Are You Getting the Most from Your Medications?

Are you getting the most effectiveness out of the supplements and medications you take? Did you know the time of day you take your medications and drug interactions may impact how well your supplements and medications work?  Today’s blog overviews the impact of time and drug interactions on your medications.

Time of day

Some prescription medications say what time of day they should be taken, but most don’t. Does the time of day impact how well the medication works?  Unfortunately, drug research is almost always done during the day and does not involve testing of new drugs at multiple times of the day. Yet many bodily functions vary throughout the day so that the impact of a drug may depend on circadian rhythms. A new field, chronobiology, hopes to change the way drug testing is done to include timing in drug tests. (1) 

There are some knowns, however. Aspirin is easier on the stomach if not taken in the morning.  Since certain diseases are worse at certain times of the day, taking your medication so it is active when symptoms are worse will give you the best benefit. So if your osteoarthritis gets worse at night, taking your anti-inflammatory around noon or in the afternoon might provide the most relief when the pain is at its peak.

Some older statin medications work better if taken at night. Asthma attacks are more frequent at night and the stomach secrets more acid at night, indicating the medications for these conditions should be taken a few hours before bedtime. (2)

Blood pressure medications are trickier. Most people’s blood pressure dips at night, so these people should take their blood pressure medication in the morning when blood pressure peaks. However, there are people whose blood pressure does not dip at night might do better by taking some of their blood pressure medication at night. (2)  

Interactions

With each medication you take, your chances of having a drug interaction increases. The interaction may either increase or decrease the effectiveness of a medication. Many times a prescription drug label will tell you about interactions (e.g., do not take alcohol while taking this medication), but many times it does not.

What are some of the common interactions?

Calcium can decrease the effectiveness of medications like antibiotics and ACE Inhibitors. To minimize the effects, take calcium at least 1 hour after or 4 hours before taking these medications. (3)  

Another common drug interaction is that medications to treat stomach disorders  can reduce the effectiveness of medications that rely on stomach acid to absorb the medication.  For example, a Canadian study of more than 60,000 people 50 and over found that those who took proton pump inhibitors for more than 5 years were 1.5 times as likely to have hip fractures. (4, 5)

Checking Interactions

Drugs.com has a Drug Interaction Checker where you enter your medications, including over the counter medications, and the website will tell you about the interactions.  This is really nice because it's customized specifically for the medications you take.

Common Drug Interactions - a Chart developed by a pharmacy graduate student.

Drug Interactions - a very nice site with a definition of drug interactions, how they occur, information on absorption and metabolism, the consequences of drug interactions and how drug interactions can be avoided.

References

1. Slate, The Best of Times, the Worst of Times. Nov 1, 2007
2. msnbc.com, What Time You Take Your Blood Pressure Pill Matters, December 17, 2007
3. WebMD.com, Calcium (click the interactions tab)
4. CBSNews.com, Acid Reflux Pills Linked To Hip Fractures, August 11, 2008
5. Everydayhealth,com, Nexium and Bone Loss?, May 7, 2007

How Much Protein is Healthy? Unhealthy?

Per one of my previous blogs, Comparison of Food and Exercise Logging Sites, I log what I eat on Livestrong.com  A benefit of using a logging tool is seeing if I get the right amount of nutrients. Most food logging websites compare your food intake nutrient breakdown with a recommended daily intake. That can cause some concern if you find your intake is over or under the recommendations.  For example, I eat more protein than the recommended USDA guideline.   How much protein do I need?  Do I need that extra protein because of my exercise regime?  Is too much protein harmful?  Today’s blog looks into these questions.

How much protein do you need?

Recommendations on protein requirements vary widely. The USDA  food pyramid suggests that protein make up between 17% to 21% percent of total calories eaten. Twenty percent equates  to 60g of protein for a 1200 calorie diet and 100g of protein for a 2000 calorie diet.  WebMD  states an woman needs about 46 grams of protein a day (that’s about 15% for a 1200 calorie diet), adult men need about 56 grams a day¹ (that’s about 11% for a 2000 diet).  The Institute of Medicine recommends we get at least 10% and no more than 35% of calories from protein.  (see the footnotes for calculating conversions). ¹  So these three recommendations for protein range anywhere from 10% of your calories to 35% of your calories.

