My dog got relief from his arthritis after 1 week of Glucosamine/Chondroitin - and it is unlikely he had a placebo effect. I had 8 years of relief from severe hip pain too, and then finally had a hip replacement. The supplements have been used for animals for many years - (starting with horses). As a former computer programmer designing drug studies, I know how many factors can alter the results of those studies.

Posted by: NatureGirl | September 28, 2009 12:14 PM

You say:

My dog got relief from his arthritis after 1 week of Glucosamine/Chondroitin - and it is unlikely he had a placebo effect.former computer programmer designing drug studies, I know how many factors can alter the results of those studies.

Apparently the drug studies you designed did not included double blind ones. While your dog didn't know he was taking the supplement, you, the evaluator of its effectiveness, did.

I always ask my doctor for some of them good placebos.

Posted by: df1995 | September 28, 2009 2:21 PM

Glucosamine is like a God-send for me. I've had to deal with post-traumatic arthritis in my knee for over 10 years and was so glad when glucosamine became available. I'm not sure how the chondroitin works or figures into my relief but I'm clear about the glucosamine..it's become a little hard to find the glucosamine by itself so I get the compound. Only one supplier has it with anti-inflammatory ingredients which gives me the optimum effect. Nothing works for me like glucosamine.

Posted by: Aadancer | September 28, 2009 4:41 PM

I am 59 and have had arthritic knees since my early twenties. I also have had arthritic problems with my shoulders and wrists. As a competitive level racquetball player, I took massive doses of ibuprofen for many years in order to be able to play. Additionally, I wore the best possible knee braces available. Even with the ibuprofen and the braces, there were days after a tough match or a tournament that I could not walk up a flight of stairs. It was impossible for me to squat down and maintain my balance. I began taking glucosamine chrodroitin about seven years ago, and I have being playing racquetball, walking long distances, and staying very active without taking ibuprofen or wearing any braces. I can squat down for long periods of time without pain or losing my balance, and the other arthritic pain is almost non-existent. As a teacher and writer, like one of the other comments notes, I am aware that many factors can affect research. What am certain about is the impact that the glucosamine chrondrotin has had on my arthritis, and I would switch doctors and hospitals before I would stop taking it.

Posted by: AD1950 | September 29, 2009 8:02 PM

At 63 I don't have arthritis, but having run competitively for half my life (I stopped years ago) I started feeling the effects of the years of abuse as both knees increasingly ached and "popped" continually for many years. Finally (again, after years of discomfort) I started the glucosamine/chondroitin/MSM routine (various brands - always buy one/get one free - about 50 cents a day.) No other lifestyle changes, just the two pills daily. Within three months (and for the last 6 years) I've had zero pain and the "popping" has ceased. Many of my friends have had the exact same experience. My brother wouldn't try it, preferred to suffer, and had to have both knees completely replaced last year. I don't know about arthritis, but I DO know for old, suffering athletes it actually works.

Posted by: John Owens | October 3, 2009 7:28 AM

"Moreover, pills can cost more than $30 a month; this is a lot of money to spend on what might be a placebo effect" There is serious flaw in your reasoning in the last sentence of your report.The scientic conclusion is being confused with medical reccomendation:If the damn thing works in relieving pain --placebo or not,without adverse side effects,unlike the other medications --the medical reccomendation should be take it by all means.And what is$30.00 compared to the cost of the other drug?For the patient what matters is not the cause but the effects and the side effects. By the way,I have taken G and C and msm with great effects on my pain and ease of movement and mobilty.And so has my neighbor's dog. I THINK THE PROBLEM WITH THESE STUDIES IS CONCEPTUAL:you have defined arthritis as unitary pehenomenon with one cause and one type of clinical manifestation in "joint spaces" etc.(This sort of problem has ocurred before in the history of medicine)The experential evidence from patients and dogs suggest as well the research you report suggests that arthritis pain has mutiple causes and multiple manifestations.And that Gluc. Chon and MSM have effects on some of the patients, and some dogs too.

