Chondroitin Sulfate for arthritis, benefits, dosage 400 mg, use with glucosamine by Ray Sahelian, M.D.e

Chondroitin supplement and arthritis treatment by Ray Sahelian, M.D. 400 mg tablets

What you will find on this page:
Joint Power Rx with Glucosamine, Chondroitin, MSM -- formulated by Ray Sahelian, M.D.
Chondroitin Sulfate supplement information

Chondroitin sulfate consists of repeating chains of molecules called glycosaminoglycans. Chondroitin sulfate is a major constituent of cartilage providing structure, holding water and nutrients, and allowing other molecules to move through cartilage—an important property, as there is no blood supply to cartilage. Chondroitin may work by acting as a building block for proteoglycan molecules, and may also have anti-inflammatory properties.

Chondroitin Sulfate, 400 mg, 60 Tablets
Source Naturals

Chondroitin Sulfate is a mucopolysaccharide found in cartilage, tendons and ligaments, where it is bound to proteins such as collagen and elastin. In our joints, it contributes to strength, flexibility and shock absorption. Current research indicates that supplemental Chondroitin Sulfate may help maintain proper joint function.

Click here to buy Chondroitin Sulfate, Joint Power Rx, or to see a complete list of top quality products
Subscribe to a FREE Supplement Research Update newsletter. Twice a month you will receive an email with a discussion of several studies on various supplements and natural medicine topics, including chondroitin sulfate, and their practical interpretation by Ray Sahelian, M.D.

Supplement Facts
Chondroitin sulfate 400 mg per tablet

Suggested Use: 2 to 4 chondroitin sulfate tablets daily, or as recommended by your health care professional. Another option is to use Joint Power Rx which has chondroitin sulfate and a number of other nutrients for joint health.
Chondroitin sulfate daily value not established.

Joint Power Rx with Chondroitin Sulfate
Because joint pain is so debilitating, glucosamine and chondroitin sulfate alone are not enough. This powerful formula includes several additional herbal extracts and nutrients that play a role in joint health.
Ingredients include: Glucosamine sulfate (from shellfish), Chondroitin sulfate, MSM, CMO complex, Boswellia serrata extract, Turmeric, Cat's claw extract, Devil's claw extract, Grape-Seed extract, and Sea Cucumber.

Click the link above for Chondroitin Sulfate to learn more about Joint Power Rx

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Chondroitin and Arthritis
In degenerative joint disease, such as osteoarthritis, there is a loss of chondroitin sulfate as the cartilage erodes. Animal studies indicate that chondroitin sulfate may promote healing of bone, which is consistent with the fact that the majority of glycosaminoglycans found in bone consist of chondroitin sulfate. Chondroitin sulfate has been shown, in numerous trials to relieve symptoms and possibly slow the progression of, or in some cases, reverse osteoarthritis.

Source
Commercially available chondroitin is derived mainly from shark and cow cartilage. it can also be derived from porcine sources. I have not seen much research comparing the benefits or risks of chondroitin derived from different sources.

Glucosamine Chondroitin side effects
Allergic reactions are possible with glucosamine or chondroitin. Otherwise, no major side effects with chondroitin have yet been reported.

Chondroitin Research
Chondroitin at 800 mg a day was given in addition to naprosyn 500 mg a day for a period of two years to a group of individuals with osteoarthritis of the hands. This group was compared to another group who only received naprosyn. Those who took chondroitin were found to have a slower rate of arthritis progression than those who only took naprosyn. See bottom of page for more studies.

Is chondroitin necessary if someone is already taking glucosamine?
The research with chondroitin is not as consistent and extensive as it is with glucosamine. If you have arthritis, one option is to start with glucosamine 500 mg three times a day for a month. If, after a month, you haven't been helped, double your dose of glucosamine. If, after another month, you need additional relief, you can try chondroitin at 500 mg three times a day. Another option is to start taking both together along with a few other nutrients and herb found through research to be helpful for arthritis.

Are there recent studies saying chondroitin cannot be absorbed into our bodies through oral consumption?
The studies I have come across show that chondroitin does get absorbed.

Can a diabetic take chondroitin sulfate?
Yes. One study providing a combination of glucosamine and chondroitin for a period of 90 days did not find any change in blood sugar levels.

