Hi bill,
I know this has been discussed before , but someone is trying to sell me a combination of Chondroitin Sulfate , Sea cucumber, Glucosamine Sulfate , Glucosamine Hydrochloride, vitamin C and Managnese, for healthy joints !
Ant contraindications? Is this product worth anything ?
Regards,
------------------
Van Canna
Healthy Joints
Moderator: Available
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Healthy Joints
Hi, Van
Looking forward to seeing you at camp.
The glucosamine salts (sulfate and HCl) are meant to provide glucosamine into the body. Glucosamine is produced in the body by combining glucose and glutamine. The enzyme that triggers this reaction decreases with age. Glucosamine then is a precursor (sort of a building block) to tendons, ligments and cartilage.
As the theory goes, the reduction in the enzyme that helps produce glucosamine is thought to be a major factor in the deterioration of articular cartilage with age. Articular cartilage is the spongy (it's literally filled with fluid), teflon-like substance that covers the ends of bones. When this stuff deteriorates due to rheumatoid (immune system related) or osteo (age related) arthritis, the trouble begins. Glucosamine is a building block of proteoglycans, which are the structure of cartilage.
Chondroitin sulfates reside in the proteoglycans, and help attract water into the cartilage. Cartilage will only provide it's shock-absorption role when properly filled (like a sponge) with water. Bringing fluid into the cartilage also helps to "feed" it, as it has no blood supply. This is one of the reason why moderate exercise (that forces fluid in and out of the spongy cartilage) helps our joints.
As the theory goes, those that are developing age-related (and NOT immune-related) arthritis MAY benefit from oral consumption of these substances. There's still research being done in the field to prove that what is going in your mouth actually makes it all the way to your joints, but the double blind studies have been done and have shown consumption of either or both of these substances to be as effective as taking ibuprofen - WITHOUT the complications. One comparing glucosamine consumption to ibuprofen consumption of people with osteoarthritis of the knee have had ALL the glucosamine group make it to the end, wherease some in the ibuprofen group have needed to discontinue the study due to stomach upset. Relief at 8 weeks between the two groups was comparable. However the relief in the ibuprofen group ceased at the end of the study, whereas the glucosamine group had some lasting effect for several months after stopping consumption of the substance.
Why the manganese? I have seen it in several formulas. I'm not exactly sure; there could be several explanations. It may help absorption. It may affect calcification.
Sea cucumbers? I haven't the foggiest idea. I'll have to check on that one.
Several considerations should be entertained before putting yourself on a regimen of this stuff:
* It is probably only useful for people at risk for osteoarthritis (aged individuals or folks like myself whose arthritis is secondary to an injury). That's the ONLY venue where it has been tested and proven to have efficacy.
* It takes 6 to 8 weeks to notice a difference.
* It must be taken forever to maintain the effect.
* Some have reported constipation from consuming these formulas. Other than that, I haven't seen ANY side effects in the literature.
* The health-food industry is totally unregulated. You have absolutely no guarantee that something you by in a health food store or from your local distributor has in it what it says it has. Research has been done on these glucosamine/chondroitin formulas in particular, and have PROVEN this to be the case here. The only combination products on the market that have been validated by independent labs are made by Nutramax (sold as Cosamin DS at pharmacies and doctors offices) and various TwinLab products. They are more expensive than the rest - for good reason. Anything else...you risk peeing your money away for nothing more than a placebo effect.
Hope this helps.
Bill
Looking forward to seeing you at camp.
The glucosamine salts (sulfate and HCl) are meant to provide glucosamine into the body. Glucosamine is produced in the body by combining glucose and glutamine. The enzyme that triggers this reaction decreases with age. Glucosamine then is a precursor (sort of a building block) to tendons, ligments and cartilage.
As the theory goes, the reduction in the enzyme that helps produce glucosamine is thought to be a major factor in the deterioration of articular cartilage with age. Articular cartilage is the spongy (it's literally filled with fluid), teflon-like substance that covers the ends of bones. When this stuff deteriorates due to rheumatoid (immune system related) or osteo (age related) arthritis, the trouble begins. Glucosamine is a building block of proteoglycans, which are the structure of cartilage.
