• Chondroitin Sulfate
Chondroitin sulfate is a naturally occurring substance in the body. It is a major constituent of cartilage—the tough, elastic connective tissue found in the joints.
Based on the evidence of preliminary
There is some evidence that chondroitin might go beyond treating symptoms and actually protect joints from damage. Current medical treatments for osteoarthritis, such as
Chondroitin is not an essential nutrient. Animal cartilage is the only dietary source of chondroitin. (When it's on your plate, animal cartilage is called gristle.) Unless you enjoy chewing gristle, you'd do best to obtain chondroitin in pill form from a health food store or pharmacy.
The usual dosage of chondroitin is 400 mg taken 3 times daily, indefinitely. Two studies (mentioned below) used an "on and off" schedule of chondroitin (taking it for 3 months, going off of it for 3 months, and then taking it again). Other studies involved taking chondroitin daily. Regardless of which way you use it, be patient! The results are thought to take weeks to develop.
There are large differences between chondroitin products based on their chemical structure.
Numerous double-blind studies
Chondroitin has also been proposed as a treatment for other conditions, such as
What Is the Scientific Evidence for Chondroitin?
For years, experts stated that oral chondroitin couldn't possibly work because its molecules are so big that it seemed doubtful that they could be absorbed through the digestive tract. However, in 1995, researchers laid this objection to rest when they found evidence that up to 15% of chondroitin is absorbed intact. 19
Reducing Symptoms of Osteoarthritis
Many but not all
For example, one study enrolled 85 people with osteoarthritis of the knee and followed them for 6 months.
Another way of comparing the results is to look at maximum walking speed among participants. Whereas individuals in the chondroitin group were able to improve their walking speed gradually over the course of the trial, walking speed did not improve at all in the placebo group. Additionally, there were improvements in other measures of osteoarthritis, such as pain level, with benefits seen as early as 1 month. This suggests that chondroitin was able to stop the arthritis from gradually getting worse. (See also
In two of these studies, chondroitin was taken for two separate 3-month periods separated by 3 months of no treatment;
Benefits were also seen in two other double-blind, placebo-controlled trials involving a total of more than 350 individuals.
Another double-blind study compared chondroitin to the anti-inflammatory drug diclofenac and found equivalent benefits.
Additional studies combined glucosamine with chondroitin. A 6-month, double-blind, placebo-controlled study of 93 people with knee arthritis found that a combination of glucosamine and chondroitin (along with manganese) was more effective than placebo.
However, a very large (1,583 participants) and well-designed study failed to find either chondroitin or glucosamine plus chondroitin more effective than placebo.
Osteoarthritis tends to worsen with time. As mentioned earlier, no conventional treatment for osteoarthritis protects joints from progressive damage. Some evidence hints that chondroitin can do this, but it is too early to consider the matter settled. 38
One study examined the progression of osteoarthritis in 119 people for 3 years.
Protective effects were also seen in three 1-year studies enrolling a total of more than 200 people.
Animal studies provide some additional evidence for a joint-protecting benefit.
How Does Chondroitin Work for Osteoarthritis?
Scientists are unsure how chondroitin sulfate works (if indeed it does).
At its most basic level, chondroitin may help cartilage by providing it with the building blocks it needs to repair itself. Chondroitin is also believed to block enzymes that break down cartilage in the joints.
Chondroitin generally does not cause much in the way of side effects, besides occasional mild digestive distress. However, there is one case report of an exacerbation of asthma caused by use of a glucosamine-chondroitin product. 26
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8. Adebowale AO, Cox DS, Liang Z, et al. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. J Am Nutraceutical Assoc. 2000;3:37-44.
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14. Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage. 2000;8:343-350.
15. L'Hirondel JL. Double-blind clinical study with oral administration of chondroitin sulphate versus placebo in tibiofemoral gonarthrosis (125 patients) [in German]. Litera Rheumatol. 1992;14:77-84.
16. Morreale P, Manopulo R, Galati M, et al. Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol. 1996;23:1385-1391.
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20. Nguyen P, Mohamed SE, Gardiner D, et al. A randomized double-blind clinical trial of the effect of chondroitin sulfate and glucosamine hydrochloride on temporomandibular joint disorders: a pilot study. Cranio. 2001;19:130-139.
21. Cohen M, Wolfe R, Mai T, et al. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol. 2003;30:523-528.
22. Verbruggen G, Goemaere S, Veys EM. Chondroitin sulfate: S/DMOAD (structure/disease modifying anti-osteoarthritis drug) in the treatment of finger joint OA. Osteoarthritis Cartilage. 1998;6(suppl A):37-38.
23. Uebelhart D, Thonar EJ, Zhang J, et al. Protective effect of exogenous chondroitin 4, 6-sulfate in the acute degradation of articular cartilage in the rabbit. Osteoarthritis Cartilage. 1998;6(suppl A):6-13.
29. Verbruggen G, Goemaere S, Veys EM. Chondroitin sulfate: S/DMOAD (structure/disease modifying anti-osteoarthritis drug) in the treatment of finger joint OA. Osteoarthritis Cartilage. 1998;6(suppl A):37-38.
31. Uebelhart D, Thonar EJ, Zhang J, et al. Protective effect of exogenous chondroitin 4, 6-sulfate in the acute degradation of articular cartilage in the rabbit. Osteoarthritis Cartilage. 1998;6(suppl A):6-13.
32. Uebelhart D, Thonar EJ, Zhang J, et al. Protective effect of exogenous chondroitin 4, 6-sulfate in the acute degradation of articular cartilage in the rabbit. Osteoarthritis Cartilage. 1998;6(suppl A):6-13.
37. Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo. Osteoarthritis Cartilage. 2004;12:269-276.
39. Product review: joint supplements (glucosamine, chondroitin, and MSM). Consumerlab website. Available at: http://www.consumerlabs.com/results/gluco.asp . Accessed May 8, 2006.
41. Braun WA, Flynn MG, Armstrong WJ, et al. The effects of chondroitin sulfate supplementation on indices of muscle damage induced by eccentric arm exercise. J Sports Med Phys Fitness. 2006;45:553-60.
44. Messier SP, Mihalko S, Loeser RF, et al. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthritis Cartilage. 2007 Jun 8. [Epub ahead of print]
Last reviewed April 2009 by EBSCO CAM Review Board
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