Do supplements for joints really work?

Four powerful nutrients available to support joint health are glucosamine, chondroitin, curcumin, and SAMe.

Let us share a little more about the science behind these supplemental nutrients so you (with the help of your practitioner) can make the best decision for your individual needs.

Glucosamine 

Glucosamine is a natural component of cartilage, an amino sugar that helps to maintain the strength and structure of cartilage. Glucosamine contributes to both its resiliency and shock-absorption properties. It is involved both in the structural matrix of cartilage and in drawing hydration to the joint [3].

When taken as a nutritional supplement, glucosamine may also help prevent some cartilage breakdown and the subsequent progression of osteoarthritis [3].

There are no natural, human food sources of glucosamine, but they can be isolated from the shells of shellfish for supplementation. While natural in its origin, it may not be an appropriate supplement for those with shellfish allergies or those living a vegan lifestyle.

Chondroitin

Like glucosamine, chondroitin is a building block of cartilage. Chondroitin is a gel-forming polysaccharide macromolecule that contributes to the cushion-like characteristics of cartilage. It may also help prevent cartilage breakdown for osteoarthritis.

Research has shown that chondroitin can reduce joint pain and stiffness in people with osteoarthritis [5]. One specific study found that short-term chondroitin supplementation improved arthritic knee pain by more than 20% [5]. In the long term, chondroitin supplementation helped to slow the narrowing of joint space, a measurement of cartilage breakdown [5].

Again, there are no common food sources of chondroitin. You can get some from the gristle (which is cartilage) between animal bones, but it is not typically a palatable food choice. This makes supplementation the easiest option, but again, not a vegan one. Supplemental chondroitin is typically isolated from animal sources.

Glucosamine and Chondroitin…together

Glucosamine and chondroitin are often found combined in supplements as it seems their activities in joint support are somewhat synergistic. Glucosamine and chondroitin are considered long-term structure-modifying agents as they have been shown to have a beneficial effect of delaying long-term knee OA cartilage loss [6], in addition to reducing pain, stiffness, functional limitations, and joint swelling [7,8].

In subjects with knee pain, glucosamine and chondroitin supplementation has demonstrated support for both pain management and locomotor functions [9]. Some of this effect may be credited to the fact that these nutrients contribute to the further production of hyaluronic acid for joint lubrication, and they are building materials for cartilage.

Aside from these structural functions, glucosamine and chondroitin have anti-inflammatory properties [1]. This anti-inflammatory action may delay inflammation-induced breakdown of the cartilage, while the building-block functions may help to support the joint structure and keep the joint lubricated.

Together, these effects may lead to more comfort and increased mobility of the affected joint. In fact, clinical trials involving highly arthritic patients have demonstrated equal pain relief between glucosamine/chondroitin and NSAID anti-inflammatory drugs [10].

Supplemental hyaluronic acid has also been shown to support tissue hydration and joint lubrication so when looking for a joint support supplement, one that combines Glucosamine/Chondroitin with hyaluronic acid may provide optimal support [4].

Curcumin

Perhaps a better option for those on a vegan diet is a supplement with curcumin. Curcumin is a naturally occurring substance, isolated from turmeric, a spice commonly used in Indian cuisines. Curcumin gives turmeric its anti-inflammatory and antioxidant effects that are thought to benefit cardiovascular health, brain function, mood, and a host of other conditions – one of which being arthritis.

A 2019 study conducted on people with symptoms of knee osteoarthritis showed that curcumin supplementation elicited a similar response to daily NSAID (diclofenac) treatment: nearly all patients in both treatment groups reported at least 50% improvement in their arthritis symptoms [11]. In addition, people taking curcumin lost an average of 2% of their body weight and experienced few side effects that were common with diclofenac [11].

A recent systematic review and meta-analysis reported that: curcumin can relieve pain, improve joint function, and reduce joint stiffness [2]. In terms of adverse events, curcumin is comparable to a placebo, with fewer side effects than NSAIDs [2].

In a study of people with rheumatoid arthritis (an autoimmune arthritic condition), curcumin supplementation was associated with more antiarthritic activity than an anti-inflammatory drug [12].

Curcumin may not be an appropriate choice for those on blood-thinning medication (anticoagulants) as it has some natural blood-thinning properties. It also may be inappropriate for those with gallbladder issues or diabetes as it can amplify problems in the gallbladder and cause a decrease in blood sugar. Please talk to your practitioner about whether curcumin is the right choice for joint support in your body.

SAMe

SAMe (S-Adenosyl-L-methionine) was initially touted as a supplement that supports a positive mood and emotional balance. However, scientists studying its effects on mood also noted that SAMe treatments led to improvements in arthritis symptoms as a side effect. Now SAMe is commonly marketed as a supplement to promote joint health, comfort, and mobility [13].

Yet again, SAMe supplementation has been shown to be about as effective as standard anti-inflammatory drugs in the promotion of comfort and mobility for people with osteoarthritis [14,15]. The long-lasting response to SAMe suggests that SAMe also has a protective effect against further damage to cartilage [14].

If you are taking selective serotonin reuptake inhibitors (SSRIs; or any medication to treat a mood disorder) do not take SAMe without first discussing it with your psychiatrist. This is especially important for patients with bipolar disorder.

As SAMe plays a role in neurotransmitter synthesis, it can have a positive effect on mood, but can also change the effect of mood-related medications. Your doctor can help you decide whether to make an adjustment to your medication or whether you should choose a different supplement for joint support.