Chondroitin sulfates reside in the proteoglycans, and help attract water into the cartilage. Cartilage will only provide it's shock-absorption role when properly filled (like a sponge) with water. Bringing fluid into the cartilage also helps to "feed" it, as it has no blood supply. This is one of the reason why moderate exercise (that forces fluid in and out of the spongy cartilage) helps our joints.
As the theory goes, those that are developing age-related (and NOT immune-related) arthritis MAY benefit from oral consumption of these substances. There's still research being done in the field to prove that what is going in your mouth actually makes it all the way to your joints, but the double blind studies have been done and have shown consumption of either or both of these substances to be as effective as taking ibuprofen - WITHOUT the complications. One comparing glucosamine consumption to ibuprofen consumption of people with osteoarthritis of the knee have had ALL the glucosamine group make it to the end, wherease some in the ibuprofen group have needed to discontinue the study due to stomach upset. Relief at 8 weeks between the two groups was comparable. However the relief in the ibuprofen group ceased at the end of the study, whereas the glucosamine group had some lasting effect for several months after stopping consumption of the substance.
Why the manganese? I have seen it in several formulas. I'm not exactly sure; there could be several explanations. It may help absorption. It may affect calcification.
Sea cucumbers? I haven't the foggiest idea. I'll have to check on that one.
Several considerations should be entertained before putting yourself on a regimen of this stuff:
* It is probably only useful for people at risk for osteoarthritis (aged individuals or folks like myself whose arthritis is secondary to an injury). That's the ONLY venue where it has been tested and proven to have efficacy.
* It takes 6 to 8 weeks to notice a difference.
* It must be taken forever to maintain the effect.
* Some have reported constipation from consuming these formulas. Other than that, I haven't seen ANY side effects in the literature.
* The health-food industry is totally unregulated. You have absolutely no guarantee that something you by in a health food store or from your local distributor has in it what it says it has. Research has been done on these glucosamine/chondroitin formulas in particular, and have PROVEN this to be the case here. The only combination products on the market that have been validated by independent labs are made by Nutramax (sold as Cosamin DS at pharmacies and doctors offices) and various TwinLab products. They are more expensive than the rest - for good reason. Anything else...you risk peeing your money away for nothing more than a placebo effect.
Hope this helps.
Bill
Healthy Joints
Thanks Bill! look forward seeing you as well !
Best,
------------------
Van Canna
Best,
------------------
Van Canna
-
RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
Healthy Joints
Van sensei: I have been using the Cosamine DS that Dr. Bill recommends for about a year. I had an initial 'plugged up' problem but apparently my body found a way to deal with it and after two weeks no side effects were apparent.
As for positive results, after about six weeks my knees stopped aching and I was able to increase the amount of aerobics that I do. I had to cut back a couple of years ago and my weight went up a bit. I'm back down to 200lbs now and am doing over 1.5 hours a week of stair climbing, treadmills, or whatever.
Interestingly, the improvement was pretty surprising. There was no obvious effect for weeks, but one day as I was ascending the stairs at home after a workout I was surprised by the absence of knee pain. The product might help a little for the lower back but I do exercises that may be helping there. I also have creaky elbows and have experienced no improvement at all. This stuff must migrate south after it is
digested.
BTW, Dr. Ann brings these products to camp and usually has a session covering them. It is interesting to hear about and discuss. Plus, it is a good break, inside in the A/C, after a few hours out in the sun.
Rich
[This message has been edited by RACastanet (edited 07-23-99).]
As for positive results, after about six weeks my knees stopped aching and I was able to increase the amount of aerobics that I do. I had to cut back a couple of years ago and my weight went up a bit. I'm back down to 200lbs now and am doing over 1.5 hours a week of stair climbing, treadmills, or whatever.
Interestingly, the improvement was pretty surprising. There was no obvious effect for weeks, but one day as I was ascending the stairs at home after a workout I was surprised by the absence of knee pain. The product might help a little for the lower back but I do exercises that may be helping there. I also have creaky elbows and have experienced no improvement at all. This stuff must migrate south after it is
digested.
BTW, Dr. Ann brings these products to camp and usually has a session covering them. It is interesting to hear about and discuss. Plus, it is a good break, inside in the A/C, after a few hours out in the sun.
Rich
[This message has been edited by RACastanet (edited 07-23-99).]
