Joint Health Supplements
I love it and think it’s good for me, but I also wonder whether eating fish could be bad for us, with all the poison in the water? I love salmon, cod and halibut, so I have a good reason to worry about this. J.S. A: The damage to the nuclear power plant in Japan did cause the release of contaminated water into the ocean. Fish caught off the coast of Japan in 2011 and 2012 did exceed recommend levels. I personally wouldn’t recommend eating fish caught off the coast of Fukushima.
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“Although we were not surprised, it is interesting to note that not only did supplemental calcium use and vitamin D use increase for all women aged 60 and over from 1988 to 1994 to 1999 to 2002, but there was also an increase from [between] 1999 [and] 2002 to 2003 to 2006,” said Jaime Gahche, a nutritional researcher with the National Center for Health Statistics and lead author of the study. Supplements can contain high amounts of specific nutrients, and are often used to increase nutrition in a person’s diet. Because so many Americans use vitamin supplements , researchers hoped to assess people’s use of them in order to get an accurate picture of the population’s dietary intake. The study, sponsored by the Centers for Disease Control and Prevention’s National Center for Health Statistics , found that more than 40 percent of Americans used supplements from 1988 to 1994, and more than one half took vitamins from 2003 to 2006. Multivitamins were found to be the most commonly used supplement. Of particular interest to the researchers were vitamin D, calcium and folic acid supplements.
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Vitamins and Vitamin Supplements: Use Increases in America
These supplements, which may be taken separately or together, have gained popularity in recent years. Studies report that glucosamine and chondroitin supplements appear to be relatively safe and well tolerated when used appropriately.5,6 Joint health supplements are formulated to support and protect healthy joint cartilage, serve as an alternative treatment for OA, and are marketed as single-entity or combination products. Table 2: Examples of Common Signs and Symptoms of Osteoarthritis1 Joint soreness after extended periods of overuse or inactivity Episodes of stiffness after periods of rest that goes away rapidly when activity resumes Morning stiffness, which typically lasts no more than 30 minutes Episodes of pain caused by weakening of muscles surrounding the joint due to inactivity or a sedentary lifestyle Joint pain that is typically less painful in the morning but worse in the evening after a days activity Deterioration of coordination, posture, and walking due to pain and stiffness Glucosamine and Chondroitin According to the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM), in recent years, glucosamine and chondroitin have demonstrated some potential for reducing pain associated with OA, although there are still conflicting results and there is no conclusive scientific evidence regarding the exact effectiveness of these supplements.6 The Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), which was cosponsored by the NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, evaluated the effectiveness and safety of glucosamine and chondroitin when taken together or separately.5,6 The trial concluded that the combination of glucosamine and chondroitin did not provide significant relief from pain associated with OA among all participants.6 However, a subgroup of study participants with moderate to severe pain reported significant relief with the combination.6 Glucosamine and chondroitin are classified as natural substances found in and around the cells of cartilage.7 Glucosamine is classified as an endogenous mucopolysaccharide that the body produces and distributes in cartilage and other connective tissue, and chondroitin sulfate is classified as a complex carbohydrate that helps cartilage retain water.7-10 In the United States, glucosamine and chondroitin are sold as dietary supplements, which are regulated as foods rather than drugs.6,7 These supplements are available as single-entity formulations but are most often found in combination formulations. Glucosamine Glucosamine is believed to maintain and strengthen cartilage for overall mobility and support.7-9 Glucosamine is used by the body as a precursor for cartilage synthesis and may also serve as a sulfur donor for the sulfur bonds used in the production of cartilage.7 Research also states that glucosamine is essential to keep cartilage tissue lubricated and to maintain its naturally slippery texture.7-9 Some studies have demonstrated that glucosamine may slow the progression of knee cartilage degradation and increase cartilage growth in some individuals.7-9 Glucosamine supplements are marketed to slow the deterioration of cartilage, relieve pain associated with OA, and improve joint motility.8 Glucosamine is typically given in doses of 1500 mg daily.7 Patients should be advised that glucosamine will not provide pain relief as quickly as analgesics such as nonsteroidal anti-inflammatory drugs and APAP. Glucosamine may take 6 to 8 weeks to exhibit a therapeutic effect; continued use of analgesics, if appropriate and if no contraindications, may be needed.7 The full effects of glucosamine may take as long as 4 to 6 months to be realized.7 The most common adverse effects include nausea, upset stomach, constipation, and diarrhea.7 Adverse effects can be minimized by taking glucosamine in divided doses.7 Pregnant and lactating women should avoid the use of this supplement due to lack of clinical safety data.7 Clinical studies have shown that glucosamine may raise blood pressure and cholesterol levels as well as exacerbate asthma in some individuals, but the clinical results are inconclusive.7-9 Researchers report that glucosamine may interact with anticoagulants such as warfarin, so caution should be observed when both products are used.7-9 In addition, there is conflicting scientific evidence regarding the effects of glucosamine on glucose metabolism. Some studies report that glucosamine may elevate blood glucose levels in patients with type 2 diabetes mellitus, so patients should consult their primary health care provider prior to using supplements that contain glucosamine.5-9 Some studies report, however, that for most diabetic patients taking glucosamine, routine blood glucose testing appears to be an effective monitoring parameter to detect elevated blood glucose levels.5-9 In addition, because glucosamine supplements are often derived from shells of shrimp, lobsters, or crabs, patients with seafood allergies should avoid the use of these supplements.5-9 Chondroitin Chondroitin sulfate is classified as a glycosaminoglycan that is normally present in cartilage.7 Chondroitin acts as a building material in cartilage production, stimulates chondrocytes to produce cartilage, and serves as a sulfur donor, which is a key function in the synthesis of cartilage.7 As a supplement, chondroitin is utilized primarily for treating OA and promoting joint health; it is marketed to reduce pain and inflammation, improve joint function, and slow the progression of OA.9-11 Usually, chondroitin is found in products that contain glucosamine as well.
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