As the summer has now officially begun, you may find yourself spending more time outdoors, partaking in recreational, physical activities. Or, you may be rubbing your achy joints. Wishing you could partake in summer fun the way you used to. 

You may not be able to fix or cure stiff, painful joints with nutrition. But, there are certainly some healthy choices you can make that target joint health from 3 key angles. Choose supplements that can 1. Help to ease pain 2. Support healthy inflammatory response 3. Nourish cartilage synthesis and lubrication.
If you read on, we will address the unique nutritional needs of someone with joint challenges and some of the all-around best supplements for joints and support supplements for joint pain.

What is Osteoarthritis?

Osteoarthritis (OA) is the most common type of arthritis, affecting approximately half of the population over 65 in at least one joint [1]. OA is characterized by gradual wear and loss of cartilage in the joints (the cartilage is partially constructed of glucosamine and chondroitin) It results in friction between the bones, painful joints, and swelling/inflammation. Some of this friction is also a result of reduced hyaluronic acid, which is the normal, natural lubricant of the joint [2]. 

The negative effects of OA are not restricted to cartilage. Bones and synovium also undergo changes from wear and inflammation [1]. As such, the best supplements for osteoarthritis target sources of pain, inflammation, and the structural integrity of joints and cartilage. Not surprisingly, these three elements are all interrelated. Several of the best joint supplements are ones that target all three elements.

Nutrients/ vitamins for joint comfort

While medical therapies primarily address the treatment of joint pain with analgesics and anti-inflammatory drugs, these treatments can cause serious, adverse gastrointestinal and cardiovascular events, especially with long-term use [3]. 

Glucosamine and Chondroitin

Luckily, there are some natural alternatives or complementary nutrients that can support joint comfort without these nasty side effects. For example, in the last couple of decades, clinical trials involving highly arthritic patients have demonstrated equal pain relief between glucosamine/chondroitin and expensive anti-inflammatory drugs [4]. 

Glucosamine and chondroitin are involved in the structural matrix of cartilage and draw hydration to cartilage as key building blocks in the production of hyaluronic acid. In fact, glucosamine is a rate-limiting factor in the natural production of hyaluronic acid, so supplementation of glucosamine may lead to more natural hyaluronic acid [5]. Hyaluronic acid supplementation has also been shown to support tissue hydration, joint lubrication, pain reduction, and improved function in patients with OA of the knee [5,6]. 

Curcumin

Curcumin, the active chemical in turmeric root, has also been shown to support reduced pain in joints [11]. Like glucosamine and chondroitin, studies have tested curcumin supplementation alongside NSAID pain relievers and found that curcumin was similarly effective in terms of joint comfort. Unlike NSAIDs, curcumin also supported the loss of excess weight and had no reported side effects [11].

A challenge with curcumin is its naturally low rates of absorption. This is why you will often see formulas of curcumin paired with piperine. Piperine can slightly increase curcumin’s bioavailability. Thanks to advances in nutritional research, however, the patented Longvida Solid-Lipid Particle has been developed to maximize the absorbability of curcumin to thereby maximize its benefits in the body, without additives like piperine. This is the type of curcumin that can be found in Metabolic Maintenance®’s Curcumin + C formula. Vitamin C has been added for both its antioxidant activities, and its contribution to collagen and structural health.

Anti-inflammatory vitamins and nutrients

You will notice some overlap here, as the best supplements for joints contribute to more than one element of joint health.

Glucosamine and Chondroitin

In addition to reducing pain, stiffness, and functional limitations, glucosamine and chondroitin have been shown to reduce joint swelling, and both nutrients express anti-inflammatory properties [8,9]. This anti-inflammatory action may delay the inflammation-induced breakdown of the cartilage while the building-block functions may help to support the joint structure and keep the joint lubricated. Together, these effects may lead to less pain and increased mobility of the affected joint.

Curcumin again is a known anti-inflammatory. Oral administration of curcumin has been demonstrated to reduce acute inflammation with a comparable effect to cortisone and phenylbutazone [12]. This action is thought to take place by lowering the body’s release of histamines and increasing natural cortisone production by the adrenal glands [12]. 

Curcumin may also help to prevent inflammation, as it inhibits the synthesis of inflammatory prostaglandins and reduces neutrophil function during inflammatory states [12].

Bromelain

Bromelain, isolated from pineapple cores, is often taken as a digestive aid. When taken between meals, however, bromelain supports a normal inflammatory response and healing [13]. The anti-inflammatory effect of bromelain has been demonstrated and well-documented in a very wide range of biological conditions [13]. Bromelain likely acts by inhibiting pro-inflammatory prostaglandin production, inducing anti-inflammatory prostaglandin production, and reducing capillary permeability [13]. Bromelain is often used postoperatively to promote healing and reduce postsurgical pain and swelling [13].

Resveratrol

Resveratrol is a potent antioxidant supplement with significant anti-inflammatory activities. Isolated from grapes, it is often credited for the “French Paradox”: the statistical phenomenon of excellent heart health despite frequent wine consumption in France. Studies show that when resveratrol supplements are combined with pharmaceuticals, patients with osteoarthritis display fewer markers of inflammation and experience less severe joint pain than with medication alone [14].

Like curcumin, resveratrol is not highly bioavailable as a stand-alone nutrient. Metabolic Maintenance® has formulated Resveratrol with Piperine to increase its absorbability and benefit to the body.

