Chondroitin msm supplement and arthritis joint health benefit, review of research studies for osteoarthritis, dosage, and interactions
Side effects, safety, allergies

March 25 2014

Chondroitin sulfate consists of repeating chains of molecules called glycosaminoglycans and is a major constituent of cartilage providing structure, holding water and nutrients, and allowing other molecules to move through cartilage—an important property, as there is no blood supply to cartilage. it may work by acting as a building block for proteoglycan molecules, and may also have anti-inflammatory properties. 
  
Methyl sulfonyl methane MSM is a dietary supplement promoted for a variety of conditions including pain, inflammation, allergies, arthritis, and the maintenance of normal keratin levels in hair, skin and nails. Until recently it had not been studied much and most of the reports on the benefits of MSM supplement had been anecdotal. However, there have been new reports that it does have benefits, particularly in arthritis and seasonal allergic rhinitis.

Joint Power Rx with Chondroitin msm Sulfate 400 mg, 60 Tablets
Chondroitin sulfate is a mucopolysaccharide found in cartilage, tendons and ligaments, where it is bound to proteins such as collagen and elastin. In our joints, it contributes to strength, flexibility and shock absorption. Current research indicates that supplemental Chondroitin sulfate may help maintain proper joint function. Studies show it does get absorbed after oral ingestion.

Joint Power Rx
This powerful joint formula includes several herbal extracts and nutrients that play a role in joint health. Ingredients include: Glucosamine sulfate  (from shellfish), Chondroitin sulfate, MSM made by Fine Nutraceuticals by the trademarked name Lignisul MSM, CMO complex, turmeric, boswellia serrata extract, cat's claw extract, devil's claw extract, grape seed extract, and sea cucumber.
 


Buy Chondroitin msm supplement, Joint Power Rx with chondroitin, MSM supplement for healthy joints as we age, Glucosamine supplement, or to see a complete list of high quality supplement products
Supplement Facts
Chondroitin sulfate 400 mg per tablet

Suggested Use: 2 to 4 chondroitin msm tablets daily, or as recommended by your health care professional.

Arthritis, osteoarthritis benefit
In degenerative joint disease, such as osteoarthritis, there is a loss of chondroitin sulfate as the cartilage erodes. Animal studies indicate that it promotes healing of bone, which is consistent with the fact that the majority of glycosaminoglycans found in bone consist of chondroitin sulfate. It, in numerous trials to relieve symptoms and possibly slow the progression of, or in some cases, reverse osteoarthritis. The combination of glucosamine and chondroitin may be more effective than the latter alone.

The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial.
Arthritis Rheum. 2008. University of Utah School of Medicine, Salt Lake City, UT, USA.
A 24-month study, conducted at 9 sites in the United States as part of the Glucosamine / Chondroitin Arthritis Intervention Trial (GAIT), enrolled 572 patients with knee osteoarthritis. Patients who had been randomized to 1 of the 5 groups in the GAIT continued to receive glucosamine 500 mg 3 times daily, CS 400 mg 3 times daily, the combination of glucosamine and chondroitin sulfate, celecoxib 200 mg daily, or placebo over 24 months. At 2 years, no treatment achieved a predefined threshold of clinically important difference in joint space width loss as compared with placebo. However, knees with K/L grade 2 radiographic osteoarthritis appeared to have the greatest potential for modification by these treatments.

Chondroitin sulphate for symptomatic osteoarthritis: critical appraisal of metaanalyses.
Curr Med Res Opin. 2008. Monfort J, Martel-Pelletier J, Pelletier JP.
Chondroitin sulphate is an important structural component of cartilage and is approved and regulated as a symptomatic slow-acting drug for osteoarthriti in Europe and some other countries. Although numerous studies have shown the clinical benefits of Chondroitin sulphate to decrease pain, improve functional disability, reduce non-steroidal anti-inflammatory drug (NSAID) or acetaminophen consumption, and good tolerability with an additional carry-over effect, there are still some concerns regarding its effectiveness in treating osteoarthritis. A MEDLINE database search was conducted for appropriate meta-analyses published between 1997 and 2007. Data provided by these meta-analyses indicate that chondroitin sulphate has a slight to moderate efficacy in the symptomatic treatment of osteoarthritis, with an excellent safety profile.

Knee arthritis benefit
Long-term use of prescription-grade chondroitin sulfate for treatment of knee arthritis reduces pain and slows joint narrowing. The Study on Osteoarthritis Progression Prevention (STOPP) involved 622 patients in Europe and the US, ages 45-80 years, with knee arthritis. On average, the patients reported moderate levels of pain when the study began. Patients were randomly assigned to 2 years of daily treatment with chondroitin or inactive placebo. X-rays of the affected knee were taken to assess the impact of treatment. Pain relief increased with time in the chondroitin group. Dr. Andre Kahan, at Cochin Hospital in Paris, report treatment with chondroitin reduced the likelihood of joint narrowing -- indicating a loss of cartilage -- by 33 percent.  Over 90 percent of the subjects reported good or very good tolerability with chondroitin, and side effects were no more likely than with placebo. Arthritis and Rheumatism, 2009.

