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'Comfort Dogs' Come to Emotional Rescue
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Ginger Can Ease Nausea From Chemotherapy Treatments
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CIRCULATORY SYSTEM
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Bad Marriages Harder on Women's Health
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
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With Psoriasis, the Internet May Offer Hope
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Gum Disease Might Boost Cancer Risk
Good Oral Hygiene May Protect Against Heart Infections
Gummy Bears Join Cavity Fight
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Spices, Herbs Boost Health for Diabetics
Fish Twice a Week Cuts Diabetics' Kidney Risks
Vitamin K Slows Insulin Resistance in Older Men
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Eating Healthy : You Can Live Longer
Eating Vegan or Raw-Vegan at Regular Restaurants
Herb Shows Potential for Rheumatoid Arthriti
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Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
What's Cookin'? It Could Be Air Pollution
City Kids Find the Breathin' Is Easier Elsewhere
Improved Fungicides May Be Easier on Environment
EYE CARE, VISION
Contact Lens Cases Often Contaminated
Too Much Sun, Too Few Antioxidants Spell Eye Trouble
Antioxidant-Rich Diet May Protect Against Eye Disease
FITNESS
After a Stroke, Light Exercise Gets Hands, Arms Working Again
The Juice From Beetroots May Boost Stamina
Early Exercise Boosts Outcomes for ICU Patients
GASTROINTESTINAL PROBLEMS
New Guidelines Issued for Management of IBS
Intestinal Bacteria Trigger Immune Response
HRT Use Raises Risk of Stomach Trouble
GENERAL HEALTH
Study Supports Swine Flu's Pandemic Potential
15-Point Test Gauges Alzheimer's Risk
Want Better Health in the New Year, Add Exercise to Your Day
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
'Comfort Dogs' Come to Emotional Rescue
Save Your Aging Brain, Try Surfing The Web
Airport Full Body Scanners Pose No Health Threat: Experts
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Man's Best Friend Helps Mend Broken Hearts
A Little Alcohol May Help the Heart: Studies
Cherry-Enriched Diet Cut Heart Risks in Rats
INFECTIOUS DISEASE
Swine Flu Closes Three Schools in NYC
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Quick Orthopedic Repair Can Save Young Shoulders
3 Home Habits Help Youngsters Stay Slim
Meaningful Conversations Boost Kids' Language Skills
MEN'S HEALTH
Whole Grains, Bran May Fight Hypertension in Men
More Vitamin C May Mean Less Chance of Gout
Exercise May Prevent Prostate Cancer: Study Shows
MENTAL HEALTH
Worries About Weight Are Tied to Teen Suicide Tries
Keeping Mentally Active Seems To Keep The Brain Active
The Acne Drug Accutane More Than Doubles Depression Risk
PAIN
Are We Exercising Pain Away? Not So Much.
Tai Chi May Help Ease Fibromyalgia
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Woman in America Are Delaying Motherhood, Study Says
Expectant Mom's Exercise Keeps Newborn's Birth Weight Down
Before Conceiving, Take Folic Acid for One Full Year
SENIORS
As You Age, Better Health Means Better Sex
Laughter Can Stimulate a Dull Appetite
Life Expectancy in U.S. Hits New High
SEXUAL HEALTH
SLEEP DISORDERS
Exercising Throat Muscles May Relieve Sleep Apnea
Sleeping Could Help Women Lose The Baby Fat
Daylight Savings: Not a Bright Time for All
WOMEN'S HEALTH
Flame-Retardant Chemical Linked to Conception Problems
Frankincense Provides Relief for Osteoarthritis
Air Pollution Slows Women's Marathon Times
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Studies Struggle to Gauge Glucosamine's Worth

FRIDAY, Jan. 30 (HealthDay News) -- Eager to relieve joint pain and repair the cushioning between bones, millions of arthritis sufferers reach for glucosamine, an over-the-counter dietary supplement.

Despite its popularity, studies examining the effectiveness of this natural therapy have yielded mixed results.

