Dietrs for the joints: myths and reality

Part 1: Anatomy and joint physiology – the basis of understanding the problem

To understand the effectiveness of dietary supplements for joints, it is necessary to have a basic idea of their structure and function. The joint is a place of connection of two or more bones, providing skeleton mobility. The main types of joints include synovial (the most mobile, for example, knee and shoulder joints), cartilage (limited mobile, for example, intervertebral discs) and fibrous (motionless, for example, bones of the skull). Here we focus on the synovial joints, since they are most susceptible to diseases for the treatment of which dietary supplements are used.

1.1. Components of the synovial joint:

Joint surfaces of the bones: Coated with hyalin cartilage, which provides smooth sliding of the bones relative to each other and depreciation of the load.
The joint capsule: The sealed shell surrounding the joint consists of an external fibrous membrane and the inner synovial membrane.
Synovial membrane: Lines the joint capsule and produces a synovial fluid.
Synovial fluid: A viscous fluid filling the joint cavity. It lubricates the articular surfaces, reducing friction, nourishes cartilage and removes metabolic products.
Blues: Durable fibers connecting the bones and ensure the stability of the joint. It can be intra -articular (for example, cross -shaped ligaments of the knee) or extracurricular.
Meniskis (in some joints): Half -lung cartilage formations (for example, in the knee joint), which increase the congruence of the articular surfaces, improve the shock absorption and distribution of the load.
Joint bags (Burses): Small fluid -filled bags located between bones, tendons and muscles reduce friction and facilitate tissue sliding.

1.2. Power and metabolism of cartilage:

Hyalin cartilage is a unique tissue devoid of blood vessels and nerves. It receives nutrients from synovial fluid by diffusion. This makes the cartilage vulnerable to damage and slow in restoration. The main components of the cartilage:

Chondrocytes: Cells producing and supporting cartilage matrix.
Cartilage matrix: Consists of:
- Type II collagen: Provides tensile strength.
- Protooglic: Molecules consisting of protein and glycosaminoglycans (GAG), such as chondroitin sulfate and keratan sulfate. Proteoglycans have high hydrophilicity and hold water, providing shock -absorption properties of cartilage.
- Water: It accounts for up to 80% of the cartilage and plays an important role in its elasticity and depreciation.

1.3. The main diseases of the joints:

Osteoarthritis (OA): The most common joint disease, characterized by progressive destruction of cartilage, inflammation and pain. Risk factors include age, overweight, injuries, genetic predisposition and repeating loads.
Rheumatoid arthritis (RA): Autoimmune disease in which the immune system attacks its own joints, causing inflammation, damage to cartilage and bones.
Gout: The disease caused by the deposition of uric acid crystals in the joints, leading to inflammation and pain.
Joint injuries: Dislocations, ligaments, ruptures of meniscus and fractures can lead to damage to the articular structures and the development of post -traumatic arthritis.
Bursites and tendinitis: Inflammation of the articular bags and tendons, respectively, often occurs due to overload or injuries.

Part 2: The main components of dietary supplements for joints: evidence and myths

Most of the joints for joints contain one or more of the following components: glucosamine, chondroitin, methyl sulfonylomethane (MSM), hyaluronic acid, collagen, omega-3 fatty acids, vitamin D, vitamin C, turmeric and plant extracts. Consider each of them in more detail.

2.1. Glucosamine:

The mechanism of action: Glucosamine is aminosahar, which is the predecessor of glycosaminoglycans (GAG), the main components of the cartilage matrix. It is assumed that glucosamine stimulates chondrocytes to the production of GAG and collagen, slowing down the destruction of cartilage and reducing inflammation.
Evidence of effectiveness: The results of clinical studies of glucosamine are contradictory. Some studies show a slight decrease in pain and improving joint function in patients with osteoarthritis, especially the knee joint. However, other major studies, including Gait (Glucosamine/Chondroitin Arthritis International Trial) and Leaps (Long-Term Evalauty of Arthritis Pain Study), did not reveal significant advantages of glucose Slow down the progression of OA.
Glucosamine forms: There are two main forms of glucosamine: glucosamine sulfate and glucosamine hydrochloride. Most studies that showed some effectiveness used glucosamine sulfate. Glucosamine hydrochloride is often less effective.
Side effects: Glucosamine is usually well tolerated. Possible side effects include stomach disorder, nausea and diarrhea. People with allergies should be careful for seafood, since glucosamine is often obtained from mollusks.
Myths:
- Glucosamine completely restores the cartilage: This is wrong. Glucosamine can have a certain supporting effect, but is not able to completely restore the damaged cartilage.
- Glucosamine is effective for all types of arthritis: Evidence of its effectiveness is mainly limited by osteoarthritis.

