Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
This supplement has been used in connection with the following health conditions:
800 to 1,200 mg a day
Many trials have shown that supplementing with chondroitin sulfate reduces pain, increases joint mobility, and promotes healing within the joints.
Chondroitin sulfate (CS) is a major component of the lining of joints. The structure of CS includes molecules related to glucosamine sulfate. CS levels have been reported to be reduced in joint cartilage affected by OA. Possibly as a result, CS supplementation may help restore joint function in people with OA.1 On the basis of preliminary evidence, researchers had believed that oral CS was not absorbed in humans;2 as a result, early double-blind CS research was done mostly by giving injections.3, 4 This research documented clinical benefits from CS injections. It now appears, however, that a significant amount of CS is absorbable in humans,5 though dissolving CS in water leads to better absorption than swallowing whole pills.6
Strong clinical evidence now supports the use of oral CS supplements for OA. Many double-blind trials have shown that CS supplementation consistently reduces pain, increases joint mobility, and/or shows evidence (including X-ray changes) of healing within joints of people with OA.7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 Most trials have used 400 mg of CS taken two to three times per day. One trial found that taking the full daily amount (1,200 mg) at one time was as effective as taking 400 mg three times per day.18 Reduction in symptoms typically occurs within several months.
Refer to label instructions
Preliminary research shows that chondroitin sulfate may prevent atherosclerosis and may also prevent heart attacks in people who already have atherosclerosis.
Preliminary research shows that chondroitin sulfate may prevent atherosclerosis in animals and humans and may also prevent heart attacks in people who already have atherosclerosis.19, 20 However, further research is needed to determine the value of chondroitin sulfate supplements for preventing or treating atherosclerosis.
Refer to label instructions
Taking chondroitin sulfate may reduce the risk of heart attack in people with a history of heart disease or who are at risk for heart attack.
Years ago, researchers reported that taking for six years substantially reduced the risk of fatal and nonfatal heart attacks in people with . Chondroitin may work by inhibiting and by acting as an anticoagulant. The few doctors aware of these older studies sometimes recommend that people with a history of heart disease or who are at risk for heart attack take approximately 500 mg of chondroitin sulfate three times per day.
Refer to label instructions
Chondroitin sulfate has lowered serum cholesterol levels in preliminary trials.
Chondroitin sulfate has lowered serum cholesterol levels in preliminary trials.21, 22 Years ago, this supplement dramatically reduced the risk of heart attacks in a controlled, six-year follow-up of people with heart disease.23 The few doctors aware of these older clinical trials sometimes tell people with a history of heart disease or elevated cholesterol levels, to take approximately 500 mg of chondroitin sulfate three times per day.
Refer to label instructions
Chondroitin sulfate may help reduce the risk of kidney stone formation. One trial found that glycosamionoglycans significantly lowered urinary oxalate levels, which reduces the risk of stone formation.
Chondroitin sulfate may play a role in reducing the risk of kidney stone formation. One trial found 60 mg per day of glycosamionoglycans significantly lowered urinary oxalate levels in stone formers.24 Chondroitin sulfate is a type of glycosaminoglycan. A decrease in urinary oxalate levels should reduce the risk of stone formation.
Sprains and Strains
Refer to label instructions
Chondroitin sulfate may promote wound healing by providing the raw material needed by the body to manufacture molecules found in skin, tendons, ligaments, and joints.
Glucosamine sulfate and chondroitin sulfate may both play a role in wound healing by providing the raw material needed by the body to manufacture molecules called glycosaminoglycans found in skin, tendons, ligaments, and joints.25 Test tube and animal studies have found that these substances, and others like them, can promote improved tissue healing.26, 27, 28, 29 Injectable forms of chondroitin sulfate have been used in Europe for various types of sports-related injuries to tendons and joints,30, 31, 32, 33 and one preliminary trial reported reduced pain and good healing in young athletes with chondromalacia patella (cartilage softening in the knee) who were given 750–1,500 mg per day of oral glucosamine sulfate.34 However, specific human trials of glucosamine and chondroitin sulfate for healing sprains and strains are lacking.
How It Works
How to Use It
For atherosclerosis, researchers have sometimes started therapy using very high amounts, such as 5 grams twice per day with meals, lowering the amount to 500 mg three times per day after a few months. Before taking such high amounts, people should consult a doctor. For osteoarthritis, a typical level is 400 mg three times per day. Oral chondroitin sulfate is rapidly absorbed in humans when it is dissolved in water prior to ingestion. Approximately 12% of chondroitin sulfate taken by mouth becomes available to the joint tissues from the blood.35
Where to Find It
The only significant food source of chondroitin sulfate is animal cartilage.
