Physically
Centered

By Jason Barker ND

Dr. Barker is a naturopathic physician specializing in sports medicine and family practice. His practice is in NW Portland. Once an avid athlete, he now gets his exercise by taking care of his brand new twin daughters!

Contact Dr. Barker at
503-243-6614

A vigorous five-mile walk will do more good for an unhappy but otherwise healthy adult than all the medicine and psychology in the world.
— Paul Dudley White

Third in a Series
Nutraceuticals and Glucosamine

Nutraceuticals
In its broadest sense, “nutraceutical” is the term given to any product that is enhanced with vitamins, minerals, herbs, or other food-derived substances. A nutraceutical is a concentrated collection of these items with proven medicinal and or health benefits.

One may think of a nutraceutical as any combination of one or more of the above substances that have been packaged for a specific health concern. Examples of nutraceuticals include glucosamine, fish oils, or one of the many combination products out there. As I have mentioned in previous articles, one must keep a wary eye on which nutraceutical products they purchase and consume. There are many excellent formulations made by several reputable manufacturers; yet for every worthy product there are 10 that leave much to be desired. In short, buyer beware as contents vary widely!

Glucosamine (Glucosamine sulfate)
Glucosamine is nutraceutical made up of amino acids and sugars. It is made in the body in a variety of different forms and is found mostly as a part of the cartilage matrix. Cartilage is typically a spongy, yet firm substance that acts as a cushion between the joints. Glucosamine is necessary for the synthesis of several different compounds that go into creating cartilage, tendons, ligaments, and synovial fluid (the fluid found in joints). When sold commercially, glucosamine is derived from the shells of marine animals. One of the biggest concerns about glucosamine is whether it is safe for people who have a shellfish allergy (shrimp, lobster, crabs). In short, the answer is YES, glucosamine is safe. There are no documented reports of allergic reactions to glucosamine in shellfish-allergic patients. However, one should always approach supplementation with caution, especially if one has allergies.

Many athletic injuries are treated with over the counter non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs include Aleve, Anaprox, Bextra, Celebrex, Motrin, Vioxx, ibuprofen, and many others. One of the main problems with these drugs (other than the major problem recently found with Vioxx…) is gastrointestinal bleeding. Aside from this, NSAIDs only address the pain associated with injury. Another side effect of these drugs is that they actually decrease the ability of cartilage to repair and regenerate itself. So, this is something to consider the next time you reach for your pain reliever.

Glucosamine, on the other hand, stimulates the production of cartilage cells as well as production of synovial (joint) fluid. In fact, glucosamine has been shown to slow the progression of osteoarthritis – something all athletes may be concerned about preventing. In addition, glucosamine has pain-relieving effects as well. In comparable doses, glucosamine was shown to have similar pain-relieving effects as ibuprofen, and fewer side effects. However, improvement in pain occurred more slowly than with NSAID, but appeared to be longer lasting. The pain relieving effects of glucosamine appear to be due to its cartilage-rebuilding properties; traditional analgesic therapy does not demonstrate the disease-modifying effects of glucosamine supplementation. For the active athlete, glucosamine can be used as an
alternative to anti-inflammatory drugs and analgesics or as a useful adjunct to standard analgesic therapy while supporting cartilage repair and regeneration. How is that for natural medicine?!

Of course, this is not to say that one should throw the ibuprofen out (vitamin I as I sometimes like to call it). Sometimes a little vitamin I is all you need to take the edge off after a long workout. However, as with all drugs, limited intake will serve your body the best. If you find yourself taking ibuprofen more than a few times a month, you may want to ask your doctor about glucosamine supplementation.

Note: Taking glucosamine as pain arises is not effective at pain relief. Glucosamine must be taken for at least two weeks for one to notice an effect and glucosamine is something that should be taken for the long term. Glucosamine has been used in multiple clinical trials safely for up to three years, so far. Other information: Some glucosamine preparations are sold as topical creams; there is no evidence that it is absorbed this way. Oftentimes glucosamine is combined with chondroitin sulfate – there is no evidence that this combination provides a greater benefit than either product alone. There is much variability between glucosamine products – please find a reputable source. One of the most commonly noted side effects of glucosamine is mild stomach upset. Clinically, this seems to pass after a week or two of supplementation. It is important to note that in clinical studies, glucosamine caused no more side effects than a placebo, or sugar pill. Please consult a nutritionally oriented physician if you are considering supplementing with glucosamine.