Structural joint support supplements

Glucosamine and Chondroitin

All-around joint support nutrients glucosamine and chondroitin are not only great for pain and inflammation. They are also considered long-term structure-modifying agents as they have been shown to have a beneficial effect of delaying long-term knee OA cartilage loss [7]. In subjects with knee pain, glucosamine and chondroitin supplementation have shown beneficial effects on both pain management and locomotor functions [10]. Some of this effect may be credited to the fact that these nutrients contribute to the further production of hyaluronic acid (HLA) for joint lubrication, and they are building materials for cartilage. Additional HLA has been added to Metabolic Maintenance®’s Glucosamine and Chondroitin product. Supplemental HLA has been shown to support tissue hydration and joint lubrication in cases of osteoarthritis [6].

SAMe

SAMe (pronounced like the name “Sammy”), or S-Adenosyl-L-methionine, is involved in numerous biochemical pathways in the body. Two of which happen to be the synthesis of neurotransmitters and the synthesis of cartilage. SAMe has been studied extensively for its assistance in healthy serotonin production and associated mood balance. It was in the middle of such research that an accidental discovery was made: SAMe also helped to relieve joint pain [15]. Now that this effect has been thoroughly researched, scientists have shown SAMe not only helps to reduce pain and inflammation, it also has a protective effect on cartilage through polyglycan synthesis. If taken regularly, it may help sustain the remaining cartilage in an otherwise deteriorating joint [16].

Glycine

Glycine is an amino acid and a building block for a multitude of useful proteins within the body. Glycine is a structural component of healthy collagen, cartilage, and connective tissues in general. Collagen synthesis is severely diminished in osteoarthritis. Studies show that supplementing glycine is beneficial to cartilage regeneration by enhancing collagen synthesis, supporting those who have or are at risk of developing osteoarthritis [17]. Just like many of the other joint support nutrients, glycine also has powerful anti-inflammatory effects [17].

How do I know which products are the best joint supplements for me?

Unfortunately, there is no one-size-fits-all recommendation. You may need to try out one or more supplements to see what feels good, and some supplements may not be right for everybody. 

For example, SAMe is not recommended for those taking antidepressant SSRI medications, as it does have an effect on serotonin production and may affect mood. Acute glycine deficiency may be a contributing factor to osteoarthritis in some individuals [17], while others may be consuming a high glycine diet, and supplementation would be superfluous. 

We have given you quite a few options to consider. It may be time to talk to your physician about the right choice for your unique body and needs. 

References

  1. Jerosch, Jörg. “Effects of glucosamine and chondroitin sulfate on cartilage metabolism in OA: outlook on other nutrient partners especially omega-3 fatty acids.” International journal of rheumatology 2011 (2011).
  2. Parade Magazine. “Osteoarthritis Treatments: Glucosamine-Chondroitin vs. Hyaluronic Acid.” Parade Magazine. July 11, 2007. https://parade.com/47747/parade/osteoarthritis-treatments-glucosaminechondroitin-vs-hyaluronic-acid/
  3. Wandel, Simon, et al. “Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.” Bmj 341 (2010): c4675.
  4. Brief, Andrew A., Stephen G. Maurer, and Paul E. Di Cesare. “Use of Glucosamine and Chondroitin Sulfatein the Management of Osteoarthritis.” JAAOS-Journal of the American Academy of Orthopaedic Surgeons 9.2 (2001): 71-78.
  5. Uitterlinden, E. J., et al. “Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants.” BMC Musculoskeletal Disorders 9.1 (2008): 120.
  6. Pavelká, Karel, et al. “Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study.” Archives of internal medicine 162.18 (2002): 2113-2123.
  7. Raynauld, Jean‐Pierre, et al. “Long‐Term Effects of Glucosamine and Chondroitin Sulfate on the Progression of Structural Changes in Knee Osteoarthritis: Six‐Year Followup Data From the Osteoarthritis Initiative.” Arthritis care & research 68.10 (2016): 1560-1566.
  8. Hochberg, Marc C., et al. “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.” Annals of the rheumatic diseases (2015): annrheumdis-2014.
  9. Zeng, Chao, et al. “Effectiveness and safety of Glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee.” Scientific Reports 5 (2015): 16827.
  10. Kanzaki, Noriyuki, et al. “Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study.” Clinical interventions in aging 10 (2015): 1743.
  11. Shep, Dhaneshwar, et al. “Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study.” Trials 20.1 (2019): 1-11.
  12. Nagpal, Monika and Shaveta Sood. “Role of curcumin in systemic and oral health: An overview” Journal of natural science, biology, and medicine vol. 4,1 (2013): 3-7.
  13. Graf, J. “Herbal anti-inflammatory agents for skin disease.”Skin Therapy Lett 5.4 (2000): 3-5.
  14. Marouf, Bushra Hassan, et al. “Resveratrol supplementation reduces pain and inflammation in knee osteoarthritis patients treated with meloxicam: a randomized placebo-controlled study.” Journal of medicinal food 21.12 (2018): 1253-1259.
  15. Kalbhen DA, Jansen G. Pharmacological studies on the anti-degenerative effect of ademetionine in experimental osteoarthritis [in German]. Arzneimittelforschung. 1990;40:1017-1021.
  16. Najm, Wadie I., et al. “S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial.[ISRCTN36233495].” BMC musculoskeletal disorders 5.1 (2004): 1-15.
  17. de Paz-Lugo, Patricia, José Antonio Lupiáñez, and Enrique Meléndez-Hevia. “High glycine concentration increases collagen synthesis by articular chondrocytes in vitro: acute glycine deficiency could be an important cause of osteoarthritis.” Amino Acids 50.10 (2018): 1357-1365.