Joint pain is one of the most common complaints among people over 40 years of age. The market of “joint” supplements is full of products – glucosamine, chondroitin, collagen, MSM, boswellia, omega-3… What is actually supported by research and what is marketing?
How the joint is arranged and what is destroyed
The joint consists of cartilage (shock absorber), synovial fluid (lubricant) and bone tissue. With osteoarthritis, cartilage gradually thins: chondrocytes (cartilage cells) do not have time to synthesize a new matrix as quickly as it is destroyed.
Additives for joints work in different ways – some provide “building material” for cartilage, others reduce inflammation, and others protect chondrocytes from destruction.
Glucosamine
Glucosamine is a natural component of cartilage matrix and synovial fluid. With arthrosis, its synthesis in cartilage decreases.
Evidence base: Meta-analyses provide conflicting results. Some large studies (GAIT, 2006) have shown an effect of glucosamine sulfate in moderate to severe pain, but not in mild pain. Glucosamine is better researched than chondroitin.
Recommended dosage: 1500 mg/day (better in 3 doses of 500 mg). The effect develops after 4–8 weeks.
Chondroitin
Chondroitin sulfate is a glycosaminoglycan, a structural component of the cartilage matrix. Retains water in the cartilage and ensures its elasticity.
Evidence base: The combination of glucosamine + chondroitin was effective in moderate to severe pain in the GAIT study. Chondroitin also exhibits anti-inflammatory properties and can slow down the destruction of cartilage.
Dosage: 800–1200 mg/day. NSP: Chondroitin and Glucosamine.
Collagen
Cartilage consists of 60–70% type II collagen. With age, its synthesis decreases, cartilage becomes thinner and less elastic.
Hydrolyzed collagen (type II): small peptides that are absorbed and accumulate in cartilage tissue. Studies show a reduction in pain and improvement in joint mobility after 3-6 months of use.
Non-denatured collagen UC-II: different mechanism of action – “teaches” the immune system not to attack its own cartilage. Effective at a dose of 40 mg/day — significantly less than hydrolyzed (10 g/day).
MSM (methylsulfonylmethane)
MSM is an organic sulfur compound necessary for the synthesis of collagen and glutathione. It has anti-inflammatory properties and reduces pain. Often combined with glucosamine for a synergistic effect.
NSP: MSM / Methylsulfonylmethane — 1000–3000 mg/day.
Boswellia (incense tree)
Boswellia extract (AKBA) is a powerful inhibitor of 5-LOX (an inflammatory enzyme), more effective than some NSAIDs in anti-inflammatory action without side effects on the stomach. Several randomized studies have confirmed a reduction in knee osteoarthritis pain after just 30 days of use.
NSP: Boswellia Plus.
Omega-3
EPA and DHA reduce the level of leukotrienes, mediators of inflammation in the joints. With rheumatoid arthritis, taking 2–4 g of omega-3 per day reduces morning stiffness and joint pain.
Selection strategy
In osteoarthritis (cartilage wear and tear):
- Glucosamine sulfate 1500 mg + Chondroitin 1200 mg + MSM 2000 mg
- The course is at least 3 months, preferably 6 months
In inflammatory pain (rheumatoid arthritis):
- Omega-3 (3–4 g EPA+DHA) + Boswellia
- Only as a supplement to the prescribed treatment!
For prevention after 40:
- hydrolyzed collagen (5–10 g/day) + vitamin C (promotes collagen synthesis)
Conclusion
No supplement will “restore” destroyed cartilage in severe arthrosis. But in the early stages and for prevention, a complex approach (glucosamine + chondroitin + MSM + omega-3) reliably reduces pain, slows down the destruction of cartilage and improves the quality of movement.
