Availability Of Glucosamine/chondroitin

[richardjm65]

I'm up country and cannot find Glucosamine 1500mg with Chondroitin 1200mg. Anyone know where I can order this from for delivery by mail? I want to try this in elevated dosage to try and avoid the necessity for hip and knee replacement.

[Sheryl]

Brand of this available in Thailand:

Atrofort complex (contains 750/600 mg so you'd take 2 to get the dosage you mention)

Made by Rottapharm, and distributed by BLH Trading

http://www.blh.co.th/contact_en.php?lang=con

You could contact BLH Traduing which is the distributor and ask them what pharmacies in your area they have supplied it to. (Or even see if you can buy in bulk directly from them as you will likjely be on this long term).

Glucosamine alone, without chond., is also available widely iunder multiple brand names, many of them locally made. But AFAIK for the combo Atrofort is the only brand.

[jrtmedic]

You may be interested in Dr Stephen Barrets article "Glucosamine and Chondroitin for Arthritis" which can be found here

http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html

[richardjm65]

Thanks, Sheryl and jtmedic. In another post, Sheryl mentioned the brand name 'Kirkland' and though this was for another product, I think this was the brand name recommended by a friend, who is convinced of the efficacy of Glucosamine/Chondroitin in his own case.

The link for Glucosamine was interesting and I noted the caution directed to those who use blood thinners, (which I do), for DVT. So, I'll consult with my DVT doc before trying them. I also noted that if positive results from its use are not noticed within three months, then perhaps they should be discontinued. I did try Glucosamine/ Chondroitin for a limited period, in small doses, as recommended by my joint and bone doc, with no discernible result. Another doc has suggested tripling the dosage.

I guess it's worth trying for a three month period at elevated dosages, if the blood thinner issue can be resolved. If it fails, then I'll have to resort to something else - perhaps hip and knee replacement - which would be expensive. Any other suggestions would be gratefully received.

[jrtmedic]

Richard

Please note the "bleeding" hazard only relates to a known interaction between Chondroitin and Warfarin(Coumadin) As the evidence for any positive effect from taking Chondroitin is very weak you might consider omitting this substance ...............

Edited January 22, 2013 by jrtmedic

[p_brownstone]

Not sure where you are but you can buy Atrofort at the Pharmacist in Villa Soi 33/1 Sukhumvit Bangkok and at the large Pharmacy next to Bully's Pub near Nana.

I recently switched from Viatril - which is only Glcosamide - and find Atrofort much better.

Patrick

[Sheryl]

Richard

Please note the "bleeding" hazard only relates to a known interaction between Chondroitin and Warfarin(Coumadin) As the evidence for any positive effect from taking Chondroitin is very weak you might consider omitting this substance ...............

Which would make the issue of finding it quiet easy as there are many of brands of glucosamine in Thailand, some of them locally made. Any reasonable sized pharamcy will have it.

BTW Kirkland is a US brand distributed by the discount store chain Costco, has many large economy size supplements and several can be found at the Bayon sueprmarket in Phnom Penh, which is where I usually get my supplements as it saves a lot of $ (assuming one is in PP to begin with)

[Sheryl]

....I guess it's worth trying for a three month period at elevated dosages, if the blood thinner issue can be resolved. If it fails, then I'll have to resort to something else - perhaps hip and knee replacement - which would be expensive. Any other suggestions would be gratefully received.

Have you seen an orthopedic specialist and been told (1) that you have OA and (2) that the joint degeneration is of a magnitude to warrant hip/knee replacement?

If not, then that is the first step.

Conservative management of OA usually involves the use of NSAIDs to reduce inflammation and pain but as you are on anticoagulants, should not take without first consulting your physician.

Other home measures include appropriate exercises to strength muscles around the joints (preferrably under the guidance of a physical therapist), weight loss, application of heat, massaging in anti-inflammatory creams, use of braces .

One little trick I find often works is to first apply heat (moist if possible...hot soak, heating pad, or just a really hot bath) and then while the skin around the joints is still quite pink from the warmth, rub in an anti-inflammatory cream such as Voltaren. This enhances the cream's absorption.

Injections of hyaluronic acid into the joint brings symptomatic improvement for some people. It is US FDA approved for use in the knee only but some use it in other joints as well. The relief lasts 6-12 months for those it helps. Doesn't help everyone but may be worth considering if other conservative measures fail or are contraindicated.

If you are at all overweight, weight loss is by far the best thing for you as it reduces strain on the joints.

