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Smart Basics May 1996 IntelliScope

A Potent Nutraceutical For Joint Tissue Support



Osteoarthritis currently affects more than 16 million people in the United States, damaging joints in the hands, feet, spine, hips and knees, and causing extreme pain and loss of mobility. Osteoarthritis is caused by the inflammation, breakdown and eventual loss of a layer of protein called articular cartilage. This cartilage layer covers the ends of the bones in a joint, acting like a shock absorber or cushion to keep bones from rubbing against each other as joints bend and flex.

With normal aging, the water content of the cartilage increases and the protein makeup of cartilage degenerates. Repetitive use of the joints over the years irritates and inflames the cartilage, causing mild to severe joint pain and swelling. Eventually the cartilage begins to degenerate by forming flakes and tiny crevasses. In advanced cases there is a total loss of this cushion, leaving the ends of the bones stripped bare of their protective cushion. At this point the bones rub together, causing further damage to the joint and leading to severe pain and the growth of bone spurs.

Conventional Medicine Lacks Cure For Primary Osteoarthritis

Conventional medicine offers little in the way of effective treatment to halt the degeneration of cartilage or to repair the damage caused by osteoarthritis. Indeed, the primary goal of contemporary medical treatment of osteoarthritis aims to reduce joint pain and inflammation through the use of pain relievers.

The first drug of choice for this treatment is common aspirin, which is inexpensive and quite effective in relieving both pain and inflammation. Unfortunately, the required therapeutic dose is relatively high (two to four grams per day) and toxicity often occurs, evidenced by tinnitus (ringing in the ears) and gastric irritation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently employed as alternatives to aspirin. Unfortunately these alternatives (ibuprofen, fenoprofen, idomethacin, sulindac, nabumetone, and naproxen) also possess strong side effects, including gastrointestinal upset and cramping, diarrhea, headaches and dizziness, and therefore can only be used for short periods of time.

NSAIDs Accelerate Cartilage Erosion

A more disturbing and little known side-effect of NSAIDs is that while they do offer temporary relief from the symptoms of osteoarthritis, they actively inhibit the synthesis of collagen matrix, the body's main cartilage repair mechanism. By inhibiting this natural regenerative process, NSAIDs actually accelerate the destruction of cartilage. This has been proven in studies showing that the use of NSAIDs is associated with acceleration of osteoarthritis and increased joint destruction.

Glucosamine Sulfate: Powerful Healing Effect

If current arthritis medications simply mask symptoms of osteoarthritis and contribute to accelerated destruction of joint tissues, what is an arthritis sufferer to do? As is often the case, nature seems to have provided the answer in the form of Glucosamine, a naturally occurring amino sugar found in high concentrations in joint structures. Glucosamine has been found to be selectively used by joint tissues to exert a powerful healing effect on arthritic symptoms while providing protective effects against further joint destruction.

Research has shown that glucosamine, taken orally in the form of Glucosamine Sulfate, is selectively taken up by joint tissues to exert a powerful therapeutic effect in osteoarthritis. Glucosamine is a natural compound normally formed in the human body from glucose. Glucosamine is required by the body for the synthesis of an important family of macromolecules called glycosaminoglycans (GAGs). These long chains of modified sugars (mucopolysaccharides) make up many body tissues, including tendons, ligaments, cartilage, synovial fluid, mucus membranes in the digestive and respiratory tracts, and structures in the eyes, blood vessels, and heart valves.

Researchers have found that glucosamine is the key precursor for all the various sugars found in GAGs, and further, that glucosamine occupies the pivotal position in connective tissue synthesis, acting to stimulate collagen production, and connective tissue.

As humans age the amount of glucosamine normally synthesized by the body declines, leading to a deficiency in the production of these important biological chemicals that form the major cushioning ingredients of the joint fluids and surrounding tissues. This further leads to specific tissue weakness as tissues in the joints become damaged and the lubricating synovial fluids in the joint spaces become thin and watery. The normal cushioning is lost leaving the bones and the cartilage to scrape against each other inside the joint space.

These problems also occur in the spinal column where the individual vertebrae are stacked on top of each other, separated only by the cushioning disc. The space between the vertebrae is where many nerves leave the spinal cord. Any injury to this part of the back can cause the gelatinous cartilage to soften, putting pressure on the nerves, causing damage and loss of nerve function. Glucosamine Sulfate has been shown to help increase the thickness of the gelatinous material, creating more support for the joints and vertebrae.