Chondroitin from shark cartilage, glucosamine hydrochloride and quercetin for osteoarthritis
A combination supplement of 1200 mg glucosamine hydrochloride, 300 mg shark cartilage (consisting of about 100 mg of chondroitin), and 45 mg of quercetin, taken daily, was found to be helpful as a treatment for osteoarthritis.

Effects of an Oral Administration of Glucosamine Chondroitin Quercetin Glucoside on the Synovial Fluid Properties in Patients with Osteoarthritis and Rheumatoid Arthritis.
Biosci Biotechnol Biochem. 2009 Feb. Matsuno Clinic for Rheumatic Diseases.
The effects of an orally administered combination of a glucosamine chondroitin quercetin glucoside supplement on the synovial fluid properties of patients with osteoarthritis and rheumatoid arthritis were investigated. Forty-six osteoarthritis and twenty-two heumatoid arthritis patients were administered with the glucosamine chondroitin quercetin supplement orally for 3 months. Several parameters of the knee joints were monitored before and after supplementation. The osteoarthritis patients showed a significant improvement in pain symptoms, daily activities (walking and climbing up and down stairs), and changes in the synovial fluid properties with respect to the protein concentration, molecular size of hyaluronic acid, and chondroitin 6-sulphate concentration were also observed. However, no such effects were observed in the heumatoid arthritis patients. These results suggest that the glucosamine chondroitin quercetin supplement exerted a special effect on improving the synovial fluid properties in osteoarthritis patients.

Chondroitin Research studies
March 2006 - In a study published in the New England Journal of Medicine, glucosamine plus chondroitin sulfate did not provide significant relief from osteoarthritis pain among all participants. However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements. Researchers led by rheumatologist Daniel O. Clegg, MD, of the University of Utah, School of Medicine, Salt Lake City, conducted the 4-year study known as the Glucosamine / chondroitin Arthritis Intervention Trial (GAIT) at 16 sites across the United States.GAIT enrolled nearly 1,600 participants with documented osteoarthritis of the knee. Participants were randomly assigned to receive one of five treatments daily for 24 weeks: glucosamine alone (1,500 mg), chondroitin sulfate alone (1,200 mg), glucosamine and chondroitin sulfate combined (same doses), a placebo, or celecoxib (200 mg). Celecoxib is an FDA-approved drug for the management of osteoarthritis pain and served as a positive control for the study. (A positive control is a treatment that investigators expect participants to respond to in a predictable way; it helps validate study results.) A positive response to treatment was defined as a 20 percent or greater reduction in pain at week 24 compared to the start of the study. The researchers found that participants taking celecoxib experienced statistically significant pain relief, as expected, versus placebo -- about 70 percent of those taking celecoxib versus 60% taking placebo had a 20% or greater pain reduction. For all participants, there were no significant differences between the other treatments tested and placebo. However, for participants in the moderate-to-severe pain subgroup, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared to placebo -- about 79% in this group had a 20% or greater pain reduction compared to 54% for placebo. In the subgroup of participants with mild pain, glucosamine and chondroitin sulfate together or alone did not provide statistically significant relief compared to placebo. On entering the study, a participant's level of pain was assessed as either mild or moderate to severe using standard pain assessment tools and scales, such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Of the 1,583 study participants, 78% were in the mild pain subgroup and the other 22% were in the moderate-to-severe pain subgroup. Level of pain was evaluated at weeks 4, 8, 16, and 24 using the WOMAC scale and other tools. In addition to taking their daily study treatment, participants could take up to 4,000 mg of acetaminophen daily for pain, except for the 24 hours before they were assessed by study staff. Few side effects from any of the treatments were reported. Those reported were generally mild, such as upset stomach, and distributed evenly across the treatment groups. The GAIT team continues their research with a smaller study to see whether glucosamine and chondroitin sulfate can alter the progression of osteoarthritis, such as delaying the narrowing of the joint spaces. About one-half of the participants in the larger GAIT study were eligible to enroll in this ancillary study. The results are expected in about a year.

