Chondroitin - What Arthritis Patients Need to Know

Is Chondroitin Beneficial for Osteoarthritis?

Dietary supplement chondroitin
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What Is Chondroitin?

Chondroitin is a component of human connective tissues that are found in joint cartilage and bone. A form of chondroitin, known as chondroitin sulfate, is sold as a dietary supplement, often in combination with other ingredients. In supplements, the chondroitin sulfate usually is derived from bovine (cow) trachea or pork by-products.

Medicinal Uses for Chondroitin

According to the Arthritis Foundation, chondroitin supplements are intended to enhance shock-absorbing characteristics of collagen and block enzymes that break down cartilage.

It may help cartilage retain water and when used together with glucosamine, chondroitin may reverse cartilage loss.

Availability of Chondroitin

Chondroitin is available in capsules, tablets and powder. Chondroitin is often sold in combination with glucosamine. The typical dosage used in clinical trials is 800 to 1,200 mg of chondroitin daily, taken in two or four divided doses.

Precautions and Warnings for Chondroitin

There are a few warnings associated with chondroitin:

  • Chondroitin tablets may contain high levels of manganese, possibly posing a problem with longterm use.
  • Chondroitin could possibly be contaminated during the manufacturing process, as it is isolated from animal products such as beef. There is a theoretical association with Mad Cow disease but no cases have been reported.
  • There may be increased risk of bleeding if chondroitin is taken with NSAIDs.
  • If you have an allergy to sulfonamides, discuss chondroitin with your doctor, who may wish to start you on a lower dose.
  • Diarrhea, constipation, and abdominal pain are other possible side effects of chondroitin.

Clinical Trial Results

Based on early clinical trial results, it appeared that chondroitin could reduce pain and possibly slow disease progression of osteoarthritis. The problem: There were inconsistent results from early trials and those early trials were said to be of moderate to poor quality.

Trials published after 2005 have essentially been negative. An analysis of all chondroitin studies showed the supplement lessened pain. But when only high-quality studies were analyzed, chondroitin lacked any true benefit. The GAIT Primary and Ancillary results were long awaited clinical trial results that turned out negative, other than perhaps for a small sub-group of patients. The GAIT trials looked at the effects of glucosamine and chondroitin sulfate in combination.

Cochrane Review of Chondroitin for Osteoarthritis

A Cochrane review that assessed chondroitin for osteoarthritis was published in January 2015. A search of chondroitin studies up to November 2013 yielded 43 studies involving a total of 9,110 subjects. Most of the studies involved knee osteoarthritis (a few involved the hand or hip).

Some of the studies were funded by makers of chondroitin, and other studies used questionable methods. There appeared to be inconsistent results based on the method used. That said, the review concluded that:

  • Chondroitin may improve pain slightly over a short-term period (less than 6 months)
  • Chondroitin improves knee pain by 20% in a few more people than placebo (53 vs. 47 out of 100 people)
  • Chondroitin may improve quality of life slightly (evaluated using Lequesne's index)
  • Chondroitin has little or no adverse events compared to other agents
  • Chondroitin slightly slows narrowing of joint space on x-ray 

The Bottom Line

The evidence to support the use of chondroitin is inconsistent. There is no clear advantage of chondroitin over glucosamine sulfate. There is also no clear advantage from combining chondroitin with glucosamine versus glucosamine alone. There may be a modest benefit of chondroitin use for a limited number of patients.

Sources:

Chondroitin for osteoarthritis. Cochrane. Singh et al. January 28, 2015.
http://www.cochrane.org/CD005614/MUSKEL_chondroitin-for-osteoarthritis

Dietary Supplements for Osteoarthritis. American Family Physician. Gregory PJ et al. January 15, 2008.
http://www.aafp.org/afp/20080115/177.html

Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). NCCAM. Jaunary 9, 2009.
http://nccam.nih.gov/research/results/gait/

Chondroitin Sulfate. Primer on the Rheumatic Diseases. Thirteenth Edition. Published by Arthritis Foundation. Accessed 8/15/2009

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