Glucosamine Sulfate vs. NSAIDs

Numerous double-blind studies have shown glucosamine sulfate to yield as good or even better results than NSAIDs in relieving the pain and inflammation of osteoarthritis. While improvements with Glucosamine Sulfate occur more slowly than with over-the-counter arthritis medications, eventually Glucosamine surpasses NSAIDs in terms of overall effectiveness.

Examples of this are to be found in clinical studies comparing the pain relieving effects of Glucosamine Sulfate and Ibuprofen. In one study, 30 patients with osteoarthritis were divided into two groups. Half of the patients (the control group) took a traditional arthritic drug formula while the other half received Glucosamine Sulfate. Both groups showed improvements in pain control in the early stages of the study, but the Glucosamine Sulfate group showed significantly greater improvement in their condition after the first several weeks. By the end of the study the total symptom score of the Glucosamine Sulfate group had improved dramatically, while the patients in the control group using the arthritis formula had reverted back to pretreatment levels.

Another study involved 20 patients suffering from osteoarthritis of the knee who were treated with either Glucosamine Sulfate or a placebo for eight weeks. The Glucosamine Sulfate group showed increased positive results, compared to the placebo group in the following areas: relieving pain, joint tenderness and swelling. The results of the Glucosamine Sulfate group were consistently higher in all 10 patients, whereas the placebo group showed some change in the beginning, but very little change over the entire length of the study.

In a third study, a group taking Ibuprofen reported greater pain control than the Glucosamine Sulfate group in the first two weeks of the study. However, by the fourth week of the study pain control scores in the group receiving the Glucosamine Sulfate showed they were doing significantly better than the Ibuprofen group.

In other clinical studies, Glucosamine Sulfate, given daily in oral dosages of 750 to 1,000 mg actually started to reverse degenerative osteoarthritis of the knee after two months. Normalization of cartilage health was documented by biopsies with electron microscopy.

Glucosamine Sulfate: Conclusions

Osteoarthritis is a classic example of how contemporary medical treatments suppress the symptoms of a condition without addressing the underlying causes, and in so doing actually promote the disease process. The emergence of Glucosamine Sulfate, on the other hand, is an excellent example of how a natural substance can improve a condition by addressing the underlying causes to support the body's natural ability to heal itself.

Glucosamine Sulfate is a stable, tasteless and water soluble nutrient that is virtually free of side effects with no known contraindications for its use. It is readily absorbed from the intestines and remains in the blood for several hours.

Glucosamine Sulfate is not an analgesic or an anti-inflammatory agent, but a newly available natural nutrient that provides a key precursor and regulator of connective tissue synthesis, providing the body with an important raw material that appears to halt the disease process itself. In the body, the main action of glucosamine on joints is to stimulate the manufacture of substances necessary for joint repair. Glucosamine has also been shown to exert a protective effect against joint destruction and, when taken orally as glucosamine sulfate, is selectively taken up by joint tissues to exert a powerful therapeutic effect in osteoarthritis.

REFERENCES
1. Kaufman, W. The use of vitamin therapy to reverse certain concomitants of aging. J. Am. Geriatr Soc 1955;11:927-936.
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3. O'Ambrosia, E. et al. Glucosamine sulfate: a controlled clinical investigation in arthritis. Pharmatherapeutica 1991; 2:504-508.
4. Pujalta, J.M. et al. Double-blind clinical evaluation of oral glucosamine sulfate in the basic treatment of osteoarthritis. Curr. Med. Res. Opin. 1980.7:110-114.
5. Ronnigen, H and Langeland, N. Indomethacin treatment in osteoarthritis of the hip joint. Acta. Orthop. Scan., 50:169-174,1979.
6. Setnikar, I., Pacini, A. and Revel, L. Artiarthritic effects of glucosamine sulfate studies in animal models. Arzneim-Forsch, 41:542-5,1991.
7. Vaz, A.L. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulfate in the management of osteoarthritis of the knee in out-patients. Curr. Med. Res. Opin., 8:145-9,1982.
8. Crolle, G and D'este, E. Glucosamine sulfate for the management of arthrosis: a controlled clinical investigation. Curr. Med. Res. Opin., 7:104-14,1980.
9. Tapadinhas, M.J., Rivera, I.C. and Bignarnini, A.A. Oral glucosamine sulfate in the management of athrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica, 3:157-68,1982.
10. D Arnbrosia, E.D., Casa, B., Bompani, R., Scali, G. and Scali, M. Glucosamine sulfate: a controlled clinical investigation in arthrosis. Pharmatherapeutica, 2:504-8, 1982.

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