Does increasing protein help?

Increasing protein intake is hyped for weight loss, building muscle mass and as needed for athletic activities.  If so, how much more do you need?  Does the average person who just started an exercise program need to boost their protein intake? 

In a 2005 study, the American Journal of Clinical Nutrition found that increasing protein from 15% to 30% of total calories, and reducing fat from 35% to 20% of calories, resulted in sustained weight loss.  Thirty percent equates  to 90g of protein for a 1200 calorie diet and 150g of protein for a 2000 calorie diet. ²

Dr. Peter W. Lemon, researcher in exercise training and proper nutrition, researched protein  needs and concluded that an increase in protein intake to 1.7g per kg of body weight is beneficial for muscle growth through weight training, but only to an extent³ (see Footnotes to calculate your protein needs).  Once a certain intake level is reached, any additional protein taken in will not help build muscle mass any more.  He also notes the American diet usually contains enough protein for the average athlete. Research at Vanderbilt University said that increased protein does help for endurance athletes who train for 2-5 hours a day, because they use protein for fuel.⁴

Is too much protein harmful?

There are three reported impacts of too much protein:  overworking the kidneys,  leaching bone calcium, and gout.

Overworking the kidneys : A common misconception about excess protein in the diet is that it can cause kidney damage. Research at Vanderbilt University concluded  that no studies have found an high rate of kidney problems in strength athletes as would be expected if too much protein caused kidney damage.

Leaching bone calcium:  Another apparent misconception  is  that increased protein intake results in calcium wasting.  Studies seem to confirm that increasing protein, when exchanged calorie-for-calorie for carbohydrates, may have a favorable impact on the skeleton in healthy older men and women. 

Whether adding protein improves bones may be partly a function of how much protein the person was eating to begin with.  But in several studies comparing the bones of people eating the standard “recommended daily requirement” of protein with those eating more protein found that those who ate more protein than the standard recommendation had less bone loss.

Gout:  Increased protein consumption from red meat or seafood is associated with an increased risk of gout. But a twelve-year study at Massachusetts General Hospital showed increased consumption of high-protein, purine-rich* vegetables (e.g., asparagus, cauliflower, kidney beans, lentils, lima beans, mushrooms, navy beans) was not associated with increased risk of gout.⁵  The study  also shows that dairy products, which are also high in protein, can help reduce gout.

Conclusion

First, it’s hard to tell just how much protein is the minimum required.   Second, to a certain extent , if you want to build muscle mass through weight lifting or sustain weight loss, if you don’t eat toward the higher end of the recommended  protein range, it might help to increase protein to about 30 percent of your calories. Finally, studies show that increasing protein does no harm, as long as the protein source is not red meat.

Footnotes

*  Purine, when metabolized, turns into uric acid and excess of which causes gout

Calculating grams of protein based on percentage of daily caloric intake:  

Grams of Protein = (Desired calories * Desired protein percentage) / 4

Example: 2000 (desired calories) * .2 (20% desired protein percentage)  / 4 (grams per calorie in protein) = 100 grams protein

Calculate your protein needs for muscle building at 1.7g per kg body weight:

weight in lbs * .7711 =  grams of protein a day

References

1. Protein: Are You Getting Enough?
2.  "A high-protein diet induces sustained reductions in appetite…”, Weigle et al, American  Journal Clinical Nutrition,  2005, pages 41–8.
3. Is increased dietary protein necessary or beneficial for individuals with a physically active lifestyle?, Dr. Peter W. Lemon, Kent State,  Nutrition Reviews, 27 April 2009.
4. How Much Protein Do Athletes Need? Lee Knight Caffery, Vanderbilt University
5. Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men, Hyon K. Choi, M.D., et al, New England Journal of Medicine 2004; 350:1093-1103, March 11, 2004
6. Do low-carb diets cause bone loss?, Laura Dolson, About.com Guide, Updated June 22, 2009, About.com Health's Disease and Condition content is reviewed by our Medical Review Board

Plyometrics – a Fun Workout; Hop, Skip and Jump Like a Kid!

