Reversal Of Glucosamine Ban Opposed: Thailand

[webfact]

Reversal of glucosamine ban opposed

PONGPHON SARNSAMAK

THE NATION

BANGKOK: -- A board member of the National Health Security Office (NHSO) yesterday protested the public health minister's reversal of a ban on glucosamine for treatment of arthritis patients under the civil-service insurance plan.

Public Health Minister Dr Pradith Sinthawanarong, who chairs the drug and pharmaceutical equipment management system, medication reimbursement and medical services committee, had instructed the Comptroller General Department (CGD) to withdraw its announcement forbidding civil servants from receiving glucosamine at state hospitals.

The minister said his order followed the committee's recommendation, which allows civil servants to receive glucosamine but only under a doctor's specific orders.

Pradith said the committee would seek a median reimbursement rate for patients who receive the treatment. Patients who use the supplement at a higher-than-approved price will not be reimbursed.

This regulation will come into effect on January 1.

Earlier this month, the CGD had announced a ban on glucosamine sulphate as a budgetary measure. The department found that the government was spending more than Bt700 million a year to reimburse civil servants who used the supplement.

The department is also seeking to limit expenses for eight illnesses and for outpatient services next year.

NHSO board member Boonyeun Siritham said she was disappointed with Pradith.

"I don't believe that the government will follow its commitment to reduce the health-care costs," she said.

The CGD's decision to ban glucosamine arthritis treatments under the civil-service health plan was not only because of financial reasons but also because the efficacy of glucosamine is disputed in medical circles.

"What kind of information, study or research did Pradith use to make his decision?" Boonyeun said.

Another NHSO board member, Dr Wichai Chokewiwat, has also opposed another idea of Pradith's - to dissolve the small health-care funds under the universal health coverage. The small funds currently help people with chronic diseases, such as diabetes, high blood pressure, heart disease, cancer and kidney disease, giving them access to medicine.

"This idea would drag the country backwards," he said.

-- The Nation 2012-11- 21

[Thai at Heart]

Considering that if you google this as a treatment, you get completely conflicting reports as to whether it works, i an more surprised that it should be considered worthwhile to fund it.

[theajarn]

Looks like another "minister" looking for new ways to line his pockets, but good to see there are people who are trying to resist corruption.

Shame, shame that this "minister" would gladly put in jeopardy the health of people in need of healthcare... just to line his own pockets. How low will snivelling politicians go?

[asiawatcher]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

[Thai at Heart]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

which allows civil servants to receive glucosamine but only under a doctor's specific orders

I think this is the kicker here. It was obviously too freely available, so now you have to get a prescription, so it can't just be handed over in excess. In which case it isn't banned. To be honest, I find the logic of the statement of the headline all a bit double negative for me.

[OzMick]

I have tried Glucosamine (combined with chondroiten) in the early stages where I would try anything, for a proposed 6 month trial that turned into 8 because I bought a few bottles at a "sale" price - which indicated the mark-up was pretty hefty. There was no discernable difference to my condition taking it or not, though anti-inflammatories do make a major difference.

None of the arthritis specialists I have consulted recommend its use, though agree that some users think it is beneficial. Some would with any placebo in a condition without treatment.

One of the 2 is supposedly cartilage material (non-human), the presence of which in the bloodstream reduces further cartilage loss. I equate this to advice to lick my cat to prevent hair loss.

[noitom]

I have tried Glucosamine (combined with chondroiten) in the early stages where I would try anything, for a proposed 6 month trial that turned into 8 because I bought a few bottles at a "sale" price - which indicated the mark-up was pretty hefty. There was no discernable difference to my condition taking it or not, though anti-inflammatories do make a major difference.

None of the arthritis specialists I have consulted recommend its use, though agree that some users think it is beneficial. Some would with any placebo in a condition without treatment.

One of the 2 is supposedly cartilage material (non-human), the presence of which in the bloodstream reduces further cartilage loss. I equate this to advice to lick my cat to prevent hair loss.

My experience with Glucosamine and Chondroitin is that it is highly effective on my back, neck and knee arthritis. I go on for 30 days and off for 30 days so as not to develop any immunity for it. I say it works. I found professional orthopedic surgeons generally don't recommend it. But GPs and family medicine guys tell you not to use vitamin supplements. I believe that's an old AMA posture that opposes self healing and holistic health practices.

[noitom]

I just had to look at the Vitamin Shoppe bottle for the blend that I use:

Glucosamine - 500mg

Chondroitin - 400mg

MSM - Methysulfonylmethane - 500mg

I usually take 2-3 of the above caps a night and 2-3 in the morning for a few weeks and it does wonders.

