Chondroitin Sulfate - What is it & How to use

In osteoarthritis, the cartilage in the joints breaks down. Taking chondroitin sulfate, one of the building blocks of cartilage, might slow this breakdown.

Effectiveness

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for CHONDROITIN SULFATE are as follows:

Possibly effective for…

  • Cataracts. Research shows that injecting a solution that contains chondroitin sulfate and sodium hyaluronate into the eye protects the eye during cataract surgery. Many different products containing chondroitin sulfate and sodium hyaluronate have been reviewed by the U.S. Food and Drug Administration (FDA) for use during cataract surgery. However, it’s not clear if adding chondroitin sulfate to sodium hyaluronate solutions helps reduce pressure within the eye after cataract surgery compared to other similar treatments. Some early studies suggest that a specific eye solution containing chondroitin sulfate and hyaluronate (Viscoat, Alcon Laboratories) can decrease pressure in the eye and improve overall eye health after a cataract is removed. However, the drops do not appear to be better than drops containing hyaluronate alone or another chemical called hydroxypropylmethyl-cellulose. The effect of solutions containing only chondroitin sulfate on cataract surgery is not known.
  • Osteoarthritis. Clinical research shows that taking chondroitin sulfate by mouth modestly improves pain and function in some people with osteoarthritis when used for up to 6 months. It seems to work best in people with more severe pain and when a pharmaceutical-grade preparation is used. Specific products that have shown benefit in patients with osteoarthritis include Chondrosulf (IBSA Institut Biochimique SA), Chondrosan (Bioibérica, S.A.), and Structrum (Laboratoires Pierre Fabre). But pain relief is likely to be small at best. Other research shows that taking chondroitin sulfate for up to 2 years might slow the progression of osteoarthritis.

    Some research has evaluated the effects of chondroitin sulfate when taken by mouth in combination with glucosamine. Some research shows that taking specific products containing chondroitin sulfate and glucosamine helps reduce symptoms of osteoarthritis. Other research shows no benefit when non-commercial preparations are used. Taking chondroitin sulfate plus glucosamine long-term appears to slow the progression of osteoarthritis.

    There is some evidence that a skin cream containing chondroitin sulfate in combination with glucosamine sulfate, shark cartilage, and camphor can reduce osteoarthritis symptoms. However, any symptom relief is most likely due to the camphor and not the other ingredients. There is no research showing that chondroitin is absorbed through the skin.

  • Urinary tract infections (UTIs). Early research suggests that administering a specific chondroitin sulfate and hyaluronic acid solution (iAluRil, IBSA Farmaceutici) through a catheter weekly for 4 weeks and then monthly for about 5 months reduces UTIs in women with a history of UTIs.

Insufficient evidence to rate effectiveness for…

  • Joint pain caused by breast cancer drugs. Early research suggests that taking a combination of glucosamine sulfate and chondroitin sulfate in two or three divided doses daily for 24 weeks improves joint pain and symptoms caused by drugs used to treat breast cancer.
  • Dry eyes. Research on the effectiveness of chondroitin sulfate on dry eyes is mixed. Early research suggests that using chondroitin sulfate eye drops decreases dry eyes. However, other evidence suggests that eye drops containing chondroitin sulfate are less effective than tear-replacement drops (Gel-Larmes). Other research shows that using a specific eye drop containing chondroitin sulfate together with xanthan gum (PRO-148, Laboratorios Sophia, SA de CV, Guadalajara, Mexico) four times daily for 60 days does not improve tears, but might improve the severity of dry eye symptoms.
  • Muscle soreness after exercise. Early research suggests that taking chondroitin sulfate daily does not reduce muscle soreness after exercise in men.
  • Acid reflux. When taken along with conventional treatments such as antacids, a syrup containing hyaluronic acid and chondroitin sulfate appears to reduce the intensity of acid reflux symptoms.
  • Bladder inflammation (interstitial cystitis). Several low-quality studies suggest that administering chondroitin sulfate solution into the bladder with or without hyaluronic acid can improve symptoms of bladder inflammation. Also, other early research suggests that taking a combination product containing chondroitin sulfate (CystoProtek) by mouth can improve bladder inflammation. However, some higher-quality research shows that inserting chondroitin sulfate into the bladder does not improve symptoms.
  • Bone and joint disease (Kashin-Beck disease). Early research suggests that chondroitin sulfate, with or without glucosamine hydrochloride, can reduce pain in people with Kashin-Beck disease. Also, taking chondroitin sulfate with glucosamine sulfate can slow joint space narrowing in people with this bone disease. However, it is unclear if taking chondroitin sulfate alone slows joint space narrowing.
  • Heart attack. Some early research shows that taking chondroitin sulfate by mouth might lower the risk of having a first or recurrent heart attack.
  • Skin redness and irritation (psoriasis). Early research suggests that taking chondroitin sulfate for 2-3 months decreases pain and improves skin conditions in people with psoriasis. But other research suggests that taking chondroitin sulfate (Condrosan, CS Bio-Active, Bioiberica S.A., Barcelona, Spain) daily for 3 months does not reduce psoriasis severity in people with psoriasis and knee osteoarthritis.
  • Overactive bladder. Early research suggests that inserting sodium chondroitin sulfate into the bladder through a urinary catheter improves quality of life in people with overactive bladder.
  • Heart disease.
  • Weak bones (osteoporosis).
  • High cholesterol.
  • Other conditions.

