Jason Determann, MD
No one likes getting older. Period. A healthy and active lifestyle free from pain and chronic disease is on everyone’s wish list. As consumers, we are eager to find that product to help achieve these goals. Thus, an industry of over 400 over-the -counter joint supplements is designed to help you achieve those goals, or so they say.
Osteoarthritis is the painful condition in which the cushioning cartilage between bones wears away. Supplements often promise to not only relieve but restore joint cartilage itself.
Nutrition and Exercise Come First
Before we get to supplements, let me remind you that nutrition and exercise are far more important than supplements. Let’s assume you have those optimized. Read on.
Natural Doesn’t Mean Safe
While most supplements are naturally occurring substances, remember that “natural” does not equal “safe.” Please consult your physician as some of these products can have GI effects, interfere with bleeding, and interact with prescription medications. Also, the FDA classifies these as “food” and not “drugs”, hence a much less regulatory process on what is in the bottle. As everyday consumers, it’s hard to find, much less interpret peer-reviewed articles and evidence to support or deny the effectiveness of a certain supplement.
Common Options and Studies Behind Them
I’ve included a short list of commonly used supplements for joint health. This list is not intended to be all inclusive.
Glucosamine – A structural component of cartilage, glucosamine exist in may forms. Well studied with mixed results. Not harmful and may improve symptoms of joint pain if related to arthritis. Typical doses 1000ml-1500 mg/day, divided into 3 doses. Often combined with the next supplement.
Chondroitin – A naturally occurring substance in our body that also in found in cartilage. Chondroitin comes in many forms, but I would recommend chondroitin sulfate. This version is most studied with some evidence it may reduce joint pain. 800mg-1200mg/day, can be divided.
MSM – Methylsulfonylmethane (MSM) has been touted to alleviate joint pain, reduce stress, and even help with snoring. MSU lacks any substantial evidence to support its claims and long terms effects are unknown.
Hyaluronic Acid – As a component of synovial (joint) fluid, hyaluronic acid is often prescribed in the injectable for for symptomatic knee osteoarthritis. American Academy of Orthopedic Surgeons recommends neither for nor against the use of these injections. No studies have shown similar improvements with the oral form.
From the Kitchen
Omega -3 fatty acids – Healthy fats found in fish that have potent anti-inflammatory properties. Looks for ones that contain “EPA” and “DHA”, a certain type of omega -3. Potential benefits of omega-3 supplements include not only joint health but also cardioprotective (heart) and neurodegenerative (brain) support. Dosages of this supplement vary widely but are often 1-3 grams/day.
Turmeric/Curcumin – A spice from the ginger family, Turmeric (and one of its active ingredients Curcumin) has been shown to block the inflammatory pathway that often leads to joint pain. Turmeric has been well reviewed with mixed evidence, but overall seems promising in reducing pain and increasing function in knees with osteoarthritis. Studied doses for Turmeric/Curcumin range from 100mg/day to 2g/day.
Do Your Research and Consider if Supplements are Right For You
In summary, quality evidence to supplement joint supplements is hard to find. When we find it, it is not uncommon to find a contradictory study. That leaves us with the same problem we started with. Are these supplements worth it? While most nutraceuticals have only minor side effects, it is still worth the time looking at their cost, potential benefits, and possible interactions to see if they are right for you. We at Gulf Orthopaedics would be happy to help devise a strategy for your joint pain to keep you in the game.