Glucosamine chondroitin

Glucosamine chondroitin sulphate is a natural supplement often prescribed for arthritis.

Patients with joint cartilage problems, such as arthritis, have probably heard of the possible benefits of glucosamine and chondroitin sulphate. Glucosamine and chondroitin are supplements that are sold over the counter in pharmacies, grocery stores, and health food stores. The benefit of glucosamine chondroitin is still under debate, and many patients wonder if they should bother taking these expensive supplements. It seems that they may help reduce pain but there is no evidence that they slow the degenerative march of cartilage.

Normal hip joint
Arthritic hip joint

Three sugars

Glucosamine and chondroitin are two molecules that make up the cartilage found within joints. Inside your joints, the cartilage undergoes a constant process of breakdown and repair. However, to be properly repaired and restored, the building blocks of cartilage must be present and available, together with plenty of oxygen and no doubt a myriad of other enzymmes, hormones, amino acids ... The theory behind the use of glucosamine chondroitin supplements is that more of the cartilage building blocks will be available for cartilage repair.

1. Glucosamine

Glucosamine is a sugar found naturally in the bones, bone marrow and cartilage of animals; in our bodies thus too.

Glucosamine structure

Glucosamine is an important precursor in the body for the manufacture of substances called Glycosaminoglycans which link to proteins to form proteoglycans which are a major component of joint cartilage.

Glucosamine + water > Glycosaminoglycans + Amino Acids > Proteoglycans >>> cartilage

The beauty of these substances, due to their polar nature, is their ability to bind water (also polar) which is strongly attracted to them. Water, like all liquids, is incompressible giving cartilage its stiff, yet flexible properties. This makes it the perfect material for example from which to build the discs between vertebrae. So when you jump up and down, the water-filled, incompressible disc prevents the bone above from crushing the one below.

The first sign on MRI that the cartilage is degenerating is loss of this water-carrying capacity. A healthy water-filled disc looks white on a scan. As cartilage degenerates, it loses this whiteness.

Disc degenerating MRI

Notice how it is the degenerated (dark, waterless) discs that have slipped. Maintaining hydrated, water-filled discs is at the heart of Chiropractic. Slipped disc symptoms ...

2. Hyaluronic acid

Hyaluronic acid is a glycosaminoglycan. It is the major component of the synovial fluid that bathes the cartilage, coating each cartilage cell, and swishing about in the joints in your body. It lubricates the joint and binds water to the cartilage molecules, making cartilage on the ends of long bones, for example, incompressible.

Without glycosaminoglycans we would be as stiff as the Empire State building. Stiff! A stiff?!! Immobilisation arthritis starts within a joint being fixated - locked... preventing the free flow of hyaluronic acid within the synovial fluid.

Google appears to frown on too many links, so phrases in bold, like that immobilisation arthritis above, need to be put into the Site Search function in the navigation bar on your left if you want more information.

Synovial joint

3. Chondroitin sulphate 

Chondroitin sulphate too is a glycosaminoglycan sugar making up a different important component of cartilage, particularly giving it much of its resilience to compression. It is also reputedly reduces the effect of destructive and noxious chemicals on cartilage. An important component thus of Glucosamine Chondroitin.

There are many different types of cartilage in the body, so the mix of these subsances will vary from one to another. For example the cartilage in the joints between the ribs and the breastbone is different to the 'hyaline' cartilage that lines the ends of your long bones (eg in the hip)

Chondroitin sulphate
  • Tietzes syndrome a condition affecting the rib cartilage causing chest pain.
  • Hip arthritis another condition which responds well to chiropractic, except in its very advanced state.

Glucosamine chondroitin research

However, alas, the research concerning the use of glucosamine and chondroitin sulphate remains controversial and debated in scientific circles.

Study one 

OBJECTIVE: To test whether glucosamine has any effect on the symptoms and progressive deterioration of hip arthritis over a two year period.

INTERVENTION: Two years of 1500 mg of glucosamine or a placebo. (patients never knew whether they were taking the real supplement or the placebo.)

CONCLUSION: Glucosamine was no better than the placebo in reducing the pain and stiffness and progressive advance of hip arthritis. There are numerous other similar studies with Chondroitin sulphate[1].

Study two

Research published in Arthritis and Rheumatism on five groups of patients with knee pain, compared the effect of

  1. Glucosamine alone
  2. Chondtroitin alone
  3. A mixture of glucosamine and chondroitin sulphate,
  4. Celebrex, an anti inflammatory medication, and
  5. a placebo 

The thickness of the cartilage in their knees was measured at the start of the study and again two years later.

