Glucosamine and Chondroitin Sulfate

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 antiinflammatory 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.

Is there convincing scientific proof of effectiveness?

	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.

Known 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 reported 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

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

Brand Name

	Cosamin DS (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 (Vitamin C), which enhance their absorption and effects.
	Drugstore.com is a trustworthy on-line source for purchasing this product at a competitive price.

Dosage

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