November, 2005 - The highly anticipated symposium finally brought some clarification to a week of controversy at the ACR (American College of Rheumatology) Annual Scientific Meeting. Dr. Clegg, lead researcher of the NIH (GAIT) Glucosamine / Chondroitin Arthritis Intervention Trial, presented further data that had not previously been presented, as well as additional information on the positive effects of chondroitin sulfate. Dr. Clegg explained that the study was designed to look at the action of chondroitin sulfate and glucosamine as drugs and not as dietary supplements. Chondroitin and glucosamine were required to meet pharmaceutical standards as the GAIT study was conducted under an Investigational New Drug application. New data that was presented by Dr. Clegg using the Omeract OARSI (Osteoarthritis Research Society International) response criteria for the total patient population indicated that the response for the combination of glucosamine and chondroitin was significantly higher than placebo. In Dr. Clegg's previous presentation, when using WOMAC response criteria, the result was that in the overall population, chondroitin sulfate and glucosamine did not outperform the positive control celecoxib, or were not significantly better than placebo. There were, however, promising signals in various sub-groups. In an exploratory analysis with patients that had moderate to high pain, the chondroitin / glucosamine combination showed a 79% response versus celecoxib at 69% and placebo at 54%. Dr. Clegg commented that "the combination appears to be more effective than placebo and outcome measures seem more robust." In more detailed analyzing results of chondroitin sulfate, it was found that in the overall population there was a significant improvement for patients experiencing joint swelling. Dr. Clegg concluded that chondroitin sulfate was risk-free and that further trials should be developed to explore the positive signals seen in the GAIT study. Further, to the anti-inflammatory and pain data from the GAIT study, Beat A. Michel, MD, followed with a presentation on the disease-modifying effects of chondroitin sulfate and its ability to control the progression of osteoarthritis. Dr. Michel presented data on the structure-modifying effects of chondroitin sulfate in knee osteoarthritis, the results of which were recently published in Arthritis Rheumatology 2005. The study concluded that chondroitin sulfate qualifies as a Disease Modifying Drug for the treatment of osteoarthritis and is especially active in overweight patients, patients under 60 years of age and patients with mild to moderate osteoarthritis. In all of the study's groups, chondroitin sulfate proved statistically superior to placebo.

The pathobiology of osteoarthritis and the rationale for using the chondroitin sulfate for its treatment.
Curr Drug Targets Immune Endocr Metabol Disord. 2004 Jun;4(2):119-27.
Structure-modifying osteoarthritis drugs are agents that reverse, retard, or stabilize the pathology of osteoarthritis, thereby providing symptomatic relief in the long-term treatment. The objective of this review is to evaluate the literature on chondroitin sulfate with respect to the pathobiology of osteoarthritis to ascertain whether this agent should be classified as a symptomatic slow-acting drug, a compound that has a slow onset of action and improve OA symptoms after a couple of weeks. Chondroitin sulfate exhibits a wide range of biological activities and from a pharmacological point of view it produces a slow but gradual decrease of the clinical symptoms of osteoarthritis and these benefits last for a long period after the end of treatment. Many literature data show that chondroitin sulfate could have an anti-inflammatory activity and a chondroprotective action by modifying the structure of cartilage. These properties are also related to the oral adsorption of chondroitin sulfate as high-molecular mass compounds having clusters of sulfate groups and high charge density capable of exert their chondroprotective activity in vivo.

A two-year study of chondroitin sulfate in erosive osteoarthritis of the hands: behavior of erosions, osteophytes, pain and hand dysfunction.
Drugs Exp Clin Res. 2004;30(1):11-6.
The aim of this study was to evaluate the effect of 800 mg/die of chondroitin sulfate per os plus naproxen versus naproxen over 2 years in patients with erosive osteoarthritis of the hands. Joint count for erosions, Heberden and Bouchard nodes, Dreiser's algofunctional index and physicians' and patients' global assessment of disease activity were studied. A total of 24 consecutive patients (22 women and 2 men, mean age 53.0 +/- 6) suffering from symptomatic OA with radiographic characteristics of osteoarthritis were evaluated. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg only. The second group was treated with chondroitin sulfate 800 mg orally plus naproxen 500 mg. Joint counts, radiological hand examinations and assessment of disease activity were performed at baseline, at 12 months and at 24 months. In the second year the treated group showed significant worsening in erosion, Heberden, Bouchard and Dreiser scores was recorded. Physician and patient global assessments of disease activity showed no significant difference from baseline scores. The untreated group showed significant worsening in erosion, Heberden and Bouchard nodes, Dreiser index and physician and patient global assessment scores. This study confirms the partial efficacy of oral chondroitin sulfate in improving some aspects of osteoarthritis.

Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind, multicenter study versus placebo.
Osteoarthritis Cartilage. 2004 Apr;12(4):269-76.
To investigate the efficacy and tolerability of a 3-month duration, twice a-year, intermittent treatment with oral chondroitin sulfate in knee osteoarthritis (OA) patients. A total of 120 patients with symptomatic knee OA were randomized into two groups receiving either 800mg chondroitin sulfate or placebo per day for two periods of 3 months during 1 year. Primary efficacy outcome was Lequesne's algo-functional index (AFI); secondary outcome parameters included VAS, walking time, global judgment, and paracetamol consumption. Radiological progression was assessed by automatic measurement of medial femoro-tibial joint space width on weight-bearing X-rays of both knees. Clinical and biological tolerability was assessed. AFI decreased significantly by 36% in the chondroitin sulfate group after 1 year as compared to 23% in the placebo group. Similar results were found for the secondary outcomes parameters. Radiological progression at month 12 showed significantly decreased joint space width in the placebo group with no change in the chondroitin sulfate group. Tolerability was good with only minor adverse events identically observed in both groups. This study provides evidences that oral chondroitin sulfate decreased pain and improved knee function. The 3-month intermittent administration of 800mg/day of oral chondroitin sulfate twice a year does support the prolonged effect known with symptom-modifying agents for OA. The inhibitory effect of chondroitin sulfate on the radiological progression of the medial femoro-tibial joint space narrowing could suggest further evidence of its structure-modifying properties in knee OA.

Chondroitin Useful in Osteoarthritis
Back in the mid 1990s the America public became aware of effective nutritional alternatives to standard medical drugs for the treatment of osteoarthritis. Glucosamine was the first nutrient that became popular. Since then, many other nutrients and herbs have been promoted, including chondroitin. Chondroitin sulfate is a major constituent of cartilage providing structure, holding water, and allowing other molecules to move through cartilage�an important property, as there is no blood supply to cartilage. In degenerative joint disease, such as osteoarthritis, there is a loss of chondroitin sulfate as the cartilage erodes. But, few studies have looked at the long-term benefit of oral chondroitin supplements. In a study performed at University of Genova Medical School, in Italy, 12 individuals with arthritis of the hands were treated with 800 mg/day of chondroitin sulfate plus naproxen, and compared to 12 others who were given naproxen only. Naproxen is an anti-inflammatory medicine similar to Motrin and sold over the counter as Aleve. X-rays of the hands were done at the start of the study and again after 24 months. In both groups, degeneration of joints showed a general tendency to increase over time, however, the damage was much lower in those treated with chondroitin sulfate plus naproxen than in patients taking naproxen alone.
Dr. Sahelian says: Although chondroitin by itself did not stop the continuing damage to joints, it did slow the progression of the arthritis. Glucsosamine supplements are known to enhance joint health in those with arthritis, and it seems reasonable to take both supplements for the treatment of arthritis. The most common dose of glucosamine is 1500 mg a day while that of chondroitin is 500 to 1000 mg per day.

Chondroitin sulfate in erosive osteoarthritis of the hands.
Int J Tissue React. 2002;24(1):29-32.
The aim of this study was to evaluate the joint count for erosions in patients with erosive osteoarthritis (EOA) of the hands treated with 800 mg/day of orally administered chondroitin sulfate plus naproxen, compared with that of patients administered naproxen only. Twenty-four consecutive patients (22 women and two men, mean age 53.0 +/- 6) suffering from symptomatic OA and with radiographic characteristics of EOA were studied. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg/day only. The second group was treated with chondroitin sulfate 800 mg/day orally plus naproxen 500 mg/day. Radiological hand examinations were performed at baseline and again after 12 and 24 months. In both groups, the joint count for erosions showed a general tendency to increase over time. Progression of erosions at 24 months was lower in patients treated with 800 mg/day chondroitin sulfate plus naproxen than in patients taking naproxen only (p <0.05). Chondroitin sulfate failed to stop the usual time-associated progression in the number of finger joints presenting erosions in EOA of the hands. It was, however, associated with a lower increase in the number of finger joints with erosions detected after 2 years of radiological observation.

