Natural Products

Chondroitin Sulfate

CDS, Chondroitin-4 and 6-sulfate

Efficacy

• Indications with proven efficacy:
  Mild to moderate osteoarthritis (symptoms reduction)
• Also used for these other indications, but with no proof of efficacy:
  Hyperlipidemia
  Ischemic heart disease
  Myocardial infarction prevention
  Osteoporosis
  Premature birth prevention
  Renal lithiasis

Security

• Risk of Drug Interactions: Low
• Adverse Effects: Rare

What is it?

Chondroitin, a mucopolysaccharide, is one of the main constituents of cartilage. It is related to glucosamine. Chondroitin comes from natural sources (beef or shark cartilage) or is synthetically manufactured. Chondroitin sulfate plays a role in the formation of joint cartilage. When taken orally, chondroitin's absorption is only about 8 to 18%.

Glucosamine and chondroitin are often combined in a single product. However, it is not known if this combination is any more beneficial than taking each product alone. A possible synergy between these products remains to be established.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

There is evidence that chondroitin effectively relieves the symptoms of osteoarthritis:

• Osteoarthritis:
  The usual dose is 200 to 400 mg 2 to 3 times a day, or 800 to 1200 mg as a single daily dose
  

There is insufficient reliable information to conclude that chondroitin sulfate is effective in any other indication.

Is it safe?

• Chondroitin sulfate is not associated with any severe toxicity. Some people may experience epigastric pain or nausea. Allergic reactions are possible.
• Since there is no safety data available concerning its use during pregnancy and breast-feeding, pregnant and lactating women should not take chondroitin sulfate.
• There are no known drug interactions.

Clinical notes

• Chondroitin sullfate is structurally related to glucosamine and its action appears to be similar.

References

1. Pharmacist's Letter, CE Booklet: Natural Medicines in Clinical Management, Fall 1999
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
3. Lininger S. et Al. The Natural Pharmacy, Prima Health, 1998
4. Passeportsanté.net. Chondroïtine. http://www.passeportsante.net
5. Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002
6. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79