In the past most doctors believed, "You can't cure
osteoarthritis!" So they didn't even try. Even now, the best many MDs
offer are: a powerful steroid, a nonsteroidal anti-inflammatory drug (NSAID), or a
pain-killer. There are dozens of these drugs, with names like prednisone, aspirin,
Motrin�, Advil�, Aleve�, Tylenol�, and codeine. These drugs may help reduce pain, but
they don't do a thing to cure arthritis. And they may even harm you.
To assert that osteoarthritis can be cured is to invite scorn, ridicule, and perhaps
even "excommunication" from the "Church" of Conventional Medicine.
After all, osteoarthritis is like tires wearing out. It's just a matter of time before
tires go bald, and you have to replace them or stop driving the car. If only you could get
the rubber to regenerate itself as you drive! Then, you'd never have to replace your
tires.
We can't replace the cartilaginous "tires" that line joints like the knee,
hip, wrists, and fingers, but we can help regenerate the cartilage. In osteoarthritis, it
is this slick, shiny, rubbery cartilage that starts showing its age by softening,
cracking, and corroding. Sooner or later, this happens to all of us. It's what medical
people like to call a "normal" part of aging, something we all just have to live
with.
There are dozens of drugs to help reduce the pain, but they
don't do a thing to cure arthritis. And they may even harm you.
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The result of this wearing-out process is painful and inflamed joints.
Sometimes, it's just a minor annoyance - a little morning stiffness or pain in the knees
when we climb stairs or get up from a chair. But as the cartilage wears thin, the pain can
become completely debilitating. Until recently, osteoarthritis has been considered to be
incurable, except by surgically replacing the painful joint with a high-tech prosthesis
once the pain becomes unbearable. Not all joints in the body are replaceable, however, and
for non-replaceable joints there has been no solution.
Glucosamine Nourishes and Rebuilds Cartilage Many doctors
in Europe are not so sure as Americans are that osteoarthritis can't be cured. For nearly
two decades, they have been treating people who have crippling osteoarthritis with
glucosamine and finding remarkable ... yes, that word ... cures.
...When researchers actually examined the cartilage of
glucosamine-treated patients who had recovered significant joint function, they found that
their previously-damaged cartilage had actually regenerated, producing a near-replica of
normal, healthy cartilage
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Cures: there's no other way to describe the phenomenon. Pain goes away,
and free movement returns. But even more significantly, when researchers actually examined
the cartilage of glucosamine-treated patients who had recovered significant joint
function, they found that their previously-damaged cartilage had actually regenerated,
producing a near-replica of normal, healthy cartilage.1
One of the few American physicians who has not ignored the use of glucosamine is Jason
Theodosakis, MD, who specializes in exercise physiology and sports medicine in Arizona. He
has recently "gone public" with his endorsement of glucosamine (plus
chondroitin). He even had the nerve to put the heretical word "cure" in the
title of his book, The Arthritis Cure. 2 Although he has been vilified and
called "irresponsible" or worse by leaders of the Church of Conventional
Medicine, the general public has responded with considerably more enthusiasm.
Disappointed, frustrated, and angry at what little hope their regular doctors are willing
to offer them, the general public has quickly launched Theodosakis's book to the top of
the bestseller lists.
Clinical Proof A number of well-controlled clinical
trials conducted in Europe and Asia over the last two decades attest to the benefits of
glucosamine in osteoarthritis. In a 1980 double-blind, placebo-controlled study from
Italy, 1 for example, 80 people, who had suffered through years of severe,
increasingly debilitating osteoarthrosis, took daily doses of either 1.5 grams of
glucosamine sulfate or an identical-looking placebo.