Last year the P90X (X for eXtreme) workout was the buzz and I bought the program.  I enjoyed it, even though I  admit my participation was more like P90L (L for Light).  One P90X workout I especially enjoyed was Plyometrics, something I’d never heard of before.  Plyometrics is a series of jumping, bounding and hopping exercises designed to build explosiveness in sports.  It increases power, which is the combination of speed and strength. For those who want specific details about the benefits of plyometrics and how the workouts build power, I’ve provided links below.

At my age, I’m not looking for power or explosiveness. I’m thankful just to put in my mileage or do spinning. I did notice a slight improvement in running and perhaps more spring and balance in my daily activities which is something us mature folks need.  Above all, plyometrics was fun! It was a break from the typical aerobics and weights.  The sideways skipping and running around a square made me feel like a grade schooler again.

I’ve read that plyometrics can lead to injury. I did the P90X program for a few months with no injury.  Just be sure to warm up and do it gently if you are older or prone to injury (the Plyometrics 101 link below gives an example of a less intense workout).

Check out the links below for plyometrics workouts. And happy hopping, skipping and jumping!

References

The first three links show more moderate versions of plyometrics.  The fourth link is a link to a more vigorous workout.

1. P90x Plyometrics, You Tube, Worldandmaerekoo - Watch this video and you’ll get double the fun by watching two average guys going through the routine. They don’t do complete reps, but you’ll get the idea.
2. P90X Week 3 Plyrometics, YouTube, EboniqueAmazon – Another video of an average person (Ebonique Amazon) going through the P90X routine.
3. Plyometrics 101, YouTube, FabsCyberFitness – Follow the woman if you want a gentler version of the routine.
4. Plyometrics Circuit, YouTube, ironbird 99 – For those who want a more vigorous Plyometric routine.
5. Cooper, Bob. "Plyometric Power." Runner's World: Running Shoes, Marathon Training, Racing. Rodale Press, Aug. 2004. Web. 08 May 2011 – Includes  12 drills for runners who want better balance, increased speed and more agility.
6. Davies, Phil. "Plyometric Training... Programs & Exercises for Power." Phil Davies' Sports Fitness Advisor - Get Fit for Sport & Life. Sporting Excellence, Ltd. Web. 08 May 2011 – Includes links to two articles on the effectiveness of plyometrics plus links to specific plyometric exercises.
7. Quinn, Elizabeth. "Plyometric Exercises – Using Plyometric Exercises to Build Speed and Power." Sports Medicine, Sports Performance, Sports Injury - Information About Sports Injuries and Workouts for Athletes. About.com, 8 Dec. 2008. Web. 08 May 2011 – A description of Plyometrics with references to safety research and safety tips.

BPA in Food Containers: Are Plastic Bottles and Food Cans Safe?

Recent scary reports of the harmful chemical BPA (bisophenol-a) leaching from plastic bottles into my food concern me. I refill plastic water bottles, many of them over 5 years old. I routinely pour boiling water in my Rubbermaid® bottle to make tea.  I use refillable plastic coffee mugs.  Are these habits risky?

BPA, an estrogen-like chemical, is found in hard, clear plastic bottles, dental sealants and in canned goods linings.   Canned beverages contain less of the chemical than canned foods like soup, pasta, fruits and vegetables, which are often processed at high temperatures. Virtually every canned product, even those labeled organic, has liners with BPA.

BPA has been shown to have risks to human development, raising concerns for early puberty, prostate effects, breast cancer, and behavioral impacts from early-life exposures. Pregnant women, infants and young children are most vulnerable to the harmful effects of BPA. More recent studies have shown a possible link to other adult diseases.

BPA in Plastic Bottles

Only a certain type of reusable plastic bottle is of concern, mainly products with a recycle code of 7 that are clear and hard.  You may be able to look up any products you use on the internet to see if they have  BPA. Rubbermaid® has a wonderful page that shows pictures of all their products and tells you which contain BPA.  Rubbermaid® discontinued the use of BPA, but older products on your shelf may have some.

Of more concern is BPA use in baby bottles and canned infant formula. Studies have shown that BPA release increases dramatically when heating plastics with BPA¹. Some manufacturers of baby products have removed BPA from their containers. Walmart and some other retailers are eliminating products with BPA. Look at the label or visit the manufacturer’s website for details on BPA usage in packaging.