2.2. Chondroitin:

The mechanism of action: Chondroitin Sulfate – glycosaminoglikan, which is part of the cartilage matrix. It is assumed that chondroitin holds water in cartilage, ensuring its elasticity and depreciation properties, and also inhibits enzymes that destroy cartilage.
Evidence of effectiveness: As in the case of glucosamine, the results of chondroitin studies are contradictory. Some studies show a slight decrease in pain and improving the function of joints in patients with osteoarthritis, especially when taking glucosamine. However, other major studies have not revealed significant advantages of chondroitin compared to placebo.
Forms of chondroitin: There are various forms of sulfate chondroitin, which differ in molecular weight and the degree of sulfate. It is believed that chondroitin sulfate with a low molecular mass is better absorbed.
Side effects: Chondroitin is usually well tolerated. Possible side effects include stomach disorder, nausea and diarrhea.
Myths:
- Chondroitin – a panacea from all joint problems: This is not true. Chondroitin can provide some symptomatic relief, but does not treat the cause of the disease.
- The larger the dose of chondroitin, the better the effect: This is wrong. The effectiveness of chondroitin does not depend linear on the dose. High doses can increase the risk of side effects.

2.3. Glucosamine and chondroitin (combination):

The mechanism of action: The combination of glucosamine and chondroitin implies a synergistic effect when both components complement each other, stimulating the synthesis of cartilage and reducing its destruction.
Evidence of effectiveness: The results of studies of the combination of glucosamine and chondroitin are also contradictory. Gait Trit has not revealed significant advantages of the combination compared to placebo for most patients with osteoarthritis. However, in the subgroup of patients with moderate and severe pain, a combination of glucosamine and chondroitin showed some advantage compared to placebo.
Myths:
- The combination of glucosamine and chondroitin is always more effective than each component separately: This is not always the case. The effectiveness of the combination may depend on the individual characteristics of the patient and the severity of the disease.

2.4. Methyl sulfonylmetatan (MSM):

The mechanism of action: MSM – organic compound of sulfur, which is contained in various foods. Sure is an important component of collagen and other structural proteins. It is assumed that MSM reduces inflammation, pain and edema in the joints.
Evidence of effectiveness: Some small studies have shown that MSM can reduce pain and improve joint function in patients with osteoarthritis. However, larger and well -planned studies are needed to confirm these results.
Side effects: MSM is usually well tolerated. Possible side effects include stomach disorder, nausea and diarrhea.
Myths:
- MSM treats arthritis: MSM can provide some symptomatic relief, but does not treat the cause of the disease.

2.5. Hyaluronic acid:

The mechanism of action: Hyaluronic acid is the main component of the synovial fluid that provides its viscosity and lubricating properties. Injections of hyaluronic acid into the joint (viscous system) can improve the lubrication of articular surfaces, reduce friction and pain. Bades with hyaluronic acid are designed to increase the content of hyaluronic acid in the synovial fluid when taken orally.
Evidence of effectiveness: Evidence of the effectiveness of oral administration of hyaluronic acid is limited. Some studies show that oral hyaluronic acid can slightly reduce the pain and improve joint function in patients with osteoarthritis, but the effect is usually less pronounced than in injections.
Side effects: Hyaluronic acid is usually well tolerated.
Myths:
- Coral hyaluronic acid is as effective as injections: This is wrong. Injections of hyaluronic acid deliver it directly to the joint cavity, providing a higher concentration and a more pronounced effect.
- Hyaluronic acid completely restores the synovial fluid: Hyaluronic acid can improve the quality of synovial fluid, but does not completely restore its structure and function.

2.6. Collagen:

The mechanism of action: Collagen is the main structural protein of connective tissue, including cartilage, bones and ligaments. When administering inside, collagen is split into peptides and amino acids, which is supposed to stimulate the synthesis of collagen in cartilage and other tissues.
Evidence of effectiveness: Some studies show that collagen intake can reduce pain and improve joint function in patients with osteoarthritis. However, larger and well -planned studies are needed to confirm these results.
Types of collagen: There are various types of collagen, the most common of which:
- Type I collagen: Contained in the skin, bones, ligaments and tendons.
- Type II collagen: The main component of cartilage.
- Type III collagen: Contained in the skin, muscles and blood vessels.
Side effects: Collagen is usually well tolerated. Possible side effects include stomach disorder and allergic reactions.
Myths:
- Collagen completely restores the damaged cartilage: Collagen can have a certain supportive effect, but is not able to completely restore the damaged cartilage.

