the effect of glucosamine on the joint cartilage. In other studies which involve the use of human test subjects, more questions could be answered

Glucosamine can reduce the need for painkillers

In their study, scientists in South Korea have reported the possibility of using glucosamine hydrochloride to reduce the prescription of painkillers for patients dependent upon their individual circumstances 8.

The researchers wanted to clarify whether glucosamine could help reduce dosage of painkillers in the case of arthritis. A mouse model was used for this purpose. The animals received indomethacin as a painkiller, or a combination of indomethacin and glucosamine hydrochloride. Less inflammatory mediators were formed when mice were given the combination with glucosamine hydrochloride. Furthermore, painkillers could be significantly reduced. 

Joint and cartilage support combination products: for complete support!

A chain is only as strong as its weakest link. This applies also to the processes of maintaining cartilage and combatting inflammation. Cartilage, ligaments and bones need a multitude of vitamins, minerals and amino acids for tissue generation and to counteract inflammation.

There are many simple glucosamine supplements on the market. Optimised joint food supplements with sensibly combined micro nutriernts however are few and far in between.

 

Glucosamine Products

We selected three products for you here, which offer daily glucosamine quantities above 1,000 mg per day – the amount, which has been clinically shown beneficial for joints.

Patients with osteoarthritis: keep moving and eat right to support your joint health!

Firstly, natural remedies tend to be complimentary to a holistic approach of treating arthritis. Secondly, it is important to gently and continuously keep your joints moving, whilst taking care to avoid high impact loads on joints.

The third and final important element of avoiding wear and tear of joints is to avoid being overweight and ensure that you eat properly. This includes avoiding foods, which promote inflammation and instead focus on foods, which combat inflammation.

Bibliography:

  1. Selvan et al. 2012. A Clinical Study on Glucosamine Sulfate versus Combination of Glucosamine Sulfate and NSAIDs in Mild to Moderate Knee Osteoarthritis. Scientific World Journal: 902676; doi: 10.1100/2012/902676
  2. Clegg, D.O. et al.: “Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis.” NEJM, 2006, 354, 795-808
  3. Henrotin et al. 2012. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis? Arthritis Research Therapy 14(1), 201
  4. Gruenwald et al. 2009. Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis. Advances in Therapy 26(9), 858-871; Haflah et al. 2009. Palm vitamin E and glucosamine sulphate in the treatment of osteoarthritis of the knee. Saudi Medical Journal 30(11), 1432-1438
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