© Jeffrey S. House, D.C.

Welcome to Ounce of Prevention's Words On Wellness. In this issue discussion will focus on arthritis, specifically degenerative joint disease, and the impact of a nutrient called glucosamine sulfate and the problems associated with arthritis. Thank you for reading Ounce of Prevention’s Words On Wellness.

What Is Arthritis?
The word arthritis simply means inflammation of a joint. Several different types of arthritis exist, the more common ones including rheumatoid, psoriatic, Reiter’s Syndrome and gout. But the most common form is degenerative joint disease (DJD), also known as osteoarthritis. As its formal name implies, this type of arthritis is caused by degeneration of a joint. This degeneration usually begins as small cracks or fissures affecting the soft, somewhat pliable material called cartilage that covers the surfaces of the bones that touch one another within the joint. When these cracks occur, bone cells called osteoblasts repair the cracks by laying down not cartilage but calcium and other minerals resulting in the touching surfaces becoming rough, therefore not permitting the joint to move smoothly. This causes inflammation of the joint and ultimately pain, deformity and loss of movement. DJD affects men and women equally and is found in some form in most individuals by 40 years of age. It is the rule, not the exception, in individuals by age 70.
In its beginning stages, DJD is subtle and gradual, affecting only one or two joints. The first symptom is often stiffness, more pronounced in the morning or following periods of inactivity, and usually diminishes after about 15 to 30 minutes of activity or movement. As the arthritis progresses, joint movement becomes limited and more painful. Tenderness, swelling and redness may occur, grating sensations on movement may develop and enlargement of the joint occurs due to the proliferation and deposition of calcium and other minerals within the joint. The end result is a complete breakdown and ultimate union of the joint resulting in little or no movement. Once this occurs, the joints surrounding the arthritic joint often compensate for the loss of movement and are overworked to the point where the entire degenerative process starts anew with these joints.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
There exists no "cure" for DJD. The most common treatment for DJD is the use of non-steroidal anti-inflammatory drugs (NSAIDs). Although NSAIDs, the most common being aspirin, ibuprofen (Motrin^®) and acetaminophen (Tylenol^®), offer relatively quick relief from the pain associated with arthritis, their long-term use has proven to be inadequate. NSAIDs are pain relievers; they do nothing to promote healing or stop the degenerative process of arthritis. In fact, clinical studies demonstrate that aspirin and other NSAIDs actually inhibit cartilage repair and appear to accelerate its destruction. Additionally, side effects with NSAIDs exist. These include liver and general toxicities, gastric irritation, tinnitus (ringing in the ears), headache and dizziness, to name a few. It therefore can be said that while NSAIDs appear to suppress the symptoms of DJD, they accelerate the actual degenerative process resulting in a worsening of the condition. Quite frankly, their use should be avoided as a treatment for arthritis.

Glucosamine Sulfate
As stated above, there exists no cure for DJD; however, with the proper management, this arthritic condition may be slowed, halted and in some cases, reversed. I believe that the best approach for combating arthritis is to supplement the diet with glucosamine sulfate, and the research agrees. Glucosamine is naturally manufactured by the body. It functions in stimulating the production of key structural components of cartilage necessary for correct joint function and repair. As is the case with many nutrients, the body loses its ability to manufacture adequate amounts of glucosamine. Many researchers believe this may be a major factor leading to DJD. Based on this information and realizing that there exists no natural food source of glucosamine, researchers wondered what would happen if individuals suffering with DJD were given supplemental glucosamine. They did and the results are outstanding.
Although glucosamine sulfate has no direct pain-relieving effects, studies indicate that it is of benefit in as high as 95 percent of patients to whom the nutrient is administered. This is because of glucosamine’s apparent repair capabilities. By getting to the root of the problem, glucosamine exerts its repair capabilities which not only may improve joint function but may cause a decrease in pain and other symptomatology associated with DJD. In comparing glucosamine with the previously discussed NSAIDs, it is important for the user of glucosamine to understand how each works: NSAIDs are pain pills that offer short-term symptomatic relief, whereas glucosamine sulfate may aid in the repair process and may offer long-term cause-related relief.
In one study, glucosamine sulfate was compared to ibuprofen for the treatment of arthritis and its symptoms. Pain scores in the ibuprofen group decreased at a faster rate than the glucosamine group in the first two weeks. If the study was stopped at this point, ibuprofen would appear to be the clear winner; however, by the fourth week, the glucosamine group reported significantly better results compared to the ibuprofen group as indicated by their pain scores. This example illustrates the importance of understanding how glucosamine sulfate works in contrast to NSAIDs. Since glucosamine is a nutrient and achieves its effects by providing the material necessary to stimulate the natural repair process of the joints, its positive effects may take time to be realized. 
In a double-blind, controlled study, researchers¹ found that glucosamine sulfate resulted in observed subjective and objective improvement in patients with DJD compared with patients on a placebo whose DJD observably progressed both subjectively and objectively.
Individuals ingesting 500 milligrams three times a day experience improvement on average in approximately four weeks. Once improvement is noted, the dose may be reduced to a point where the beneficial effects are still achieved. This will vary with each individual and may range from the full 1500 milligrams a day dosage to 500 milligrams every two or three days. Fortunately, glucosamine’s safety record indicates it may be taken long-term without adverse side effects.

Glucosamine Sulfate’s Safety Record
Glucosamine sulfate appears to be extremely safe, non-toxic and is tolerated very well by most individuals. The most common, albeit rare, side effects concerning glucosamine sulfate are stomach upset, heartburn, and indigestion. If these occur, ingesting glucosamine with a meal will probably remedy the gastrointestinal symptoms.
Additionally, concern has been raised regarding the sulfate in glucosamine. If you’re allergic to sulfa drugs or sulfite-containing foods, rest assured that sulfur is an altogether different substance. Sulfur is an essential mineral and the sulfate form of sulfur is present in relatively high concentrations in the blood. The sulfate in glucosamine will not cause an allergic reaction.

All statements made have not been evaluated by the FDA. All statements are based on studies and/or research,  are for informational purposes only and are not intended to diagnosis, treat, cure or prevent any disease. The nutritional supplement discussed in this newsletter is not a drug and should not be used as a drug or in lieu of drugs prescribed by your physician. Always consult with your physician before taking any pharmaceuticals and nutritional supplements.

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