ARTHRITIS AND OSTEOPOROSIS For some, glucosamine and calcium may help

A healthy lifestyle is the best medicine for arthritis and osteoporosis.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
YOUNGSTOWN -- Local doctors and nutrition experts say the effectiveness of glucosamine and chondroitin for arthritis pain, and calcium with vitamin D for osteoporosis, can depend on the severity of the arthritis pain and the age of the patient with osteoporosis, respectively.
Reacting in separate interviews to studies that overall found the use of glucosamine and chondroitin for arthritis pain, and calcium and vitamin D to strengthen bones, to have minimal effect, the doctors say they are not yet ready to recommend that people throw out their diet supplements.
That being said, the local experts agree the most important "medicine" for the prevention of arthritis and osteoporosis is a healthy lifestyle, starting in childhood, that includes getting adequate nutrients from a well-balanced diet and staying fit with regular exercise.
"Unless you are sick, your diet should provide all the nutrients you need," said Diane Snyder, clinical dietitian at Humility of Mary Health Partners.
When supplements are called for, Snyder said she recommends liquids, or powders or other mediums that provide protein, calories, minerals and vitamins in a balanced form.
"Generally, if a person is missing one nutrients, he is missing several," Snyder said.
Though the overall finding of the GAIT (Glucosamine Chondroitin Arthritis Intervention Trial) is that use of the supplement has minimal effect on pain, there is a caveat.
The study found that the more severe the damage and arthritic pain, the more effective the supplement.
No surprises
Similarly, the results of a calcium study done with older post menopausal females that showed little impact was not unexpected. By that age, the damage is already done, said Dr. Mohammad Shayesteh, Ph.D., of the Fit For Life Nutrition and Weight Loss Centers.
However, calcium supplements can be effective in building bone mass, or preventing bone loss, in younger women, said Shayesteh, a board certified nutritionist and diabetes educator.
The theory behind the use of glucosamine and chondroitin is that they are building blocks for cartilage and lubricant for the joints, said Dr. Mary Toth, a rheumatologist with Rheumatology Associates.
"My current feeling is to have patients try glucosamine and chondroitin. The supplements have no significant adverse side effects, and if I don't see improvement in a couple of months, then I'd advise them to go off it or try a different brand," Dr. Toth said.
Regarding the use of calcium supplements and vitamin D for older women to strengthen bones, Shayesteh said it has little or no effect by itself.
"The best way to deal with osteoporosis is to prevent it by getting sufficient calcium through the diet, and exercise, from an early age," he said.
If a patient has osteoporosis, calcium alone is not enough. However, prescription drugs are available that help build new bones, Dr. Toth said.
About bone density
Generally, osteoporosis occurs after menopause. When women are young, they make more bone mass than needed. When they hit menopause, they lose estrogen protection and start to lose more bone mass than they build, which can lead to osteoporosis, Dr. Toth said.
Shayesteh said the best treatment for arthritis in the weight bearing joints, such as knees, back and hips, is weight loss. Excess weight even compromises the effectiveness of supplements, he said.
Glucosamine and chondroitin may help relieve some of the symptoms of arthritis, but they will not address the main cause, which is excess weight. Once the damage is done, the only thing that helps is losing weight. Surgery is a last resort, he said.
Regarding glucosamine and chondroitin, he said people who are diabetic or allergic to shell fish should not take the supplements. The glucosamine and chondroitin contain fish products, and in diabetics, it increases blood sugar, he said.
To get the best results, women should start using calcium at age 30. Also, Shayesteh said, calcium supplements should have vitamin D, which helps absorb the supplement, and magnesium, which helps prevent constipation. He also said children and women should drink water and milk or tea instead of pop, which he says actually strips calcium from the body.
Opinions vary on the effectiveness of glucosamine and chondroitin and calcium, but the highly-publicized study results have not adversely affected sales of the products, said Ben Prat, director of PR at General Nutrition Centers, which has its headquarters in Pittsburgh.
Prat said there are so many conflicting study reports that if people perceive they benefit from a product, and there are no adverse side effects, they are going to continue to use it, he said.
alcorn@vindy.com