Healthy Joints
Thanks Rich_ I will join you in the session with Dr. Ann !
See you at camp__
------------------
Van Canna
See you at camp__
------------------
Van Canna
-
RACastanet
- Posts: 3744
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA
Healthy Joints
Van: On GEM's latest schedule Dr. Ann is listed at 9AM Saturday.
Rich
Rich
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Healthy Joints
J.D.
That's why you do randomized, double-blinded studies. Then all your concerns are unfounded.
I'll get you the reference (a recent one, past your 1997 quackwatch article which - by the way - doesn't show up when I click on it). I had all my "Favorites" erased when they updated my machine. My assistant will give me a Medline address and I'll pull up the most recent study (one done in China) as soon as I get back online.
In the meantime, I was just quoting one article. Theodosakis and Adderly (The Arthritis Cure) have a number of references (19 to be exact, from chapter 3) which support what I have written. Almost all the references refer to randomized, double-blinded studies.
And why is it - my dear Dr. Morenski - that M.D.s like you are so skeptical? Partially because:
1) Most M.D.s get their information about drugs from the pharmaceutical industry. Admit it, J.D., they send floozies to your office with short skirts delivering the latest articles on the drugs that THEIR drug company wants you to prescribe. My wife never needs to bring lunch; one or another drug manufacturer brings it in every day. And they bring the male M.D.s on fishing trips, golf outings, outings to the "dance clubs", dinners at Ruths Chris (top-o-the-line local steak place), etc. - all under the guise of "educating" the M.D.s.
2) Glucosamine is relatively cheap, and the cost to entry for producing this is relatively low. There is no patent, as it is a naturally occuring substance.
3) Because of #1 and #2 above (and because with reduced budgets for research from NIH, NSF, etc, many academics are dependent on "drug money"), you won't find a lot of this research going on in this country.
4) Because of #3 above, most M.D.s will not pay attention to the research being done - regardless of its quality.
- Bill
That's why you do randomized, double-blinded studies. Then all your concerns are unfounded.
I'll get you the reference (a recent one, past your 1997 quackwatch article which - by the way - doesn't show up when I click on it). I had all my "Favorites" erased when they updated my machine. My assistant will give me a Medline address and I'll pull up the most recent study (one done in China) as soon as I get back online.
In the meantime, I was just quoting one article. Theodosakis and Adderly (The Arthritis Cure) have a number of references (19 to be exact, from chapter 3) which support what I have written. Almost all the references refer to randomized, double-blinded studies.
And why is it - my dear Dr. Morenski - that M.D.s like you are so skeptical? Partially because:
1) Most M.D.s get their information about drugs from the pharmaceutical industry. Admit it, J.D., they send floozies to your office with short skirts delivering the latest articles on the drugs that THEIR drug company wants you to prescribe. My wife never needs to bring lunch; one or another drug manufacturer brings it in every day. And they bring the male M.D.s on fishing trips, golf outings, outings to the "dance clubs", dinners at Ruths Chris (top-o-the-line local steak place), etc. - all under the guise of "educating" the M.D.s.
2) Glucosamine is relatively cheap, and the cost to entry for producing this is relatively low. There is no patent, as it is a naturally occuring substance.
3) Because of #1 and #2 above (and because with reduced budgets for research from NIH, NSF, etc, many academics are dependent on "drug money"), you won't find a lot of this research going on in this country.
4) Because of #3 above, most M.D.s will not pay attention to the research being done - regardless of its quality.
- Bill
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Healthy Joints
Ask and ye shall receive.
Here are two review articles on glucosamine/chondroitin, and one clinical trial on glucosamine/chondroitin/manganese.
By the way, I selected the review articles because the papers on individual trials were too numerous to list. I got over 700 articles when I asked for Glucosamine and Chondroitin
**********************
REVIEW ARTICLE
Rheum Dis Clin North Am 1999 May;25(2):379-95
Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate.
Deal CL, Moskowitz RW
Division of Rheumatology, Case Western Reserve University School of Medicine, University Hospitals, Cleveland, Ohio, USA.
