The arthritis patients who reported the most pain relief were more likely to have taken the combination than glucosamine alone
by Craig Weatherby
When this writer co-authored The Arthritis Bible with Leonid Gordin, M.D., back in 1999, glucosamine and chondroitin sulfate were very new to the U.S market.
At the time, only a few small clinical trials supported their alleged ability to relieve the joint pain of knee or hip osteoarthritis… the common kind caused by aging of cartilage.
Since then, supplements of each of these natural constituents of cartilage have shown benefit in larger trials.
While clinical studies have produce mixed results, the preponderance of evidence suggest these compounds can help alleviate pain, possibly by stimulating re-growth of cartilage, or by as yet unknown means.
As the authors of an evidence review wrote last year from the University of Southern California, “Many studies confirmed OA pain relief with glucosamine and chondroitin sulfate use… these supplements may serve a role as an initial treatment modality for many OA patients” (Vangsness CT Jr et al 2009).
Now, the first trial to test the combination of omega-3 fatty acids—which possess proven, albeit mild, anti-inflammatory properties—and glucosamine shows that these so-called “nutraceuticals” may work better together… at least for people with more severe pain.
Clinical trial is first to test omega-3s and glucosamine together
The new study comes from Berlin, and is the first clinical trial to test the combination of glucosamine and omega-3s in people suffering from osteoarthritis (Gruenwald J et al. 2010).
The aim was to see how a combination of glucosamine sulfate and the two major fish-derived omega-3s (EPA and DHA) would work compared with glucosamine sulfate alone.
It was quite well-designed (randomized, double-blind), and its authors report results suggesting that combining omega-3s with glucosamine could be better than using glucosamine alone.
They divided 177 patients with moderate-to-severe hip or knee osteoarthritis (OA) into two groups:
After 26 weeks, Group A (omega-3s + glucosamine) reported more pain relief, compared with Group B (glucosamine alone).
- Group A took a combination of glucosamine sulfate (1,500 mg per day) and omega-3 fatty acids (200 mg).
- Group B took glucosamine alone (1,500 mg per day).
When minimal pain reduction was the criteria, there was no statistically significant difference in between the two groups.
But when substantial pain was the criteria, the combination of glucosamine sulfate and omega-3s reduced morning stiffness and hip or knee pain significantly more than was reported by people taking glucosamine alone.
The scientists noted the combination probably acted synergistically:
“Omega-3 fatty acids inhibit the inflammation process in osteoarthritis, whereas glucosamine sulfate further supports the rebuilding of lost cartilage substance” (Gruenwald J et al. 2010).
These encouraging results should prompt the conduct of larger controlled trials.
- Black C, Clar C, Henderson R, MacEachern C, McNamee P, Quayyum Z, Royle P, Thomas S. The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation. Health Technol Assess. 2009 Nov;13(52):1-148. Review.
- Gruenwald J, Petzold E, Busch R, Petzold HP, Graubaum HJ. Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis. Adv Ther. 2009 Sep;26(9):858-71. Epub 2009 Sep 4.
- Pavelká K, Gatterová J, Olejarová M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002 Oct 14;162(18):2113-23.
- Vangsness CT Jr, Spiker W, Erickson J. A review of evidence-based medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis. Arthroscopy. 2009 Jan;25(1):86-94. Epub 2008 Sep 30. Review.