Glucosamine/Chondroitan

One more set, one more rep…you tear down those muscle fibers and you rebuild them. That’s the ticket to muscle mass. And if you’re an aerobic creature, hill repeats, intervals on the track, and not to mention, the long slow distance work. All of these stresses you put on your fast and slow twitch muscles takes a toll. On your joints that is! Without healthy joints, you’re as good as a legless dog in an ear scratching contest.

Our joints, more than just the meeting of two bones, are the very structures that withstand the day to day beating. And if you work out harder a lion chasing a pack of wildebeest, then it would behoove you to take care of your joints. They too are affected by training and need the proper rest and recovery similar to your muscles.

For the purposes of this article, we’re going to stick to those supplements that might assist you in maintaining joint health and integrity. Granted, you need to eat a nutrient-dense diet that is rich in lean protein, unprocessed/unbleached complex carbohydrates, and healthy fats. But you may need some extra help, just in case you feel that nagging ache in your elbows, knees, or hips. Here we go.

Glucosamine and Chondroitan – A Potent Duo
Glucosamine, which is made from glucose and glutamine, is one component of connective tissue and cartilage in the body. There have been numerous scientific review articles published in respectable journals that have shown favorable results for both glucosamine and chondroitin (1, 2, 3). Interestingly, you’ll find some hesitation in the medical community in “prescribing” these supplements because of concerns of quality assurance and control. Is the glucosamine or chondroitan levels listed on the supplement facts panel in fact the actual or true amount? Certainly, this could be a concern; however, many companies do in fact test these products to insure that levels are indeed accurate. But make no mistake about it, supplements like glucosamine and chondroitan can be as kind to your joints as creatine and protein are to your muscles. For instance, glucosamine sulfate is more effective than placebo in delaying structural progression in knee osteoarthritis. The risk of disease progression was reduced by 54% if you consumed glucosamine sulfate. (12)
Most investigations have used either glucosamine or chondroitan separately. And of the two, glucosamine probably has more solid evidence to support it. For instance, work from German scientists (4) compared glucosamine sulfate with ibuprofen in osteoarthritis of the knee. These scientists believed that glucosamine’s anti-inflammatory properties might be helpful to those with osteoarthritis (the “wear-and-tear” arthritis). So in randomized, double-blind, placebo-controlled trial, subjects received either glucosamine sulfate (500 mg, three times a day for a total dose of 1500 mg/day) or ibuprofen (400 mg, three times a day for a total dose of 1200 mg). The study looked at 200 hospital patients with osteoarthritis of the knee who has symptoms for at least 3 months. After 4 weeks of treatment, they found that glucosamine was as effective as ibuprofen for treating osteoarthritis symptoms. And more importantly, they found that only 6% of the glucosamine patients reported an adverse event (mainly abdominal distress) compared to many more (35%) complaints in the ibuprofen-treated group.
In another study, a combination of 1500 mg glucosamine hydrochloride (HCl), 1200 mg chondroitin sulfate (SO4), and 228 mg manganese ascorbate was given each day for 8 weeks and was shown to be effective also (5). Also, man’s best friend responds favorably to lower molecular weight versions of the chondroitin (6). Yes, your friendly mutt needs joint help too!

Vitamins
Subjects in the Framingham Osteoarthritis Cohort study (7) were studied to see whether anti-oxidants had an effect on osteoarthritis. They found that those who had a high vitamin C intake also had a reduced risk of developing knee pain. A reduction in risk of OA progression was seen for beta carotene and vitamin E intake. However, vitamin C seemed to have the most favorable effect. This doesn’t mean that loading up on beta-carotene, vitamin E, and vitamin C will necessarily prevent or avert osteoarthritis, but as an insurance policy, it’s worth trying. There are other vitamins that might improve joint health. For instance, niacin (also known as nicotinic acid, nicotinamide, or niacinamide) can improve joint flexibility, reduce inflammation, decrease the need for anti-inflammatory medications and generally produce an overall decrement in symptoms of osteoarthritis (8).
Add to the list, folate and vitamin B12. University of Missouri scientists tested the effects of 6400 micrograms of folate, 6400 micrograms of folate plus 20 micrograms of cobalamin versus a placebo in osteoarthritic patients who were currently on non-steroidal anti-inflammatory medicines (9). They found that strength, as assessed by both right and left hand grip strength, was higher in the folate-cobalamin group versus folate alone. Furthermore, they found that this vitamin combination was better than non-steroidal anti-inflammatory medicines with regards to hand joint tenderness.