[davejones]

Considering that if you google this as a treatment, you get completely conflicting reports as to whether it works, i an more surprised that it should be considered worthwhile to fund it.

Google anything and you'll get conflicting opinions. Good job you're not in charge of healthcare if you use Google to see if something works or not. Glucosamine is a fantastic supplement.

[davejones]

I have tried Glucosamine (combined with chondroiten) in the early stages where I would try anything, for a proposed 6 month trial that turned into 8 because I bought a few bottles at a "sale" price - which indicated the mark-up was pretty hefty. There was no discernable difference to my condition taking it or not, though anti-inflammatories do make a major difference.

None of the arthritis specialists I have consulted recommend its use, though agree that some users think it is beneficial. Some would with any placebo in a condition without treatment.

One of the 2 is supposedly cartilage material (non-human), the presence of which in the bloodstream reduces further cartilage loss. I equate this to advice to lick my cat to prevent hair loss.

For treatments to work it is generally true that you need to be using pharmaceutical grade supplements and not the low-quality stuff than many shops sell. It is also important to treat the body as a whole and not aim to treat one condition with one supplement. I tried what you tried and had disappointing results. But working under a great doctor with many years of clinical experience I've had fantastic results. The key is to get all the nutrients your body needs over a long period, usually 6-24 months. Can take up to 48 months for some patients. Also, regular testing and adjustments of supplements are necessary. Glucosamine works, but like anything, it won't work for every single patient in every single situation. Maybe your body needed some additional supplements to get it to work, or maybe you didn't adjust your diet to cut out inflammatory foods. It is usually food that causes arthritis, so keep eating the same food and you are bound to continue having problems. It's like trying to put a fire out with water, but at the same time continuing to throw petrol on it.

Edited November 21, 2012 by davejones

[McMagus]

There is a lot of anecdotal evidence that it does work but double blind studies generally are inconclusive at best. The problem is not that the substances are not any good for you but that they are most likely not absorbed in the gut and if they are, can make their way to the arthritic sites. I suffer from arthritis and have yet to try any of these remedies. it is laughable though that the Thais would ban it when you can get virtually anything else over the counter.

[Thai at Heart]

Considering that if you google this as a treatment, you get completely conflicting reports as to whether it works, i an more surprised that it should be considered worthwhile to fund it.

Google anything and you'll get conflicting opinions. Good job you're not in charge of healthcare if you use Google to see if something works or not. Glucosamine is a fantastic supplement.

So why shouldn't it be necessary for someone to get a prescription from a doctor, and measure whether it is effective for that individual? Not saying it doesn't work, just that even reading here, for some people it doesn't work at all. In which case, what would be the point in continuing to prescribe it to someone for whom it doesn't work?

[noitom]

There is a lot of anecdotal evidence that it does work but double blind studies generally are inconclusive at best. The problem is not that the substances are not any good for you but that they are most likely not absorbed in the gut and if they are, can make their way to the arthritic sites. I suffer from arthritis and have yet to try any of these remedies. it is laughable though that the Thais would ban it when you can get virtually anything else over the counter.

The ban occurred because the proper envelope wasn't passed to the right hand. They ban something like this when the Thais parade and stream in daily to the clinics and hospitals with food poisoning from fish balls or something else contaminated with no health standards or regulations. Preposterous set of priorities. Leave it to the Thais. Boy oh boy , these Thais , they are something else. They are very slick, on top of everything.

[OzMick]

I have tried Glucosamine (combined with chondroiten) in the early stages where I would try anything, for a proposed 6 month trial that turned into 8 because I bought a few bottles at a "sale" price - which indicated the mark-up was pretty hefty. There was no discernable difference to my condition taking it or not, though anti-inflammatories do make a major difference.

None of the arthritis specialists I have consulted recommend its use, though agree that some users think it is beneficial. Some would with any placebo in a condition without treatment.

One of the 2 is supposedly cartilage material (non-human), the presence of which in the bloodstream reduces further cartilage loss. I equate this to advice to lick my cat to prevent hair loss.