For good overviews on management of OA see:

http://www.mayoclini...ments-and-drugs

http://www.nhs.uk/Co.../Treatment.aspx

[richardjm65]

Thanks again Sheryl, jtmedic and p_brownstone. I did consult 2 orthopedic doctors at the military hospital in Korat. The first waggled my knee about, did not bother with x-rays and prescribed Glucosamine which, as I said, seemed ineffectual in the dosage prescribed over the time frame of a couple of months. The second doctor (who was recommended heartily by the staff) did order x-rays, told me the erosion of cartilage was too great for Glucosmine to affect, pointed out what he called 'spurs', and suggested that knee joint replacement would be the answer.

I had greater confidence in the second doctor. I have not consulted yet on the hip, as it occurs to me that possibly limping to favour the dodgy knee might well throw strain on the hip on the other side, thus causing pain. I think I'd be inclined to try the glucosamine (without the chond), at elevated dosages for three months, coupled with the home treatment and exercise suggested by Sheryl. I'm a little overweight (72kg) and inactivity to rest the joints seems to have reduced muscle mass whilst growing a bit of a pot.

I'm on 5mg/day of Warfarin for the DVT and was concerned that exercise might result in a pulmonary embolism, but if you feel that moderate exercise (stationery bike, walking and so on) would be safe and beneficial, I'll get started. I use Difelene gel to rub into the knee and when in pain, use an elasticated knee support. I also take Difelene tablets (1 x 50mg) twice a day. If I do not take these, there's a definite increase in pain levels in both the hip and knee. For the DVT I also use a foot to thigh support stocking - it's on the leg without the knee problem.

Thanks again for you interest and helpful posts.

[richardjm65]

Just to round this out, yesterday I was able to find boxes of 30 X 3.95gm (1500mg) water dissolvable glucosmine sulfate sachets distributed by Bangkok Drug Co., Ltd., manufactured by Bangkok Lab & Cosmetic Co., Ltd., at 420baht/box. Worth a try.

[Sheryl]

Yes, Glucosamine is readily available in locally made brands.

From what you say, your hip pain has never been evaluated; if it persists, it should be.

As for your knee, as the doctor who saw your xrays stated the cartiledge loss was too great to be likely to be relieved by glucosamine and also that there were bone spurs present, it may indeed prove the case that you need surgery. Bone spurs can often be removed through minimally invasive surgery, and some degree of cartiledge repair can sometimes be effected that way also. Whether this is true in your case or you need to think of a joint replacement depends on the specifics of the joint. Sometimes bione spurs are present but have little to do with the pain experienced, other times they cause significant pain.

Dr. Panya at Bumrungrad specializes in knee problems and has been favorably recommended by many TV members. Might be with the trip to get his opinion.

[tropo]

You may be interested in Dr Stephen Barrets article "Glucosamine and Chondroitin for Arthritis" which can be found here

http://www.quackwatc...lucosamine.html

Very interesting and thanks for posting that.

I discontinued using Glucosamine/Chondroitin a few years ago after persisting with it for a number of years. I was getting a good product sent from Australia. All I got from it was intestinal gas. Never noticed even a slight benefit from it.

The only thing that helps my knees is regular full range of motion exercises designed to strengthen the muscles around the knee... and I take the regular bone/joint support supplements.

[Ulysses G.]

I first tried the glucosomine/chrondoitin combination many years ago for arthritis pain and have been successfully using it ever since.However, it took 3 full months for it to kick in when I first started using it and I had almost given up when I read somewhere that it often takes that long to have any real effect. Don't give up on it too quickly.

[Ulysses G.]

You have to use it for at least 90 days or many times it will not start to work. I almost gave up the first time I tried the Glucosamine/Chondroitin/Msm combination, but waited the full 90 days when it finally kicked in and have been using it successfully ever since.

Edited January 26, 2013 by Ulysses G.

[richardjm65]

I've heard a good number of positive reports about the use of Glucosamine/Chondroitin. Also heard a few negative reports. The common opinion from successful users seems to be that it does take, (as has been suggested), about 3 months to start to become effective. A friend who is well pleased with his result suggested an elevated dose of two or three times the recommended dose for the first month and after that, backing off to the normal dose which, he says, you must continue to take indefinitely. I've started by doubling the dose.

Given the cost and inconvenience of a joint replacement, I'm quite happy to give it a try for, say, six months. Earlier in this thread jtmedic brought up the fact that the Chondroitin component may have a negative reaction with folk taking blood thinners. As I take Warfarin for another condition, I decided to use Glucosamine only. It would be interesting to know if the blood thinner/Chondroitin issue also applies to the regular use of small doses of aspirin, usually taken to defend against stroke and heart problems.

