Chondroitin Sulfate, Glucosamine
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What It Is:
Glucosamine, chondroitin sulfate, and MSM (methylsulfonylmethane)
occur naturally in the body. The glucosamine used in supplements
is typically derived from the shells of crabs although a corn
source is also available. Glucosamine is available in a variety
of chemical forms, such as glucosamine hydrochloride and glucosamine
sulfate. These vary in terms of the amount of actual glucosamine
available for use in the body from an equal weight of each form
(See ConsumerTip™ for Glucosamine for more information).
Chondroitin sulfate is generally derived from cow cartilage, but
porcine (pig) and even chicken cartilage has been used and algae
are another potential source. MSM is synthetically produced.
What It Does:
Glucosamine and Chondroitin:
Glucosamine and chondroitin sulfate supplements are used to slow
the progression of osteoarthritis — the deterioration of
cartilage between joint bones — and to reduce the associated
pain. Glucosamine is thought to promote the formation and repair
of cartilage. Chondroitin is believed to promote water retention
and elasticity in cartilage and inhibit enzymes that break down
cartilage. In veterinary medicine, glucosamine and chondroitin,
often in combination, are commonly used in the treatment of degenerative
joint disease — typically in older dogs and cats as well
as in horses.
MSM:
MSM is used primarily for treating pain associated with osteoarthritis
and has been proposed for treating other conditions including
rheumatoid arthritis, inflammation of the bladder wall (interstitial
cystitis), snoring, muscle spasm, and cancer. All of these uses
for MSM, including those for arthritis, are based on limited research,
so its effectiveness hasn't been well established. Many additional
claims are found on MSM products, including skin-softening and
nail-strengthening effects, but none of these are well supported
by research. As a veterinary medicine, MSM is used to treat muscle
and tendon soreness and inflammation in horses. The mechanism
by which MSM may work isn't well understood, although it's known
to contribute sulfur to the body, which can then be used to synthesize
certain amino acids (building blocks for proteins), and it can
act as an antioxidant. MSM is also used in veterinary medicine
to treat pain and inflammation, but its effectiveness has not
been well studied.
Quality Concerns and What CL Tested for:
Glucosamine and Chondroitin:
Chondroitin is an expensive material, so experts have been concerned
about the quality and quantity of the ingredient in supplements.
Because chondroitin typically comes from cow cartilage, an additional
concern has been whether the products may be contaminated with
the causative agent of Mad Cow disease (known scientifically as
bovine spongiform encephalitis or BSE). The risk, however, seems
to be miniscule because the prion thought to be the causative
agent of the disease exists only in very low levels in cartilage;
it's most abundant in nervous and glandular tissues. In addition,
some manufacturers have stated that the process used to make chondroitin
supplements should inactivate the prion - although this hasn't
been shown conclusively. Unfortunately, there's no simple way
to test for BSE prion contamination in supplements, so products
in this review weren't evaluated for contamination.
MSM:
MSM is chemically related to DMSO (dimethyl sulfoxide), which
has been used in ways similar to MSM. Unlike MSM, however, DMSO
is a chemical solvent. DMSO was found to cause a range of adverse
reactions and is no longer approved as a supplement. It still
has limited use, however, for those under medical supervision.
Because no government agency is responsible for routinely testing glucosamine, chondroitin, and MSM supplements for their contents or quality, ConsumerLab.com independently evaluated several human and veterinary products to determine whether they contained the amounts of these ingredients stated on their labels. MSM products were also tested for DMSO contamination. Although not thought to be a health risk in small amounts, DMSO in products indicates poor-quality manufacturing. In addition, all tablets and caplets were tested for their ability to properly disintegrate ("break-apart").
What CL Found:
Among the products that ConsumerLab.com selected and tested, problems
were found only among combination products, four of which were
low in chondroitin sulfate — a particularly expensive ingredient.