For treatments to work it is generally true that you need to be using pharmaceutical grade supplements and not the low-quality stuff than many shops sell. It is also important to treat the body as a whole and not aim to treat one condition with one supplement. I tried what you tried and had disappointing results. But working under a great doctor with many years of clinical experience I've had fantastic results. The key is to get all the nutrients your body needs over a long period, usually 6-24 months. Can take up to 48 months for some patients. Also, regular testing and adjustments of supplements are necessary. Glucosamine works, but like anything, it won't work for every single patient in every single situation. Maybe your body needed some additional supplements to get it to work, or maybe you didn't adjust your diet to cut out inflammatory foods. It is usually food that causes arthritis, so keep eating the same food and you are bound to continue having problems. It's like trying to put a fire out with water, but at the same time continuing to throw petrol on it.

Ah yes. On my visits to Oz, with its aging population, I have noticed the huge number of arthritis remedies, cure-alls and dietary supplements, all with their paid mouth-pieces proclaiming how great they are. The sharks smell blood in the water...........

Inflammatory foods? Would that be chillies, dairy products or one of the other food groups I've been advised to avoid, except by my doctors who have no proven trial on any dietary input or avoidance?

BTW "fantastic" has a dictionary meaning quite different to the colloquial usage.

[rucus7]

I have tried Glucosamine (combined with chondroiten) in the early stages where I would try anything, for a proposed 6 month trial that turned into 8 because I bought a few bottles at a "sale" price - which indicated the mark-up was pretty hefty. There was no discernable difference to my condition taking it or not, though anti-inflammatories do make a major difference.

None of the arthritis specialists I have consulted recommend its use, though agree that some users think it is beneficial. Some would with any placebo in a condition without treatment.

One of the 2 is supposedly cartilage material (non-human), the presence of which in the bloodstream reduces further cartilage loss. I equate this to advice to lick my cat to prevent hair loss.

Same here, I used it for well over one year. No results. True double blind testing now seems to indicate it is less effective than a placebo.

[partington]

Buy anything you like that's safe and does nothing, like glucosamine. Makes you feel better and gives glucosamine manufacturers a living.

Better still buy water in capsules marked glucosamine.

The reason why all drugs are tested using double blind studies (where neither the doctor or the patient knows who is taking the drug and who is taking the sugar pill placebos) is because things with no active ingredient WORK.

Taking a pill with nothing in it WORKS for nearly all medical conditions: this is not imagination but a fact.

It is this fact that compels drug companies to do trials that cost twice as much as just testing the active pharmaceutical on its own. It is so well recognised that testing a compound without a simultaneous parallel test of no compound is meaningless that they just have to do it. You have to prove the drug-containing pill gives a greater improvement than the improvement that you always get from a blank pill.

So people who say this or that supplement "makes them feel better" or "works" are being at best, naive about how minds and bodies are well recognised to work. You DO feel better. The question that has to be answered is: if you were taking water and thinking it was glucosamine would the effect be any less?

For glucosamine there's no evidence it does anything, and the thinking underlying its use it seems magical at best, as someone pointed out above. It's like thinking if I ate a load of eyeballs my eyesight would get better!

[Old Man River]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

which allows civil servants to receive glucosamine but only under a doctor's specific orders

I think this is the kicker here. It was obviously too freely available, so now you have to get a prescription, so it can't just be handed over in excess. In which case it isn't banned. To be honest, I find the logic of the statement of the headline all a bit double negative for me.

Yeh, the headline is very confusing.

The government just wants to set a standard price for reimbursement purposes.

[lemoncake]

Considering that if you google this as a treatment, you get completely conflicting reports as to whether it works, i an more surprised that it should be considered worthwhile to fund it.

It does work though not covered under any insurance because its not considered a medicine but a suppliment

I been on it for past 5 years, if i come off, i suffer crazy pain(after shoulder surgery)

2 of my elderly dogs also on it and without it they can hardly walk

Saying that, it is not a medicine, so i can understand why it is not covered, just like herbs are not covered

[Thai at Heart]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

which allows civil servants to receive glucosamine but only under a doctor's specific orders

I think this is the kicker here. It was obviously too freely available, so now you have to get a prescription, so it can't just be handed over in excess. In which case it isn't banned. To be honest, I find the logic of the statement of the headline all a bit double negative for me.

Yeh, the headline is very confusing.

The government just wants to set a standard price for reimbursement purposes.

That is what I read. So, if you go to buy extremely expensive glucosamine from one of these multilevel marketers, who ironically, could be say your wife, so she can run a business on the back of your purchase, you aren't going to get reimbursed because the pricing of such product has to include commissions for 5 people in your line.

Which of course, no completely honest civil servant would ever ever do.

[BillyBobThai]

Friends back in the states had a black lab that would not use his back legs to walk. He would drag himself around the yard with his front feet. After using liquid Glucosamine for three months this dog was running like the other dogs.

