Approximately one of every six Americans suffers
from arthritis. The US Center for Disease control predicts that by 2020,
the number will increase to one in five. Osteoarthritis (OA), the most
common type of arthritis, is characterized by the degeneration of the cartilage
in the joints and is often caused by physical injury or repetitive joint
stress.
Cartilage acts as the shock absorber of the joints. Think of cartilage
as a balloon filled with water and a big sponge inside of it. When you
press your hand into the center of the balloon and move the pressure from
side to side, the water redistributes in response to the pressure. This
is the way the cartilage in joint distributes the pressure evenly to account
for the excess forces from jumping, twisting, and excess loads, thus protecting
the bone and joint. With age and use, the cartilage loses this resiliency,
much like the sponge in the balloon dries out. The pain and inflammation
that results from the degradation of cartilage is referred to as "osteoarthritis."
People who suffer from osteoarthritis are often told that their condition "will
only get worse". For most, this is not true. The symptoms associated
with OA can improve slowly through daily exercise, physical therapy, and
a choice of either oral non-steroidal anti-inflammatories (NSAIDs) or corticosteriods
injected into the joint spaces. While this treatment approach helps to
alleviate the pain and inflammation associated with osteoarthritis, NSAIDs
and corticosteroids unfortunately present potential side effects of gastrointestinal
upset or local irritation. Furthermore, these treatments only manage symptoms
of OA and not necessarily the root of the problem. In fact they may worsen
the arthritic condition with long term use.
The focus has changed from "how do we treat the symptoms" to "how
do we stop the progression of OA heal the cartilage?" Joint lubrication
through oral glucosamine or hyaluronic acid injected into the joint space
may have the ability to both hydrate cartilage and restore the visco-elasticity
of the joint fluid, and ultimately slow the progression of OA. In order
to understand the theory of how glucosamine works, we present a picture
of what cartilage is made of and how it protects the joint.
The major components of cartilage are water, glycosaminoglycans (GAG's),
hyaluronic acid, proteoglycans, chondroitin sulfate molecules: collagen
and elastin. The elements are held in a collagen matrix, much like a sponge holds
water. These elements are responsible for the cushioning and gliding qualities
of the joint. To maintain the properties of healthy cartilage, one needs a
diet rich in GAG's, chondroitin sulfate, and proteoglycans, else the cartilage
will begin to break down. The decay of proteoglycans and glycosaminoglycans
is the central process in the disease progression of OA. Glucosamine protects
and repairs the proteoglycans in cartilage.
How does it work?
In addition to clinical studies, animal based clinical trials have been
performed to evaluate how glucosamine works. It has been found that in
vitro, glucosamine stimulates cartilage cells to synthesize glycosaminoglycans
and proteoglycans. In animal studies, oral glucosamine has had a beneficial
effect on reducing inflammation and arthritic pain.
Does oral glucosamine supplementation really get to the right place
in the joint to stimulate new cartilage growth as many people claim?
Yes, it does. In February 2000, an article published in the Journal of
the American Medical Association (JAMA) addressed this concern. In the
trial, participants were given glucosamine tagged with a radioactive dye.
This technique allowed the investigators to follow the glucosamine through
the body. The results showed that indeed oral glucosamine became a component
of cartilage, supporting all of the subjective results by patients.
How much Glucosamine should I take?
A minimum of 1500mg of glucosamine should be taken each day. There
is no toxicity from taking more than that amount. Joint
Juice is a beverage-based
glucosamine supplement which contains 1500mg of glucosamine in each can.
Most of the Stone Clinic athletes drink 2 cans of Joint
Juice per day, or 3000mg of glucosamine.
Are there any side effects?
The Arthritis Association
cautions the use of glucosamine sulfate during pregnancy or lactation.
There has been some concern that Glucosamine may also elevate blood glucose
in diabetics though this has been only infrequently noted. Diabetics wishing to
take glucosamine should be encouraged to increase their blood glucose monitoring
during the first 3 months of taking glucosamine and report any increases
in their glucose values to their physicians. Joint
Juice uses American corn as the source of pure glucosamine.
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