Posted by: robert perin | October 3, 2009 7:28 AM

We too had good success with glucosamine condroitin when used for animals. Although my husband is too impatient to give it a reasonable trial, I used his capsules for our new-old Golden Retriever when she came to live with us at 10 years of age and could barely walk. Between a weight-loss diet and the glucosamine she could not only walk but occasionally chase the other dog. The horse version not only kept us from having to put down an aged gelding with severe arthritis (he stumbled constantly just going out to the pasture and was in obvious pain))but also allowed him to be safely ridden again for a few more years. Size of molecules? I had a friend who found great relief in shark cartilage which he chose over glucosamine. I thought those molecules were too large to be effective but he regained comfortable use of his knee. How was the particular glucosamine condroitin used in this study chosen? What about dosage(s)?

Posted by: 1stLadyDawn | October 3, 2009 9:58 AM

My hallux rigidus was CURED by Glucosamine/Chondroitin/MSM supplements. It took several months to notice an improvement, and after a couple of years, X-ray showed an increase in joint space! Future studies should include other joints besides the knee. I know it wasn't placebo effect, because I had a hard time running or even walking some times before I started on the pills.

Posted by: ChuckB | October 3, 2009 11:10 AM

I have used Glucosamine/Chondroitin/MSM very successfully. I resolved a sore knee problem in the summer of 2008. I quit the therapy on the warning from my DR that glucosamine affected glucose levels. The problem returned, and I tried glucosamine alone with only moderate success. I resumed the tripple combination and am now pain free. At 68 yrs old, having to deal with with diabetes and atherosclerosis, I walk 60 mins @ day; this is no longer possible without the glucosamine tripple combo therapy. I suggest that further study with focus on those who benefit is warranted. Cartilage measurement is not conclusive, but positive result is. The info you supply from the study is scant, but I would think there is an important subset of patients who benefit from this thereapy, and is not helped by negative input from ill designed studies. Sore joints can be crippling and lead to very poor quality of life. I know several other people who swear by glucosamine. It would not have gained such popularity without providing some benefit to those who spend their hard earned money to pay for it..

Posted by: Leo in Montreal | October 3, 2009 2:55 PM

This article does not say whether the sudy used Glucosamine Sulfate or Glucosamine Hydrochloride. It also does not state whether the dosage was 500mg three times a day or a loaded dose or even whether a reduced dose was used. There have been over 300 studies on the effectiveness of Glucosamine Sulfate (500mg T.I.D.) which have been very positive. It has been reported most all the relief comes from the GS as the Chondroitin s molecular weight does not allow the penetration needed. I have used GS for 12 years with the studied dose and when going off it noticed hip pain returning after a two month interval. After resuming the treatment again the pain goes away after a short time. It is unfortunate that we cannot take your word for the quality of the study (studies) as it is obvious there are some significant flaws that have not been brought to your attention. If you are going to publish something like this let's see the facts (Study protocol), as your word that these were quality studies just doesn't cut it.

Posted by: blackr20 | October 3, 2009 8:13 PM

My wife and I took Glucosamine for many years with no benefit. Took the dog to a major university vet school for a weight loss program. At one point in this program one of the vet professors mentioned that she had had good results using Dasuquin, a "joint health supplement" for dogs which consists primarily of glucosamine hydrochloride and sodium chondroitin. I would have never tried it if anyone else had recommended it, but being a professor who recommended it I decided to try it. Amazing! Our dog is about 13 years old and she hops around like a 3 year old. I told my wife I'm thinking seriously about taking those dog supplements. :)

Posted by: geezer33 | October 16, 2009 7:39 PM

I am a medical research writer and very familiar with studies involving glucosamine, chondroitin sulfate, and/or the two in combination. The National Institutes of Health-sponsored Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) (Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate and the two in combination for painful knee osteoarthritis. N Eng J Med 2006;354:795-808) has much information to offer, if one takes the time to fully read and understand it. However it was by no means the definitive study and the readers of the Johns Hopkins Health Alerts have in my opinion, been mislead by implying that to be the case.

