Osteoarthritis supplements: quick guidance on 2 major categories.

Introduction

Supplements has become a major discussion, nonetheless osteoarthritis supplements. I am assuming you are reading this article because you determined that one of your issues is osteoarthritis based my prior article or you were told you have osteoarthritis by your providers. Supplements is a dicey matter. I can NOT recommend supplements to you as I am not a nutritionist.

However, this is how I can help. I reviewed literature (scientific papers) on some supplements. I will translate their lingo to layman terms. If I find issues with the supplement, I will provide a warning. Keep in mind, I cannot encompass every single supplement ever discovered. I, also, cannot know all possible side effects from supplements. However, I will give you some information to start with.

I will focus more on osteoarthritis supplements but not herbals. Herbals are plants that have active substances that probably we do not know the active ingredient. I think it is more appropriate to dedicate an article for each supplement or lump sum two or three together. Here is how we will go: I will mention the osteoarthritis supplement, the dose that has a reasonable study on it, then its possible side effects. Then you as an informed person, make your decision.

How do we figure out if a supplement is good?

Let me explain though some words about research before delving into information. The best form of studying something is comparing two groups. One group takes a fake pill, and another takes the real pill(osteoarthritis supplement). Mostly, we try to not let the people prescribing (docs) or taking the pill (patients) know which pill is being taken. We call that double blind. Then, we choose the people who take what randomly.

For example, a person will pull an envelope from a stack. Half the stack has fake pills, and the other half is the osteoarthritis supplement. This combination of choice and not knowing is called random double blind clinical trials, which are considered the best form of testing. At times, however, we cannot do this study or all we have are observational studies. The latter form is generally information deduced from looking at patient charts or questionnaires. Of course, in observation studies the two groups might be quite different, making comparison not accurate. Now let us talk supplements.

Vitamins

Vitamin C 1 gram calcium ascorbate in a randomized double-blind trial showed improvement in pains. But there is no clear research that shows reduced worsening of osteoarthritis. The good thing is that patients who took vitamin C used less NSAIDS. Therefore, to me if we take less NSAIDS that is good due to their side effects. Keep in mind though that people with kidney disease, high vitamin C can lead to creation of kidney stones. If you have kidney issues or have kidney stones, it would probably better to avoid vitamin C as an osteoarthritis supplement. Keep in mind that high vitamin C doses has been associated with kidney disease.

Vitamin E. Well, this one is confusing. It seems that there are good randomized double-blind studies that prove it helps with pain, mainly in the short term, while others said no. There are studies that said that it can delay progression/worsening of osteoarthritis, others said no. Keep in mind that the same conflicting results of vit E and cardiovascular disease. Therefore, I would not be excited about this one to be one of your osteoarthritis supplements. Better to avoid, you make your judgement.

Vitamin D. Ahh the vitamin that we used to give to any breathing woman. Well, that continued till women health initiative told us we might be increasing risk of death from cardiovascular disease. If you look at vitamin D osteoarthritis studies, the impression that vit D is good was based that people with low vitamin D had more osteoarthritis progression and more heart disease. I think it might be a good idea as a supplement for osteoarthritis if your vitamin D is low and you use enough to reach normal range and do not overdo it. I will recommend vitamin D if a patient has osteoporosis. Again, I would give enough to let you reach a normal level.

Folate and B12. I don’t feel like talking about this for 2 reasons. These are over prescribed for patients by primary providers. It seems to me folate is low in a lot of people because they don’t eat healthy foods. Keep in mind that most breads are supplemented with folate. Regarding B12, its deficiency can lead to nerve issues as explained previously.

Even though there is one study showing benefit of the combination, it is too old and probably nutritional deficiency was more of an issue at the time of the study. If your vitamin B12 is low though, I do not think it is a bad idea as I have not found a lot of issues with too much B12. I still would not recommend B12 beyond normal level as an extra supplement for osteoarthritis.

Cartilage and tendon support. 2 cents on micronutrients.

Glucosamine and chondroitin: well researcher has tried hard and long to prove that these 2 works. Then there are researchers who looked at all prior studies and found that even when a study showed possible minimal benefit, the way it was conducted/done was bad. You know, it seems these 2 supplements have been pushed so much that I feel we need to move on and forget about them. Maybe in the future biochemists will find a way to make these two substances directed to the joints and more effective as an osteoarthritis supplement. Till that happens, I do not think you want to take it. However, I see no clear harm from trying either.

Collagen, particularly Undenatured type II collagen, had some evidence of benefit. Curcumin and ginger can help with OA. However, for the latter 2, patients on blood thinner medications or platelet suppressing medications like aspirin should be careful taking them. Also, diabetics should be careful with ginger as it can lower blood sugar more and prove dangerous.

For Curcumin, it is interesting to point out that absorption is quite variable, and it seems it is hard for our gut to absorb it enough. Some studies hint that solid lipid particles can improve their absorption. There seems to be some products that claim they reached that combination, but I cannot promote it as I am not sure if they have been tested in clinical trials. However it is reasonable to consider as a supplement for osteoarthritis.

Fish oil and Trace elements like boron, selenium, zinc, and copper did not have enough data to prove their effect on osteoarthritis.

Verdict on osteoarthritis supplements

To summarize, there is a lot out there in regards supplements. I would subtly suggest asking your primary provider to do vitamin panels if you truly think that your diet might lack some micronutrients/vitamins. Honestly though as good pediatrician will tell kids “Eat all colors in your food from vegetables and fruits”, I try to live by that motto.

If you have osteoarthritis and dreaming about supplements, it might be worth trying one osteoarthritis supplement at a time for 6 months and see if you need less NSAIDS. Consider collagen and Curcumin. If you are taking blood thinners or anti-platelet, do not try curcumin. If you want to try curcumin, maybe try a type that said it has solid lipid particles to improve absorption.