I took it for about 2 years for a bad shoulder, and to this day, some 15 years later the shoulder is fine.

[skippybangkok]

Artrodar is far superior anyway....

[geriatrickid]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

Nonsense. The Thai FDA does not endorse drugs of this class. Endorsement is not within the mandate of the Thai FDA. Nor would the FDA endorse a product that has unproven benefits. Independent clinical trials have not supported the claims of the product manufacturer(s). in the absence of clinical trial evidence, the dispensing of the drug is treated as a "placebo" distribution. Claims of charlatans and snake oil purveyors on the internet can not replace bonafide clinical trial data. There are plenty of claims on the internet that enemas and colonic irrigation are cure alls too, and thankfully, most people have enough common sense to avoid such activity.

[01322521959]

This is ridiculous. Glucosamine has been around for decades, is helpful in the majority of cases and endorsed by the watchdog bodies of FDA (Food and Drug Administrations) and TGA (Therapeutic Goods Administrations) globally and Thailand now wants to remove it as a safe alternative to drugs? Even the internet will provide gazillions of articles of successes and some conflict as it reacts differently as we are all different in diet and build. It works far better when people have a non active life, sportsmen being at far higher risk and less effective.

Nonsense. The Thai FDA does not endorse drugs of this class. Endorsement is not within the mandate of the Thai FDA. Nor would the FDA endorse a product that has unproven benefits. Independent clinical trials have not supported the claims of the product manufacturer(s). in the absence of clinical trial evidence, the dispensing of the drug is treated as a "placebo" distribution. Claims of charlatans and snake oil purveyors on the internet can not replace bonafide clinical trial data. There are plenty of claims on the internet that enemas and colonic irrigation are cure alls too, and thankfully, most people have enough common sense to avoid such activity.

So lets get this straight. I started taking Glucosamine this week, I have awfully painful shoulder and elbow joints, 1500 mg, 240 Baht for 10 days worth.Will it help or not?

[TongueThaied]

According to my research, glucosamine seems to work for some people and not for others. Nobody seems to know why this is. Could it be the placebo effect? Could be, but how does that explain the success with dogs and racehorses?

My maternal grandmother, my father and my mother all developed serious arthritis in the hands. My mom read something about glucosamine sulfate back in the 80's (mostly it was used for racehorses back then). By this time she was 60 and her hands were already showing deformation in the knuckles; she had it pretty bad. She and my dad decided to give the stuff a try. It worked. It completely arrested their arthritis. The deformation i my mom's hands never when away, but the progression -- and the pain -- stopped forever. My grandmother was dead by then, but I remember her constant suffering because of her arthritic hands. She could not open a jar or do anything else that required hand strength.

With my arthritic genes, I developed arthritis in my hands when I was around 45. I started taking glucosamine and it stopped it. At various times, when my supply ran out, I stopped taking it. I mean, no pain, what's to think about? Within several months, it always came back, and I started taking it again. After a few months, the arthritis was banished again. My sister has the same story. Thee days, I try to stay on it. I also make an effort to exercise my hands. I have some of those spring-loaded things you squeeze and a couple of rubber balls to squeeze. All this hand exercise is also good for my sex life when my wife has a headache.

Taking glucosamine is harmless; it is not a drug. Taking anti inflammatories and other drugs is not healthy. I can't speak for anybody else, but glucosamine sulfate sure works for me and I swear by it. I take 2,000 mg a day. Despite a lot of research, I have never found any support for the efficacy of chondritin (except by those who sell it), so I don't waste my money on it.

If it is the placebo effect, so be it, I really don't give a shit, as long as I am not plagued by the pain and weakness arthritis brings to my hands.

It's a damned shame, though, like with vitamins, that the greedy wealthy families that have a monopoly on the drug trade in Thailand cut such a fat hog on the stuff. No competition. I buy it from Puritan's Pride on the Internet in the US and have my sister ship it over by post. Costs about half as much as the Thai offering.

[oldthaihand99]

According to the Mayo clinic:

"Glucosamine and chondroitin. Studies have been mixed on these nutritional supplements. A few have found benefits for people with osteoarthritis, while most indicate that these supplements work no better than placebo. Don't use glucosamine if you're allergic to shellfish. Glucosamine and chondroitin may interact with blood thinners such as warfarin (Coumadin) and cause bleeding problems."

http://www.mayoclinic.com/health/osteoarthritis/DS00019/DSECTION=alternative-medicine