These four products are listed as "Not Approved" in
the table below and had the following short-comings:
One product, for human use, claimed to contain 500 mg per serving
of "Chondroitin sulfate complex" which ConsumerLab.com's
testing showed to contain less than 90 mg of chondroitin sulfate
— only 18% of the 500 milligrams. ConsumerLab.com has cautioned
consumers in the past to be wary of supplements with ingredients
that include words such as "complex," "formula,"
or "blend" when the weight of each component is not
listed. While it may be legal for a manufacturer to use these
terms, ConsumerLab.com often finds such information misleading
to consumers.
A second product for human use contained less than 85% of its
claimed chondroitin sulfate.
Shockingly, no chondroitin sulfate could be detected in two pet
supplements despite each displaying a "guaranteed analysis"
showing a significant amount of chondroitin sulfate.
All of the tablet and caplet products properly disintegrated (broke
apart) on testing and all of the MSM products lacked DMSO contamination.
(See How Products Were Evaluated).
Test Results by Product:
Listed below by name are examples of the products that were selected
for testing in this review and a summary of their results. Also
included in the list are other products (indicated with an asterisk)
that have gone through the same testing and met the same review
criteria through CL's Voluntary Certification Program.
A total of 49 products are listed in the full version of this report for ConsumerLab.com subscribers. (Log in if you are a subscriber or click here to subscribe.) Listed first are forty-three products for human-use, consisting of 10 glucosamine products, 2 chondroitin products, 9 MSM products, 11 glucosamine/chondroitin products, 3 glucosamine/MSM products, and 8 glucosamine/chondroitin/MSM products. Pet supplements are listed second and consist of 2 glucosamine products, 3 glucosamine/chondroitin products, and 1 glucosamine/MSM product. The full list of ingredients is available for each product by clicking on the word "Ingredient" beneath its name in the third column. A separate review of SAMe products, which are also used for osteoarthritis, will be posted shortly.
EXAMPLES† OF RESULTS OF CONSUMERLAB.COM
TESTING OF JOINT SUPPLEMENTS (GLUCOSAMINE, CHONDROITIN, AND MSM)
The complete list of results for this review contains 49 products
and is available to subscribers.
Click on for additional information on the product
To find retailers that sell some of the listed products click
here.
SUPPLEMENTS FOR HUMAN USE
Glucosamine Only Products
Knox® NutraJoint® Plus Glucosamine, Maximum Strength Formula
Dietary Supplement Drink Mix (1650 mg Glucosamine Hydrochloride
per scoop of powder, 1 per day)* Dist. by KNOX® a Division
of NBTY Glucosamine Hydrochloride: 1650 mg
Ingredients APPROVED
NA
Nature Made® Glucosamine 500 mg (500 mg Glucosamine Sulfate
and Hydrochloride per tablet, 3 per day)* Dist. by Nature Made
Nutritional Products Glucosamine Sulfate and Hydrochloride: 1500
mg
Ingredients APPROVED
NOW® Glucosamine Sulfate, 750 mg Complex, Superior Joint
Support (750 mg Glucosamine Potassium Sulfate Complex per
capsule, 2-4 per day)* Mfd. by NOW Foods Glucosamine Potassium
Sulfate Complex: 1500-3000 mg
Ingredients APPROVED
NA
Nutrilite® Glucosamine HCl with Boswellia (375 mg Glucosamine
Hydrochloride per capsule, 4 per day)* Dist. by Access Business
Group International LLC Glucosamine Hydrochloride: 1500 mg
Ingredients APPROVED
NA
Spring Valley® Glucosamine Sulfate (1000 mg Glucosamine
Sulfate•2 Potassium Chloride per capsule, 2 per day)* Mfd.
by Nature's Bounty, Inc. Glucosamine Sulfate•2 Potassium
Chloride: 2000 mg
Ingredients APPROVED
Vitamin World® Glucosamine Sulfate (500 mg Glucosamine
Sulfate•2 Potassium Chloride per capsule, 3 per day)* Mfd.
