Patients will frequently ask me what supplements they should use to help treat their conditions and more often, they begin to take something even prior to asking. I was recently asked my thoughts on glucosamine and chondroitin for arthritis, and more specifically, osteoarthritis pain management.
Glucosamine and chondroitin has a lot of mixed evidence for efficacy. For every study that you find supporting its use, you can often punch holes in the studies and identify situations where there may have been biases or placebo effects. You can also question if some of the positive changes in the studies are clinically significant in real life. For the studies that did not find a significant difference, many will often point to inadequate dosing or an underpowered trial.
If you aren’t convinced by the evidence, you’ll be unlikely to recommend glucosamine and chondroitin to patients. I generally don’t recommend its use unless I’m really grasping for options. In geriatrics, we can and often do run into the situation where numerous medications have been tried in the past and were unsuccessful or the patient has contraindications to certain medications (NSAIDs being a common example). This is where glucosamine and chondroitin might sneak into my thought process.
The more common scenario I run into is when patients ask if they can start taking it for arthritis pain. The side effect profile is typically pretty minimal when this combination is used at standard dosages. I will typically allow patients to give it a shot if they are inclined to do so. I typically recommend taking it for 3-6 months. Patients should monitor their symptoms closely for new adverse effects and clinical improvement. If they don’t notice any changes after a few months, then I would recommend discontinuing it. If adverse effects are encountered, glucosamine and chondroitin should be discontinued.
My bottom line: I don’t often recommend glucosamine and chondroitin due to limited efficacy in the literature, but if patients really want to try it, there are not many reasons to avoid its use other than cost and pill burden. What do you think about glucosamine and chondroitin?
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