There are a sufficient number of short-term studies with these agents suggesting efficacy equal to that seen in the symptomatic treatment of OA using NSAIDs. Two recent meta-analyses by McAlindon and colleagues and Towheed et al reviewed clinical trials of glucosamine and chondroitin in the treatment of osteoarthritis. The study by McAlindon and co-workers included all double-blind placebo-controlled trials of greater than 4 weeks' duration, testing oral or parenteral glucosamine or chondroitin for treatment of hip or knee osteoarthritis. Thirteen trials (six with glucosamine, seven with chondroitin) met eligibility criteria. The authors used global pain score or the Lequesne index in the index joint as the primary outcome measure and considered the trial positive if improvement in the treatment group was equal to or greater than 25% compared with the placebo group, and was significant (P < or = .05). All 13 studies reviewed were classified as positive, demonstrating large effects, compared with placebo (39.5% [S.D. 21.9] for glucosamine, 40.2% [S.D. 6.4] for chondroitin). The authors concluded that clinical trials of these two agents showed substantial benefit in the treatment of osteoarthritis but provided insufficient information about study design and conduct to allow definitive evaluation. Towheed and colleagues reviewed nine randomized, controlled trials of glucosamine sulfate in osteoarthritis. In seven of the randomized controlled trials, in which they compared glucosamine with placebo, glucosamine was always superior. In two randomized controlled trials comparing glucosamine to ibuprofen, glucosamine was superior in one and equivalent in one. Methodologic problems, including lack of standardized case definition of osteoarthritis and lack of standardized outcome assessment led the authors to conclude that further studies are needed to determine if route of administration is important and whether the therapeutic effect is site specific. A meta-analysis of chondroitin sulfate trials has also been published. Of the 12 published trials, 4 randomized double-blind placebo or NSAID-controlled trials with 227 patients on chondroitin sulfate were entered into the analysis. All four studies showed chondroitin sulfate to be superior to placebo, with respect to Lequesne index, visual analog scale for pain and medication consumption. Significant changes (P < or = .05) were seen in those treated from day 60 to the study endpoints (150 to 180 days). Pooled data demonstrated at least 50% improvement in the study variables in the chondroitin treated group. Discrepancies in some of the study findings reported in the literature may relate to the composition of the nutritional supplements used. Studies in the United States have revealed that a number of preparations claiming to contain certain doses of glucosamine or chondroitin sulfate have significantly less (or none) of the dosages described. Accordingly, it is essential that studies performed with these agents use preparations that are carefully defined in manufacture. The amounts generally administered are glucosamine, 1500 mg, and chondroitin sulfate, 1200 mg, daily. Although glucosamine has been described as effective when used alone, it is probably reasonable to use the combination pending further studies. The average cost is approximately $30 to $45 per month. In the interim, what should physicians tell their patients when they ask whether these agents are effective, or whether they should or should not take them? The authors emphasize that these agents are not FDA-evaluated or recommended for the treatment of OA. They are available as health food supplements, and the number of studies of toxicity, particularly with respect to long-term evaluations, is limited. The pros and cons of these agents and the published data are described so that patients can make a reasonably informed decision as to whether they wish to proceed with use of these agents in therapy.
******************************
REVIEW ARTICLE
Altern Med Rev 1998 Feb;3(1):27-39
The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease.
Kelly GS
Successful treatment of osteoarthritis must effectively control pain, and should slow down or reverse progression of the disease. Biochemical and pharmacological data combined with animal and human studies demonstrate glucosamine sulfate is capable of satisfying these criteria. Glucosamine sulfate's primary biological role in halting or reversing joint degeneration appears to be directly due to its ability to act as an essential substrate for, and to stimulate the biosynthesis of, the glycosaminoglycans and the hyaluronic acid backbone needed for the formation of proteoglycans found in the structural matrix of joints. Chondroitin sulfates, whether they are absorbed intact or broken into their constituent components, similarly provide additional substrates for the formation of a healthy joint matrix. Evidence also supports the oral administration of chondroitin sulfates for joint disease, both as an agent to slowly reduce symptoms and to reduce the need for non-steroidal anti-inflammatory drugs. The combined use of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease has become an extremely popular supplementation protocol in arthritic conditions of the joints. Although glucosamine sulfate and chondroitin sulfates are often administered together, there is no information available to demonstrate the combination produces better results than glucosamine sulfate alone.
*****************************
CLINICAL TRIAL
Mil Med 1999 Feb;164(2):85-91
Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study.
Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD
Medical Department, Naval Special Warfare Group Two, Naval Amphibious Base Little Creek, Norfolk, VA 23521, USA. occdr@aol.com
OBJECTIVE: A 16-week randomized, double-blind, placebo-controlled crossover trial of a combination of glucosamine HCl (1,500 mg/day), chondroitin sulfate (1,200 mg/day), and manganese ascorbate (228 mg/day) in degenerative joint disease (DJD) of the knee or low back was conducted. METHODS: Thirty-four males from the U.S. Navy diving and special warfare community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores, and running times. Changes were presented as a percentage of the patient's average score. RESULTS: Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p = 0.05), patient assessment of treatment effect (p = 0.02), visual analog scale for pain recorded at clinic visits (-26.6%; p = 0.05) and in a diary (-28.6%; p = 0.02), and physical examination score (-43.3%; p = 0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects. CONCLUSIONS: The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting.
[This message has been edited by Bill Glasheen (edited 07-26-99).]
Here are two review articles on glucosamine/chondroitin, and one clinical trial on glucosamine/chondroitin/manganese.
By the way, I selected the review articles because the papers on individual trials were too numerous to list. I got over 700 articles when I asked for Glucosamine and Chondroitin
**********************
REVIEW ARTICLE
Rheum Dis Clin North Am 1999 May;25(2):379-95
Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate.
Deal CL, Moskowitz RW
Division of Rheumatology, Case Western Reserve University School of Medicine, University Hospitals, Cleveland, Ohio, USA.
There are a sufficient number of short-term studies with these agents suggesting efficacy equal to that seen in the symptomatic treatment of OA using NSAIDs. Two recent meta-analyses by McAlindon and colleagues and Towheed et al reviewed clinical trials of glucosamine and chondroitin in the treatment of osteoarthritis. The study by McAlindon and co-workers included all double-blind placebo-controlled trials of greater than 4 weeks' duration, testing oral or parenteral glucosamine or chondroitin for treatment of hip or knee osteoarthritis. Thirteen trials (six with glucosamine, seven with chondroitin) met eligibility criteria. The authors used global pain score or the Lequesne index in the index joint as the primary outcome measure and considered the trial positive if improvement in the treatment group was equal to or greater than 25% compared with the placebo group, and was significant (P < or = .05). All 13 studies reviewed were classified as positive, demonstrating large effects, compared with placebo (39.5% [S.D. 21.9] for glucosamine, 40.2% [S.D. 6.4] for chondroitin). The authors concluded that clinical trials of these two agents showed substantial benefit in the treatment of osteoarthritis but provided insufficient information about study design and conduct to allow definitive evaluation. Towheed and colleagues reviewed nine randomized, controlled trials of glucosamine sulfate in osteoarthritis. In seven of the randomized controlled trials, in which they compared glucosamine with placebo, glucosamine was always superior. In two randomized controlled trials comparing glucosamine to ibuprofen, glucosamine was superior in one and equivalent in one. Methodologic problems, including lack of standardized case definition of osteoarthritis and lack of standardized outcome assessment led the authors to conclude that further studies are needed to determine if route of administration is important and whether the therapeutic effect is site specific. A meta-analysis of chondroitin sulfate trials has also been published. Of the 12 published trials, 4 randomized double-blind placebo or NSAID-controlled trials with 227 patients on chondroitin sulfate were entered into the analysis. All four studies showed chondroitin sulfate to be superior to placebo, with respect to Lequesne index, visual analog scale for pain and medication consumption. Significant changes (P < or = .05) were seen in those treated from day 60 to the study endpoints (150 to 180 days). Pooled data demonstrated at least 50% improvement in the study variables in the chondroitin treated group. Discrepancies in some of the study findings reported in the literature may relate to the composition of the nutritional supplements used. Studies in the United States have revealed that a number of preparations claiming to contain certain doses of glucosamine or chondroitin sulfate have significantly less (or none) of the dosages described. Accordingly, it is essential that studies performed with these agents use preparations that are carefully defined in manufacture. The amounts generally administered are glucosamine, 1500 mg, and chondroitin sulfate, 1200 mg, daily. Although glucosamine has been described as effective when used alone, it is probably reasonable to use the combination pending further studies. The average cost is approximately $30 to $45 per month. In the interim, what should physicians tell their patients when they ask whether these agents are effective, or whether they should or should not take them? The authors emphasize that these agents are not FDA-evaluated or recommended for the treatment of OA. They are available as health food supplements, and the number of studies of toxicity, particularly with respect to long-term evaluations, is limited. The pros and cons of these agents and the published data are described so that patients can make a reasonably informed decision as to whether they wish to proceed with use of these agents in therapy.
