I think most alternative medicine is garbage. Having owned a health food store I can tell you that the majority of the supplements we sold were total crap with inflated claims. However the data on glucosamine is nowhere as bad as this NIH study suggests. There was a 3 year study in Belguim and in 2001 the Lancet published the results of this double-blind clinical trial involving 212 people with osteoarthritis who took either glucosamine or a placebo. The researchers found that connective tissue improved 12% in the glucosamine group but decreased in the placebo group. Rather than subjectively measuring pain as in the NIH study this study was based on radiological evidence of connective tissue repair. Both studies used a standard 1500mg dose. Why should one weight the evidence from NIH's 6 month study more heavily than the Belgian 3 year study?
While anecdotal too many animal trainers use glucosamine to dismiss it entire. Animals don't succumb to placebo effect very easily. My own personal experience with arthritic animals that I have trained as therapy animals is that this product works. I have a 14 year old cat who was confined to one floor of my house because he could not climb stairs. If he receives twice weekly glucosamine supplements he can climb the stairs and use all three floors of the house. He can also jump from the floor to the bed without using a set of steps. If I forget to give him supplement powder he suffers a noticeable decline in climbing ability. I have repeated this experiment several times with this animal and since he is housebound and eats only the food provided his diet is easy to control for. No, I don't think doing this experiment was cruel. Since he does not know he is taking a supplement there is no placebo effect at work.
My seat of the pants obvervation is that most people who are quick to embrace conclusions that refute "hippie arthritis treatments" (surely a loaded term) based on a single study is that they are demonstrating their level of sophistication over the rubes who fall for such treatments as much as anything else. There are very few supplements that have data to support their claims, glucosamine is one of them. There are more double-blind placebo controlled studies showing glucosamines effectiveness than demonstrating it's ineffectiveness. Labelling this product quackery based on this NIH study while ignoring previous studies is hardly an objective or sophisitcated look at the issue.
What is missing from most criticisms of alternative medicine is that a good number of people buying them have no insurance. Certainly not all buyers are in this position but a significant number are. What is a person with no health insurance supposed to do? I had many people with arthritis who had no insurance and could not afford traditional medicine. These people are desperate. If there is a chance they will receive even moderate relief from glucosamine and they cannot afford celecoxib then offering them that chance is better than denying them any hope. It is certainly safer than aspirin. If the NIH wants to target homeopathic cures I'm with them 100%. If they want to target products like glucosamine and chondroitin then either demand everyone guaranteed access to traditional medicine at non-bankrupting prices or you appear to be nothing more than the handmaiden of the pharmaceutical industry.
John Thornton
On 8 Aug 2006 at 8:24, Doug Henwood wrote:
> On Aug 8, 2006, at 7:50 AM, ravi wrote:
>
> >> Both studies failed to show clinical efficacy. All this
> >> should mark a sea change in how the public views such treatments.
> >>
> >
> > Why? The real comparison should be to the efficacy of "mainstream"
> > medicine (henceforth referred to as professional-racket-medicine),
> > especially as a ratio of public and individual dollars spent.
>
> But that's what the article reported - a comparison of hippie
> arthritis treatments to orthodox ones (and a placebo). The NIH isn't
> staffed by idiots.
>
> Doug