Because the body makes chondroitin, the possibility of a dietary deficiency remains uncertain. Nevertheless, chondroitin sulfate may be reduced in joint cartilage affected by osteoarthritis and possibly other forms of arthritis.
Interactions with Supplements, Foods, & Other Compounds
It is not known whether taking glucosamine sulfate and chondroitin sulfate in combination is a more effective treatment for osteoarthritis than taking either one by itself.
There have been more than 20 case reports in which the use of glucosamine was associated with an apparent decrease in the efficacy of warfarin (as demonstrated by an increase in the International Normalized Ratio [INR]).36 Because INR values can fluctuate randomly, controlled trials are needed to determine whether the increased INR values in these case reports were caused by glucosamine. Nevertheless, people taking warfarin should not take glucosamine without consulting their doctor.
Potential Negative Interaction
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.
Nausea may occur at intakes greater than 10 grams per day. No other adverse effects have been reported.
One doctor has raised a concern that chondroitin sulfate should not be used by men with prostate cancer. This concern is based upon two studies. In one, the concentration of chondroitin sulfate was found to be higher in cancerous prostate tissue as compared to normal prostate tissue.37 In the other study, it was shown that higher concentrations of chondroitin sulfate in the tissue surrounding a cancerous prostate tumor predict a higher rate of recurrence of the cancer after surgery.38 However, no studies to date have addressed the question of whether taking chondroitin sulfate supplements could promote the development of prostate cancer. Simply because a substance is present in or around cancerous tissue does not by itself suggest that that substance is causing the cancer. For example, calcium is a component of atherosclerotic plaques that harden the arteries; however, there is no evidence that taking calcium supplements causes atherosclerosis. To provide meaningful information, further studies would need to track the incidence of prostate cancer in men taking chondroitin supplements. Until then, most nutritionally-oriented doctors remain unconcerned about this issue.
1. Kerzberg EM, Roldan EJA, Castelli G, Huberman ED. Combination of glycosaminoglycans and acetylsalicylic acid in knee osteoarthritis. Scand J Rheum 1987;16:377.
2. Baici A, Hörler D, Moser B, et al. Analysis of glycosaminoglycans in human serum after oral administration of chondroitin sulfate. Rheumatol Int 1992;12:81–8.
3. Kerzberg EM, Roldán EJA, Castelli G, Huberman ED. Combination of glycosaminoglycans and acetylsalicylic acid in knee osteoarthrosis. Scand J Rheumatol 1987;16:377–80.
4. Rovetta G. Galactosaminoglycuronoglycan sulfate (Matrix) in therapy of tibiofibular osteoarhtirits of the knee. Drugs Exptl Clin Res 1991;17:53–7.
5. Conte A, Volpi N, Palmieri L, et al. Biochemical and pharmacokinetic aspects of oral treatment with chondroitin sulfate. Arzneimittelforschung 1995;45:918–25.
6. Ronca F, Palmieri L, Panicucci P, Ronca G. Anti-inflammatory active of chondroitin sulfate. Osteoarthritis Cartilage 1998;6(Suppl A):14–21.
7. Uebelhart D, Thonar EJ, Delmas PD, et al. Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthritis Cartilage 1998;6(Suppl A):39–46.
8. Verbruggen G, Goemaere S, Veys EM. Chondroitin sulfate: S/DMOAD (structure/disease modifying anti-osteoarthritis drug) in the treatment of finger joint OA. Osteoarthritis Cartilage 1998;6(Suppl A):37–8.
9. Bucsi L, Poór G. Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthritis Cartilage 1998;6(Suppl A):31–6.
10. Bourgeois P, Chales G, Dehais J, et al. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3X400 mg/day vs placebo. Osteoarthritis Cartilage 1998;6(Suppl A):25–30.
11. Pipitone V, Ambanelli U, Cervini C, et al. A multicenter, triple-blind study to evaluate galactosaminoglucuronoglycan sulfate versus placebo in patients with femorotibial gonarthritis. Curr Ther Res 1992;52:608–38.
12. Bazières B, Loyau G, Menkès CJ, et al. Le chondroïtine sulfate dans le traitement de la gonarthrose et de la coxarthrose. Rev Rhum Mal Ostéoartic 1992;59:466–72 [in French].
13. Conrozier T, Vignon E. Die Wirkung von Chondroitinsulfat bei der Behandlung der Hüft Gelenksarthrose. Eine Doppelblindstudie gegen Placebo. Litera Rheumatologica 1992;14:69–75 [in German].
14. L’Hirondel JL. Klinische Doppelblind-Studie mit oral verabreichtem Chondroitinsulfat gegen Placebo bei der tibiofermoralen Gonarthrose (125 Patienten). Litera Rheumatologica 1992;14:77–82 [in German].