Fats
Essential fatty acids (EFAs) play an integral role in your body’s overall health. Two important EFAs are linoleic and gamma-linolenic acid. Linoleic acid is not made by your body and must be obtained through your diet. Linoleic acid is converted to gamma-linolenic acid or GLA. You can obtain GLA from evening primrose oil and borage oil. Is it possible that these fats are good for your joints (10, 11)?
In a study done at the Royal Infirmary in Glasgow, 40 patients with rheumatoid arthritis and upper gastrointestinal lesions (due to the ingestion of non-steroidal anti-inflammatory drugs) were given evening primrose oil (6 g/day) versus an olive oil placebo. Each patient kept taking their anti-inflammatory medications. They found that after 3 months of treatment, they found that evening primrose oil reduced pain and symptoms associated with rheumatoid arthritis. The olive oil treatment had no effect. In another study done at the same institution, they found that patients who consumed evening primrose oil tended to reduce their consumption of non-steroidal anti-inflammatories. Keep in mind that GLA is not an approved treatment for rheumatoid arthritis. But hey, if you can consume a healthy fat instead of a drug, it’s probably easier on your system and at the same time, good for joint function.

The moral of the story
It is apparent that glucosamine, chondroitan, certain vitamins and fats can have a profound and beneficial effect on joint function or health. I’d suggest you try about a couple months minimum of 1500 mg glucosamine plus 1200 mg of chondroitan to get an effective response. In addition, take your multivitamins and eat plenty of essential fats! But what does this mean to the bodybuilder? Of course, rheumatoid arthritis or osteoarthritis is not prevalent amongst bodybuilders or other competitive athletes. However, joint pain and tenderness are not uncommon. It would certainly be worth trying these various supplements to see if they have an impact on one’s joint function. Although it may not have the immediate impact of something like creatine, a cocktail of glucosamine plus certain vitamins and fats may be your joints best friends. Besides, what’s the alternative? Walking around with a pained constipated look?

References:
1) Sowers, M. and L. Lachance, Vitamins and arthritis. The roles of vitamins A, C, D, and E. Rheum Dis Clin North Am, 1999. 25(2): p. 315-332.
2) Towheed, T.E. and M.C. Hochberg, A systematic review of randomized controlled trials of pharmacological therapy in osteoarthritis of the knee, with an emphasis on trial methodology.
Semin Arthritis Rheum, 1997. 26(5): p. 755-770.
3) Deal, C.L. and R.W. Moskowitz, Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999 May;25(2):379-95.
4) Muller-Fassbender, H. et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994 Mar;2(1):61-9.
5) Leffler, C.T., et al., Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med, 1999. 164(2): p. 85-91.
6) Asari, A., et al., Molecular weight-dependent effects of hyaluronate on the arthritic synovium. Arch Histol Cytol, 1998. 61(2): p. 125-135.
7) McAlindon, TE et al. 1996. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis? Arthritis Rheum 1996 Apr;39(4):648-56.
8) Jonas WB et al. The effect of niacinamide on osteoarthritis: a pilot study. Inflammation Research 1996;45:330-334.
9) Flynn MA et al. The effect of folate and cobalamin on osteoarthritic hands. Journal American College of Nutrition 1994;13:351-356.
10) Leventhal L J et al. Treatment of rheumatoid arthritis with gammalinolenic acid. Annals of Internal Medicine. 1993;119:867-873.
11) Johnson MM et al. Dietary supplementation with gamma-linolenic acid alters fatty acid content and eicosanoid production in healthy humans. Journal of Nutrition 1997;127:1435-1444.
12) Poolsup N, Suthisisang C, Channark P, Kittikulsuth W. Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. Ann Pharmacother. Jun 2005;39(6):1080-1087.