by Vitamin World, Inc. Glucosamine Sulfate•2 Potassium Chloride:
1500 mg
Ingredients APPROVED
Chondroitin Only Products
NOW® Chondroitin Sulfate, Joint Support 600
mg (600 mg Chondroitin Sodium Sulfate per capsule, 2-6 per day)*
Mfd. by NOW Foods Chondroitin Sodium Sulfate: 1200-3600 mg
Ingredients APPROVED
NA
MSM Only Products
Spring Valley® MSM, Methylsul-
fonylmethane, 1000 mg (1,000 mg MSM per tablet, 2 - 3 per day)*
Mfd. by Nature's Bounty, Inc. MSM: 2,000 - 3,000 mg
Ingredients APPROVED
Spring Valley® MSM, Methylsulf-
onylmethane, 500 mg (5000 mg MSM per capsule, 2 per day)* Mfd.
by Nature's Bounty, Inc. MSM: 2,000 - 3,000 mg
Ingredients APPROVED
Vitamin World® MSM 1500 mg Dietary Supplement (1,500 mg MSM
per tablet, 2 per day)* Mfd. by Vitamin World, Inc. MSM: 3,000
mg
Ingredients APPROVED
Vitamin World® Naturally Inspired™ MSM Methylsul-
fonylmethane 750 mg Dietary Supplement (750 mg MSM per capsule,
4 per day)*
Mfd. by Vitamin World, Inc. MSM: 3,000 mg
Ingredients APPROVED
Glucosamine and Chondroitin Combination Products
Cosamin®DS Double Strength Joint Health Supplement (500 mg
Glucosamine Hydrochloride and 400 mg Chondroitin Sodium Sulfate
per capsule, 3 per day)* Dist. by Nutramax Laboratories, Inc.
Glucosamine Hydrochloride: 1500 mg Chondroitin Sodium Sulfate:
1200 mg
Ingredients APPROVED
Double Strength Glucosamine 500mg Chondroitin 400mg (500 mg Glucosamine
Hydrochloride and 400 mg Chondroitin Sulfate per tablet, 3 per
day)* Mfd. by U.S. Nutrition Glucosamine Hydrochloride: 1500 mg
Chondroitin Sulfate: 1200 mg
Ingredients APPROVED
NOW® Extra Strength Glucosamine & Chondroitin, Joint
Support Factors (750 mg Glucosamine Potassium-Sulfate Complex
and 600 mg Chondroitin Sodium Sulfate per tablet, 2 per day)*
Mfd. by NOW Foods Glucosamine Potassium Sulfate Complex: 1500
mg
Chondroitin Sodium Sulfate: 1200 mg
Ingredients APPROVED
Puritan's Pride® Double Strength Glucosamine 500mg
Chondroitin 400 mg (500 mg Glucosamine Hydrochloride and 400 mg
Chondroitin Sulfate per tablet, 3 per day)* Mfd. by Puritan's
Pride, Inc. Glucosamine Hydrochloride: 1500 mg Chondroitin Sulfate:
1200 mg
Ingredients APPROVED
Rexall® Osteo Bi-Flex® Glucosamine Chondroitin Complex,
Triple Strength (750 mg Glucosamine Hydrochloride and 600
mg Chondroitin Sulfate per caplet, 2 per day)* Mfd. by Rexall
Sundown, Inc. Glucosamine Hydrochloride: 1500 mg Chondroitin Sulfate:
1200 mg
Ingredients APPROVED
Vitamin World® Triple Strength Glucosamine 750 mg Chondroitin
600 mg, Supports Joint Health (750 mg Glucosamine Hydrochloride
and 600 mg Chondroitin Sodium Sulfate per caplet, 2 per day)*
Mfd. by Vitamin World, Inc. Glucosamine Hydrochloride: 1500 mg,
Chondroitin Sodium Sulfate: 1200 mg
Ingredients APPROVED
Glucosamine and MSM Combination Products
Spring Valley® MSM with Glucosamine (250
mg Glucosamine Sulfate•2 Potassium Chloride and 250 mg MSM
per capsule, 6 per day)* Mfd. by Nature's Bounty, Inc. Glucosamine
Sulfate•2 Potassium Chloride: 1500 mg
MSM: 1500 mg
Ingredients APPROVED
Vitamin World® Glucosamine/MSM Complex (500 mg Glucosamine
Sulfate•2 Potassium Chloride and 333.3 mg MSM per tablet,
