Chondroitin Sulfate

Chondroitin sulfate is a chemical compound that is a major component of many tissues including skin, bone, cartilage, tendon, and ligament. 

Chondroitin sulfate is a complex substance composed of sulfur, nitrogen, and sugar. It’s unique chemical structure gives it a high negative charge that allows it to attract an abundance of water molecules. Chondroitin’s interaction with water confers special mechanical properties that are important for resistance to compression and elasticity.

Chondrotin is available in supplemental form, with usual doses from 800mg to 1200mg daily. Chondroitin sulfate is normally derived from animal sources, such as cow, pig, and shark cartilage.

What are the potential health benefits of chondroitin sulfate?

Investigators have primarily focused their research efforts on the role of chondroitin sulfate as a treatment option for osteoarthritis. The logic being that a prominent finding in osteoarthritis is deterioration and dysfunction of cartilage’s extra cellular matrix. Chondroitin sulfate is a cardinal component of the extra cellular matrix. Therefore, providing optimal levels of chondroitin sulfate may provide the building blocks for the synthesis of new matrix components and re-establish normal cartilage function.

Research has suggested many potential mechanisms in which chondroitin sulfate could boost joint health:

  • Anti-inflammatory
  • Anabolic (promotes new tissue growth)
  • Anti-catabolic (inhibits tissue destruction)
  • Anti-apoptotic (inhibits programmed cell death)
  • Antioxidant

What does the evidence say?

The efficacy of chondroitin sulfate supplementation is still debated with research yielding mixed results:

The largest-ever clinical study examining the effects of chondroitin and glucosamine was conducted by University of Utah School of Medicine. The study called The Glucosamine/Chondroitin Arthritis Intervention Trial or GAIT, is the first wide-reaching, multicenter trial in the United States to examine the effects of supplements glucosamine and chondroitin sulfate for the treatment of knee osteoarthritis.

16 rheumatology research centers in the U.S. and more than 1,500 participants took part in the GAIT study, which compared the effects of chondroitin sulfate and glucosamine separately and in combination against the effects of placebo and prescription medicine. The study lasted for 6 months.

Participants were given one of five treatments, including glucosamine and chondroitin, a popular osteoarthritis drug called celecoxib or a placebo. A positive response was defined as a 20% or higher reduction in pain after the 6-month study period compared to the study onset.

The results showed that for patients with moderate to serious pain, the glucosamine-chondroitin sulfate combo provided remarkable pain relief than the placebo – 79% against 54% in the placebo group. In fact, this supplement combination worked for more patients than the prescription did.

However, for patients with mild pain, the combo appeared to do less to relieve pain. Statistically, these patients didn’t experience marked pain relief like those in the severe pain group did.

Another study published in the journal Arthritis and Rheumatism examined the effects of chondroitin on osteoarthritis of the hand. This double-blind, place-controlled clinical trial studied 162 patients. The results showed that the participants who took 800 mg of chondroitin sulfate daily for 3 to 6 months experienced modest pain relief, decreased morning stiffness and enhancements in overall functionality of the hands. Also, chondroitin sulfate didn’t cause any side effect on majority of the patients.   

Other Potential Health Benefits

May improve wound healing and skin health

Chondroitin combined with glucosamine are used to heal wounds, skin inflammation, and skin-related defects because chondroitin can aid in the production of collagen in the body. Collagen, the most abundant protein in our body, is important for skin health and fighting the effects of skin aging.

Medications made using chondroitin-glucosamine combo are often used for dressing. It is also applied over burns, lesions and scrapes to keep wounds moist and stimulate recovery. Some studies have shown that burn patients needing skin grafting experienced faster healing time and had their inflammation under control after using chondroitin in treatment gels

 

Safety First

Chondroitin sulfate is considered safe when taken orally or used in the eye during cataract surgery. In studies, chondroitin sulfate has been taken safely through mouth for up to 6 years. The US FDA gave chondroitin sulfate premarket approval to be used as an eye solution during surgery of the cataract.

But some experts concerned about its safety because it is derived from animal sources. As some chondroitin products contain too much manganese, a doctor’s advice should be taken in order to find the right brand.