CONCLUSION: There was no statistically significant difference between the four treatment groups and the placebo group; if anything, the placebo group did better than those taking the combination of glucosamine and chondroitin.

Study three

One thousand six hundred patients were followed in sixteen different studies, using the same five groups used in Study two above. Known as the GAIT research study, the found

  • 60% of the placebo group claimed a 20% or greater reduction in pain. 
  • 70% of the Celebrex group claimed a 20% or greater pain reduction.
  •  Overall, the glucosamine and chondroitin groups, both singly and jointly did no better than the placebo. 

ie. Neither chondroitin, glucosamine, nor celebrex did particularly well.

Mild vs severe knee pain with combined glucosamine and chondroitin:

  •  In the group with moderate / severe pain, 79% of the combined  group claimed a 20% or more reduction in pain.
  • In the mild pain group there was no statistically significant pain relief compared to the placebo group. 

Study four

In a so called meta analysis of all glycosamine chondroitin studies, reported in the Journal of the American Medical Association 2000, it was found that only 15 of 37 studies stood up to scientific standards; of the 15, fourteen were funded by manufacturers of glucosamine chondroitin sulphate, making them suspect.

Study five

On the positive side, research reported in Lancet in 2001 measured the joint space in patients suffering from knee arthritis concluded that glucosamine sulphate did indeed modify the cartilage within knees, and prevent degeneration. It's a strong study which was double blinded, placebo controlled and randomised.

Participants taking glucosamine had less pain and a greater range of motion at the end of the three year study.

Chicken bones broth

Chicken bones broth is for your joints. Whilst the glucosamine chondroitin theories appear neat and plausible, it seems that there are other ingredients in the bones and cartilage of animals that are necessary for the proper uptake of these sugars and to turn them into healthy hyaline. Rather like natural vitamin C is much more effective than synthetic ascorbic acid.

My theory is that, without the gelatine, the amino acids found in bones that the glycosaminoclycans must bind onto to form the proteoglycans, the actually building block in cartilage, these sugars are of little if any benefit.

Thus the gelatine, glucosamine and chondroitin sulphate that you can extract in your own kitchen has proved far more affective in the treatment of arthritis than glucosamine and chondroitin on their own.

So, rather make your own GELATINE powder for arthritis at home. Dead easy, zero cost, makes a delicious soup.

chicken bones

Fish oil health benefits

Fish oil health benefits are controversial and probably not as effective as enjoying whole fatty fish.

Whilst glucosamine chondroitin sulphate supplements remain controversial and expensive, the research on fatty cold-water fish is unequivocal. It helps arthritis and a heap of other diseases. Follow this link on making your own inexpensive gelatine-rich fish bouillon... FISH OIL HEALTH BENEFITS ...

In conclusion

It seems, especially for those suffering from relatively severe osteoarthritis, that glucosamine chondroitin sulphate may have significant pain relieving properties, though it remains doubtful that they inhibit the progression of arthritis.

For mild cases of osteoarthritis the research in the main seems to suggest little known benefit.

Another negative is that glucosamine is made from shark fins, and we know that population is being seriously depleted.

In contrast, both chicken bones and the fleshy skeleton and head of salmon are throw away products; the remains after the flesh has been removed.

It certainly does take more effort than swallowing pills from a bottle, but the cost, the effectiveness and the great taste all suggest to me that the bouillon prepared from chicken bones and fish and made in your own kitchen makes good sense.

Both chicken bones and fish bouillon and glucosamine chondroitin sulphate have one enormous plus. They keep people off anti inflammatory drugs.

Google appears to frown on too many links, so phrases in bold, like that dual antiinflammatory drugs above, and lemon drop drink recipe below, need to be put into the Site Search function in the navigation bar on your left if you want more information.

Lemon juice

Lemon juice, despite its citric and several other acids, is said to have an overall alkalysing effect (though I can find no confirmation in any scientific text). In any case, it's full of vitamins and minerals, and anti-cancer bioflavanoids and carotene. And it's nice! Lemon drop drink recipe ...


  1. Chiropractic Help
  2. Early Symptoms of Arthritis
  3. Glucosamine chondroitin

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti-inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He is doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost pain-free. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily stroll has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift; he has a short leg.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

Do you have a problem that is not getting better?

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Interesting questions from visitors

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Greetings, Dr B.

You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70 percent of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there is a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong. Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what a DC does.

The quickest and most interesting way is to read one of my eBooks of anecdotes. Described by a reader as gems, both funny and healthful from the life and work of a chiropractor, you will love them. Priced right at $2.99, though Kindle fiddles the amount without telling me.