2.7. Omega-3 fatty acids:

The mechanism of action: Omega-3 fatty acids, such as eicopascentaenic acid (EPK) and dairyxaenic acid (DGC), have anti-inflammatory properties. It is assumed that they reduce inflammation in the joints and relieve pain.
Evidence of effectiveness: Some studies show that the intake of omega-3 fatty acids can reduce pain and stiffness in joints in patients with rheumatoid arthritis and osteoarthritis.
Sources of omega-3 fatty acids: Fat fish (salmon, tuna, mackerel), linseed oil, chia, walnuts.
Side effects: With high doses of omega-3, fatty acids can cause stomach disorder, nausea and diarrhea.
Myths:
- Omega-3 fatty acids treat arthritis: Omega-3 fatty acids can reduce inflammation and pain, but do not treat the cause of the disease.

2.8. Vitamin D:

The mechanism of action: Vitamin D plays an important role in the health of bones and joints. He participates in the regulation of calcium metabolism necessary to maintain bone strength. Vitamin D deficiency can increase the risk of osteoarthritis and other joint diseases.
Evidence of effectiveness: Studies show that vitamin D deficiency is associated with an increased risk of osteoarthritis and worsening its course. Taking vitamin D can improve the condition of bones and joints in people with deficiency.
Sources of vitamin D: Sunlight, oily fish, egg yolks, enriched products.
Side effects: With an overdose, vitamin D can cause hypercalcemia (an increased level of calcium in the blood).
Myths:
- Vitamin D treats arthritis: Vitamin D is important for the health of bones and joints, but does not treat the cause of arthritis.

2.9. Vitamin C:

The mechanism of action: Vitamin C is a powerful antioxidant that protects the cells from damage to free radicals. It is also necessary for the synthesis of collagen, an important component of cartilage and other connective tissues.
Evidence of effectiveness: Studies show that sufficient consumption of vitamin C can reduce the risk of osteoarthritis and improve its course.
Sources of vitamin C: Citrus fruits, berries, pepper, broccoli.
Side effects: At high doses, vitamin C can cause stomach disorder.
Myths:
- Vitamin C treats arthritis: Vitamin C is important for the health of the joints, but does not treat the cause of arthritis.

2.10. Curcumin:

The mechanism of action: Kurkumin is an active substance contained in turmeric. It has anti -inflammatory and antioxidant properties.
Evidence of effectiveness: Some studies show that curcumin can reduce pain and joint inflammation in patients with osteoarthritis and rheumatoid arthritis. However, the bioavailability of curcumin during oral administration is limited. To improve the assimilation of Kurkumin, they are often combined with piperin (a substance contained in black pepper).
Side effects: Curcumin is usually well tolerated. Possible side effects include stomach disorder.
Myths:
- Kurkumin is a miraculous remedy for all diseases: Kurkumin has useful properties, but is not a panacea.

2.11. Plant extracts:

The mechanism of action: Many plant extracts, such as Bosvelia, the devilish claw and ginger, have anti -inflammatory properties. It is assumed that they reduce pain and inflammation in the joints.
Evidence of effectiveness: Evidence of the effectiveness of plant extracts for the treatment of joint diseases is limited. Some small studies show that they can provide some symptomatic relief, but larger and well -planned studies are needed.
Side effects: Side effects of plant extracts can vary depending on the type of plant. It is important to consult a doctor before taking plant additives.
Myths:
- Plant extracts are always safe because they are natural: This is wrong. Plant extracts can cause side effects and interact with other drugs.

Part 3: Assessment of the quality of the dietary supplement and the recommendations for the choice

When choosing dietary supplements for joints, it is important to consider the following factors:

3.1. Quality and cleanliness:

Friendly testing: Look for dietary supplements tested by independent laboratories such as NSF International, USP (United States Pharmacopeia) or Consumerlab.com. These organizations check dietary supplements for the content of the ingredients, purity and compliance with the declared characteristics.
GMP (Good Manufacturing Practice): Make sure that the manufacturer of the dietary supplement complies with GMP standards that guarantee the quality and safety of production.
Composition: Check the composition of the dietary supplement for allergens, artificial dyes, flavors and other undesirable ingredients.

