3524: Should I Supplement with Glucosamine and Chondroitin for Joint Pain and Inflammation on Nutrition Advice

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[00:01:30] It's another Q&A edition of Optimal Health Daily and I'm Dr. Neal Malik, your host of the show. Hey there, happy Friday and welcome to another Q&A edition of Optimal Health Daily where I answer your health questions related to fitness, diet and nutrition and lots more. You send me the questions and I answer them for you. It's one of my favorite times of the week so I thank you in advance for sending me your questions. In case you're new here or wondering why should I bother, does this guy really know what he's talking about?

[00:01:57] Well I do have my doctor of public health degree with an emphasis in chronic disease prevention and nutrition. I also have my master of public health degree with an emphasis in health promotion and health education. I'm a registered dietitian nutritionist, a certified health education specialist and a certified exercise physiologist through the American College of Sports Medicine. Now I'll let you know how you can send in your own question at the end of the show. But for now I'm sure you're eager to hear today's question so let's get right to it and start optimizing your life.

[00:02:30] Hi, due to an injury several years ago I have hallux rigidus, I believe that's what it's called, in my big toe. And I was just curious if taking glucosamine or any of those other supplements really has any impact on pain. And I am in pain quite a bit. I'm a runner and a tennis player. And I do have inserts that my doctor made for me that I'm supposed to be putting in my shoes, which I do.

[00:02:57] But the joint itself is just super inflamed, particularly after the end of a long run. So I was just curious if any of these over-the-counter options actually work to reduce inflammation. Thank you. Thank you for your question, Kathleen. Joint pain, unfortunately, is something most of us can expect to experience at some point in our lives, particularly as we get older. And this is without being diagnosed with rheumatoid arthritis or osteoarthritis.

[00:03:24] This is because, much like the rest of our bodies, our joints deteriorate with use over time. There are some situations where joint deterioration occurs more rapidly. Again, this may be due to an underlying health condition like rheumatoid or osteoarthritis. Or sometimes even being overweight or obese can do it. In these cases, deterioration of the joints and the associated pain that comes with it is due to inflammation in the body.

[00:03:51] So is it possible that glucosamine and chondroitin supplements can relieve that pain or slow the onset of joint damage? I'm so glad you asked. I'll first talk about what glucosamine and chondroitin actually are. Glucosamine is a compound that contains both sugar, that's where the glucose in glucosamine comes from, and it contains a protein, that's the amine in glucosamine, where amine is short for amino acid.

[00:04:22] Glucosamine is found naturally in the bodies of most animals. In humans, we find it specifically in the cartilage, which is the tissue surrounding our joints. Now because glucosamine is found in so many animals, we actually find that glucosamine supplements specifically are made from the shells of shrimp or crab. But there are varieties that are made in a lab too. In fact, there's now a version made from corn. Now chondroitin is a large sugar molecule that's often found attached to proteins,

[00:04:51] and it's also found in most animals. In humans, chondroitin is found in connective tissue, similar to where we'd find glucosamine. Chondroitin supplements are usually found in the form of chondroitin sulfate, and are often made from cow, pig, chicken, or shark cartilage. At this point, you may be wondering if you can get glucosamine and chondroitin from your diet, since they're both found in the connective tissues of animals. The answer would be yes, absolutely.

[00:05:18] Anytime you eat the gristle found in meat, or some of the connective tissue, you're getting a dose of glucosamine and chondroitin. The problem is, the dosage is very, very small. The amounts found naturally in foods is much lower than what you would get with a supplement. So that's why most doctors and nutritionists wouldn't tell you to just get more glucosamine and chondroitin in your diet. They would actually advise you to take a supplement.

[00:05:44] Speaking of which, why might a healthcare provider recommend you take a glucosamine or chondroitin supplement? Do they actually help? Well, it's believed that glucosamine specifically helps to repair damaged connective tissues like cartilage. Chondroitin's claim to fame is that it first helps promote water retention, which helps cushion the joints, and second, may help prevent cartilage breakdown. So, is supplementing with glucosamine and chondroitin safe and effective? Most researchers study glucosamine and chondroitin together,

[00:06:13] and it looks like when they are taken together, they may provide some pain relief after consistent use. Usually the pain relief though isn't earth shattering. Most researchers found that the pain relief was moderate. And folks don't usually experience this moderate pain relief for a few months. And unfortunately, chondroitin and glucosamine don't seem to relieve back or hip pain. Most study participants found some relief in knee pain only.

[00:06:41] So how much would you need to take to actually start feeling its effects? As with many supplement studies, the data aren't super clear. Some study participants experience improvement, whereas others don't experience any at all. As far as glucosamine is concerned, the consensus seems to be that 1200 mg per day in the form of glucosamine sulfate or glucosamine hydrochloride is the sweet spot.

