Q & A
Arthritis Q & A
Book Q & A
Supplements Q & A
Q & A
About Dr. Theo
Can I keep taking anti-inflammatories
like ibuprofen if I go on glucosamine and chondroitin?
The brief answer
people take Celebrex®, Aleve®, Advil®, ibuprofen or
other non-steroidal anti-inflammatory drugs (NSAIDs) chronically
for pain control. I advise patients to stay on their NSAID while
taking both glucosamine and chondroitin, or ASU.
After taking the supplements for a few weeks, and if your doctor
approves, you can try to slowly wean off of the anti-inflammatory
Try to decrease the medication dose slowly, perhaps about
10% per week. this is often performed by skipping an occasional
doses or using a lower dose tablet over time.
my patients, I consider it a great victory to eventually eliminate
the medication. Fortunately, large numbers of people are able to
either reduce or eliminate their reliance on these drugs by following
the principles in my nine-step treatment program.
(not even in combination) showed a 67% reduction in NSAID use in
a large study of 11,000 people. ASU can also reduce the need for
reported on several sections of this website, these anti-inflammatory
medications are not at all benign drugs.
10% of anti-inflammatory users develop high blood pressure from
the medication, a substantial portion develop kidney and liver damage,
blood disorders, bleeding, serious interactions with other medications
and even death. Most people are surprised to learn that over
16,500 people in the U.S. each year die from the complications of
anti-inflammatory medications. That's about 45 people every day,
on average. And these are 1998 numbers - the values might
be much higher today since millions more take these drugs due to
I warned people
that the COX-2 inhibitor NSAIDs were over-hyped for safety.
As I predicted, Vioxx® was recently removed from the market
because it showed a 50% increase risk of heart attacks.
should understand that the anti-inflammatory medication does absolutely
nothing to treat or improve the disease other than control your
pain. For any given brand or type of NSAID product, only about 40
to 60 percent will notice improvement. The value for Tylenol®
is much lower, only about 30 to 40%.
There is some experimental evidence that glucosamine and chondroitin
can counteract some of the negative effects of NSAIDs on cartilage.
The supplements cannot, however, counteract other potential adverse
effects of NSAIDs such as drug interactions, high blood pressure,
kidney damage, and bleeding ulcers.
How long does it take for glucosamine and chondroitin to begin working?
Some people will notice an effect within a few days, while others may have
to wait up to eight weeks. Very rarely, I'll hear of a patient who
has needed 3-4 months to notice an effect. If there's no noticeable
improvement in pain or function after 8-12 weeks, I usually tell
people to stop using glucosamine and chondroitin, but continue with
the other steps of The Arthritis Cure.
Can I take glucosamine and chondroitin
with anti- inflammatory pills (NSAIDs) or acetaminophen (eg. Tylenol®?)
| Yes, the combinations appear to be safe. In fact, using glucosamine with
NSAIDs may be helpful. Some evidence suggests that using glucosamine
counteracts the normal decrease in proteoglycan (cartilage) synthesis
associated with the use of some NSAIDs. Fortunately, most patients
are able to stop using their NSAIDs after taking glucosamine and chondroitin
for 2-8 weeks. Some who have been taking NSAIDs for decades have been
able to get off of them completely. About
80 to 90% will be able to stop anti-inflammatory drug use completely
if follow all the steps in The Arthritis Cure treatment program.
What products do you recommend?
As a physician and an opinion leader in the area of joint health, I have
a professional interest in assuring people take products that meet
label claims. I have seen reports of products containing glucosamine
and chondroitin that do not contain what is claimed. If people take
placebos, my treatment will (falsely) appear to be ineffectual.
People will waste money and may require unnecessary, dangerous medicine
In order to protect the public interest and to assure treatment
effectiveness, I have decided to recommend some top quality products.
These products are tested for potency by qualified laboratories.
In addition, the manufacturing process and quality assurance programs
of these suppliers are continuously reviewed and evaluated by independent
experts. I even perform my own independent testing by buying products
and sending them for independent chemical analysis. I have spent
about $50,000 just to make sure my recommendations are valid. These
evaluations negate physician concern that supplements are not regulated.
once tested, you can be more sure of the contents of the supplements
that they can be of the contents of many over-the-counter drugs,
for which no independent organization has done post-manufacture
Quality assurance evaluations.
See my recommendations
is wide availability of these products in pharmacies, chain stores
and even some grocery stores.
I have tried to report some of the companies that have failed testing,
but these companies have threatened me and I'm not particularly
interested in spending my time in court, even if the results speak
for themselves. Some of the very worst products on the market are
sometimes big sellers, may be quite expensive, have the fanciest
labels and make the bold claims of quality. Some of the bad products
are cheap and are just trying to make a quick buck before they're
shut down. Looking at the label gives you little idea if you have
a good or bad product.
You certainly can't go by the recommendations of consumerlab.com.
In my opinion is organization is useless since it apparently tests
only one batch of a product before declaring it to be “acceptable.”
Once a product passes their one test, they can get a menu of advertising
services. Many have called it an extortion scheme.
This method makes as much sense as determining the quality of the
teaching at a school by picking one child at random and testing
that child, and no others. Obviously, a larger number of tests must
be performed to get a meaningful idea of the quality as a whole.
