About Viscosupplementation

• Osteoarthritic joints often have the following characteristics:-
  • Poor lubrication due to low hyaluronic acid levels,
  • Painful movements due to an increased level of inflammatory substances called prostaglandins,
  • Reduced cartilage depth on joint load bearing surfaces.
• Viscosupplementation is a term which implies that treatment can achieve the following:-
  • Improve the viscosity of the synovial (lubricating) fluid.
  • Reduce pain and swelling within the joint.
  • Increase the articular cartilage depth on load bearing surfaces.
  • Viscosupplementation can be achieved by two methods:-
    • Taking oral supplements like Glucosamine, Chondroitin and MSM (Methyl Sulphonyl Methane).
    • Injecting Hyaluronic Acid into the affected joint.
• To buy Glucosamine, Chondroitin and MSM online, please click on one of the links below:-

• Which conditions may benefit from Glucosamine therapy ?
  • There is weak evidence that people with mild to moderate osteoarthritis may benefit from taking additional glucosamine supplements in their diets.
  • There is no evidence to suggest that those with autoimmune disorders like lupus (SLE) and rheumatoid arthritis derive any benefit from it.
  • It has also been suggested that those with musculo-skeletal injuries may benefit from glucosamine supplements to aid tissue healing.
• How does Glucosamine work ?
  • Cartilage contains compounds called proteoglycans and glycosaminoglycans (GAG's) contained within a collagen matrix. GAG's and proteoglycans form long chains and lattices to which the collagen adheres.
  • Glucosamine is the major building block by which the body manufactures proteoglycans and GAG's, and the supply of glucosamine is the rate limiting step in the manufacturing process.
  • Cartilage and other related structures like discs, tendons and ligaments are continuously being remodeled in health, being worn away during activity and then reformed again afterwards.
  • Low levels of glucosamine can be associated with delayed repair to cartilage and these other related tissues.
  • Taking glucosamine supplements can boost GAG and proteoglycan levels by up to 170%, thereby facilitating the repair process.
• What types of Glucosamine are there ?
  • Glucosamine is available as glucosamine sulphate or glucosamine hydrochloride. Almost all of the studies done with glucosamine have used the sulphate, however the hydrochloride form has been used for many years and it seems to work just as well. The hydrochloride form is cheaper.
• What is the recommended dose of Glucosamine ?
  • The maximum recommended dose is 1500 mg per day. This can be taken as a single dose or divided into 500 mg three times a day. Beware combination products which contain vitamin C - it may be quite easy to exceed the maximum RDA (Recommended Daily Allowance) with these products. The UK and USA RDA for vitamin C is 60 mg.
• Can Glucosamine be combined with anything else ?
  • If glucosamine itself is not helpful in relieving arthritic symptoms, it may be combined with chondroitin and other nutrients. alternatively, glucosamine and chondroitin can be started together. The positive effects of glucosamine reducing joint pain are often noticed within a few weeks.
  • Glucosamine can be taken together with acetaminophen and NSAIDs such as ibuprofen and diclofenac. After glucosamine starts working in a few weeks, hopefully the dose of the drugs can be reduced or eliminated.
• Does Glucosamine interact with traditional medicines ?
  • There are reports of glucosamine interacting with prescribed diuretics (water tablets) such that a higher dose of diuretic is required to achieve a normal therapeutic effect.
  • NOTE: Be sure to consult your GP before trying any nutritional supplement. Do not stop or reduce any currently prescribed medications without consulting your GP.
• Is it possible to be allergic to Glucosamine products ?
  • Glucosamine is derived from shrimp and crab shells and chondroitin is derived from cartilage of cows, pigs, and sharks. There is no synthetically made glucosamine on the market. Those allergic to these types of sources may find they are allergic to glucosamine products.
• Are there any long term safety concerns with glucosamine ?
  • Based on current understanding, glucosamine can be taken for extended periods, months and years. Thus far, after being on the market for quite a number of years, there have not been any reports in the medical literature of any significant side effects resulting from the use of glucosamine. However, as with most nutrients and medicines, long term effects are not clearly known.
  • I am not aware of any significant changes to blood sugar resulting from glucosamine. The dose of glucosamine, one or two grams a day, is minimal as a sugar source compared to the amounts of glucose and other simple carbohydrates found in the foods we consume. There is a hypothetical possibility that glucosamine may increase insulin resistance within cells. High amounts of glucose are able to bind to protein within cells and increase insulin resistance which is not helpful for diabetics. Theoretically glucosamine can also bind to proteins in cells and cause insulin resistance, but glucose and sugars generally are ingested in the diet in a much higher amount than glucosamine.
  • It is best pregnant women not take glucosamine until more is known about this interaction.