BPA in Other Food Products

But what about BPA use in other products?  I haven’t found a lot of research on BPA in can linings. In December 2008, Consumer’s Reports tested canned foods².  They found the highest concentrations of BPA (about 80 times higher than their expert’s recommended daily limit),  in canned green beans and canned soups.  They noted there could be variability among products.  Canned juice had low levels of BPA, but Consumer’s Reports reminded readers that children may consume several cans a day. It should be noted that some manufacturers are taking BPA out of their canned goods liners.  Check the can label or the manufacturer’s website.

Conclusion

I found that refilling my water bottles is safe. They don’t contain BPA. I may reconsider making tea in a plastic container. Even though it doesn’t have BPA,  I wonder what other harmful chemicals might be leaching out of the plastic because of the boiling water.  If you find some of the containers you use for food storage have BPA, you might choose to discard them.  Both ConsumerReports and The National Institute of Health Sciences – National Institutes of Health showed some concern over canned products and recommend reduced usage if you are concerned. Many sources also recommend not using plastic in the microwave.

References

1. Plastic Bottles Release Potentially Harmful Chemicals (Bisphenol A) After Contact With Hot Liquids, ScienceDaily (Feb. 4, 2008), A University of Cincinnati study discovered the amount of BPA that leaches from products increases from 15-55% when boiling water is put into the container. 
2. Concern over canned foods, lab tests, ConsumerReports, December 2009, pp 54-55.
3. Timeline: BPA from Invention to Phase-Out, Environmental Working Group (EWG), Jane Houlihan, Sonya Lunder, Anila Jacob. April 2008, Updated March 2011   A Very detailed listing of activities by agencies in BPA research, laws, etc.
4. Since You Asked  - Bisphenol A (BPA ),  National Institute of Health Sciences – National Institutes of Health.
5. FAQs: The Safety of Plastic Beverage Bottles, Plastics Info, sponsored by the American Chemistry Council.
6. Update on Bisphenol A (BPA) for Use in Food: January 2010, U. S. Federal Drug Administration.
7. Are toxic plastics lurking in your kitchen?, New York Times - Health, Tara Parker-Pope, April 22, 2008.

Seven Stick with it Tips

We all have days when we have trouble sticking with a healthy lifestyle .  My slump days are frequently based on mood. Today is a round-up of tips I’ve collected for sticking with healthy eating and exercise.   

Get a buddy. Form a relationship with a person or group who inspires hope and belief; someone who makes you say, if she can do it, I can, too. This the way many of the weight loss programs work. They are a support system to keep you going and to show you it is possible.¹ 

Read for inspiration. Reading magazines such as Runner’s World, Shape, and Fitness Magazine  boosts my enthusiasm towards working out and eating healthy. I read of people who face struggles similar to my own and how they overcome them. Just seeing the pictures of healthy people and healthy food keeps me enthused.  And nowadays, you can see most of the magazine’s content online. ^2,3,4

Have a Plan B. Figure out your biggest obstacle and have two or three back-up plans. If your obstacle is unhealthy snacking, always have healthy treats that you love around whether it’s crunchy (carrot, jicama or celery sticks with hummus) or sweet ( sugarless gum, sugarless jello,  sugarless hard candy). If you have a hard time exercising, have a plan that will make it easy – some favorite DVDs or a buddy at work to take a lunchtime walk.

Enter a race. Some people find working toward a goal keeps them on a program. Many of my friends swear by races as a motivational tool. Once you’ve entered a race, you have to train to complete the race. Not only do these events keep you striving to do your best, you have a great sense of accomplishment when you complete the race.

Hold a Contest. Several of us at work have a mass weight reduction plan. Contribute $50 in the beginning with a goal of losing 5% of your weight in 15 weeks. If you gain weight any week, $2 gets deducted from your pot for every pound you gain. At the end of the 15 weeks, those who reached their 5% weight loss goal split the money.  Everybody who reaches their goal wins!

Face your mood. One thing I’m slowly learning is to change my thinking when I feel tired or uninspired. When I start thinking of eating a treat to boost my energy or spirits, I ask myself if a treat is really going to make me feel any better.  The answer is always no (unless it’s a Ghirardelli dark chocolate square, broken into pieces and slowly savored).