After only 30 days, the people taking glucosamine had significantly fewer symptoms
overall than those taking the placebo (73% vs. 41%), and they reduced their symptoms by
half significantly faster (20 days vs. 36 days); 20% of the glucosamine-treated group
reported no more symptoms, compared with none of the placebo group. Similar results have
been reported by other researchers in Italy, 3 the Philippines, 4
and Thailand. 5
Several other studies are worthy of note because they expose new dimensions of
glucosamine's value. In one large multicenter study from Portugal, 252 doctors treated a
total of 1,208 osteoarthritis patients with glucosamine (1.5 g/day) for up to 64 days
(mean, 50 days). The results were quite impressive, even without a placebo control. The
investigators reported a "good" or "sufficient" response in 95% of the
patients, an effect that persisted 6 to 12 weeks after patients stopped taking
glucosamine. This result makes sense only if the subjects were building new cartilage.
Only 14% of patients reported any adverse effects (compare that with any NSAID or
painkiller), and most of those were minor. 6
The other Portuguese study was a head-to-head comparison of glucosamine and ibuprofen
(Motrin,� Advil,� et al) in people with osteoarthritis of the knee. Such direct
comparisons are rare events, because pharmaceutical companies, who sponsor most of the
large, well-controlled drug trials in this country, are afraid their expensive, high-tech
drugs might come out looking second-best compared with the other substance. In this case,
such fears would have been well-founded.
The double-blind study was designed so that 40 people with osteoarthritis took either
glucosamine 1.5 g or ibuprofen 1.2 g (about six over-the-counter pills) each day for eight
weeks. During the first two weeks, ibuprofen patients seemed to have less pain, but soon
after, the situation reversed. Those taking glucosamine continued to improve throughout
the study, so that after eight weeks their average pain score (on a 0-3, low-high scale)
was 0.8, compared with 2.2 for the ibuprofen group. 7 Similar results were
found in another head-to-head study conducted by an international team of researchers from
Italy and Germany. 8
How Does Glucosamine Work? Glucosamine, which is composed
of glucose and the amino acid glutamine, is a natural dietary substance that the body uses
to help keep cartilage smooth, moist, and flexible. It is a primary ingredient in two
other substances called proteoglycans and glycosaminoglycans (GAGs), which fill
cartilage's collagen matrix, attracting and binding water molecules that lubricate and
nourish the cartilage. Glucosamine also stimulates cells called chondrocytes, which help
produce proteoglycans and GAGs.
Studies have shown that glucosamine is the key factor in determining the amount of
proteoglycans that chondrocytes churn out. Increase the amount of glucosamine available
and you increase the amount of proteoglycans they can make. And, as noted above, cartilage
needs lots of proteoglycans to stay healthy and well-lubricated. 8 Other
studies have shown that glucosamine contributes to the production of collagen and helps
normalize cartilage metabolism. This can keep your "tires" from wearing out,
even when you put a lot of mileage on them.
If we can keep cartilage healthy- or even repair damaged
cartilage- by a program that includes sufficient glucosamine, and other nutrients combined
with sensible exercies, then we are, in essence, "curing" osteoarthritis
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At the same time, evidence indicates that these glucosamine-dependent
processes can also help repair damaged cartilage. 3 The way many doctors
"treat" osteoarthritis makes you forget that cartilage is not like rubber. It is
not true that cartilage is a static tissue, and once it wears out, it's finished. In fact,
there are very few tissues in the body that are not constantly renewing themselves when
they wear down or are damaged. Even bone heals quite well after a fracture, provided the
proper building materials are available. So it is for cartilage. While we're young,
glucosamine produced by the body and supplied by dietary sources helps keep cartilage
healthy. But, as we age, our cartilage repair mechanisms begin losing their efficiency.
The reasons are complex, having to do with hormonal imbalances, less-than-ideal nutrition,
free-radical-induced damage, and other factors, some of which are unknown. Nevertheless,
to the degree that we can keep these repair mechanisms running close to their youthful
efficiency, we can prevent, or even repair, damage that was once thought to be incurable.
