Glucosamine and Chondroitin vs. Celebrex Heart Risk

By Chris Centeno, MD /

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celebrex heart risk

We’ve all seen the Celebrex commercial with the gentle, lapping waves and the comforting voice of the narrator promising relief from arthritis pain. The smiling actor rushes down the steps, plays Frisbee with his dog, and for a few joyous seconds, arthritis sufferers may feel Celebrex is exactly what they need. Then comes the kicker—the possible side effects, including (along with all NSAIDs) the chance of heart attack or stroke that can lead to death, serious skin or allergic reactions, liver and kidney failure, sudden intestinal bleeding that may cause death…The truth is, they lost me at the fine print of side effects scrolling across the screen—I’d rather take my chances with arthritis pain! But did you know you don’t have to choose between arthritis pain and the Celebrex heart risk? Glucosamine and chondroitin are both alternatives to Celebrex for arthritis.

What Is Celebrex?

Celebrex (celecoxib) is a nonsteroidal anti-inflammatory drug (NSAID), and NSAIDs are used to treat pain and inflammation. Celebrex is a common prescription drug for arthritis. Celebrex has serious cardiac sudden-death side effects and has other serious complications associated with its use.

What Are Glucosamine and Chondroitin?

Glucosamine and chondroitin are natural components of cartilage. Glucosamine is a building block of cartilage, and chondroitin helps the cartilage retain water. Glucosamine and chondroitin supplements are usually made by breaking down shellfish or other animal by-products. They are safe supplements for long-term use, and there are few known side effects. Many studies have shown that they relieve pain and improve function in patients with arthritis.

A Study on the Effectiveness and Safety of Glucosamine, Chondroitin, and Celebrex (Celecoxib)

The purpose of this new analysis of prior studies was to “investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or Celebrex in the treatment of knee osteoarthritis (OA).” The study covered 54 previous studies and a total of 16,427 patients.

Researchers discovered that all the treatment options showed improvements in pain, but only glucosamine plus chondroitin showed improvement in function and reduction in the narrowing of the joint space seen in arthritis. In addition, stomach adverse effects were seen in those using the Celebrex. Researchers concluded that the combination of glucosamine and chondroitin was an effective treatment for osteoarthritis of the knee.

Glucosamine and Chondroitin Improve Pain

While this new study shows significant improvement in pain with the use of glucosamine and chondroitin, there are studies that show sledgehammer NSAIDs like Celebrex or ibuprofen are more effective at pain relief. The reason is that while other supplements, like curcumin, have clinical trials supporting that they have ibuprofen’s kick for pain relief, glucosamine and chondroitin seem to be primarily disease-modifying agents (i.e., their focus is to preserve the cartilage you have). While that can translate into reduced pain (i.e., if your pain was getting progressively worse due to cartilage loss), glucosamine and chondroitin may not pack the immediate punch that NSAIDs throw at pain, but glucosamine and chondroitin also don’t carry the risks of death and other side effects.

If glucosamine and chondroitin aren’t effectively eliminating your pain, you can still benefit from their cartilage benefits and throw a hard upper cut at your pain by adding a curcumin supplement.

Glucosamine and Chondroitin Reduce Cartilage Loss

There have been a bevy of studies in addition to this new one that show that glucosamine and chondroitin help MRI cartilage findings when taken over many months to years. For example, I blogged on a study a few years ago that showed that chondroitin helped to reduce cartilage loss on MRI. There are other studies for both glucosamine and chondroitin that show this, especially when they’re taken for long periods of time (i.e., more than a year).

Another study shows again that when both are taken together over two years, they slow the progression of arthritis as seen on X-rays. The study looked at more than 600 middle-aged and elderly patients who still had a small amount of cartilage (>2 mm joint space width—almost, but not quite, bone on bone) and who were randomized to take either supplement alone, the two together, or a placebo. Only the two supplements taken together showed protection of cartilage over the two year period.

Glucosamine and Chondroitin Reduce Inflammation

In addition to slowing cartilage degeneration in arthritis and reducing pain, glucosamine and chondroitin are powerful anti-inflammatories in their own right. In fact, I’ve blogged before on a study showing that a glucosamine and chondroitin combination was as powerful an anti-inflammatory as Celebrex.

Another study looked solely at blood levels of a common inflammatory marker known as CRP (c-reactive protein) in a small group of overweight patients. Half the patients received glucosamine and chondroitin (GC) and half took a placebo for four weeks, and then the groups switched (crossed over), where the half that was taking GC took a placebo and vice versa. When the patients were taking GC, their CRP levels were 23% lower, meaning there was a measurable anti-inflammatory effect.

Glucosamine and Chondroitin: Few Known Side Effects

The untold story here is obviously that while Celebrex is a dangerous drug that was nearly pulled off the market for severe cardiac side effects (basically more than tripling your risk of sudden death from a massive heart attack), there are no such known risks for glucosamine and chondroitin.

While NSAIDs like Motrin, ibuprofen, Aleve, Naprosyn, Advil, and Celebrex are good at reducing inflammation and pain, they have serious side effects. Every day we see patients who are so dependent on NSAIDs for normal functioning that the prospect of getting off NSAIDs is unfathomable. These are usually middle-aged and physically active patients who have learned to consume large amounts of NSAIDs to be able to stay active. We usually want them off of these NSAIDs in order to properly treat them because they have been shown to reduce the body’s ability to heal.

Even if we take the least concerning of the NSAID brood (Aleve-Naprosyn), this medication increased cardiac risk by a whopping 82%! The worst was Vioxx (followed closely by Celebrex), pulled off the market in 2004 due to dangerous side effects, which increased the risk of a having a serious heart problem by 202%! Celebrex was left on the market but only because its manufacturer, Pfizer, agreed to the FDA’s demand that it provide strict warnings of its heart attack and stroke risks (a “Black Box” warning about Celebrex heart risk).

How Do I Choose the Right Supplement?

Make sure your supplement has both glucosamine and chondroitin for the best benefit. There are two major forms of glucosamine commonly seen in supplements: G-HCL and G-SO4. G-HCL seems to have better pain-relieving properties while G-SO4 is better at helping cartilage.

The upshot? You don’t need to put up with Celebrex heart risk to relieve arthritis pain! Based on the ongoing research, glucosamine and chondroitin appear to be great alternatives to Celebrex for arthritis, so flush the NSAIDs and pick up a high-quality supplement.

Category: Diet/Nutrition, Knee

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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