Baby boomers embrace popular arthritis remedy
If you’d guessed 20 years ago what the “it” drug of the new millennium would be, at least for baby boomers, you probably wouldn’t have said a pill made from shellfish shells and cow trachea.
The pill -- a combination of glucosamine and chondroitin -- is popular with aging boomers because it may ease the pain of arthritis. It’s also the treatment of choice for their beloved aging pets. Can you get any more with-it than that?
Glucosamine is the nutritional supplement derived from crab, shrimp and lobster shells, often combined in a large, hard-to-swallow capsule with another supplement, chondroitin sulfate, the one made from cow cartilage.
And, no surprise here, stores aren’t giving these capsules away.
So why are Americans, from George W. Bush on down, scarfing them up to the tune of $679 million in 2002, according to the San Diego-based Nutrition Business Journal? Two reasons.
First, osteoarthritis -- the kind of arthritis involving the breakdown of a joint’s cushioning cartilage -- now affects an estimated 20.7 million Americans. That’s a lot of painful knees.
Second, those hard-to-swallow capsules may actually work. Research studies have shown that they seem to alleviate symptoms about as well as nonsteroidal anti-inflammatory drugs like Advil, without being as hard on your stomach. (But they usually take longer -- sometimes weeks or months -- to start doing it.)
More intriguingly, they may slow joint deterioration.
“Only recently have people been talking about glucosamine,” says Pat Yevics, 53, a runner who lives in Baltimore. “We’re all starting to have little nagging things.”
Last fall her left knee started to hurt and then gave out in the middle of a marathon. Her diagnosis was torn cartilage, and her doctor suggested she start taking a glucosamine-chondroitin combination before her surgery this January.
“Right before the surgery the knee felt better than it had,” she says, “but I went ahead with the surgery anyway. I’ve been taking it since then. Do I absolutely know it’s making a difference? No, but I think it is; and I’m not taking any chances.”
That seems to be the attitude of a lot of doctors and their patients. Try it. If it works, keep taking it. If it doesn’t, well, there don’t seem to be many side effects. And, unlike some nutritional supplements, the claims for glucosamine are backed up with a certain amount of scientific research, at least enough to have the medical profession interested and the Arthritis Foundation using words like “promising.”
In the last decade, as the body of scientific research on dietary supplements has grown, more doctors have had a change in attitude toward the products, which used to be viewed with nearly universal suspicion. Dr. David Hungerford, a professor of orthopedic surgery at Johns Hopkins Orthopedic at Good Samaritan Hospital in Baltimore, was an early convert.
In 1996 he decided to try glucosamine, which he had read about in an article, “The Neglect of Glucosamine as a Treatment for Osteoarthritis” in the journal Medical Hypotheses. His fingers had started to be so stiff and sore he was afraid he couldn’t operate. It took about two weeks for him to see a difference, although it can take as long as three months.
Glucosamine doesn’t act as a painkiller, Hungerford says, or it would work right away, “so it has to be modifying the disease’s progress.”
All this is making Todd Henderson a very happy man. And why not? He’s sitting in the catbird seat. A former veterinarian, he’s now vice president of Nutramax Laboratories, one of the most successful manufacturers of glucosamine-chondroitin supplements in the country. His company, in Edgewood, Md., makes CosaminDS, the brand often used in clinical trials in the United States.
The fact that Henderson was a veterinarian is significant. More than a decade ago he saw a possible market in treating arthritic animals. Who knew then that people would be willing to spend so much money on their cats and dogs to keep them active into extreme old age? Of the 22,000 small-animal veterinary practices in the country, he says, 19,000 now dispense the company’s product Cosequin.
Not only that, Nutramax supplies glucosamine-chondroitin to the Ringling Bros. and Barnum & Bailey circus for its elephants’ feet. The several SeaWorld parks treat their seals with it (for arthritic flippers). In a Texas A&M; study of animal patients, Henderson says, “About 80% improved -- about what we find in people.”
The human body manufactures its own glucosamine to help keep joint cartilage healthy. Eating shellfish shells and cow cartilage to increase the supply of glucosamine has a magic feel to it.
But there is evidence it works. The problem is that so far, those promising scientific studies have involved only a small number of people. That’s going to change next spring, when the National Institutes of Health releases the first set of results in an important new clinical trial.
The NIH study, coordinated by the University of Utah, is a double-blind, placebo-controlled trial involving 1,600 people ages 40 and older with osteoarthritis of the knee. The patients get glucosamine only, chondroitin only, a combination of the two, celecoxib (Celebrex is the brand name most people know) or a placebo. The first part of the study looks at how well the products reduce symptoms, but the researchers are also using X-rays to see if the supplements slow the progression of arthritis.
“Does anything alter the course of the disease?” says Daniel Glegg, chief of the Division of Rheumatology at Utah. “It’s a question well worth asking. The drugs are very safe. The question is whether they have any efficacy.”