Picture It.  For several years I had a picture of a running,  muscular 70-year old woman who placed first in her age group in the Ironman Triathalon on my desk. She had been a swimmer since she was a young adult. The image of someone who had kept at fitness her entire life inspired me. Some people post pictures of their slender selves on their refrigerators. Others post pictures of themselves when they were heavier as a reminder to avoid certain foods. Pick whichever picture works for you – the carrot (an inspiring picture) or the stick (a picture of something you want to avoid).

We all face times when it’s hard to stay on the healthy path. Hopefully, some of these tips will help you. Let us hear what you do when you to keep on track.

References

1. Losee, Stephanie. "The Willoower Myth. How to Really Make a Change at Work and in Life - Oprah.com." Oprah Winfrey's Official Website - Live Your Best Life - Oprah.com. Jan. 2008.Losee, Stephanie. "How to Really Make a Change at Work and in Life - Oprah.com." Oprah Winfrey's Official Website - Live Your Best Life - Oprah.com. Jan. 2008. -
2. Shape Magazine
3. Runner’s World -
4. Fittness Magazine 

Food Label Gotchas

If you’re trying to eat healthy, you most likely look at food labels to make sure you aren’t overloading on trans fats, cholesterol and calories.  But it takes more than a glance at the nutritional information to get the entire picture.  Here are some of the ways food labels can be deceptive.

Number of servings: The other night I had Trader Joe’s Butter Chicken. I glanced at the calories and it said 270, which is reasonable for a frozen dinner. But wait, something’s wrong. This dinner is at least one-third bigger than some of the other dinners I enjoy. Looking more carefully, the label said the dinner  had 1.5 servings.  I could see if it had two servings, you would split the dinner, but 1.5 servings? What would I do with the other ½ serving? I ate if, of course!

Many food packages that appear to be for one person have more than one serving.  Snack foods such as trail mix or nuts frequently have multiple servings per package. So watch out! You could be eating two or three times more calories than you expected.

Trans fats: Many labels say ‘contains no trans fat.’ But manufacturers can say that a food has no trans fats if it contains less than .5 grams of trans fat per serving. If the food contains .5 grams of fat per serving and you eat four servings, you’d get 2 grams of trans fats. You’d also get 2 grams of trans fat if during the day you ate four different foods, each with .5 grams of trans fats. While there is no agreement on how much trans fat you can eat, many health specialists say trans fat in any amount cannot be safely consumed, especially if you are at risk for high cholesterol, heart disease or stroke.

So how do you avoid trans fats?  If the ingredient list contains partially hydrogenated oil, or shortening, the food has trans fats. Surprisingly, fully hydrogenated oil does not contain trans fats.³ But if the label simply says hydrogenated oil, it’s best to assume it has trans fats.

You should also be aware that trans fats are in the oils many restaurants use for frying. A Mayo Clinic article points out that a large serving of French fries could contain as much as 5 grams of trans fat.

How to avoid the Gotchas:

1. Check the serving size – I do sometimes buy snacks like peanuts or trail mix that have more than one serving, but try to eat only one serving and clip the package and hide them in my drawer for the next day.
2. Read the ingredients list – Avoid foods with hydrogenated oils. Some people say to avoid foods where high fructose corn syrup is one of the first three ingredients or to avoid it altogether. Many health specialists say to avoid foods with ingredients you don’t recognize because they are chemicals. Remember the Breyers Ice Cream commercial, “our ice cream contains only milk, strawberries and cream.  Other ice cream labels contain ingredients you can't pronounce like carrageenen.  Carrageenen, ooh, that’s glue!”

So read those labels carefully.  You may be getting more than you bargained for.

Side note:  In blog post When Did I Get Fat, Gal Josefsberg plots his weight against life events and concludes that Life Matters. He says “We like to think that health is about eating and exercise but health is about much more than that.  Health is about how you feel and what your life is like.  Changes in your health don’t just happen, they usually involve some kind of major life change.  That corollary to this is, if you want to make a change in your health, you’ll need to make a change in your life.”  Read the entire article. I loved it!

