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Chondroitin sulfate benefits

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What is it?

Chondroitin sulfate is a chemical that is normally found in cartilage around joints in the body. Chondroitin sulfate is usually manufactured from animal sources, such as shark and cow cartilage.

Chondroitin sulfate is used for osteoarthritis. It is often used in combination with other ingredients, including manganese ascorbate, glucosamine sulfate, glucosamine hydrochloride, or N-acetyl glucosamine.

Chondroitin sulfate is also taken by mouth for HIV/AIDS, heart disease, heart attack, weak bones (osteoporosis), joint pain caused by drugs used to treat breast cancer, acid reflux, high cholesterol, muscle soreness after exercise, a bladder condition called interstitial cystitis, a bone disease called Kashin-Beck disease, and itchy and scaly skin (psoriasis). Chondroitin sulfate is also used in a complex with iron for treating iron-deficiency anemia.

Chondroitin sulfate is available as an eye drop for dry eyes. In addition, it is used during cataract surgery, and as a solution for preserving corneas used for transplants. It is approved by the FDA for these uses.

Some people with osteoarthritis use ointments or skin creams for pain that contain chondroitin sulfate, in combination with glucosamine sulfate, shark cartilage, and camphor.

Some people also inject chondroitin sulfate into the muscles for osteoarthritis.

Some people insert chondroitin sulfate into the bladder for urinary tract infections (UTIs), bladder conditions, or loss of control of the bladder.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for CHONDROITIN SULFATE are as follows:

Possibly effective for…

  • Cataracts. Research shows that injecting a solution that contains chondroitin sulfate and sodium hyaluronate into the eye protects the eye during cataract surgery. Many different products containing chondroitin sulfate and sodium hyaluronate have been reviewed by the U.S. Food and Drug Administration (FDA) for use during cataract surgery. However, it’s not clear if adding chondroitin sulfate to sodium hyaluronate solutions helps reduce pressure within the eye after cataract surgery compared to other similar treatments. Some early studies suggest that a specific eye solution containing chondroitin sulfate and hyaluronate (Viscoat, Alcon Laboratories) can decrease pressure in the eye and improve overall eye health after a cataract is removed. However, the drops do not appear to be better than drops containing hyaluronate alone or another chemical called hydroxypropylmethyl-cellulose. The effect of solutions containing only chondroitin sulfate on cataract surgery is not known.
  • Osteoarthritis. Clinical research on the effectiveness of chondroitin sulfate taken by mouth for osteoarthritis is inconsistent. The reason for contradictory findings is unclear, but could be due to differences in people studied, different products used, or other differences in study design. Overall, the evidence shows that some people with osteoarthritis of the knee or hand may experience pain relief after taking chondroitin sulfate for 3-6 months. But pain relief is likely to be small at best. Other evidence shows that taking chondroitin sulfate for about 2 years might prevent osteoarthritis from becoming worse.
    Some research has evaluated the effects of chondroitin sulfate when taken by mouth in combination with glucosamine sulfate or glucosamine hydrochloride. Most research shows that taking these combination products for about 3-4 months reduces pain and improves joint function in patients with knee osteoarthritis. But some conflicting evidence exists.
    Some skin creams containing chondroitin sulfate are promoted for reducing osteoarthritis pain. There is some evidence that a skin cream containing chondroitin sulfate in combination with glucosamine sulfate, shark cartilage, and camphor seems to reduce arthritis symptoms. However, any symptom relief is most likely due to the camphor and not the other ingredients. There is no research showing that chondroitin is absorbed through the skin.
  • Urinary tract infections (UTIs). Early research suggests that administering a specific chondroitin sulfate and hyaluronic acid solution (iAluRil, IBSA Farmaceutici) through a catheter weekly for 4 weeks and then monthly for about 5 months reduces UTIs in women with a history of UTIs.