[00:07:07] Combining that with anywhere from 800 to 1500 mg of chondroitin each day may provide some modest pain relief. And again, since most studies looked at glucosamine and chondroitin supplements taken together, we don't know whether glucosamine alone or chondroitin alone would lead to any pain relief. Now, while these supplements may help ease some of the pain, they may not actually repair joint damage that has already occurred. They also don't seem to help reduce inflammation either.

[00:07:37] Now, before going out and buying any of these products, it's important to first understand that the quality of supplements available on the market, especially in the US, can vary quite a bit. So, be sure to purchase one that has been tested for purity and quality by consumerlab.com or look for one or both of these symbols on the supplement packaging, NSF or USP. Also, there are some reported side effects when supplementing with glucosamine or chondroitin.

[00:08:06] For example, some folks have found that these supplements mess with their blood sugar levels. And, if you need to avoid shellfish or other animal products for any reason, be sure you purchase supplements that are vegan-friendly. Oh, and if you take a blood thinner like warfarin or painkillers like acetaminophen, which is Tylenol, regularly, you want to be careful taking these supplements. The most commonly reported side effect from taking glucosamine and chondroitin is gastrointestinal upset.

[00:08:35] The most commonly reported form of this was nausea. Now, like I always say, please check with your healthcare provider before taking any supplement. That's because they know your health history way better than I do, and they can help determine whether taking these supplements will do no harm, whether the benefits outweigh the risks. And again, if you and your healthcare provider decide that you should begin taking glucosamine and chondroitin supplements, know that you may not experience any pain relief for several months.

[00:09:03] Now, are there other ways to potentially help manage joint pain and joint damage without these supplements? Yes. First, definitely stay hydrated. Water helps to cushion the joints. Now, there's no need to over-hydrate, but just try to avoid being dehydrated for long periods of time. Also, the American College of Sports Medicine, or ACSM, recommends both cardiovascular and resistance training, but with some modifications to avoid further pain and further joint damage.

[00:09:31] For cardio, they say, work out at your current level of fitness and slowly improve that level of fitness, but avoid any jarring activities that may be hard on the joints, like racquetball, where you're required to quickly stop and change direction. Avoid jumping moves like box jumps and plyometrics. For resistance training, yes, you can actually still do resistance training, but they recommend to not go heavy.

[00:09:59] Aim for a weight that you can lift 10 to 15 times. And when you're doing resistance training, if you were to lift with weights, avoid just hitting one body part each day, like having shoulder day. Instead, perform exercises for all the major muscle groups, so that you're moving from one large muscle group to the next. Shoulders, then chest, then back, then legs, for example. That would all be done in one day. By doing this, it'll help prevent repeated stress injuries.

[00:10:26] Performing exercises in water or receiving hydrotherapy can also help. Now, this next tip is really fascinating and something that most trainers, most health professionals, honestly, don't know. Researchers have found that performing your cardio or resistance training at the same time every day can help minimize muscle soreness, muscle discomfort, and even prevent injury.

[00:10:50] So, if you like to work out at 9 a.m., let's say, try and stick to that 9 a.m. workout as often as you can. Don't work out, for example, on Mondays at 9 a.m., then Tuesdays at 3 p.m., and then Wednesdays at noon, and so on. Instead, make 9 a.m., or whatever time that works for you, your official workout time. By working out at the same time every day, it actually may help ease some of the pain you're experiencing.

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[00:12:18] Need to hire? This is a job for Indeed Sponsored Jobs. Sierra has all the best active and outdoor brands you need. From athletic stuff, like a full-court pickup game, swish, to athletic-ish stuff, like a half-mile stroll. Get those steps in! And for morning hikes up the mountain trail, good pace! It's a nighttime ghost choice from the camping chair. What a twist! Whatever level of active, Sierra loves it all.

[00:12:45] Head to Sierra or Sierra.com for the brands you want at the prices that let you do it all. From athletic to athletic-ish, Sierra's got it! And Kathleen, I wish you speedy healing. And if you want to submit a question, you can email one to health at oldpodcast.com. Or if you want your voice on the show, you can call 61-ILOVE-OHD to leave a voicemail question.

[00:13:11] Another way, if you want to listen back to your question or do retakes, is to submit your audio question at oldpodcast.com. And again, thank you so much in advance for sending in your questions. I love listening to and answering them. Fridays are my favorite day because I get to do just that. Thank you again so much for listening every day. Thank you for listening all the way through. I hope you have a wonderful start to your weekend. And I'll see you back here tomorrow, where your optimal life awaits.