Know Your Joint Supplement Options

Glucosamine, chondroitin and calcium have been popular choices for regular supplementation for joint problems and bone strength, but each has drawbacks with respect to risks, bioavailability and tolerability.  The often overlooked mineral silica is an attractive alternative providing similar benefits without the drawbacks associated with these options. 

Glucosamine:  The amino sugar glucosamine has shown moderate ability to relieve osteoarthritis pain and restore partial movement to affected joints.  However, taking glucosamine derived from sea creatures may cause allergic responses in individuals who are allergic to shellfish.  Diabetics may experience elevated blood sugar levels if they inject glucosamine which interferes with insulin and may even raise blood sugar for individuals who do not have diabetes.  Pregnant or breastfeeding women should not take glucosamine because little is known about its effects on this patient population. 

During research studies, gastrointestinal complaints such as constipation, diarrhea, and nausea were attributed to taking glucosamine; drowsiness and headache were also reported.  In addition, glucosamine may increase the risk of excessive bleeding when taken in conjunction with warfarin; other anticoagulants or anti-platelet drugs; aspirin; or herbal products that reduce the blood's ability to clot.

Chondroitin:  Chondroitin is a sulfate molecule believed to provide a chemical important in the formation of cartilage; however, its effects are not understood as well as glucosamine's.  Chondroitin may help keep cartilage healthy by absorbing fluid into the connective tissue.  However, studies have not shown conclusively that chondroitin helps repair cartilage or even prevents further deterioration.

Many chondroitin supplements are made from cow cartilage.  Vegetarians or those who object to the use of animal-based products should look for the supplement made from algae instead.  Side effects reported include nausea, upset stomach, diarrhea, constipation, indigestion, stomach pain and heartburn. Chondroitin is similar in chemical composition to heparin, a drug used to thin the blood; accordingly, it is theoretically possible for chondroitin to increase the effects of blood thinners. 

Chondroitin is often combined with glucosamine in many popular supplement products such as Osteo Bi-Flex, Cosamin and Estroven.  The Arthritis Foundation recommends exercising caution in taking glucosamine and chondroitin for the treatment of osteoarthritis.  Moreover, the National Institutes of Health funded a study to test the effects of chondroitin and glucosamine on osteoarthritis of the knee.  This multicenter, placebo-controlled, double-blind, six month long trial found that glucosamine plus chondroitin had no statistically significant effect on symptoms of osteoarthritis in the overall group of osteoarthritis patients.[1]

Calcium:  Calcium supplements are widely popular and come in several forms including calcium carbonate and calcium citrate.  The primary difference is calcium carbonate contains almost twice as much elemental calcium as citrate and is generally less expensive.  Calcium citrate is often recommended for the elderly because it may be easier for their digestive systems to absorb.  A recent review of calcium and bone mass studies found that calcium citrate malate has high bioavailability in all age ranges including young girls as well as postmenopausal women. 

Side effects of calcium supplementation include nausea, vomiting, loss of appetite, constipation, stomach pain, thirst, dry mouth and increased urination.  Although calcium supplements reduce the risk for osteoporosis, there is concern that high calcium dosages may increase the risk for hardening of the arteries and kidney stones.  High calcium intake can result in calcium deposition into soft tissue and impair absorption of other minerals such as magnesium, zinc, and iron.  Do not eat large amounts of bran or whole grain cereals and breads because they may reduce absorption of calcium.  Similarly, consuming alcohol, large amounts of caffeine or vitamin D, or using tobacco products may also impair the absorption of calcium.

Silica:  Silica, also called silicon, is an essential mineral and potentiator of other minerals like calcium for bones; glucosamine for joints; and antioxidants for healthier arteries and cardiovascular function.  It is required for the formation of healthy connective tissue, bone, skin, hair, and nails.  Silica is also essential for collagen formation, healthy arteries, and regulation of calcium deposition in the bones.  Studies show silica can even be converted into calcium when there is a deficiency.  Absorption is critical for its effectiveness.  Dietary sources of silica such as those found in food, horsetail, and colloidal gel products are very poorly absorbed because of their insoluble, polymerized forms.  For optimal absorption to occur, silica must be converted to organic silicon like monomethylsilanetriol.  This form of silica has excellent bioavailability and is found in premium product offerings such as Orgono Living Silica.  Unlike the other nutritional supplements discussed for joints, silica has no known side effects.

In addition to knowing the differences between each option available, a few other considerations to keep in mind when selecting a nutritional supplement for joint health are delivery, quality and tolerability. Being informed is the best way to decide which supplement is right for you.