Glucosamine and Chondroitin have been aggressively promoted as safe and effective arthritis treatment. The adverts are everywhere and the Sunday tabloid is likely to have a full page spread on the benefits of glucosamine and chondroitin in arthritis. Is it just hype or is there evidence that these two items are useful treatment for arthritis?

Glucosamine is an amino acid sugar produced by the body and present in cartilage. There are no serious side effects with glucosamine. It is extracted from shells of shellfish so if you are allergic to shellfish be aware of this. If you are a diabetic, remember that glucosamine is an amino acid sugar and can impact on your blood sugar level.

Chondroitin is a carbohydrate compound and is present in cartilage. It gives the cartilage elasticity. Articular surface of joints are protected by cartilage (articular cartilage) and this cartilage is a tough smooth gristle that reduces friction and protects the underlying bone from wear. Damage and wear of the cartilage is seen on an x-ray as loss of joint space. Cartilage contains both glucosamine and chondroitin.

Chondroitin is available as chondroitin sulfate, obtained from cows' cartilage. There are no serious side effects of chondroitin. Reported side effects are increased intestinal gas and loose stools. It should not be given to children or taken by women considering pregnancy or who are pregnant. It may potentiate the effects of anti-coagulants.

The rationale for the use of chondroitin and glucosamine as treatment of arthritis is that these two drugs, according to some, will improve the health of affected articular cartilage. Both chondroitin and glucosamine are manufactured by the body.

Your family doctor is not likely to recommend glucosamine or chondroitin as an arthritis treatment because there is no clear evidence that they confer greater benefits over placebo in arthritis treatment.

Both Chondroitin and glucosamine are considered supplements and therefore the manufacture is not regulated. When purchasing these products make sure you purchase from a reputable company and check the label. The quality of the product will vary from one manufacturer to another.

A qualitative assessment of various trials was done by T.E. McAlindon et al. to evaluate the benefits of glucosamine and chondroitin products for osteoarthritis of the knee and/or hip. The studies were randomised, double blind, placebo controlled of four weeks duration. Fifteen studies reached the criteria and were included in the analysis. Conclusions: Trials of glucosamine and chondroitin products for osteoarthritis of the knee and hip showed moderate to higher effects but there were quality issues and possible bias suggesting that benefits were exaggerated. They concluded, however, that some degree of benefits appears probable.

A trial by H.Muller-Fassbender et al. in 1994 compared glucosamine sulfate to ibuprofen in osteoarthritis of the knee. The result showed that glucosamine was as effective as ibuprofen but without the potential serious side effects.

Although there are no large trials to confirm the real benefits of Chondroitin and Glucosamine, anecdotally some arthritis patients swear by them. If you are considering taking them, use them for three month before making a decision on their efficacy. They are much safer than NSAIDs and COX2 inhibitors.