Arthritis Supplements

Many people with arthritis -- especially osteoarthritis -- use supplements in their diet to ease the pain of arthritis. Glucosamine and chondroitin are the most well-known. Methyl sulfonylmethane (MSM) is another supplement used to ease the pain of arthritis, but it has not been through as much scientific testing.

It is important to check with your doctor before starting any new treatments. Your doctor can review the other medications you are taking and help you decide whether or not these arthritis supplements are right for you. In addition, always follow the instructions on the medication label. Do not take more of the supplements than is recommended.

What Are Glucosamine and Chondroitin?

Glucosamine and chondroitin sulfate are components of normal cartilage. In the body, they are the building blocks for cartilage and appear to stimulate the body to make more cartilage.

There are conflicting studies on glucosamine and chondroitin, some demonstrating a beneficial effect on osteoarthritis pain. Others, including the NIH-sponsored multicenter Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), did not show benefit for the primary outcome of reducing pain. More recently another study also found that glucosamine did not slow down cartilage damage or reduce knee pain.

The supplements, which are available in pharmacies and health food stores without a prescription, are well-tolerated and appear to be safe. However, there are no long-term studies to confirm their long-term safety and effectiveness. Keep in mind that the U.S. Food and Drug Administration (FDA) regulates supplements, but treats them like food rather than drugs; supplement manufacturers are not required to prove their products are safe or effective before selling them in the marketplace.

Many physicians may still recommend a trial of glucosamine at this point, and if there is not apparent improvement by three months, it would be reasonable to stop glucosamine. Research is ongoing.

Which Brand of Arthritis Supplement Should I Use?

There are many different brands of glucosamine and chondroitin, which are usually sold together as one arthritis supplement. Again, there is no government monitoring to ensure the purity of these products.

In order to assure that you get a consistent dose of the supplements, stick with a reputable manufacturer; choose products sold by large and well-established companies. If you don't recognize a brand name, ask about the company's reputation, how long it has been in business, and how long the store has stocked the brand.

Who Should Not Take These Arthritis Supplements?

People with diabetes should use caution when taking glucosamine because it may raise blood sugar. People taking blood-thinning medication (anticoagulants) should check with their doctors before taking glucosamine and chondroitin.

These arthritis supplements may also have a blood-thinning effect, so people taking these supplements in addition to an anticoagulant may have to have their blood tested more often. People who are allergic to shellfish also should consult their doctors before using glucosamine and chondroitin. Glucosamine is extracted from a substance in shellfish.

The effects of these supplements on a growing child or developing baby are not yet known. For that reason, glucosamine and chondroitin are not recommended for children, women who are pregnant, women who are nursing, and women who could become pregnant.

What Are the Side Effects of Glucosamine and Chondroitin?

These arthritis supplements are generally well-tolerated. However, side effects can occur. The most commonly reported side effects of glucosamine and chondroitin include:

• Nausea
• Diarrhea or constipation
• Heartburn
• Increased intestinal gas

What Is MSM and Can It Help My Arthritis?

MSM, or methylsulfonylmethane, is a supplement that is used to try to help a wide range of conditions, including arthritis, allergies, and even snoring.

MSM is an odorless and tasteless natural sulfur compound found in all living things. Sulfur is needed by the body for healthy connective tissue and joint function and has purported pain-quashing and anti-inflammatory properties.

While MSM is found in many foods -- including meat, fish, certain fruit, vegetables, and grains -- it is destroyed when foods are processed. MSM supplements have become increasingly popular in recent years and many people feel they have had some pain relief since taking MSM. Although some studies have reported improvement in pain with MSM, more research needs to be done to support its use as an arthritis supplement.

Those patients with multiple health conditions should be aware that current prescription medication may interact with dietary supplements, and they should consult their doctor so that side effects can be best monitored. Moreover, as with many supplements that have not been studied, the long-term benefits and safety of the chemical are unknown.

Talk to your doctor before taking MSM.

What Are the Side Effects of MSM?

MSM is considered very safe, and side effects are rare. Side effects that have been reported include:

• Diarrhea
• Skin rash
• Headache
• Fatigue

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