• What is Chondroitin Sulfate ?
  • Chondroitin sulfate belongs to a family of complex polysaccharides called glycosaminoglycans (GAGs). Chondroitin sulfate consists of a long chain of repeating units of disaccharides called chondrosines. These chondrosines are composed of D-glucuronic acid and D-Galactosamine.
  • Depending on where these chondrosine units bind to each other determines which kind of chondroitin you have. Chondroitin sulfate A (also called chondroitin 4-sulfate) is the most numerous and chondroitin sulfate C (chondroitin 6-sulfate).
  • Depending on how the chondroitin sulfate is prepared, there can be anywhere from 15 to 150 of these repeating chondrosine units. The commercially available chondroitin products are a mixture of chondroitin A and C.
• What is its fate in the body ?
  • Chondroitin sulfate molecules join with proteins to become proteoglycans. These proteoglycans comprise the ground substance in the extracellular matrix of connective tissue (cartilage, tendons, ligaments, etc.).
• What is its source ?
  • The major source of chondroitin sulfate commercially is from the cartilaginous rings of bovine trachea (the windpipe in cattle). Another, rather expensive source is shark cartilage.
• What are its indications ?
  • Chondroitin sulfate may be indicated for the prevention and treatment of osteoarthritis. It may be used by itself or in combination with glucosamine.
• What is its mechanism of action ?
  • Oral chondroitin sulfate may help maintain and repair the structure and function of cartilage. In addition, it appears to reduce pain and inflammation.
  • The exact mechanism of action has yet to be clarified. It does appear, however, that a significant increase in hyaluronic acid occurs after taking oral chondroitin sulfate. Hyaluronic acid is a major component of synovial fluid which is the lubricating fluid in joints. This alone should improve joint lubrication, reduce pain, and improve mobility.
  • Additionally, it is well known that chondroitin sulfate and hyaluronic acid are fundamental components of articular cartilage that provides shock-absorbing qualities. Recent clinical studies seem to verify the positive role oral chondroitin can have on joint health.
  • It normally takes one to two months for symptoms improve.
• What is the correct dose ?
  • The usual recommended dose of Chondroitin sulfate is 1200 milligrams in divided doses. Glucosamine sulfate is 1500 milligrams in divided doses.
  • NOTE: Be sure to consult your GP before trying any nutritional supplement. Do not stop or reduce any currently prescribed medications without consulting your GP.
• Does it have any interactions ?
  • Chondroitin may form a complex with Chitosan (weight loss treatment), thereby reducing the absorption of chondroitin.
• Are there any precautions ?
  • Side effects are rare and mostly of a mild gastrointestinal variety.
  • As a result of insufficient data, children, pregnant women, and nursing mothers should avoid chondroitin sulfate.
  • Because chondroitin may have antithrombotic activity, those individuals taking anti-coagulants or those with hemophilia should exercise caution.
  • Although allergic reactions have not been reported with chondroitin, if you experience symptoms such as a rash, hives, or shortness of breath, stop taking the supplement and call your GP.

• What is MSM ?
  • MSM (Methyl sulphonyl methane) is also known as dimethyl sulphone, sulphonylbismethane, methyl sulphone and DMSO2. It is derived from DMSO (dimethyl sulphoxide). MSM is a natural sulphur compound and an excellent source of bio-available sulphur. Sulphur is a mineral that is essential to the normal structure and function of the body. Sulphur is an essential raw material of protein, especially connective tissue proteins like collagen. A normal adult has about 2 kg of sulphur as body weight.
• Why is MSM important ?
  • Sulphur is lost from food when it is processed, dried, cooked or preserved. Therefore, MSM serves as an important source of bio-available sulphur. This is critical since sulphur is essential for healthy connective tissue, joint function, proper enzyme activity, hormone balance, and proper function of the immune system.
  • Research seems to suggest that MSM is helpful in improving joint flexibility, reducing stiffness and swelling, and reducing pain. MSM may also play a role in improving circulation, cell vitality, softening and reducing scar tissue, and in breaking up calcium deposits.
  • MSM is an odorless, water-soluble, white crystalline material that supplies a bio-available form of dietary sulphur. At the molecular level, sulfur is responsible for the flexible bond between cells, including those that make up the skin. It acts to block undesirable chemical and physical cross-linking or bonding of collagen which is associated with tough, aging skin. Approximately half of the total body sulfur is concentrated in the body's muscles, skin, and bones. Sulfur is an important component of keratin, the tough substance in the skin, nails and hair. Most importantly, sulfur is necessary for making collagen, the primary constituent of connective tissue and an important part of cartilage. Sulfur is responsible for maintaining the integrity of the collagen protein molecule through the formation of disulfide bonds.
  • The body is constantly producing new cells and connective tissue 24 hours a day. Therefore, there is an ever present need for sulphur and all the other essential nutrients. Tests conducted with laboratory animals indicated that wound healing occurred faster with a group receiving MSM, but even faster with both MSM and vitamin C supplementation. The common signs of sulphur deficiency include slow wound healing, tough scar tissue, brittle hair or nails, gastrointestinal problems, arthritis, acne, depression, and more. Since the body is in a constant state of repair, it must have all of the basic raw materials to avoid producing dysfunctional cells.
  • MSM is non-allergenic, non-pyretic (does not induce fever), and has no interfering or undesirable pharmacological effects. There are no known reports of overdose with MSM. It is thought the body will use what it needs and flush out the rest without harm. MSM is not a vitamin or a drug. 
• What is its mode of action ?
  • The mode of action for MSM has not been proven. In a double-blind study of MSM's impact on degenerative arthritis, researcher's found that patients who ingested 2,250mg of MSM a day for six weeks felt an improvement in their pain reduction by 82 percent, on average.
  • Researchers are not sure if MSM is effective in arthritis because of its sulphur content, its anti-inflammatory and analgesic properties, a combination of these, or because of some yet-undiscovered mechanism. MSM may take 2 - 4 weeks before you have significant improvement.
• What are the safety aspects ?
  • Patients who have received oral MSM as part of their treatment show no toxic build-up, even after years of ingesting more than 2,000mg of MSM each day. It appears the body uses what it requires and flushes out the rest within 12 hours.
• What is the normal dose ?
  • Doses used are typically 1 to 3 grams per day, with 2 grams being the most common.
  • NOTE: Be sure to consult your GP before trying any nutritional supplement. Do not stop or reduce any currently prescribed medications without consulting your GP.
• Are there any precautions ?
  • Side effects are rare but can include nausea, diarrhea, and headache.
  • As a result of insufficient data, pregnant and nursing mothers should avoid MSM.
  • Although allergic reactions have not been reported with MSM, if you experience symptoms such as a rash, hives, or shortness of breath, stop taking the supplement and call your physician.