Do any of you guys know of the side effects of elevated Glucosamine dosage? The pharmacist also stated that it should be taken on an empty stomach, preferably about an hour before breakfast, though the dosage advice on the package made no mention of this. I'm now just three days into it and have noticed an increase in interesting stomach noises and an urge to use the bathroom that will not be denied!

I'm grateful for the interesting and informative responses so far.

[Sheryl]

This is, unfortunately, a side effect of glucosamine in some people.

I'm not aware of any reason why it cannot be taken with food, you might try that and see if it makes a difference.

http://www.mayoclinic.com/health/glucosamine/NS_patient-glucosamine/DSECTION=safety

[F4UCorsair]

The orthopedic surgeon who replaced my hip 6+ years ago told me that glucosamine, etc., is no more than a waste of money. I had used it for about a year with no noticeable improvement. He didn't say that it may have only been so for me, or that it doesn't work for anybody, and those who do use it feel an improvement due to the placebo effect. It's possible that it does I suppose.

Both my knees need replacement due to many years of road running, and the same surgeon said that can be delayed by some years if I worked a lot on strengthening my quads (above the knee muscles). I've been using a stationary recumbent bike, and doing leg raises with huge amounts of weight, and there is definitely an improvement, a massive improvement. He also said that when replacement does become inevitable, very strong quads will aid recovery enormously. Squats aren't recommended because of the compression of the joint. Leg raises don't put the same forces on the mechanics of the joint.

[Filadog]

The glucosamine/chondroitin supplements are not really effective and studies have shown it is merely a placebo effect. Google it. For me they did not work even over an extended period of consumption and honestly the products do not come cheap. Five months ago I did the hyaluronic acid injections for OA in my knees and had reasonable results. I definitely can walk 18 holes of golf completely pain free which I could not before. Studies have shown that it works reasonably well for those without advanced degradation of the knee or what would be considered a younger cross section of people with OA. I am 51 and it helped but there is precaution to be taken which I was not made aware of nor did I run across in my online research prior to starting the treatment. The skill and care with which the injections are given is quite important as I later found out. Fortunately I did not have any lasting adverse effects but if the hyaluronic acid is injected anywhere outside of the knee pocket, it can cause severe and permanent damage to the ligaments or tendons. For me what happened was a tightening around the outside of the knee extending to the top (injection site is on the outside). It was not possible for me to fold my leg all the way due to this tightening. With time this subsided but I would recommend caution in doctor selection and to look for any such symptoms during the treatments and stop them if this happens. I stopped after 4 weekly treatments skipping the 5th. Evidently, the treatment range is actually 3-5 weeks anyway. You may be safer off and have the same results with 3 weeks of treatment as well as saving a bit of money. Shots are 2000 THB each so I spent 16000 THB for the four weekly rounds. Good luck.

[Sheryl]

Filadog, could you share the name& location of the doctor who you went to for HA injections?

The efficacy of glucosamine may relate to when and how it is used, i.e. as a preventive or early in the process as opposed to once significant cartiledge loss has occurred. The studies done to date have a number of limitations. Personally I take it as a preventive measure. Whether it is helping or not I can't say except that at 60 I have no joint problems so far.

[Ulysses G.]

The glucosamine/chondroitin supplements are not really effective and studies have shown it is merely a placebo effect. Google it.

I suggest you do more Googling. Even Quackwatch concedes that glucosamine is probably helpful and many medical studies agree. Chondoritin is more suspect. Edited January 27, 2013 by Ulysses G.

[Tolley]

Krill and or fish oil should be helpful for these type of conditions.

General diet also has an influence. So all the usual things like avoid processed foods, sugar and alcohol and limit read meat consumption

[perconrad]

When I lived in Greenland I took Glucosamine for knee pain, the doctor said it was arthritis and worn knee and the hospital gave it out for free. After having taken it for 2-3 weeks the pain started to disapear, so I took it for more years when in Greenland and did not had any sideeffect. I took 3 tablets a day in the morning as prescribed.

Before taking Glucosamine another doctor gave me Ibuprofen for the pain and that really hurt my stomach, so I stopped with that, better some pain in the knees than ulcer.

Then one time I went on holiday to Thailand and discovered that here in the warm weather I did not have any pain in the knees, so now after I retired I live here on Phuket and even after more than 6 years I have no pain. I do not take Glucosamine here.

And some funny thing, after retiring I have been in Greenland a few times working a few month each time and the pain did not reappear and I did not take Glucosamine again.

[tropo]

The glucosamine/chondroitin supplements are not really effective and studies have shown it is merely a placebo effect. Google it.