Can Osteoarthritis Really Be Cured? It's common to think
of a "cure" in terms of infection. Take an antibiotic, kill the
"bugs," and you're cured. In fact, few diseases are curable by this standard,
especially those associated with aging, such as cardiovascular diseases, cancer, diabetes,
and of course, osteoarthritis. With diseases like these, the definition of a
"cure" is more ambiguous. Physicians often consider cancer "cured,"
for example, if the patient is cancer-free for a rather arbitrary period of time - say,
five years-that is based on clinical experience and statistics. A cancer cure may not mean
you can be certain the cancer is completely gone and can't ever come back; it's just very
unlikely to.
Similarly with heart disease: no conventional surgical or pharmaceutical treatment used
today even comes close to a cure. All are merely palliative, temporarily removing arterial
obstructions or artificially normalizing heart rhythm, lipid levels, or blood pressure.
The only thing that approaches a "cure" for heart disease today is a long-term
nutritional and exercise program that emphasizes high-quality fats combined with
antioxidant supplements and EDTA-based chelation to keep arteries clear of plaque. Fall
off this wagon, though, and your heart disease is almost certain to come back. You're
"cured" only as long as the body continues getting what it needs to keep you
healthy.
It's no different with osteoarthritis. If we can keep cartilage healthy - or even
repair damaged cartilage - by a program that includes sufficient glucosamine and other
nutrients combined with sensible exercise, then we are, in essence, "curing"
osteoarthritis. All joints move normally and painlessly, just as long as we supply them
with what they need to keep on making and maintaining cartilage. Of course, with severely
damaged joints, where cartilage is too far gone, it may be too late even for glucosamine.
The Promise of Glucosamine That is the promise of
glucosamine. By now, enough studies have demonstrated its benefits, proven its safety, and
hinted at its unique mechanism of action, to demand that American doctors take it
seriously. It's about time they give up their outmoded belief that the only way to treat
osteoarthritis is to deaden the pain and reduce the inflammation. If experience is any
model, though, it seems highly unlikely we'll be seeing the expensive, large-scale,
double-blind, placebo-controlled, American studies on glucosamine that most doctors - and
the FDA - think they need before they'll believe in any treatment.
Perhaps someone will start one of these studies in the next 10 or 20 years, and in
another 20 or 30 years, we'll have the results. But, by then, I'll be in my 80s or 90s,
and much of the tread will have worn off my "tires," if I don't do something
now. I can't afford to wait for the day when a green light might go on in Washington, and
doctors could then feel comfortable enough to take a crack at rebuilding cartilage and
curing osteoarthritis, instead of just postponing the "inevitable" with
dangerous drugs that, in the long run, may do more harm than good.
References
1. Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral
glucosamine sulphate in osteoarthrosis: A placebo-controlled double-blind investigation.
Clin Therapeutics. 1980;3:260-272.
2. Theodosakis J, Adderly B, Fox B. The Arthritis Cure. New York: St. Martin's Press;
1997.
3. Crolle G, D'Este E. Glucosamine sulphate for the management of arthrosis: A
controlled clinical investigation. Cur Med Res Opin. 1980;7:104-109. 4. Pujalte JM,
Llavore EP, Ylescupidez FR. Double-blind clinical evaluation of oral glucosamine sulphate
in the basic treatment of osteoarthrosis. Curr Med Res Opin. 1980;7:110-114.
5. Vajaradul Y. Double-blind clinical evaluation of intra-articular glucosamine in
outpatients with gonarthrosis. Clin Ther. 1981;3:336-343.
6. Tapadinhas MJ, Rivera JC, Bignamini AA. Oral glucosamine sulphate in the management
of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica.
1982;3:157-168.
7. Vaz AL. Double-blind clinical evaluation of the relative efficacy of ibuprofen and
glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr
Med Res Opin. 1982;8:145-149.
8. MŸeller-Fa�bender HM, et al. Glucosamine sulfate compared to ibuprofen in
osteoarthritis of the knee. Osteoarthritis and Cartilage. 1994;2:61-69.
