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Joint Health 
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Nutritional Support For Healthy Joints:

Connective tissues such as joints are composed of two main components: collagen and proteoglycans.  Glucosamine sulfate is a building block for glycosaminoglycans, which are the building blocks for the larger proteoglycans. Joint space loss as we age is known to be caused by a loss of proteoglycans, secondary to chronic inflammation and inappropriate joint loading. Consequently, supplemental glucosamine sulfate and chondroitin sulfate have been popular for years for the purpose of reducing pain and preserving joint space. Indeed, glucosamine/ chondroitin have been shown to have anti-inflammatory and joint protective effects (1,2).

The best evidence for glucosamine/chondroitin supplementation is for osteoarthritis of the knee, while clinical experience suggests that is is beneficial for other joints as well.  Regarding expectations of positive outcomes, the best evidence suggests that glucosamine/chondroitin is most effective for knee pain when the patient's Body Mass Index is below 28 (3).

In a three-year, double-blind, placebo-controlled study, 212 patients suffering from knee osteoarthritis were randomly selected to receive 1,500 mg, once a day, of oral glucosamine sulfate or a placebo.  Outcome assessments included joint space changes and pain reduction.  Patients who recieved placebo experienced progressive joint space narrowing, representing further loss of cartilage, but patients who received glucosamine sulfate showed no further joint space narrowing.  Additionally, pain and function limitation worsened with placebo, but improved with original glucosamine sulfate.  The study also showed that glucosamine sulfate is a safe compound (2).

1. Iovu M, Dumais G, du Souich P. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis Cart. 2008; 16(supp 3): S14-S18.

2. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001; 357:251-56.

3. Bennett AN, Crossly KM, Brukner PD, Hinman RS. Predictors of symptomatic response to glucosamine in knee osteoarthritis: an exploratory study. Br J Sports Med. 2007;41:415-419.

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