Monthly Archives: February 2013

Spotlight on Supplements: Chondroitin, Glucosamine and MSM

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I’m covering these three supplements in the same post because they are often combined into a single pill, which is how I take them. Again, I’m not a doctor and you should discuss all supplements with your physician.

Chondroitin sulfate is a component of cartilage, and is often sourced from cattle cartilage.

SIDE NOTE: As a former aquarist, I must beg you not to take chondroitin sourced from or combined with shark cartilage, as it is really hard on shark populations, which need our protection–they have it hard enough; we have overfished a lot of their food sources. Back to our regularly scheduled program.

Glucosamine is most often taken as glucosamine sulfate, but can also be found as glucosamine hydrochloride, or N-acetyl glucosamine. It is another building block of cartilage, and is usually sourced from shellfish shells or synthesized.  Taking chondroitin and glucosamine is thought to support the body’s maintenance of the cartilage tissues in the joints, but the latest research on a combination of chondroitin and glucosamine is not very encouraging as far as pain relief goes. It is most often recommended to sufferers of osteoarthritis, but in the latest study showed the combo to have only a mild benefit to only those in the most severe pain, and that group was so small it was hard to tell if the results were statistically significant.

MSM, or Methlysulfonylmethane, is recommended more generally for numerous types of pain. This remedy is solidly in the alternative medicine camp, as there is not much science to back it up. From my research, MSM is recommended mostly because of a single book written by two doctors, which looks a lot like another one of those “natural miracle cure” claims that so often are set up simply to prey on people in pain who are desperate for help.

It is possible that these supplements could serve a more of a preventative purpose, ensuring that cartilage breakdown does not happen because of deficiencies in the diet. I recall mention of a study in dogs in which similar supplements looked like they helped prevent arthritis if it was taken starting young, although I have no idea of the study’s scientific validity.

The other disturbing news turned up as I researched for this blog post was that the supplements that claim to contain chondroitin and glucosamine have been tested with widely varying results–some of the pills sold in stores turned out not to have any of one or the other compound, or the amount from batch to batch varied although the label stayed the same.

After what I’ve learned about these three compounds, I’ll probably take them off my list of supplements I’m currently taking. The combination of “they probably don’t do much” with “you can’t be sure you’re actually taking any” makes me think that I could be spending my money more wisely than on any more bottles of these.

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Life Tweaks

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I’ve tweaked a few things about my life lately that seem to be helping. First, sweetie and I have put some more effort into our meals. I’m pretty good at planning well-rounded meals, figuring out when things need to be defrosted and making shopping lists. My sweetie is not so good at all that, but can do a lot of the standing and stirring or chopping that takes me forever and makes me hurt, so we have become more team-oriented and are eating better, which makes everyone feel better and lets us save time by eating leftovers instead of figuring out something to throw together at the last minute.

We also scheduled time to spend together during my best time of day, which happens to be around 2pm. By the time sweetie gets home from work, my mental and social capabilities are usually pretty adversely affected by my pain level. While I do get to feeling pretty desperate for non-canine social contact, by the time we’ve taken care of food and such necessities, many evenings I just want to disappear in a book or TV show. Getting to eat leftovers for dinner helps with this, but it’s sad that sweetie misses the parts of the day where I can think and interact without it being so much work. So we’ve decided to try to schedule occasional “lunch dates” on days he can split up his work shift and spend time together that is more enjoyable. Our first one was this week and was very nice–I feel like we’re much better caught-up than we have been lately, and that I was much more able to be fully present for our conversation.

I’m finding it’s really important to think creatively about what can be adjusted to make life with CRPS work better. The timing of when to sleep, take medications, spend social time, prepare food, all that can be very flexible when you really think on it. While I do keep a pretty regular schedule, because I find I sleep better and thus have less pain when I do, if the timing of something is not really working, I can often find ways to adjust my schedule so that things work better. An hourly pain journal was really helpful when I first started with this, but now I find I can get a pretty good idea of my patterns without one, although if I needed to make a drastic change I might need to do the journal again to make sure I get the results I’m looking for. With Pain Brain, it’s usually better to trust important things to paper or the computer than my memory!

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Spotlight on Supplements: NAC

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I’ve decided to break down my supplements post, as it’s been hanging over my head feeling like too much work to get started on for way too long now. So I’m going to do a Spotlight on Supplements feature every so often and just introduce one supplement at a time. Remember that I am not a medical professional and am not qualified to give advice on supplements, I’m just sharing my research and personal experience with you. Talk with your doctor if you want to change what you’re taking, over-the-counter or not.

NAC, or N-Acetyl Cysteine, is a new addition to my mound of supplements I take to help with my CRPS. It’s a derivative

Schematic of the metabolism of acetaminophen (...

Schematic of the metabolism of acetaminophen (paracetamol) by the hepatocyte. (Photo credit: Wikipedia)

of L-Cysteine, an amino acid used by the liver to help break down toxins. NAC specifically is used to bind with the toxic by-products of acetaminophen (Tylenol) that occur as the liver breaks down the drug. This is important for pain patients because we often are taking a high amount of acetaminophen as part of our medications–common prescriptions of both hydrocodone (Vicodin) and oxycodone (Percocet) contain high levels of acetaminophen.

The acetaminophen in these drugs is present for two reasons. First, opioids are more effective at pain control when combined with a little acetaminophen. Second, the acetaminophen is present as a not-very-well-thought-out deterrent to abuse of opioid prescription medications, as acetaminophen in too-large doses causes liver damage. Because this is a punitive system, it merely serves to make people who take too many of these pills very ill, eventually. Not the best deterrent, to make a sick person (addict) sicker (liver damage) for being sick, but what can I say, our society’s treatment of drug addiction is inhumane and I find it sickening. See previous posts for more on that.

However, many people have been prescribed these kinds of combination pills for breakthrough pain with an as-needed label. For instance, I had one prescription that was labeled, “Take 1-2 every 6 hours as needed.” Sounds great, except my new doctor pointed out that the maximum of 8 pills a day, which was what I was needing at that time, was significantly over the safe maximum daily dose of acetaminophen, which is 3000mg/day. (New doctor=better than old doctor! He changed my prescription to a better ratio for me.) Even at the safe maximum, it can be hard for the liver to keep up with processing all that acetaminophen without using up the necessary amino acids.

Another factor is the typical diet of a pain patient: we’re not cooking ourselves labor-intensive home-cooked meals so much as trying to eat as best as we can with the energy we have to spend on our food. Some days, this is a well-rounded diet. On more difficult days, TV dinners and other quick fixes are more the norm. This makes supplements even more important for us, since we are not fully in control of our diets.

NAC supplements could be helpful to anyone who takes a regular amount of acetaminophen every day, and that includes many of us with CRPS or other pain conditions.

If you think my Spotlight on Supplements feature is a good idea, or a bad idea, or if you have any requests for specific supplements for me to cover, tell me what you think in the comments!

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