"There is still a lot of uncertainty about glucosamine," said Dr. Steven C. Vlad, a fellow in clinical epidemiology and rheumatology at Boston University School of Medicine.

So what is glucosamine, anyway? It's a type of sugar that the body produces and distributes in cartilage and other connective tissue. Chondroitin sulfate, often taken in combination with glucosamine, is a complex carbohydrate that helps cartilage retain water, according to the U.S. National Center for Complementary and Alternative Medicine.

These substances are derived from animal tissues, according to the Arthritis Foundation. Glucosamine is extracted from crab, lobster or shrimp shells, and chondroitin sulfate comes from animal cartilage, such as tracheas or shark cartilage.

Vlad's own study tried to determine why the results of glucosamine trials differed so widely. Of the 15 studies he reviewed, there was one clear finding: A particular glucosamine preparation, called glucosamine hydrochloride, doesn't work.

Results among trials involving another common preparation, glucosamine sulfate, showed wide variation -- more than would be expected by chance. Based on the evidence, Vlad concluded that supplement industry support could be a source of bias in some of these studies.

Although critics questioned Vlad's finding, he stands by the results. "Numerous analyses have showed that industry funding is correlated with stronger findings and selective publication of positive results," he noted.

More recently, researchers at the University of Utah School of Medicine reported results from a follow-up to an earlier glucosamine trial. Arthritis patients in this leg of the study took glucosamine; a combination of glucosamine and chondroitin; the anti-inflammatory drug celecoxib (Celebrex), or a placebo. X-rays were taken of patients' knees before the trial began and one and two years later to determine whether glucosamine alone, or in combination with chondroitin, would slow the loss of cartilage.

Lead author Dr. Allen D. Sawitzke, an associate professor of internal medicine at the University of Utah School of Medicine, said he and his colleagues had hoped to have enough patients and measurement accuracy to be able to show some slowing of the damage, but in the end, the results were inconclusive.

"So, it's an example of a null study, that is, a study where there is no difference detected, which isn't the same as saying there is no difference," Sawitzke said.

Dr. Jason Theodosakis, an assistant professor at the University of Arizona College of Medicine and author of the book, The Arthritis Cure, said the study was flawed in many ways, including the small sample size, short duration and imprecise X-ray methodology. "I really can't believe it was even published," he said.

Like many physicians, Theodosakis continues to recommend glucosamine and chondroitin. "This study does nothing to discourage that," he said.

Trying glucosamine for 60 days makes sense, especially for patients who can't tolerate ibuprofen or other nonsteroidal anti-inflammatory drugs, said Dr. Stephen Dahmer, a former fellow in integrative medicine at Beth Israel Medical Center in New York City, and now a staff physician at the VA San Diego Medical Center.

Sawitzke said he sees some merit in the supplement for pain relief, but there's a lot less evidence to support glucosamine as a way to slow cartilage damage.

Vlad, however, tells patients he's doubtful it works very well, if at all. "But I also tell them that it is safe and will not hurt them. If they want to try it, they are more than free to do so at any time, with the understanding that no insurance company will pay for it."

-Karen Pallarito

More information

For advice on choosing a pain medicine, visit the U.S. Department of Health and Human Services.



SOURCES: Steven C. Vlad, M.D., fellow, clinical epidemiology and rheumatology, Boston University School of Medicine; Allen D. Sawitzke, M.D., associate professor, medicine, University of Utah School of Medicine, Salt Lake City; Jason Theodosakis, M.D., assistant professor, University of Arizona College of Medicine, and author, The Arthritis Cure; Stephen Dahmer, M.D., staff physician, VA San Diego Medical Center; U.S. National Center for Complementary and Alternative Medicine, Bethesda, Md.; Arthritis Foundation, Atlanta; July 2007 and October 2008 Arthritis & Rheumatism; Aug. 15, 2008, American Family Physician

Last Updated: Feb. 01, 2009

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