Thursday, October 11, 2007

Glucosamine Sulfate

When I finished my sports medicine fellowship at DePaul University, I was doing the usual family practice thing in the office but then applying physical medicine to all patients. I was seeing a large number of knee pains especially during spring and summer. Many consults were from my partners and at that time they had a large number of older patients. With the multitude of medicines they were on already, I dedided to try something I read about in a journal. At the time glucosamine sulfate was just gaining momentum in the US. All the studies available were from Europe comparing glucosamine sulfate to naprosyn and ibuprofen in joint range of motion. Of course the results were equal if not better than the two medicines. With the lack of gastrointestinal side effects. I began asking patients to try 1500 mg daily of the supplement but there was no place to buy it aside from walgreens. Nothing against that chain (thats when they didnt have drive through) but I found only a small group had nice results. Usually it was the patient that went a step further and found a distributor that marketed their own brand. So quality was proving a better impact with knee pain patients that the quanitity driven chain stores.

Glucosamine sulfate studies were usually with chondroitin sulfate. The action was thought to be stimulation of that little cell called a chondroblast. These are the ones that build up the cartilage matrix when damage has occurred to the smooth moving surface of a joint. There were later studies in the US, a big one was teh GAIT study which said it didnt help compared to celebrex. Problem is that the study doesnt specify if the glucosamine was pharaceutical grade or off the "walgreens shelf" brand. They also only used glucosamine not g-sulfate or g-HCL. Well, my patients respond and no side effects to stomach ulcers, renal failure or heart disease like they do with celebrex.

The "Saguil Approach"= remember, glucosamine is a means to get to an end. I always combine it's use with a proper diet, an antiinflammatory diet and visits with a good physical therapist (that knows McConnell Taping-I believe she is an Austrailian therapist). One the patient and therapist develop better flexibility and Quad control and fix the "Q-angle" of the knee, should be able to decrease the supplement. Omega 3 fish oil is good as well as turmeric, ginger, boswelia, white willow bark (see previous posts) and cryotherapy.