References

1. Eng, Monica. "Girl Scout Cookies and Other Sweets Offer Confusing Labeling on Trans Fats - Chicago Tribune." Featured Articles From The Chicago Tribune. 25 Jan. 2011. Web. 17 Apr. 2011.
2. Gurd, Vreni. "Deceptive Food Labels | Trusted.MD Network." Trusted.MD Network | Empowering Healthcare Relationships. 27 Jan. 2007. Web. 17 Apr. 2011.
3. Mayo Clinic Staff , Trans Fat Is Double Trouble for Your Heart Health. Mayo Clinic. Web.  
4. Van Dusen, Allison. "Nine Ways Food Labels Mislead - Forbes.com." Information for the World's Business Leaders - Forbes.com. Forbes Magazine, 29 July 2008. Web. 17 Apr. 2011.
5. Wright, Brierley. "Health | Eating Well." Healthy Recipes, Healthy Eating, Healthy Cooking | Eating Well." Eating Well, 5 Mar. 2010. Web. 17 Apr. 2011.

Pushing Yourself – Workout Challenges That Make You Stronger and Help You Burn Fat

This morning I was spinning to Radar Love by Golden Earring, about 200 beats per minute. I felt tired and my brain started the self talk, “Why am I so tired? Did I over-exercise yesterday?” Then I looked at my heart rate monitor. It was at 100%, theoretically my highest rate.  No wonder I felt so tired.  I decided to push through the entire song, six minutes, a big challenge. 

I constantly give myself challenges.  While spinning, I tell myself, “I won’t put my butt on the seat until the end of this song.” Other times while spinning I crank up the tension on the bike until it’s really hard to peddle through the entire Led Zeppelin song, Kashmir.  For me, it’s a perfect challenge song. I love the song and I imagine myself plodding through the desert. In running, I’ll increase the speed and challenge myself to keep that speed until the end of the song. See my Feburary 13 blog, Music to Get You Moving for links to challenge (fast-paced) songs.

Challenges are the way you improve. It’s those challenge moments that help increase aerobic ability and strength. Runners do challenge runs several times a week to improve, e.g., intervals (bursts of speed followed by low-intensity recovery repeated throughout the workout) and running hills for strength.  Evidence shows that intervals improves cardio vascular fitness and raises the body’s potential to burn fat.¹

So the next time your brain tells you, “stop, this is too hard!” challenge yourself: I’ll finish this song, I’ll go to the end of the block. I’ll do two more reps of that weight. It will make you stronger. It most likely will help you burn fat. And you will be proud of your efforts.

Warnings:

Do gradual challenges.  For example, runners are told to only increase their mileage by maximum of 10% a week. If you are just starting an exercise program, consult the internet or books to tell you how to increase your ability. Many exercise videos will also tell you how to start and how to challenge yourself in the workout.

Do warm up before pushing yourself.  You risk injury if you start high-intensity workouts before you muscles are warmed.

Don’t overdo it. As Harry Callahan (Dirty Harry) said, “A man’s got to know his limitations.” I’ve been jogging and spinning for many years, and have had a stress test, so I know pushing myself at 100% for six minutes isn’t going to hurt me.  If you don’t know yourself, you might want to talk to your doctor or find articles about how to safely push yourself in whatever exercise you do.

Don’t push until your form is bad. That usually leads to injury.

Don’t exercise while injured. In Brain Training For Runners, author Matt Fitzgerald,  says you should stop exercise if you are injured – it will only get worse.²  Matt’s book and recommendations are the result of compiled evidence from the latest research in exercise physiology. A great read for runners, or even other athletes, who want to improve their performance.

References

Jaret, Peter. "A Healthy Mix of Rest and Motion." The New York Times: Fashion and Style. The New York Times, 9 May 2007. Web. 10 Apr. 2011.

Fitzgerald, Matt. Brain Training for Runners: a Revolutionary New Training System to Improve Endurance, Speed, Health, and Results. New York: New American Library, 2007. Print.

Karp, Jason R. "Interval Training: Follow This Training Plan and You Could Become One Of Our Weight Loss Success Stories: Shape Magazine." Shape Magazine: Diet, Fitness, Recipes, Healthy Eating Expertise. 02 July 2010. Web. 10 Apr. 2011.

