DEAR DR. ROACH: I disagree with your recent article on glucosamine/chondroitin supplements. I have arthritis in my lower back. I take this supplement every day and my lower back pain is completely gone. I can now bend from the waist down. I was very skeptical about this or any other supplement and was surprised when it worked. Give it another look. –GR
ANSWER: Glucosamine and chondroitin are common supplements used by people with osteoarthritis for many different joints. Many studies, when looked at together, have failed to show that they are any better than placebo, a pill with no activity.
In a placebo-controlled trial, a person is given either the drug being studied or a placebo, sometimes called a sugar pill or a dummy pill. In the most rigorous trials, neither the subject nor the researcher knows what a person is getting until the end of the trial. The two groups are compared to see how many people did well in one group compared to the other.
In the case of glucosamine and chondroitin, the number of people with arthritis relief was about the same among those given the placebo as among those given the glucosamine and chondroitin. However, for a given person, either the drug works or it doesn’t. People can have striking improvements on the placebo.
I think taking something that you think will make you better can lead to increased exercise, and exercise is known to have beneficial effects on arthritis. This leads to even better results.
It is important to recognize that the placebo response acts on the symptoms. It does not improve arthritis, as evidenced by x-rays. But the improvement in symptoms is certainly worth the effort in itself.
If glucosamine and chondroitin are working well for you, you should continue taking them. I don’t know if this is a placebo response for you, or if you are someone for whom this really has a pharmacological benefit. But since the drug is safe, low in toxicity in recommended doses, and relatively inexpensive, there’s no reason not to take it if it helps.
DEAR DR. ROACH: I am a healthy 75 year old female. I think my diet is good enough, but I know I’m not getting enough fiber daily. What is your opinion on gummed fiber as a supplement? I’ve read about these, and they seem like a good idea to me. I would appreciate your thoughts. –WD
ANSWER: Fiber is my first choice for most people with diarrhea or constipation who otherwise don’t have gastrointestinal issues. Fiber is safe and effective for both conditions for most people, especially when started slowly and taken with plenty of water. You can increase your fiber intake through diet (whole grains, legumes, and fruits are some of your best sources), but if you need a supplement, that’s fine. Gums are easier for many people to take than liquids or capsules.
If you have no problem, you don’t need to supplement. Many studies have been done on extra fiber in healthy people, and they have failed to reduce the risk of cancer. A diet rich in the foods I mentioned reduces colon and other cancer risks.
Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can send questions to ToYourGoodHealth@med.cornell.edu or mail to 628 Virginia Dr., Orlando, FL 32803.
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