Chondroitin sulfate is considered safe when applied to the skin short-term, when injected into the muscle short-term, when used as an eye drop short-term, and when inserted into the bladder with a catheter by a physician.

Pregnant and breastfeeding women

Not enough information is available on the safety of chondroitin sulfate for pregnant women or breastfeeding mothers. Experts however, advice you to stay on the safe side and not use it.

Blood clotting disorders

Taking chondroitin sulfate might heighten the risk of bleeding in patients with blood clotting disorders.

Asthma

If you have asthma, you’re advised to use chondroitin sulfate cautiously.

Prostate cancer

Prostate cancer spread or recurrence may be caused by chondroitin, according to early research. However, this effect hasn’t been seen while using chondroitin sulfate supplements. Therefore, patients with prostate cancer should avoid taking chondroitin sulfate until more research is done.

 

References

Zhang, W., Doherty, M., Arden, N., Bannwarth, B., Bijlsma, J., Gunther, K.P. et al. (2005) EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULARStanding Committee for International Clinical StudiesIncluding Therapeutics (ESCISIT). Ann Rheum Dis64: 669681.

Zhang, W., Moskowitz, R.W., Nuki, G., Abramson, S.,Altman, R.D., Arden, N. et al. (2008) OARSI recommendationsfor the management of hip and knee

osteoarthritis, Part II: OARSI evidence-based, expertconsensus guidelines. Osteoarthritis Cartilage16: 137162.

Zhang, W., Nuki, G., Moskowitz, R.W., Abramson, S.,

Altman, R.D., Arden, N.K. et al. (2010) OARSI recommendationsfor the management of hip and knee osteoarthritis Part III: changes in evidence followingsystematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 18(4):476-499

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Barnhill, J.G., Fye, C.L., Williams, D.W., Reda, D.J.,Harris, C.L. and Clegg, D.O. (2006) Chondroitinproduct selection for the glucosamine/chondroitinarthritis intervention trial. J Am Pharm Assoc (Wash DC) 46: 1424.

Bassleer, C.T., Combal, J.P., Bougaret, S. and Malaise,M. (1998) Effects of chondroitin sulfate and interleukin-1 beta on human articular chondrocytes cultivatedin clusters. Osteoarthritis Cartilage 6: 196204.

Bian, L., Kaplun, M., Williams, D.Y., Xu, D.,Ateshian, G.A. and Hung, C.T. (2009) Influence of chondroitin sulfate on the biochemical, mechanical and frictional properties of cartilage explants in longterm culture. J Biomechanics 42: 286290.

Campo, G.M., Avenoso, A., Campo, S., D’Ascola, A.,Ferlazzo, A.M. and Calatroni, A. (2004) Reduction ofDNA fragmentation and hydroxyl radical production by hyaluronic acid and chondroitin-4-sulphate in ironplus ascorbate-induced oxidative stress in fibroblast cultures. Free Radic Res 38: 601611.

Campo, G.M., Avenoso, A., Campo, S., D’Ascola, A., Traina, P. and Calatroni, A. (2008) Chondroitin- 4-sulphate inhibits NF-kB translocation and caspase activation in collagen-induced arthritis in mice. Osteoarthritis Cartilage 16: 14741483.

Campo, G.M., Avenoso, A., Campo, S., D’Ascola, A.,Traina, P., Sama, D. et al. (2009a) Glycosaminoglycans modulate inflammation and apoptosis in LPS-treated chondrocytes. J Cell Biochem106: 8392.

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Forsyth R, Brigden C, Northrop A (2006). "Double blind investigation of the effects of oral supplementation of combined glucosamine hydrochloride (GHCL) and chondroitin sulfate (CS) on stride characteristics of veteran horses". Equine veterinary journal. Supplement. 38 (36): 622–5. doi:10.1111/j.2042-3306.2006.tb05615.xPMID 17402494.

 Hydrolyzed Collagen with 10% Chondroitin Sulfate Wound Gel. 510(k) Number: K081724 

https://www.webmd.com/vitamins-supplements/ingredientmono-744-chondroitin%20sulfate.aspx?activeingredientid=744&activeingredientname=chondroitin%20sulfate

http://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/guide/chondroitin-sulfate.php

https://www.zpd.dk/chondroitin-sulfate/what-cs/