What are glucosamine and chondroitin sulfate?:

• Glucosamine (GA) and Chondroitin Sulfate (CS) are important building blocks for the collagen molecule.
• Collagen is a strong protein structure that provides significant strength to tissues in the body, including the cartilage in joints.
• Both, GA and CS are produced naturally by cells in our body.
• The goal of oral supplementation of GA and CS is to hopefully prevent and perhaps, delay or reverse the onset of arthritis.
• The oral form of GA and CS comes from shellfish and cow tracheas, respectively.

How do they work?:

• GA stimulates production of collagen and its precursors, It may also have an amti-inflamrnatory role.
• CS inhibits enzymes that break down cartilage. It also adds to the pool of molecules that form collagen.
  The combination of these compounds is considered to enhance cartilage protection.

• There is no evidence that GA and CS have a long term effect on arthritis.
  Recent studies show at least a short term relief in some patients using both, GA and CS.
• Many human and animal studies have been conducted in Europe. Most of these studies have used either GA or CS, but not their combined forms.
• There are current trials in the U.S. to better define the benefit of combined GA and CS.
• Much of the public awareness comes from word of mouth from some patients who have obtained relief with these preparations.

Side Effects:

• In general, both, GA and CS are relatively safe.
• Most reported side effects involve the gastrointestinal system (heartburn, nausea, stomach discomfort, constipation, diarrhea, etc.).
• Also reportcd are headaches, insomnia, drowsiness, skin reactions and tachycardia.
• Since the CS molecule is similar to heparin, it may have an effect if used with anticoagulants (such as coumadin), but this is not well documented.
• Despite the origin of GA from shellfish, there are no known allergic side effects.
• Glucosamine does not appear to have adverse effects on diabetics.

Insurance coverage: No

• Since it isn't FDA approved, it is sold over-the-counter as a nutritional supplement without prescription. It is not covered by insurance.

Brand Name:

• Cosamin OS (Nutramax, Baltimore, MD) is the most recognized combination of both supplements. The double strength preparation has an optimal combination of GA/CS. It also contains the purest form of these compounds.
• Cosamin DS also has a patented combination of ingredients, including manganese and ascorbic acid

Dosage:

• If less than 120 lbs: GA 1000mg + CS 8OOmg (1 tab twice a day)
• Between 120-200: GA l500mg + CS l200mg (2 tabs in morning and 1 tab in afternoon)
• If greater than 200: GA 2000mg + CS 1600mg (2 tabs twice a day)
• Note: a minimum usage of 2-3 months is recommended for noticeable results.

References: For further reading, consult: Theodosakis, Jason, Adderly, B, Fox, B, The Arthritis Cure St. Martin’s Press, New York, 1997.

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