Osteoarthritis (OA) is a very common consequence of aging in the modern world. On average, we’re living longer than ever and our joints are taking their fair share of the burden as a result. There are many conventional treatments for dealing with the impaired mobility and pain associated with this condition. However, many of us would prefer to avoid taking medications or resorting to surgical procedures unless it’s the only remaining option. In the field of natural medicine field, there are several well known alternatives for OA. The most familiar names are probably glucosamine and chondroitin. This duo is often effective in managing the symptoms of OA and perhaps even in slowing its progression. But they don’t work for everyone. Fortunately, the natural health industry is much like its pharmaceutical counterpart in that it’s always looking for new choices for consumers.

Two recent studies have examined the potential of a “seaweed derived mineral supplement” (Aquamin F) in aiding patients with OA. The theory behind this natural remedy is that a mineral imbalance may contribute to the degeneration of cartilage. The details of the trial are as follows:

• 29 participants were divided into two groups: Group A received 2,400 mg of Aquamin F. Group B received a similar looking placebo for 12 weeks.
• Tests measuring pain, range of motion and walking ability were administered prior to and post treatment.
• All of the patients were gradually asked to reduce their consumption of pain relievers (NSAIDs – nonsteroidal anti-inflammatory drugs) based on their degree of discomfort.

The results of the study were modest, but relatively positive. The subjects using Aquamin F demonstrated improved range of motion and benefits in walking speed. These results were found in patients that had reduced their NSAID intake by 50%. The authors of this trial concluded that this seaweed supplement “may allow partial withdrawal of NSAIDs” and that additional research is warranted. (1)

The first study found that Aquamin was equivalent to the placebo in terms of safety. The same cannot be said for long term NSAID use. Another difference between conventional pain relievers and this seaweed extract is that the latter provides a considerable nutritional punch. In fact, it’s an extremely rich source of calcium and also provides trace minerals, such as boron, that support bone health.

A second study on Aquamin involved 70 patients with “moderate to severe OA”. The participants were divided into four groups: 1) received 1,500 mg of glucosamine sulfate daily; 2) received 2,400 mg of Aquamin; 3) received a combination of both; 4) received a placebo. Both Aquamin and glucosamine improved arthritic symptoms when taken independently. Aquamin outperformed glucosamine in terms of pain, range of motion, stiffness and walking distance measures. An interesting finding is that combining both supplements actually had less favorable results. This indicates that they don’t have a synergistic effect and probably shouldn’t be used together. (2)

Another new supplement on the market is called Natural Eggshell Membrane (NEM). It contains certain building blocks (glycosaminoglycans) that can be used to promote the health of connective tissue and the synovial fluid that lubricates joints. 67 patients with OA were randomly assigned to two groups. The first received one 500 mg NEM capsule per day. The remainder of the participant pool was given a placebo for an 8 week period of time. A diagnostic tool referred to as WOMAC (Western Ontario and McMasters Universities Osteoarthritis Index) was used to quantify the level of function, pain and stiffness throughout this experiment. The most exciting finding in this research has to do with how quickly the study volunteers responded to treatment with NEM. There was a 16% reduction in pain and a 13% decline in stiffness within the first 10 days of the trial. The benefits continued during the remainder of the research at days 30 and 60.

A less reliable form of study, called an “open-label trial”, was also recently used to test this new supplement. In this type of research, a placebo is not used as a control/comparison. A total of 39 participants took 500 mg of NEM for 30 days in this experiment. Improvements in flexibility (28%) were noted by the 7 day mark. By day 30, positive changes in flexibility (44%) and “general pain” (73%) were reported. No significant side effects were found. However, if you have a known allergy to eggs you should probably avoid this supplement. (3,4)

An herbal blend that combines extracts of cork tree (Phellodendron amurense) and orange peel (Citrus sinensis) has recently been shown to improve knee OA symptoms in healthy and overweight volunteers. The weight issue is important because obesity adds to the strain placed on cartilage and an increase in inflammatory markers have been associated with a high body mass index (BMI). An 8-week long trial published in August 2009 tested the effects of this herbal combination vs. a placebo in both “normal” and obese OA sufferers. There was a statistically relevant improvement in mobility and pain scores in the patients receiving the herbal remedy – independent of weight. The overweight volunteers also exhibited meaningful drops in C-reactive protein levels (a measure of inflammation). There were a few added bonuses found by the researchers: a) those who were obese “lost an average of 5% body weight after 8 weeks”; b) significant reductions in LDL “bad cholesterol”, triglycerides and an increase in “good” HDL cholesterol; and c) a decline in blood pressure and fasting blood sugar. (5,6)

One final point has to do with improving the efficacy of glucosamine. Earlier in this column, I mentioned that combining seaweed and glucosamine probably wasn’t a good idea. But a new study from Germany does offer some advice about a truly viable adjunct to glucosamine therapy. According to that research, the addition of fish oil to standard glucosamine supplementation may help improve the response rate. It’s important to note that these two ingredients appear to work in different ways. Glucosamine supports the structure of cartilage. Fish oil seems to tame the inflammation that can affect joint function and stability. Therefore, a combination of the two could complement each other quite well. (7)

It’s very common for dozens of prescription medications to address similar health concerns. One reason is because not everyone reacts to medications in the same way. This individualized response relates to both the efficacy of drugs and also the potential side effects. The same is true with natural remedies. Even if you’ve tried other joint supplements and found them ill-suited or lacking, I would suggest not giving up on this entire class of remedies altogether. It could very well be that one or more of the options I’ve highlighted today will be the right fit for you.

Be well!

JP

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