Posted by: DrRon | October 22, 2009 1:40 PM

Continuing my previous posting, there were a number of factors that limited the GAIT study. The investigators estimated that they would need 1,588 patients enrolled in the study to obtain statistically meaningful results, assuming a 20% dropout rate and a 35% response rate to placebo, which is typical for clinical trials. They were right-on with the dropout rate, but the response to placebo was an amazing 60.1%. Since 80% of the patients enrolled in the study had signs and pain associated with mild osteoarthritis (OA), the power of “mind over body” would be expected to have a greater effect on them than the 20% who had moderate-to-severe OA signs and pain, and it did, as the placebo effect in this more severely afflicted group was 48.6 to 54.3% (depending on which grading scale was used). Since all of the results are compared to the placebo response, a lower placebo response coupled with a higher response to the “active treatment” results in a greater strength for the findings of a study.

Posted by: DrRon | October 22, 2009 1:42 PM

More on GAIT interpretation: Another problem which confounded the results was that patients had to have a measured improvement in pain reduction of at least 20% by the end of their 6-month enrollment in the study. A 20 % reduction in pain in patients with mild pain to begin with, can be difficult to measure, and in fact, the authors of the study stated in the published paper that, “Widely used outcome measures for osteoarthritis treatments may be insensitive in identifying improvement, making it difficult to identify improvement in patients with mild symptoms”. Keep in mind that 80% of the patients in the study did indeed have mild symptoms! The most revealing results of the study were found in those patients with moderate-to-severe symptoms. In these patients, the response to placebo was lower, and the overall response to treatment with the glucosamine/chondroitin sulfate combination was the highest when compared to any other group in the study. As measured by the WOMAC pain score, the response rate was 79.2% to this combination and was 10% greater than the response to celecoxib, which was only 69.4%.

Posted by: DrRon | October 22, 2009 1:44 PM

My last comments on the first phase of GAIT: These strikingly positive findings for glucosamine and chondroitin sulfate in the subset of patients with moderate-to-severe knee pain were lost when the results were combined with the much larger group with difficult-to-measure mild knee pain improvement. It is unfortunate that much of the media reported only the diluted results and not the true gem of the study found in the results of the more painful population of patients. Please read my next posting on interpretation of the second phase of the GAIT study.

Posted by: DrRon | October 22, 2009 1:46 PM

Lastly, Analysis of the second phase of GAIT: This 18-month continuation of GAIT was designed to indirectly measure cartilage loss in the arthritic knee by measuring any decrease in the distance between the end of the femur (thigh bone) and the end of the tibia (shin bone). Since cartilage cannot be seen on an x-ray, a decrease in the distance between the bones is assumed to be a decrease in the thickness of the cartilage on their interfacing surfaces. The plan was to follow a subgroup of about 800 patients however only 572 patients were enrolled in this phase of the extended study and by the end of the study, only 357 completed it. The researchers who designed the study predicted a loss of joint space width in the placebo group of 0.4 mm over the 24 months of the study, which was based on the results found in previously published studies, and theorized that a loss of 0.2 mm or less in any of the treatment groups would indicate a slowed rate of cartilage loss. When the results of the measurements made from the x-rays were analyzed, it was found that the placebo group had only experienced a loss of 0.166 mm of width. As I said before, in controlled studies, all results are compared to placebo, so if the results of the placebo treatment don’t change significantly, there is nothing to compare the results of the other groups to. In the study, the average loss of joint space width of the different groups was: 0.013 mm for glucosamine; 0.107 mm for chondroitin sulfate; 0.194 mm for the glucosamine/chondroitin sulfate combination group; and 0.111 mm for the celecoxib group. Yet another problem plaguing the study was that the group receiving the glucosamine/chondroitin sulfate combination had the fewest number of enrollees, but had 30% more patients with moderate-to-severe OA symptoms than the other groups. It was noted (as would be expected) that patients with moderate-to-severe OA lost joint space width more rapidly than patients with mild OA.

Posted by: DrRon | October 22, 2009 1:48 PM