Chondroitin glucosamine hydrochloride and quercetin benefit osteoarthritis
A combination supplement of glucosamine hydrochloride 1200 mg, shark cartilage 300 mg (consisting of about 100 mg of chondroitin), and quercetin, taken daily, benefits osteoarthritis patients.

Effects of an Oral Administration of Glucosamine Chondroitin Quercetin Glucoside on the Synovial Fluid Properties in Patients with Osteoarthritis and Rheumatoid Arthritis.
Biosci Biotechnol Biochem. 2009. Matsuno Clinic for Rheumatic Diseases.
The effects of an orally administered combination of a glucosamine chondroitin quercetin glucoside supplement on the synovial fluid properties of patients with osteoarthritis and rheumatoid arthritis were investigated. Forty-six osteoarthritis and twenty-two rheumatoid arthritis patients were administered with the glucosamine chondroitin quercetin supplement orally for 3 months. The osteoarthritis patients showed a significant improvement in pain symptoms, daily activities (walking and climbing up and down stairs), and changes in the synovial fluid properties with respect to the protein concentration, molecular size of hyaluronic acid, and chondroitin 6-sulphate concentration were also observed. However, no such effects were observed in the heumatoid arthritis patients. Gucosamine chondroitin quercetin supplement has a beneficial effect on the synovial fluid properties in osteoarthritis patients.

Source
Commercially available chondroitin is derived mainly from shark and cow cartilage. It can also be derived from porcine sources. I have not seen much research comparing the benefits or risks of chondroitin derived from different sources.

Glucosamine chondroitin side effects, allergies, toxicity, safety
Allergic reactions are possible with glucosamine or chondroitin. Otherwise, no major side effects with chondroitin have yet been reported in the medical literature.


Research review
Chondroitin 800 mg a day was given in addition to naprosyn 500 mg a day for a period of two years to a group of individuals with osteoarthritis of the hands. This group was compared to another group who only received naprosyn. Those who took chondroitin were found to have a slower rate of arthritis progression than those who only took naprosyn.

Is chondroitin supplement necessary if someone is already taking glucosamine supplement?
Research with chondroitin supplements is not as consistent and extensive as it is with glucosamine. If you have arthritis, one option is to start with glucosamine 500 mg three times a day for a month. If, after a month, you haven't been helped, double your dose of glucosamine. If, after another month, you need additional relief, you can try chondroitin 500 mg three times a day. Another option is to start taking both together along with a few other nutrients and herb found through research to be helpful for arthritis. Some doctors think it may be better to use double the dose initially (at least once you have found out you are not getting side effects or have an allergic reaction to the lower dosages).

Can a diabetic take chondroitin sulfate supplement?
Yes. One study providing a combination of glucosamine and chondroitin for a period of 90 days did not find any change in blood sugar levels.

Emails
Q. I have a brief question: Have you had anyone using either glucosamine alone or in combination with chondroitin report that their total cholesterol increased? I have a friend who discontinued taking the combination for that reason; I'm sorry, I don't know how long she had been taking it.
   A. We have not heard of the connection or a major influence between these nutrients and cholesterol at this time.

Q. This sounds like a joke but it's not. Perhaps a month or two after I began to take a glucosamine and chondroitin supplement to protect against knee pain, I began to notice that my penis, which had always assumed a straight position in the erect state, was developing a noticeable bend. (If I had said I was taking the supplement for joint pain, then you really would have been inclined to toss this one out.) Over the next month or two, the bend became more pronounced and I was on the verge of consulting a urologist to look into the possibility of Peyronie's Disease, a condition that apparently afflicts our ex-president Clinton and can I understand, interfere with sex if it progresses too far. The only change in my daily routine I could think of during this time was the addition of the glucosamine and chondroiten to my usual vitamins and mineral regimin. I dropped the supplement and over the next couple of months the bend in the penis gradually disappeared. Perhaps it was a coincidence (although I don't think so).
  A. I read your email with interest. This is the first time I have heard of glucosamine and chondroitin involved in this after several years of looking into these combinations. I don't know what to say. I think it's possible. Were there other ingredients in the formula or just glucosamine and chondroitin? There's so little we know about the long term effects of supplements and herbs that I keep any side effects as a possibility. I guess a good way to find out for sure is to retake it and see what happens, since it appears to be reversible on stopping... but i can see one's reluctance in this trial when it comes to such an important member of the body :)

Q. I just began taking a chondroitin glucosamine supplement (1500 / 1200 mg/day, respectively, as recommended on bottle. When taking it (all mg) during the day I thought I noticed I was much more tired than usual - almost fatigued. Last night I took it about 2 hours before bedtime and for the first time in memory slept clear through the night (I usually get up at least once to urinate and/or drink water for dehydration.) I can't find that anyone has reported this anecdotally or in medical lit.
   A. We have not had any feedback thus far that chondroitin and glucosamine cause sleepiness.