Insufficient evidence to rate effectiveness for…

  • Joint pain caused by breast cancer drugs. Early research suggests that taking a combination of glucosamine sulfate and chondroitin sulfate in two or three divided doses daily for 24 weeks improves joint pain and symptoms caused by drugs used to treat breast cancer.
  • Dry eyes. Research on the effectiveness of chondroitin sulfate on dry eyes is mixed. Early research suggests that using chondroitin sulfate eye drops decreases dry eyes. However, other evidence suggests that eye drops containing chondroitin sulfate are less effective than tear-replacement drops (Gel-Larmes). Other research shows that using a specific eye drop containing chondroitin sulfate together with xanthan gum (PRO-148, Laboratorios Sophia, SA de CV, Guadalajara, Mexico) four times daily for 60 days does not improve tears, but might improve the severity of dry eye symptoms.
  • Muscle soreness after exercise. Early research suggests that taking chondroitin sulfate daily does not reduce muscle soreness after exercise in men.
  • Acid reflux. When taken along with conventional treatments such as antacids, a syrup containing hyaluronic acid and chondroitin sulfate appears to reduce the intensity of acid reflux symptoms.
  • Bladder inflammation (interstitial cystitis). Several low-quality studies suggest that administering chondroitin sulfate solution into the bladder with or without hyaluronic acid can improve symptoms of bladder inflammation. Also, other early research suggests that taking a combination product containing chondroitin sulfate (CystoProtek) by mouth can improve bladder inflammation. However, some higher-quality research shows that inserting chondroitin sulfate into the bladder does not improve symptoms.
  • Bone and joint disease (Kashin-Beck disease). Early research suggests that chondroitin sulfate, with or without glucosamine hydrochloride, can reduce pain in people with Kashin-Beck disease. Also, taking chondroitin sulfate with glucosamine sulfate can slow joint space narrowing in people with this bone disease. However, it is unclear if taking chondroitin sulfate alone slows joint space narrowing.
  • Heart attack. Some early research shows that taking chondroitin sulfate by mouth might lower the risk of having a first or recurrent heart attack.
  • Skin redness and irritation (psoriasis). Early research suggests that taking chondroitin sulfate for 2-3 months decreases pain and improves skin conditions in people with psoriasis. But other research suggests that taking chondroitin sulfate (Condrosan, CS Bio-Active, Bioiberica S.A., Barcelona, Spain) daily for 3 months does not reduce psoriasis severity in people with psoriasis and knee osteoarthritis.
  • Overactive bladder. Early research suggests that inserting sodium chondroitin sulfate into the bladder through a urinary catheter improves quality of life in people with overactive bladder.
  • Heart disease.
  • Weak bones (osteoporosis).
  • High cholesterol.
  • Other conditions.

More evidence is needed to rate chondroitin sulfate for these uses.

How does it work?

In osteoarthritis, the cartilage in the joints breaks down. Taking chondroitin sulfate, one of the building blocks of cartilage, might slow this breakdown.

Are there safety concerns?

Chondroitin sulfate is LIKELY SAFE when taken by mouth or used as an eye solution during cataract surgery. Chondroitin sulfate has been taken by mouth safely in research for up to 6 years. Also, chondroitin sulfate has been given premarket approval by the US Food and Drug Administration (FDA) to be used as an eye solution during cataract surgery.

But there is some concern about the safety of chondroitin sulfate because it comes from animal sources. Some people are worried that unsafe manufacturing practices might lead to contamination of chondroitin products with diseased animal tissues, including those that might transmit bovine spongiform encephalopathy (mad cow disease). So far, there are no reports of chondroitin causing disease in humans, and the risk is thought to be low. It can cause some mild stomach pain and nausea. Other side effects that have been reported are bloating, diarrhea, constipation, headache, swollen eyelids, leg swelling, hair loss, skin rash, and irregular heartbeat.

Some chondroitin products contain excess amounts of manganese. Ask your healthcare professional about reliable brands.

Chondroitin sulfate is POSSIBLY SAFE when injected into the muscle short-term, when applied to the skin short-term, when used as an eye drop short-term, and when inserted into the bladder with a catheter by a physician.

Special precautions & warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking chondroitin sulfate if you are pregnant or breast feeding. Stay on the safe side and avoid use.

Asthma: There is some concern that chondroitin sulfate might make asthma worse. If you have asthma, use chondroitin sulfate cautiously.

Blood clotting disorders: In theory, administering chondroitin sulfate might increase the risk of bleeding in people with blood clotting disorders.

Prostate cancer: Early research suggests that chondroitin might cause the spread or recurrence of prostate cancer. This effect has not been shown with chondroitin sulfate supplements. However, until more is known, do not take chondroitin sulfate if you have prostate cancer or are at high risk for developing it (you have a brother or father with prostate cancer).

Are there interactions with medications?

Moderate
Be cautious with this combination.
Warfarin (Coumadin)
Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking chondroitin with glucosamine increases the effect of warfarin (Coumadin) on blood clotting. This can cause bruising and bleeding that can be serious. Don’t take chondroitin if you are taking warfarin (Coumadin).

Are there interactions with herbs and supplements?

There are no known interactions with herbs and supplements.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The following doses have been studied in scientific research:

BY MOUTH:

  • For osteoarthritis: the typical dose of chondroitin sulfate is 800-2000 mg taken as a single dose or in two or three divided doses daily for up to 3 years.

APPLIED TO THE SKIN:

  • For osteoarthritis: a cream containing 50 mg/gram of chondroitin sulfate, 30 mg/gram of glucosamine sulfate, 140 mg/gram of shark cartilage, and 32 mg/gram of camphor has been used as needed for sore joints for up to 8 weeks.

INJECTED INTO THE MUSCLE:

  • For osteoarthritis: chondroitin sulfate (Matrix) has been injected into the muscle daily or twice weekly for 6 months.