3.2. Dosage:

Recommended doses: Follow the dosage recommendations indicated on the Bad packaging. Do not exceed the recommended dose, as this can increase the risk of side effects.
Dosage compliance with the results of research: Check whether dosage of doses used in clinical studies that showed effectiveness corresponds to.

3.3. Output form:

Absorption: Some forms of producing dietary supplements (for example, liposomal forms) can be better absorbed by the body.
Convenience accepts: Select the output form that is convenient for you (for example, tablets, capsules, powders, liquids).

3.4. Manufacturer:

Reputation: Choose dietary supplements from famous and reliable manufacturers with a good reputation.
Reviews: Read the reviews of other users about dietary supplements.

3.5. Consultation with a doctor:

Necessity: Be sure to consult a doctor before taking dietary supplements for the joints, especially if you have any chronic diseases or take other medicines. The doctor will help to determine whether dietary supplements are suitable for you, and choose the optimal dosage.
Individual recommendations: The doctor can give individual recommendations for the choice of dietary supplements, taking into account your features and needs.

3.6. Expectations:

Realistic expectations: Bades are not a replacement for the traditional treatment of joint diseases. They can provide some symptomatic relief, but do not treat the cause of the disease.
Complex approach: To achieve the best results, it is recommended to use dietary supplements in combination with other treatment methods, such as physiotherapy, physiotherapy exercises, diet and drug therapy.

3.7. Examples of dietary supplements:

It is impractical to give specific examples of dietary supplements, since the market is constantly changing, and the information quickly becomes obsolete. However, you can give general recommendations for the choice:

Look for dietary supplements with a proven composition and dosage.
Give preference to dietary supplements from famous manufacturers with a good reputation.
Make sure the dietary supplement is tested by an independent laboratory.
Consult a doctor before the reception.

Part 4: Badam alternatives and an integrated approach to the treatment of joint diseases

Despite the popularity of dietary supplements, there are other methods of treating joint diseases that can be more effective and scientifically sound. It is important to remember that the most effective is an integrated approach that includes several treatment methods.

4.1. Drug therapy:

Nonsteroidal anti -inflammatory drugs (NSAIDs): Relieve pain and inflammation, but can cause side effects from the gastrointestinal tract and cardiovascular system.
Opioid analgesics: They are prescribed to relieve severe pain, but can cause addiction and other side effects.
Corticosteroids: They have a powerful anti -inflammatory effect, but can cause serious side effects with prolonged use.
Disease-modifying anti-Russian drugs (BMARP): Used to treat rheumatoid arthritis and other autoimmune joint diseases.
Hyaluronic acid injections (viscous system): They are introduced directly into the articular cavity to improve the lubrication of the articular surfaces and reduce pain.
Injections of corticosteroids: They are introduced directly into the articular cavity to quickly relieve pain and inflammation.

4.2. Physiotherapy and physiotherapy exercises (exercise therapy):

Physiotherapeutic procedures: Ultrasound, electrophoresis, magnetotherapy and other methods can reduce pain and inflammation, improve blood circulation and accelerate tissue restoration.
Exercise: Exercises for strengthening muscles that support joints, improve mobility and coordination. It is important to perform exercises under the guidance of an experienced exercise therapy.

4.3. Weight loss:

Reducing the load on the joints: Weight reduction can significantly reduce the load on the joints, especially the knee and hip, and relieve pain.
Diet: It is recommended to adhere to a balanced diet with restrictions on the consumption of calories, fats and simple carbohydrates.

4.4. Using auxiliary means:

Orthes: Support and stabilize the joint, reducing the load and pain.
Cane or crutches: Reduce the load on sore joints.
Special shoes: Provides depreciation and support of the foot.

4.5. Alternative treatment methods:

Acupuncture: Some studies show that acupuncture can reduce pain in osteoarthritis.
Massage: It can improve blood circulation, relax muscles and reduce pain.
Yoga and Tai-Chi: They can improve joint mobility, strengthen muscles and reduce stress.

4.6. Surgical treatment:

Arthroscopy: Miniyinvasive operation, which allows you to inspect and remove damaged tissues from the joint.
Joint endoprosthetics: Replacing the damaged joint with artificial prosthesis.

Dietrs for the joints: myths and reality