A friend of mine forwarded to me an email that I hope you can comment on. This is what it said, "Chondroitin is now falling out of favor due to a new analysis published in Annals of Internal Medicine. Most of the early research on chondroitin shows substantial benefit for reducing pain and improving functionality in people with osteoarthritis of the knee. But research published since 2005 has been mostly negative. When the analyses evaluated ALL chondroitin studies as a whole, it found that chondroitin significantly reduced pain. When only larger, higher-quality, and more recent studies were included there was no significant benefit. The method used for the analysis is stirring up a lot of controversy. And there are still questions about potential long-term benefits such as slowing disease progression. This is not likely to be the last word on chondroitin."
    We never rely on the findings of the latest study to come to a conclusion regarding the benefit or harm of that particular supplement. The research with chondroitin sulfate is not conclusive, but based on everything that I have read and my professional experience, as of May 2007 We think chondroitin should be included in a joint formula along with glucosamine and other herbs and nutrients for a potential synergistic effect on joint health. We will await results of further studies.

MSM supplement information
Methylsulfonylmethane is a popular dietary supplement promoted for a variety of conditions including pain, inflammation, allergies, arthritis, and the maintenance of normal keratin levels in hair, skin and nails. Until recently MSM had not been studied much and most of the reports on the benefits of MSM supplement had been anecdotal. However, there have been recent reports that MSM supplements do have benefits, particularly in arthritis and seasonal allergic rhinitis.

Benefit
MSM is found in small amounts in everyone's blood and it is also found in many foods. It's unclear what role dietary it plays in the complex chemistry of the human body, but like other sulfur compounds, dietary MSM is a necessary building block for proteins, especially those found in the hair, muscles, and connective tissue of the joints and skin. Sulfur also is found in insulin hormone and bile acid. Taken as an oral supplement, it is able to cross the blood brain barrier.
   MSM supplements appear to be a promising nutrient in the treatment of arthritis and possibly certain types of allergies. A study finds the combination of MSM and glucosamine to benefit in the treatment of arthritis (see study below). More research is needed before we determine the full benefit of MSM supplements and the potential MSM side effects with long term use. As of December 2007, I have not seen any studies regarding the benefit of a MSM supplement in hair or nail growth.

MSM side effects
Studies in rats show MSM supplements to have very low toxicity. We don't know enough about the long term use of a MSM supplement to fully know the full range of side effects. To prevent any potential MSM side effects, use the lowest dose that works for you, and occasionally take a break for a few days.
   We received this email in October 2006 regarding a potential MSM side effect on high doses: Hi, Dr Sahelian, I appreciate your web site and your comments about alternative remedies. I took about 10 grams a day MSM supplement for about 3 months, for a back problem, which the MSM supplement helped greatly. However, after 3 months of taking the MSM, I noted small white pimples on my ears and face. It appeared to me that taking such a large MSM dose for a fairly long time had loaded up my body and that the excess was being excreted thru the skin. I have now stopped the MSM supplement and the extrusion thru the skin seems to be lessening. I thought you would be interested in my possible MSM side effect. Incidentally, I searched the internet and could find no mention of this out break as a MSM side effect.

Horses
The effect of methyl sulphonyl methane supplementation on biomarkers of oxidative stress in sport horses following jumping exercise.
Acta Vet Scand. 2008. Horsepital SL, Madrid, Spain.
Methyl Sulphonyl Methane is a naturally occurring sulphur compound with well-known antioxidant properties. On the other hand, Vitamin C is important in limiting free radical damage in the aqueous phase of the cell, and cellular vitamin C status may be linked to the mechanisms involved in quenching cellular reactive oxygen species. The aim of this study was to determine if supplementation with MSM and vitamin C could alleviate exercise-induced oxidative stress in horses undergoing jumping competition. Twenty four jumping horses involved in competition were used. Horses were given the following three treatment diets: control (without supplementation), MSM 8 mg/kg, and combined supplements (MSM 8 mg/kg + Vit-C 5 mg/kg). Nitric oxide, carbon monoxide, lipid hydroperoxides and the antioxidant enzymes, glutathione peroxidase, glutathione transferase and glutathione reductase, plasma levels were determined. Competition induced a significant increase in lipid peroxidation, nitric oxide and carbon monoxide. By contrary, reduced glutathione as well as antioxidant enzyme activities, were decreased. MSM administration significantly ameliorated all these exercise-related changes, and this effect was potentiated by Vit C reaching values in some of the parameters similar to those found before competition. These results suggest that jumping exercise could induce harmful effects on horses, probably due to an increase in oxidative damage and proinflammatory molecules. In addition, we have demonstrated that MSM could exert some protective effect on oxidative and inflammatory exercise-induced injury.

Additional supplements for purchase
CholesFiber is an all natural soluble fiber drink mix which helps support normal cholesterol levels.
OptiMSM is a trademarked form of MSM supplement.

Cilengitide is an inhibitor of alphavbeta3 and alphavbeta5 integrin receptors.
Cissampelos pareira is the botanical name for a plant that grows in the Amazon rainforest known as Abuta. This plant is known as Laghupatha in India and is an important medicinal plant in Indian traditional system of medicine and has anti-inflammatory and analgesic properties that make it attractive to study as an herb in conjunction with glucosamine, chondroitin, and MSM for the treatment of osteoarthritis.