A randomized double-blind clinical trial of the effect of chondroitin sulfate and glucosamine hydrochloride on temporomandibular joint disorders: a pilot study.
Cranio. 2001 Apr;19(2):130-9.
Previous studies have shown chondroitin sulfate and glucosamine hydrochloride have beneficial effects on symptoms of osteoarthritis of the knee. Our aim was to study the effect of a daily dose of 1500 mg of glucosamine hydrochloride (GH) and 1200 mg of chondroitin sulfate taken for twelve weeks on subjects diagnosed with capsulitis, disk displacement, disk dislocation, or painful osteoarthritis of the temporomandibular joint (TMJ). Forty-five subjects were enrolled in the study and were randomly assigned to either an active medication group or a placebo group. Eleven subjects were lost from the study for various reasons, resulting in fourteen subjects remaining in the active medication group and twenty subjects remaining in the placebo group. Subjects taking chondroitin sulfate-GH had improvements in their pain as measured by one index of the McGill Pain Questionnaire, in TMJ tenderness, in TMJ sounds, and in the number of daily over-the-counter medications needed. Subjects taking the placebo medication had improvements in their pains as measured by the visual analog scale and by four indices of the McGill Pain Questionnaire. Additional studies are required to evaluate the clinical effectiveness of chondroitin sulfate-GH and to determine the exact mechanism by which chondroitin sulfate-GH affects the articular cartilage of synovial joints.

Chondroitin emails
Q. I have a brief question: Have you had anyone using either Glucosamine alone or in combination with Chondroitin report that their total cholesterol increased? I have a friend who discontinued taking the combination for that reason; I'm sorry, I don't know how long she had been taking it.
A. We have not heard of the connection between glucosamine, chondroitin, and cholesterol at this time.

Q. This sounds like a joke but it's not. Perhaps a month or two after I began to take a glucosamine and chondroitin supplement to protect against knee pain, I began to notice that my penis, which had always assumed a straight position in the erect state, was developing a noticeable bend. (If I had said I was taking the supplement for joint pain, then you really would have been inclined to toss this one out.) Over the next month or two, the bend became more pronounced and I was on the verge of consulting a urologist to look into the possibility of Peyronie's Disease, a condition that apparently afflicts our ex-president Clinton and can I understand, interfere with sex if it progresses too far. The only change in my daily routine I could think of during this time was the addition of the glucosamine and chondroiten to my usual vitamins and mineral regimin. I dropped the supplement and over the next couple of months the bend in the penis gradually disappeared. Perhaps it was a coincidence (although I don't think so).
A. I read your email with interest. This is the first time I have heard of glucosamine and chondroitin involved in this after several years of looking into these combinations. I don't know what to say. I think it's possible. Were there other ingredients in the formula or just glucosamine and chondroitin? There's so little we know about the long term effects of supplements and herbs that I keep any side effects as a possibility. I guess a good way to find out for sure is to retake it and see what happens, since it appears to be reversible on stopping... but i can see one's reluctance in this trial when it comes to such an important member of the body :)

Q. I just began taking a chondroitin glucosamine supplement (1500/1200 mg/day, respectively, as recommended on bottle). When taking it (all mg) during the day I thought I noticed I was much more tired than usual - almost fatigued. Last night I took it about 2 hours before bedtime and for the first time in memory slept clear through the night (I usually get up at least once to urinate and/or drink water for dehydration.) I can't find that anyone has reported this anecdotally or in medical lit.
A. We have not had any feedback thus far that chondroitin and glucosamine cause sleepiness.

Q. I read on a website that there does not seem to be a risk of mad cow disease regarding the use of chondroitin sulfate from bovine cartilage. Would you please do a Google search with the terms - chondroitin sulfate BSE. Number six on the list after the scholarly articles says Caution - Know The Risk Of Your Chondroitin. The website is activexamerica.com and talks about its product of chondroitin sulfate from shark cartialge. Even though they have a product to sell, the sources they mention seem to be very credible. To your knowledge, are there any differences in the effects of shark cartilage versus bovine cartilage chondroitin sulfate on the human body? The reason I am asking is because I have had a scaling skin condition for 21 years on my lips and I found an article from a Google search with the terms - parakeratosis scaling skin treatment. Number 22 on the list mentions an article witht the title, Clinical And Histopathological Improvement Of Psoriasis With Oral Chondroitin Sulfate: A Serendipitous Finding. The study uses 800mg of chondroitin sulfate for two months from a bovine source and I would like to duplicate the effects on my lips.
A. There is some debate regarding the risk of mad cow disease and chondroitin sulfate consumption from a bovine source and not all questions have been completely answered. Thus far there have not been any cases of mad cow disease diagnosed in anyone who has consumed chondroitin sulfate, and it appears tens of millions of people have over the past few years. Furthermore, the risk of mad cow disease in the USA is so small that one would have a higher risk of injury or death by just getting in the car and taking a trip to the shopping mall, yet few people think of this risk when they get in their car but worry about extremely small and extremely unlikely scenarios such as mad cow disease. Therefore, at this point, for practical purposes, it appears that the use of chondroitin sulfate from bovine sources is acceptable and appears to be safe. Since human studies comparing shark cartilage derived chondroitin sulfate has not been compared to bovine source of chondroitin sulfate, we cannot say which form is better. Chances are they are similar.

