Is Chondroitin sulfate effective in osteoarthritis?
Chondroitin is naturally found in animal tissues and is currently extracted from shark or beef cartilage or produced by artificial means. When produced in the lab, it is generally combined with mineral salts to form chondroitin sulfate. The presence of mineral salts improves the bio-availability of chondroitin.
Chondroitin sulfate is available in powder, tablet, capsule and liquid form. It is generally used in conjunction with Glucosamine, another chondoprotective agent. As chondroitin and glucosamine sulfate occur naturally in the body, they have almost no toxicity and are considered safe for long term use in osteoarthritis.
While there is a body of evidence to support the benefits of chondroitin sulfate, opinion also exists that it may have little more benefit than a placebo.
How does Chondroitin sulfate work?
Chondroitin belongs to a family of complex carbohydrates (polysaccharides) called glycosaminoglycans (GAGs). Cellulose and Chitin are some other well known forms of glycans. The primary purpose of glycosaminoglycans is to provide elasticity, turgidity and protection among cell spaces.
Cartilage between bones contain cells called chondrocytes surrounded by a flexible mesh of collagen fibres, elastic fibers and proteoglycans. Proteoglycans are chemical compounds to which are attached complex carbohydrates – one of which is chondroitin sulfate. Chondroitin sulfate stores water allowing it to be flexible and resistant to shock and friction. It provides the cushioning necessary to protect cartilage and prevent bones from rubbing against each other. Chondroitin known for its anti-inflammatory and cartilage protection properties.
However in cases of osteoarthritis, chondroitin sulphate gets depleted causing the cartilage to lose its water-retentive ability. The larger weight bearing joints of the body like the knee and hips are usually the most affected. In such situations, chondroitin sulphate can help when taken as oral supplements to replenish the body’s natural chondroitin. There is also scientific evidence to show that chondroitin stimulates living cartilage cells and inhibits elastase, an enzyme that breaks down elastic fibers.
Is Chondroitin Sulphate effective as an oral supplement?
Studies have shown that chondroitin sulphate taken as an oral supplement is absorbed into the blood and does produce positive results. In some cases it has shown better results that conventional NSAIDs (Nonsteroidal Anti-inflammatory Drugs) which are generally taken to relieve inflammation and back pain but cause side-effects.
Chondroitin sulphate has been used in Europe in place of NSAIDs.
In a study conducted on 146 patients in Italy, patients were divided into groups and were given NSAIDs, Chondroitin Sulphate and placebos. While patients treated with the NSAID got quick, effective pain relief, the pain returned when they stopped taking it. The group that took Chondroitin Sulphate took longer to get relief but the effects lasted for three months after it was discontinued.
In a study in France, 122 patients were tested for the effectiveness of chondroitin sulphate in osteoarthritis of the knees and hips. Not only did pain and joint function improve but chondroitin also caused no side effects such as ulcers and digestive disorders frequently noted with NSAID use.
In a study published in 2017, 604 patients in Europe with knee arthritis were administered Chondroitin sulfate 800 mg/day. In the 6 month study it was found that Chondroitin sulfate was better than a placebo and had similar effects as as prescription drug celecoxib in reducing pain and improving functions in knee osteoarthritis.1
In a study called the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) which took place at several sites across the US, it was found that glucosamine plus chondroitin sulfate provided significant relief to a group of participants who had moderate-to-severe pain even though it did not provide significant relief from osteoarthritis pain among all participants. 2
What dosage of Chondroitin sulphate is effective?
Chondroitin sulphate needs to be taken for at least 2 months to show results as the body will take time to absorb it. Dosage can be 400mg taken 3 times per day.
You may also be interested in the following articles:
Benefits of Chondroitin
Benefits of Glucosamine
1. Reginster J, Dudler J, Blicharski T, et al Pharmaceutical-grade Chondroitin sulfate is as effective as celecoxib and superior to placebo in symptomatic knee osteoarthritis: the ChONdroitin versus CElecoxib versus Placebo Trial (CONCEPT) Annals of the Rheumatic Diseases Published Online First: 22 May 2017. doi: 10.1136/annrheumdis-2016-210860
2.The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Sawitzke AD1, Shi H, et al