3 per day)* Mfd. by Vitamin World, Inc. Glucosamine Sulfate•2
Potassium Chloride: 1500 mg
MSM: 999.9 mg
Ingredients APPROVED
Glucosamine, Chondroitin and MSM Products
Maximum Strength Flex-a-min® Glucosamine,
Chondroitin, MSM Dietary Supplement (500 mg Glucosamine Sulfate•2
Potassium Chloride, 400 mg Chondroitin Sulfate and 166.7 mg MSM
per tablet, 3 per day)* Mfd. by Arthritis Research Corp. Glucosamine
Sulfate•2 Potassium Chloride: 1500 mg
Chondroitin Sulfate: 1200 mg
MSM 500.1 mg
Ingredients APPROVED
Nature Made® Triple Flex™ Triple Strength Supplement
(750 mg Glucosamine Hydrochloride, 600 mg Chondroitin Sulfate,
and 125 mg MSM per caplet, 2 per day) * Dist. by Nature Made Nutritional
Products Glucosamine Hydrochloride: 1500 mg Chondroitin Sulfate:
1200mg
MSM: 250 mg
Ingredients APPROVED
Puritan's Pride® Glucosamine Chondroitin & MSM Dietary
Supplement (500 mg Glucosamine Sulfate•2 Potassium Chloride,
400 mg Chondroitin Sulfate, and 125 mg MSM per tablet, 3 per day)*
Mfd. by Puritan's Pride, Inc. Glucosamine Sulfate•2 Potassium
Chloride: 1500 mg
Chondroitin Sulfate: 1200 mg
MSM: 500.1 mg
Ingredients APPROVED
Vitamin World® Joint Soother™, Glucosamine, Chondroitin,
MSM (500 mg Glucosamine Sulfate•2 Potassium Chloride,
400 mg Chondroitin Sulfate and 166.7 mg MSM per tablet, 3 per
day)* Mfd. by Vitamin World, Inc. Glucosamine Sulfate•2 Potassium
Chloride: 1500 mg
Chondroitin Sulfate: 1200mg
MSM: 500.1 mg
Ingredients APPROVED
PET SUPPLEMENTS:
Glucosamine and Chondroitin Combination Pet Products
Cosequin®DS Double Strength (500 mg Glucosamine
Hydrochloride and 400 mg Chondroitin Sodium Sulfate per capsule,
1-4 per day)* Dist. by Nutramax Laboratories, Inc. Glucosamine
Hydrochloride: 500-2000 mg
Chondroitin Sodium Sulfate: 400-1200 mg
Ingredients APPROVED
†The example(s) shown represent(s) products whose manufacturers/distributors
participated in ConsumerLab.com's voluntary testing and/or licensing
programs for this Product Review.
*Tested through CL's Voluntary Certification Program prior to,
at time of, or after the posting of this Product Review.
Unless otherwise noted, information about the products listed
above is based on the samples purchased by ConsumerLab.com (CL)
for this Product Review. Manufacturers may change ingredients
and label information at any time, so be sure to check labels
carefully when evaluating the products you use or buy. If a product's
ingredients differ from what is listed above, it may not necessarily
be of the same quality as what was tested.
The information contained in this report is based on the compilation
and review of information from product labeling and analytic testing.
CL applies what it believes to be the most appropriate testing
methods and standards. The information in this report does not
reflect the opinion or recommendation of CL, its officers or employees.
CL cannot assure the accuracy of information provided to it by
third parties. Liability to any person for any loss or damage
caused by errors, omissions, or inaccuracies in this report is
hereby disclaimed.
Copyright ConsumerLab.com, LLC, 2003. All rights reserved. Not
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