15. Morreale P, Manopulo R, Galati M, et al. Comparison of the antiinflammatory efficacy of chondroitin sulfate and diclofenac sodium in patients with knee osteoarthritis. J Rheumatol 1996;23:1385–91.
16. Leeb BF, Petera P, Neumann K. Results of a multicenter study of chondroitin sulfate (Condrosulf) use in arthroses of the finger, knee and hip joints. Wien Med Wochenschr 1996;146:609–14.
17. Wildi LM, Raynauld JP, Martel-Pelletier J, et al. Chondroitin sulphate reduces both cartilage volume loss and bone marrow lesions in knee osteoarthritis patients starting as early as 6 months after initiation of therapy: a randomised, double-blind, placebo-controlled pilot study using MRI. Ann Rheum Dis 2011;70:982–9.
18. Bourgeois P, Chales G, Dehais J, et al. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3X400 mg/day vs placebo. Osteoarthritis Cartilage 1998;6(Suppl A):25–30.
19. Morrison LM, Branwood AW, Ershoff BH, et al. The prevention of coronary arteriosclerotic heart disease with chondroitin sulfate A: Preliminary report. Exp Med Surg 1969;27:278–89.
20. Morrison LM, Enrick NL. Coronary heart disease: Reduction of death rate by chondroitin sulfate A. Angiology 1973;24:269–82.
21. Izuka K, Murata K, Nakazawa K, et al. Effects of chondroitin sulfates on serum lipids and hexosamines in atherosclerotic patients: With special reference to thrombus formation time. Jpn Heart J 1968;9:453–60.
22. Nakazawa K, Murata K. Comparative study of the effects of chondroitin sulfate isomers on atherosclerotic subjects. ZFA 1979;34:153–9.
23. Morrison LM, Enrick NL. Coronary heart disease: reduction of death rate by chondroitin sulfate A. Angiology 1973;24:269–87.
24. Baggio B, Gambaro G, Marchini F, et al. Correction of erythrocyte abnormalities in idiopathic calcium-oxalate nephrolithiasis and reduction of urinary oxalate by oral glycosaminoglycans. Lancet 1991;338:403–5.
25. Morrison LM, Murata K. Absorption, distribution, metabolism and excretion of acid mucopolysaccharides administered to animals and patients. In: Morrison LM, Schjeide OA, Meyer K. Coronary heart disease and the mucopolysaccharides (glycosaminoglycans). Springfield: Charles C. Thomas, 1974, 109–27.
26. Denuziere A, Ferrier D, Damour O, et al. Chitosan-chondroitin sulfate and chitosan-hyaluronate polyelectrolyte complexes: biological properties. Biomaterials 1998;19:1275–85.
27. McCarty MF. Glucosamine for wound healing. Med Hypotheses 1996;47:273–5 [review].
28. Glade MJ. Polysulfated glycosaminoglycan accelerates net synthesis of collagen and glycosaminoglycans by arthritic equine cartilage tissues and chondrocytes. Am J Vet Res 1990;51:779–85.
29. Prudden JF, Wolarsky ER, Balassa L. The acceleration of healing. Surg Gynecol Obstet 1969;128:1321–6 [review].
30. Bucci L. Nutrition applied to injury rehabilitation and sports medicine. Boca Raton, FL: CRC Press, 1995, 193.
31. Sprengel H, Franke J, Sprengel A. Personal experiences in the conservative therapy of patellar chondropathy. Beitr Orthop Traumatol 1990;37:259–66 [in German].
32. Lysholm J. The relation between pain and torque in an isokinetic strength test of knee extension. Arthroscopy 1987;3:182–4.
33. Ziegler R, Rau R. Conservative or operative treatment for chondropathia patellae? Beitr Orthop Traumatol 1980;27:201–11 [in German].
34. Böhmer D, Ambrus P, Szögy A, et al. Treatment of chondropathia patellae in young athletes with glucosamine sulfate. In: Bachl N, Prokop L, Suckert R, eds. Current topics in sports medicine. Vienna: Urban & Schwarzenberg, 1984, 799.
35. Ronca F, Palmieri L, Panicucci P, Ronca G. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis Cartilage 1998;6(Supplement A):14–21.
36. Knudsen JF, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8.
37. De Klerk DP, Lee DV, Human HJ. Glycosaminoglycans of human prostatic cancer. J Urol 1984;131:1008–12.
38. Ricciardelli C, Quinn DI, Raymond WA, et al. Elevated levels of peritumoral chondroitin sulfate are predictive of poor prognosis in patients treated by radical prostatectomy for early-stage prostate cancer. Cancer Res 1999;59:2324–8.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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