Supports Joint Structure, Function, and Comfort*
The Roles of Glucosamine and Chondroitin Sulfate in Joints
Articular cartilage is a connective tissue composed of specialized cells (chondrocytes) embedded in a matrix of protein fibers (mostly collagen) and clusters of complex proteoglycan molecules that consist of a protein core with numerous side chains. These side chains, chiefly chondroitin sulfate and keratin sulfate, are long polysaccharide molecules called glycosaminoglycans.
Chondroitin sulfate (CS) and the other glycosaminoglycans strongly attract water due to the negative charges of their sulfate groups. These negative charges also repel each other, creating spaces between glycosaminoglycan side chains where water can enter. This combination of solid and liquid gives cartilage a compressible quality that allows it to function as a shock absorber for joints.1
Glucosamine is a fundamental building block for proteoglycans and glycosaminoglycans. Glucosamine sulfate (GS) helps to maintain joint health through its ability to both act as a component of and stimulate formation of cartilage glycosaminoglycans and the hyaluronic acid backbone essential for the formation of cartilage proteoglycans.2
The Abundant Evidence Behind Glucosamine and Chondroitin Sulfate
Extensive joint health research over the past few decades has investigated the effects of glucosamine sulfate, chondroitin sulfate, or a combination of the two. A 2009 meta-analysis summarized results from 6 well-designed studies involving a total of 1,502 research participants. The authors of this meta-analysis were able to make some conclusions about the apparent effectiveness of long-term oral supplementation with CS or GS. Glucosamine sulfate at 1,500 mg daily over a period of at least 3 years and chondroitin sulfate at 800 mg daily over a period of at least 2 years both helped subjects maintain healthy knee cartilage structure.3 In a 2008 review of GS & CS used for joint support, the London physician who wrote it concludes that, “Glucosamine, chondroitin, and the combination of these two agents have stood the test of time.”4
Glucosamine sulfate is one of the most important—and thoroughly researched—dietary supplements for joint health ever developed. 5 In addition to its potential to influence joint structure (and thus function), research also backs the ability of GS to influence joint comfort. In one such multicenter, randomized, double- blind, parallel-group study of 252 subjects, joint comfort in the knee was found to be higher in the glucosamine sulfate group than the placebo group.6 Similar studies of equal magnitude found that GS enhanced joint comfort.7, 8 Key among findings from these types of studies is the reoccurring theme of a good safety profile for glucosamine sulfate; reported “side effects” of GS were essentially no different than placebo.
Similar to glucosamine, chondroitin sulfate is known to influence the maintenance of healthy cartilage—in this case by acting on matrix metalloproteases (MMPs). Chondroitin sulfate has been shown to inhibit MMP-3 synthesis, which plays an important role in homeostasis of cartilage proteoglycans. Additionally, CS can downplay MMP-13 in chondrocytes, helping to maintain the integrity of articular cartilage matrix.9
Clinical Trials Explore MSM’s Joint Action
A exploratory study conducted at the U.C.L.A. School of Medicine examined the potential of Lignisul® MSM to effect maintenance of joint comfort. In this small double-blind trial of sixteen subjects, those taking MSM registered an 82 percent higher level of comfort compared to 20 percent among placebo. Though preliminary due to the small number of subjects, these results suggest potential for MSM as a joint support nutrient that warrants further investigation in larger double-blind trials.10 Results from a pilot clinical trial examining the effect of MSM supplementation on joint comfort in 50 men and women are also encouraging. Subjects taking MSM for 12 weeks experienced greater joint comfort than those on placebo.11 MSM has also been used in combination with glucosamine to study their impact on the health of joints. In one such study, a total of 118 subjects were randomized into one of four groups for 12 weeks: glucosamine (500 mg three times daily), MSM (500 mg three times daily), the combination of glucosamine and MSM, or a placebo treatment. Glucosamine alone and MSM alone were shown to enhance joint function, while he combination was found to be even more effective, by both subjective and objective measurements.12
1.Mansour, J., Biomechanics of Cartilage, in Kinesiology: The Mechanics and Pathomechanics of Human Movement. 2004, Lippincott Williams & Wilkins: Baltimore. p. 14.
2.Kelly, G.S., The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev, 1998. 3(1): p. 27-39.
3.Lee, Y.H., et al., Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int, 2010. 30(3): p. 357-63.
4.Huskisson, E.C., Glucosamine and chondroitin for osteoarthritis. J Int Med Res, 2008. 36(6): p. 1161-79.
5.Vangsness, C.T., Jr., W. Spiker, and J. Erickson, A review of evidencebased medicine for glucosamine and chondroitin sulfate use in knee osteoarthritis. Arthroscopy, 2009. 25(1): p. 86-94.
6.Noack, W., et al., Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis and Cartilage, 1994. 2: p. 51-59.
7.Muller-Fassbender, H., et al., Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage, 1994. 2(1): p. 61-9.
8.Herrero-Beaumont, G., et al., Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator.
9.Monfort, J., et al., Biochemical basis of the effect of chondroitin sulphate on osteoarthritis articular tissues. Ann Rheum Dis, 2008. 67(6): p. 735-40.
10.Lawrence, R.M., Lignisul MSM (Methylsufonylmethane): A Double Blind Study of its Use in Degenerative Arthritis. p. 8 pgs. Unpublished report, likely 2001.
11.Kim, L.S., et al., Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthritis Cartilage, 2006. 14(3): p. 286-94.
12.Usha, P.R. and M.U. Naidu, Randomised, Double-Blind, Parallel, Placebo- Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig, 2004. 24(6): p. 353-63.