INSERTED INTO THE BLADDER:

  • For urinary tract infections (UTIs): 50 mL of a specific solution containing chondroitin sulfate and hyaluronic acid (iAluRil, IBSA Farmaceutici), has been inserted into the bladder once weekly for 4 weeks, and then once or twice monthly for up to 5 months.

APPLIED TO THE EYE:

  • For cataracts: Several different eye drops containing sodium hyaluronate and chondroitin sulfate (DisCoVisc, Alcon Laboratories; Viscoat, Alcon Laboratories; DuoVisc, Alcon Laboratories; Viscoat, Alcon Laboratories; Provisc, Alcon Laboratories) have been used during cataract surgery.

Other names

Calcium Chondroitin Sulfate, CDS, Chondroitin, Chondroitin Polysulfate, Chondroitin Polysulphate, Chondroitin Sulfate A, Chondroitin Sulfates, Chondroitin Sulfate B, Chondroitin Sulfate C, Chondroitin Sulphates, Chondroitin Sulphate A Sodium, Chondroïtine, Chondroïtine Sulfate A, Chondroïtine Sulfate B, Chondroïtine Sulfate C, Chondroïtine 4-Sulfate, Chondroïtine 4- et 6- Sulfate, Condroitin,

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

  1. Volpi N. Quality of different chondroitin sulfate preparations in relation to their therapeutic activity. J Pharm Pharmacol 2009;61:1271-80. View abstract.
  2. Lauder RM. Chondroitin sulphate: a complex molecule with potential impacts on a wide range of biological systems. Complement Ther Med 2009;17:56-62. View abstract.
  3. Barnhill JG, Fye CL, Williams DW, Reda DJ, Harris CL, Clegg DO. Chondroitin product selection for the glucosamine/chondroitin arthritis intervention trial. J Am Pharm Assoc 2006;46:14-24. View abstract.
  4. Zegels B, Crozes P, Uebelhart D, Bruyère O, Reginster JY. Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthritis Cartilage 2013;21:22-7. View abstract.

 

Omega-3 Fatty Acids Prevent (or Slow) Progression of Osteoarthritis

Salmon Oil

New Research From University of Bristol UK Report… 
New research has shown for the first time that omega-3 in fish oil could “substantially and significantly” reduce the signs and symptoms of osteoarthritis.

According to the University of Bristol study, funded by Arthritis Research UK and published in the journal Osteoarthritis and Cartilage, omega-3-rich diets fed to laboratory subjects, which naturally develop osteoarthritis, reduced disease by 50 per cent compared to a standard diet.

The research is a major step forward in showing that omega-3 fatty acids, either from fish oil or flaxseed oil sources, may help to slow down the progression of osteoarthritis, or even prevent it occurring, confirming reports about the benefits of fish oil for joint health.

Researchers from the Matrix Biology Research group at the University of Bristol’s School of Veterinary Sciences, said classic early signs of the condition, such as the degradation of collagen in cartilage and the loss of molecules that give it shock-absorbing properties, were both reduced with omega-3.

“Furthermore, there was strong evidence that omega-3 influences the biochemistry of the disease, and therefore not only helps prevent disease, but also slows its progression, potentially controlling established osteoarthritis,” they said.

They added “and all of the evidence supports the use of omega-3 in human disease.”

Medical researchers of Arthritis Research UK said: “The possibility that omega-3 fatty acids could prevent osteoarthritis from developing has been a tantalising one. Some limited, previous research in dogs has suggested that we were a long way away from understanding the potential use in humans. However, this current research in guinea pigs is exciting as it brings us closer to understanding how omega-3 might fundamentally interfere with the osteoarthritis process, and that it could potentially be taken as a treatment.”

Following government guidelines on dietary intake of omega-3 fatty acids could be effective in reducing the burden of osteoarthritis. Fish oil is far more effective than the flax oil based supplement, but for vegetarians flax oil remains a viable alternative.

“Most diets in the developed world are lacking in omega-3, with modern diets having up to 30 times too much omega-6 and too little omega-3. Taking omega-3 will help redress this imbalance and may positively contribute to a range of other health problems such as heart disease and colitis.”

Further studies are needed to determine the influence of omega-3 fatty acids on established disease in guinea pigs, and to confirm the effects in human osteoarthritis, said the researchers.

Osteoarthritis affects around eight million people in the UK, and is caused when the cartilage at the ends of bones wears away and the underlying bone thickens, leading to stiff, painful joints. Currently, there is no effective treatment to slow down disease progression, and treatment is limited to pain relief and ultimately joint replacement.

Story Source: University of Bristol.

Journal Reference: “Regulation of osteoarthritis by omega-3 (n-3) polyunsaturated fatty acids in a naturally occurring model of disease. Osteoarthritis and Cartilage”  2011;

This article is for informational and educational purposes only, and is not intended to provide medical advice, diagnosis or treatment. Contact your doctor or healthcare professional for medical and nutritional consultation.

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