Chondroitin sulfate

Synonym(s): chondroitin

Nutrient group: Active agents for joints & tissues

Sources and physiological effects

Dietary sources
Chondroitin sulfate is an important building material for bones, cartilage and connective tissue. It is mainly found in meat and seafood - especially oysters and mussels.
Physiological effects
Cartilage	It is the most important cartilage component that binds water and forms a gelatinous substance for buffering the joints Stimulation of anabolic processes in cartilage – new synthesis of proteoglycan
Inflammations	Chondroitin has an anti-inflammatory effect

Detailed information

Glucosamine sulfate, chondroitin sulfate - the classics of arthrosis therapy

Glucosamine sulfate and chondroitin sulfate are classics of the nutritional support of arthrosis therapy. They are natural building blocks of joints and serve to form the synovial fluid. Their water-binding capacity ensures elasticity and suppleness of the cartilage, optimum viscosity of the synovial fluid and thus a better buffer function, which reduces joint pain (1) (2). In addition, the substances contained in the synovia serve as a substrate for the chondrocytes (cartilage cells), which must be regenerated regularly.
Controlled clinical studies and meta-analyses confirm the effectiveness of sulfur-containing glycoproteins in degenerative joint diseases.
A systematic evaluation of clinical studies confirmed the effectiveness of chondroitin sulphate in reducing arthrosis symptoms (3). The positive results are stronger with a combination of glucosamine sulphate and chondroitin sulphate than with just one of the substances alone (4). Studies show that optimal results are achieved at doses as low as 1500 mg glucosamine and 800 mg chondroitin. A higher dosage is not necessary (5) (6).
The activation of cartilage metabolism by glucosamine and chondroitin can also be observed at the cellular level, a mechanism that is not triggered by common painkillers such as ibuprofen or placebo (7).

European premium quality raw material: CS b-Bioactive® Chondroitin sulfate

The quality of the raw materials used has a significant influence on the therapeutic efficiency of the entire preparation. The demand of therapists and patients for trustworthy, traceable and clinically tested raw materials (2) led to the development of pharmaceutical grade premium quality raw materials. The use of these raw materials in micronutrient therapy protects the patient from ineffective or contaminated unsafe ingredients, which may be found in cheap preparations.
CS b-Bioactive® Chondroitin is produced by the Spanish company Bioibérica. Bioibérica has been intensively involved in cartilage research for many years and is one of the world's leading producers in this segment thanks to decades of experience. CS b-Bioactive® Chondroitin, unlike many other chondroitin sources available on the market, is not derived from shark cartilage but from bovine cartilage and is therefore a sustainable raw material.

Indications

Effect	Indication	Dosage
Physiological effects at a low intake	For degenerative and/or inflammatory joint diseases such as osteoarthritis or osteochondritis	800 – 1200 mg/d
	To maintain and rebuild cartilage structures and improve joint function in moderate to severe degenerative joint diseases	800 – 1200 mg/d
	For nutritive treatment of acute and severe joint and cartilage injuries	800 – 1200 mg/d
	Preventive to preserve cartilage tissue and joint functions under heavy strain, especially in older patients (e.g. older recreational athletes > 45 years) and in high-performance	800 – 1200 mg/d

Administration

General mode of administration
When	Chondroitin should be taken between meals. Notes: For the treatment of degenerative joint diseases, 800 mg chondroitin sulphate should be taken daily. The symptoms are expected to improve after 8 weeks on average. In acute phase injuries take 1200 – 1600 mg daily for 1 week 1, then 800 mg until healing is complete.
Side effects
No side effects are known to date.
Contraindications
No contraindications are known to date.

Interactions

Drug interactions
NSAIDs (e.g. Ibuprofen, ASS)	The need for NSAIDs can be reduced by taking glucosamine/chondroitin.
Nutrient interactions
Trace elements	Manganese supports the effects of glucosamine and chondroitin.
Glucosamine	Synergistic effects with chondroitin on joint pain and –degradation.
Vitamins	Sufficient vitamin C, E and D levels support the mode of action of glucosamine and chondroitin.

References

1) Uitterlinden, E. et al. 2008. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskeletal Disorders 9, Nr.1(November). doi:10.1186/1471-2474-9-120.

2) David-Raoudi, M. et al. 2009. Chondroitin sulfate increases hyaluronan production by human synoviocytes through differential regulation of hyaluronan synthases: Role of p38 and Akt. Arthritis & Rheumatism 60, Nr. 3: 760–770. doi:10.1002/art.24302.

3) Monfort, J. et al. 2008. Chondroitin sulphate for symptomatic osteoarthritis: critical appraisal of meta-analyses. Current Medical Research and Opinion 24, Nr. 5: 1303–1308. doi:10.1185/030079908x297231.

4) Chou, M. M. et al. 2005. Effects of chondroitin and glucosamine sulphate in a dietary bar formulation

on inflammation, interleukin-1beta, matrix metalloprotease-9, and cartilage damage in arthritis. Exp Biol

Med. 230(4):255-62.

5) Uebelhart, D. 2008. Clinical review of chondroitin sulfate in osteoarthritis. Osteoarthritis and Cartilage 16. doi:10.1016/j.joca.2008.06.006.

6) Norman, T. et al. 2010. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial. Arthritis Research & Therapy 12, Nr. 1. doi:10.1186/ar2932.

7) Petersen, S. et al. 2010. Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training. Osteoarthritis and Cartilage 18, Nr.1:34–40. doi:10.1016/j.joca.2009.07.004.

References Interactions:

Stargrove, M. B. et al. Herb, Nutrient and Drug Interactions: Clinical Implications and Therapeutic Strategies, 1. Auflage. St. Louis, Missouri: Elsevier Health Sciences, 2008.

Gröber, U. Mikronährstoffe: Metabolic Tuning –Prävention –Therapie, 3. Auflage. Stuttgart: WVG Wissenschaftliche Verlagsgesellschaft Stuttgart, 2011.

Gröber, U. Arzneimittel und Mikronährstoffe: Medikationsorientierte Supplementierung, 3. aktualisierte und erweiterte Auflage. Stuttgart: WVG Wissenschaftliche Verlagsgesellschaft Stuttgart, 2014.