Can I use glucosamine and chondroitin sulfate if I'm allergic to sulfates?
| To be safe, patients with sulfate allergies should just take glucosamine
hydrochloride (not sulfate), and skip the chondroitin sulfate. (Chondroitin
in anything but a sulfated form.)
cartilage may be a substitute for the chondroitin sulfate, but there's
no guarantee that the shark cartilage is not sulfated, as well.
I do not recommend experimenting to see if your sulfate allergy
applies to these substances.
can have allergies to almost anything they can put in their mouths.
Despite reading many studies and hearing from hundreds of patients
taking glucosamine and chondroitin, I have yet to find anyone with
a true allergy to glucosamine and chondroitin sulfates. (a true
allergy would produce symptoms such as hives, itching, breathing
difficulties, swelling, a drop in blood pressure, passing out, etc.)
Still, I suspect that there are people who will be allergic to glucosamine
and chondroitin, just as there are people who are allergic to peanuts,
strawberries or shellfish and other common food substances. Be careful
if you have, or think you have, any food allergies, for severe allergies
can be life-threatening.
I am pregnant. Should I use glucosamine and chondroitin?
| No. Pregnant women should not take anything except prenatal vitamins
unless their physician advises differently. There are no adequate
studies to this date that support the safety of glucosamine and chondroitin
during pregnancy or women who are nursing.
I have high blood pressure and take medication, will glucosamine and chondroitin
interact with my medicine or affect my blood pressure?
I am not aware of any known medication interactions with glucosamine and
chondroitin. None of the clinical studies have shown this to be
a problem, even the long-term studies up to 5 years.
However, products containing these supplements often contain some
sodium, which can raise blood pressure in people who have salt-sensitive
hypertension. This is not a medication interaction, but an effect
from the sodium itself.
The Dr. Theo's Official Product, AVOSOY
Plus is sodium-freeand should have no effect on blood pressure.
Consider using this product if you're on a low-sodium diet.
I have adult-onset diabetes, will glucosamine and chondroitin raise my
blood sugar levels?
| I am not aware of any published information on this in humans. I have not
seen blood sugar elevations in my patients taking these supplements.
Just to be safe, however, I generally recommend closer monitoring
of blood sugar when using these supplements as well as using the minimum
effective dose. Despite the name similarity, glucosamine and glucose
actually have a different pathway of metabolism in the body.
There has been
some small studies in rats showing glucosamine can impair insulin
resistance. One study showed that this did not occur in diabetic
rats, just the normal ones. I'd like to see some more human studies
in this area.
There are many varieties of glucosamine, what's the difference between
| The supplement comes in forms: glucosamine hydrochloride, glucosamine hydroiodide,
n-acetyl glucosamine and glucosamine sulfate.
The sulfate form is has the most research evidence to back its use.
However, this is probably related to the simple fact that this form
was patented in Europe and more research money was available to for
study. Clinically, glucosamine hydrochloride and glucosamine sulfate
are identical in terms of their effects. Indeed the glucosamine hydrochloride
form is sulfated in the body anyway. I do not recommend n-acetyl glucosamine
since its action on boosting proteoglycan synthesis is weak and it
doesn't seem to work as well in patients. (if you have thyroid conditions
you should avoid glucosamine hydroiodide.)
I have already had a knee replacement. Will glucosamine, chondroitin or
ASU help regrow cartilage in the new joint?
No. Artificial joints do not have chondrocytes (cartilage-producing cells).
However, there is some value to glucosamine/chondroitin and ASU
in this case. These supplements may help slow or prevent loosening
of the artificial joint from the connecting bone. The loosening
is often related to certain chemicals that can be blocked, at least
partially, by these supplements.
should understand, however, that if a joint was damaged enough by
osteoarthritis to have required replacement - you're highly likely
to have other joints that have, or are developing osteoarthritis. Therefore,
the supplements, and the rest of the treatment program are a good
Can you use topical glucosamine and chondroitin
instead of oral supplements when treating arthritis?
| I have not been able to find any information to support the notion that glucosamine
and chondroitin will be absorbed, in any quantity by topical administration.
There is theoretical reasoning that they won't. Since the oral forms
of these supplements have been shown to be so effective, there's probably
no reason to consider another route of entry.
Why haven't we heard of using glucosamine and chondroitin for arthritis
| The American medical establishment is dominated by pharmaceutical companies
that are interested in disseminating information about drugs they
have patented and offer for sale. These companies, which provide much
of the money for medical research and spend millions of dollars "educating"
doctors about their products, have absolutely no interest in researching,
supporting or disseminating information about glucosamine and chondroitin
sulfates. Why? Because these two natural substances cannot be patented,
which means that the pharmaceutical companies cannot "corner the market"
for these products and make a lot of money selling them. (indeed,
the pharmaceutical companies would be happier if all supplements disappeared
from the shelves, for then their drugs would be the only "game in
the supplement companies don't have nearly as much money as the
pharmaceutical industry, and because many doctor's mistakenly believe
that only drugs can be "real medicine," it has taken a long time
for news of glucosamine and chondroitin sulfates to reach the United
States. They have, however, been in use in Europe for some time (over 20 years).
Learn about and purchase the book
90% of people who follow The Arthritis Cure treatment program don't need anti-inflammatories (like Aleve, Celebrex or Advil).
Dr. Theo warned people that these drugs, used first... read more