Q. A friend of mine forwarded to me an email regarding chondroitin sulphate that I hope you cna comment on. This is what it said, "Chondroitin is now falling out of favor due to a new analysis published in Annals of Internal Medicine. Most of the early research on chondroitin shows substantial benefit for reducing pain and improving functionality in people with osteoarthritis of the knee. But research published since 2005 has been mostly negative. When the analyses evaluated ALL chondroitin studies as a whole, it found that chondroitin significantly reduced pain. When only larger, higher-quality, and more recent studies were included there was no significant benefit. The method used for the analysis is stirring up a lot of controversy. And there are still questions about potential long-term benefits such as slowing disease progression. This is not likely to be the last word on chondroitin."
A. I never rely on the findings of the latest study to come to a conclusion regarding the benefit or harm of that particular supplement. The research with chondroitin sulfate is not conclusive, but based on everything that I have read and my professional experience, as of May 2007 I think chondroitin should be included in a joint formula along with glucosamine and other herbs and nutrients for a potential synergistic effect on joint health. I will await results of further studies.

Q. I read with great interest your page on chondroitin supplements. In 2005 a small study was published on:
Clinical And Histopathological Improvement Of Psoriasis With Oral Chondroitin Sulfate: A Serendipitous Finding.
Although small scale it showed extremely promising results on all but one (10 out of 11) cases of psoriasis. However psoriasis seems responsive to placebos quite regularly, yet n this case the trial was originally about osteoarthritus of the knee so arguably the placebo affect should not have affected outcome regarding psoriasis coverage. My question to add to your page is have you since seen any medical studies regarding the role of chondroitin sulfate and psoriasis treatment? And do you have any knowledge, direct or otherwise on whether this chondroitin treatment works with psoriasis.
A. I have not seen any chondroitin psoriasis studies since the one in 2005, but it does look quite encouraging, 10 out of 11 people were helped. If a person has psoriasis, it is certainly worth a try.

Clinical and histopathological improvement of psoriasis with oral chondroitin sulfate: a serendipitous finding.
Dermatol Online J. 2005 Mar 1;11(1):31. Clinical Research Unit, Scientific Medical Department, Bioib�rica, S.A., Barcelona, Spain.
We describe the clinical and histopathological results of plaque psoriasis in eleven adult patients with knee osteoarthritis and long-standing, moderate to severe psoriasis resistant to conventional therapy treated with chondroitin sulfate. Patients received 800 mg per day of chondroitin sulfate for 2 months. All patients but one presented a dramatic improvement of the condition of the skin, with a reduction of swelling, redness, flaking, and itching (clearance of psoriasis in one patient), increase in the hydration and softening of the skin, and amelioration of scaling. Histopathologically, there was a statistically significant decrease in epidermal thickness, a decrease in the thickness between the stratum basale and the stratum granulosum, a significant improvement of the degree of psoriasis activity, and a decrease in the number of keratinocytes stained with Ki-67. The confirmation of these serendipitous findings in controlled prospective studies could represent an important advance in the therapeutic armamentarium for patients with psoriasis given the excellent safety profile of chondroitin sulfate.

Q. Joint Power Rx supplement appears to be suitable for my needs, particularly because it includes CMO. Over the Internet, there has been some discussion regarding the formulation of chondroitin, with some providers insisting that unless chondroitin is in the form of low molecular weight, it is essentially ineffective. Is that a valid consideration? And, is the chondroitin in Joint Power Rx a low molecular weight chondroitin?
A. The human studies we have reviewed do not mention the molecular weight of chondroitin. You may wish to ask the websites that claim this substance has to be in a particular molecular weight size to refer you to such studies so we can review them. Our chondroitin ingredient supplier does not mention this aspect in their certificate of analysis.