I suggest you do more Googling. Even Quackwatch concedes that glucosamine is probably helpful and many medical studies agree. Chondoritin is more suspect.

My take away from that article is that both are waste of money.

[tropo]

Krill and or fish oil should be helpful for these type of conditions.

General diet also has an influence. So all the usual things like avoid processed foods, sugar and alcohol and limit read meat consumption

How does red meat influence the joints?

[Ulysses G.]

At the ACR Annual Meeting 2005, results from two glucosamine trials were presented. GAIT (Glucosamine/Chondroitin Arthritis Intervention Trial) was funded by the NIH and designed to determine safety and efficacy with glucosamine, chondroitin, taken separately or together, and GUIDE (Glucosamine Unum In Die Efficacy) was a European clinical trial. GUIDE results showed glucosamine provided more relief than acetaminophen.

GAIT results showed the combination of glucosamine and chondroitin is better than placebo but the benefits seem to depend on severity of pain. In patients with mild knee osteoarthritis pain, the glucosamine chondroitin combination was not significantly more effective than placebo. http://arthritis.about.com/cs/glucosamine/a/glucosamine.htm

Edited January 27, 2013 by Ulysses G.

[Tolley]

Krill and or fish oil should be helpful for these type of conditions.

General diet also has an influence. So all the usual things like avoid processed foods, sugar and alcohol and limit read meat consumption

How does red meat influence the joints?

Red meat is not good for arthritic conditions as it is very acidic on the system. There is plenty of research to suggest limiting red meat consumption if you have an arthritic condition. Google red meat and arthritis and draw your own conclusions.

[jrtmedic]

For those interested in meat consumption and osteoarthritis of the hip/knee go to this link http://www.ncbi.nlm....pubmed/21235820

"Routinely eating burgers and steak, however, may only influence people with a predisposition for RA. "It may be that the high collagen content of meat leads to collagen sensitization and consequent production of anticollagen antibodies, most likely in a subgroup of susceptible individuals," the authors note. "Meat consumption may be linked to either additives or even infectious agents, but, again, there is no evidence as to what might be important in relation to RA."

"A high level of red meat consumption may represent a novel risk factor for inflammatory arthritis or may act as a marker for a group of persons with an increased risk from other lifestyle causes," Dr. Pattison and colleagues conclude. "It is unclear whether the association is a causative one."

Article: "Dietary Risk Factors for the Development of Inflammatory Polyarthritis: Evidence for a Role of High Level of Red Meat Consumption," Dorothy J. Pattison, Deborah P.M. Symmons, Mark Lunt, Ailsa Welch, Robert Luben, Sheila A. Bingham, Kay-Tee Khaw, Nicholas E. Day, and Alan J. Silman, Arthritis & Rheumatism, December 2004; 50:12; pp. 3804-3812."

Edited January 28, 2013 by Sheryl
edited to remove unnecessarily baiting tone

[Sheryl]

This thread started to degenerate into a flamefest. several posts were removed and one edited accordingly. Any further such will lead to official warnings.

innumerable health problems have shown a correllation to high consumption of red met and/or fat (the two tending to go together), although the mechanisms are often unclear. I am not ware of any research linking it directly to osetoarthritis, although as noted above there are correlations to Rheumatoid Arthritis, an entirely different disease process. Whatever the reason for the correllation may be (and note that corellation does not necessarily mean causation), it has nothing to do with acidity. It is impossible to alter the acid-base balance of the body's tissues through food intake as it is (fortunately for us) tightly regulated by the kidneys and lungs within a very -- and alkaline -- narrow range.

While there has not AFAIK been any scientific studies linking red meat intake to osteoarthritis, the problem certainly is linked to obesity, and high red meat consumption likewise often goes with obesity.

[tropo]

Krill and or fish oil should be helpful for these type of conditions.

General diet also has an influence. So all the usual things like avoid processed foods, sugar and alcohol and limit read meat consumption

How does red meat influence the joints?

Red meat is not good for arthritic conditions as it is very acidic on the system. There is plenty of research to suggest limiting red meat consumption if you have an arthritic condition. Google red meat and arthritis and draw your own conclusions.

I was curious if you were going to mention uric acid. I eat a moderate quantity of red meat but my uric acid is normal.

[Sheryl]

Red meat is not the sole (or even the worst) offender with regard to uric acid. In addition, people vary in how efficiently their bodies excrete it. Most people do fine no matter what they eat, while others have heriditary predisposition towards gout, or kidney problems which impair excretion.

Moderate amounts of red meat are fine if you do not have kidney or liver disease , gout, or elevated blood lipids.