******************************
REVIEW ARTICLE
Altern Med Rev 1998 Feb;3(1):27-39
The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease.
Kelly GS
Successful treatment of osteoarthritis must effectively control pain, and should slow down or reverse progression of the disease. Biochemical and pharmacological data combined with animal and human studies demonstrate glucosamine sulfate is capable of satisfying these criteria. Glucosamine sulfate's primary biological role in halting or reversing joint degeneration appears to be directly due to its ability to act as an essential substrate for, and to stimulate the biosynthesis of, the glycosaminoglycans and the hyaluronic acid backbone needed for the formation of proteoglycans found in the structural matrix of joints. Chondroitin sulfates, whether they are absorbed intact or broken into their constituent components, similarly provide additional substrates for the formation of a healthy joint matrix. Evidence also supports the oral administration of chondroitin sulfates for joint disease, both as an agent to slowly reduce symptoms and to reduce the need for non-steroidal anti-inflammatory drugs. The combined use of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease has become an extremely popular supplementation protocol in arthritic conditions of the joints. Although glucosamine sulfate and chondroitin sulfates are often administered together, there is no information available to demonstrate the combination produces better results than glucosamine sulfate alone.
*****************************
CLINICAL TRIAL
Mil Med 1999 Feb;164(2):85-91
Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study.
Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD
Medical Department, Naval Special Warfare Group Two, Naval Amphibious Base Little Creek, Norfolk, VA 23521, USA. occdr@aol.com
OBJECTIVE: A 16-week randomized, double-blind, placebo-controlled crossover trial of a combination of glucosamine HCl (1,500 mg/day), chondroitin sulfate (1,200 mg/day), and manganese ascorbate (228 mg/day) in degenerative joint disease (DJD) of the knee or low back was conducted. METHODS: Thirty-four males from the U.S. Navy diving and special warfare community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores, and running times. Changes were presented as a percentage of the patient's average score. RESULTS: Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p = 0.05), patient assessment of treatment effect (p = 0.02), visual analog scale for pain recorded at clinic visits (-26.6%; p = 0.05) and in a diary (-28.6%; p = 0.02), and physical examination score (-43.3%; p = 0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects. CONCLUSIONS: The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting.
[This message has been edited by Bill Glasheen (edited 07-26-99).]
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Healthy Joints
J.D.
Hey, unlike what you may be accustomed to, some scientists are cute!
Sexism aside...
Van
I think I have the answers about manganese and sea cucumber. I found one reference (in German) that suggests that manganese levels in the blood are down in rheumatoid arthritis. Remember, all the supplements to-date only claim to be useful in osteoarthritis. From what I can tell, that article I listed is the only clinical trial available using manganese, and it doesn't isolate the effect of it alone.
As for the sea cucumber, well it appears that it is a "natural" source of many of the compounds (like chondroitin, glucosamine) and subsequent products that the body makes from them. I can't find any references in the scientific literature, though, that suggest this particular source is more beneficial than the man-made variety. So...just a little foo foo in the witch's brew.
Hope that helps.
- Bill
Hey, unlike what you may be accustomed to, some scientists are cute!
Sexism aside...
Van
I think I have the answers about manganese and sea cucumber. I found one reference (in German) that suggests that manganese levels in the blood are down in rheumatoid arthritis. Remember, all the supplements to-date only claim to be useful in osteoarthritis. From what I can tell, that article I listed is the only clinical trial available using manganese, and it doesn't isolate the effect of it alone.
As for the sea cucumber, well it appears that it is a "natural" source of many of the compounds (like chondroitin, glucosamine) and subsequent products that the body makes from them. I can't find any references in the scientific literature, though, that suggest this particular source is more beneficial than the man-made variety. So...just a little foo foo in the witch's brew.
Hope that helps.
- Bill
