Dietary Supplements
Several dietary supplements have been touted as beneficial for arthritis. Glucosamine-chondroitin (sold in combination or separately), MSM (methylsulfonylmethane), and SAM-e (S-adenosylmethionine) are the most widely known supplements for arthritis. As with any treatment decision you make, you should discuss taking supplements with your doctor. There are many questions associated with dietary supplements for arthritis. Because they are sold over-the-counter, most consumers assume supplements are safe. In reality, they are considered safe for most people, but may be contraindicated in some situations.
Fact
With the exception of vitamin E, taking “natural” vitamins and minerals is no more effective than taking synthetic vitamins and minerals, since natural and synthetic vitamins have equal potency. Synthetic forms of folic acid and vitamin B12 are actually absorbed better than the natural forms.
Glucosamine/Chondroitin
Glucosamine and chondroitin sulfate are both found in normal cartilage. Glucosamine and chondroitin are thought to stimulate the formation of cartilage and play a role in joint repair, but studies have not confirmed their efficacy. Some studies have shown benefit for osteoarthritis pain. Other clinical studies, including the Glucos-amine/Chondroitin Arthritis Intervention Trial (GAIT trial), did not conclude that the supplements were effective for osteoarthritis. The supplements are considered safe, though no long-term studies yet exist which confirm long-term safety and effectiveness. Many doctors recommend a trial of glucosamine/chondroitin to osteoarthritis patients for a period of about three months (considered a reasonable time to notice benefit). Patients who are going to try glucosamine/chondroitin are advised to stick with a well-known, reputable manufacturer to assure product integrity.
Alert
Patients with diabetes should be aware that glucosamine can raise blood-sugar levels. The supplements may also have a blood-thinning effect that may be of concern to patients already taking blood thinners. Glucosamine supplements are derived from shellfish.
MSM (Methylsulfonylmethane)
MSM is a naturally occurring sulfur compound in fresh fruits and vegetables, milk, grains, and fish. Though it is found in foods, as the foods are processed, MSM is destroyed. MSM is also sold as an over-the-counter dietary supplement. It is sold as a solution, tablets, or capsules, and is sometimes sold in combination with glucosamine, chondroitin, or vitamin C. MSM is also sold as a topical cream.
In animal studies involving mice, MSM relieved symptoms similar to rheumatoid arthritis and lupus nephritis. To date, there are two human double-blind, placebo-controlled clinical trials that have indicated MSM is effective for osteoarthritis. The Arthritis Foundation recommends starting with 500 mg twice a day of MSM and increasing gradually to 1,000 mg twice daily, according to the