Quinn, Elizabeth. "Interval Training Workouts - Interval Training Workouts Improve Speed and Endurance." Sports Medicine, Sports Performance, Sports Injury - Information About Sports Injuries  

Does Glucosamine / Chondroitin help osteoarthritis?

Last month the pain in my left knee got so bad I dreaded climbing the seven steps in my tri-level home. That's pretty bad, since each morning to get to work I have to climb seven flights of stairs at the subway toting a backpack.  I went to a doctor and now I am taking anti-inflammatory medication, but my prescription is running out.  So I want to research my options. You see advertisements for Glucosamine frequently, so I wanted to know more about it. Also, some of my followers have asked for information on Glucosamine.

People who suffer with knee pain from osteoarthritis have very few choices. Anti-inflammatory medications provide relief, but you shouldn’t take them for a long time.

Glucosamine is touted as a possible solution. Yet, Glucosamine is expensive, even if you get it “Buy one get one Free.”  So before you spend the money, you want some assurance that it works.

I plowed through Internet reports trying to determine if Glucosamine or Glucosamine / Chondroitin help Osteoarthritis. Google glucosamine and your get  8,740,000 results. How do you know which of these are valid? (see my previous blog “How can you tell if a health study is valid.”)

My Findings: Studies to determine if glucosamine is useful in reducing osteoarthritis pain or preventing osteoarthritis are conflicting. But, according the Quackwatch website, endorsed by the American Medical Association, the best-designed studies evaluating the benefit of glucosamine are negative.¹ 

Still, many doctors think there is no harm, and possibly some benefit, in taking glucosamine provided you follow these conditions:

• Take glucosamine sulfate instead of glucosamine hydrochloride.^1,2
• Take glucosamine alone. There seems to be no evidence that chondroitin helps.
• Pay attention to your cholesterol levels. Several studies indicate glucosamine increases cholesterol counts.
• Buy high quality products, as the quality and effectiveness of glucosamine is not regulated.
• Quit taking glucosamine if your symptoms don’t reduce in three months (at that time, you can assume the glucosamine is not working).

So, what do you do?

1. Dr. Barrett, Quackwatch¹, says you should get a diagnosis from a competent physician and discuss recommended treatments.
2. I’d recommend seeing a Physical Therapist. They’ve always helped me to overcome injuries and minimize chronic problems. They can assess your strength and body structure, suggest exercises and  show you how to do the exercises properly.  Many times your primary care physician overlooks this option, so I frequently go to a sports medicine doctor to recommend a good therapist. With many health care plans you can go directly to a physical therapist.
3. The Arthritis Foundation recommends icing to reduce swelling and fluid leakage. As a long-time runner, I swear by icing. You can buy knee ice wraps, or as the Arthritis Foundation suggests, use a bag of peas. Ice for about 15-20 minutes at a time. Ice several times a day, especially after exercise.  However, heat is recommended in the morning to loosen joints and muscles and don’t ice before exercise.
4. Other suggestions from the Arthritis Foundation include (see the website for all of the suggestions plus exercise and stretching videos):

Exercise. Movement lubricates your joints. Some people say slow movement like Tai Chi is good. The arthritis Foundation and Physical therapists also recommend muscle strengthening exercises to keep help support the knees. They also recommend exercising in water to build strength and range of motion while reducing wear and tear on joints.

Lose weight. Every pound you lose takes four pounds of pressure off your knees

Stretch. Stretching keeps your joints and muscles flexible.

References

1. “Glucosamine and Chondroitin for Arthritis:  Benefit is Unlikely,” Quackwatch, Dr. Steven Barrett, http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html Note: I did some research to determine if Quackwatch is a legitimate website. Apparently organizations such as the American Medical Association, FDA Commissioner’s Special Citation, The American Cancer Society and many more have endorsed this website.
2. “Glucosamine, Evidence,” The Mayo Clinic, http://www.mayoclinic.com/health/glucosamine/NS_patient-glucosamine/DSECTION=evidence
3. “Glucosamine: Is It A Beneficial Arthritis Treatment?,” Arthritis.about.com,  http://arthritis.about.com/cs/glucosamine/a/glucosamine.htm  
4. “How to Care For Yourself,” Arthritis Foundation, http://www.arthritis.org/how-to-care-for-yourself.php