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Can I keep taking anti-inflammatories like ibuprofen if I go on glucosamine and chondroitin?

The brief answer is... Yes.


Some 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 medication.

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.

In 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.

Using chondroitin alone (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 chondroitin.

As reported on several sections of this website, these anti-inflammatory medications are not at all benign drugs. 

About 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 heavy advertising.

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.

You 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 and surgery.

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

There 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 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.)

Shark 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.

People 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 them?
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.

You 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 idea.

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 sooner?
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 town.")

Because 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



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