More evidence is needed to rate chondroitin sulfate for these uses.

Dose

The following doses have been studied in scientific research:

BY MOUTH:

  • For osteoarthritis: the typical dose of chondroitin sulfate is 800-2000 mg taken as a single dose or in two or three divided doses daily for up to 3 years.

APPLIED TO THE SKIN:

  • For osteoarthritis: a cream containing 50 mg/gram of chondroitin sulfate, 30 mg/gram of glucosamine sulfate, 140 mg/gram of shark cartilage, and 32 mg/gram of camphor has been used as needed for sore joints for up to 8 weeks.

INJECTED INTO THE MUSCLE:

  • For osteoarthritis: chondroitin sulfate (Matrix) has been injected into the muscle daily or twice weekly for 6 months.

INSERTED INTO THE BLADDER:

  • For urinary tract infections (UTIs): 50 mL of a specific solution containing chondroitin sulfate and hyaluronic acid (iAluRil, IBSA Farmaceutici), has been inserted into the bladder once weekly for 4 weeks, and then once or twice monthly for up to 5 months.

APPLIED TO THE EYE:

  • For cataracts: Several different eye drops containing sodium hyaluronate and chondroitin sulfate (DisCoVisc, Alcon Laboratories; Viscoat, Alcon Laboratories; DuoVisc, Alcon Laboratories; Viscoat, Alcon Laboratories; Provisc, Alcon Laboratories) have been used during cataract surgery.

Safety Concerns

Chondroitin sulfate is LIKELY SAFE when taken by mouth or used as an eye solution during cataract surgery. Chondroitin sulfate has been taken by mouth safely in research for up to 6 years. Also, chondroitin sulfate has been given premarket approval by the US Food and Drug Administration (FDA) to be used as an eye solution during cataract surgery.

But there is some concern about the safety of chondroitin sulfate because it comes from animal sources. Some people are worried that unsafe manufacturing practices might lead to contamination of chondroitin products with diseased animal tissues, including those that might transmit bovine spongiform encephalopathy (mad cow disease). So far, there are no reports of chondroitin causing disease in humans, and the risk is thought to be low. It can cause some mild stomach pain and nausea. Other side effects that have been reported are bloating, diarrhea, constipation, headache, swollen eyelids, leg swelling, hair loss, skin rash, and irregular heartbeat.

Some chondroitin products contain excess amounts of manganese. Ask your healthcare professional about reliable brands.

Chondroitin sulfate is POSSIBLY SAFE when injected into the muscle short-term, when applied to the skin short-term, when used as an eye drop short-term, and when inserted into the bladder with a catheter by a physician.

Special precautions & warnings:

Pregnancy and breast-feeding: There is not enough reliable information about the safety of taking chondroitin sulfate if you are pregnant or breast feeding. Stay on the safe side and avoid use.

Asthma: There is some concern that chondroitin sulfate might make asthma worse. If you have asthma, use chondroitin sulfate cautiously.

Blood clotting disorders: In theory, administering chondroitin sulfate might increase the risk of bleeding in people with blood clotting disorders.

Prostate cancer: Early research suggests that chondroitin might cause the spread or recurrence of prostate cancer. This effect has not been shown with chondroitin sulfate supplements. However, until more is known, do not take chondroitin sulfate if you have prostate cancer or are at high risk for developing it (you have a brother or father with prostate cancer).

Interaction with medication

Moderate
Be cautious with this combination.
Warfarin (Coumadin)
Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking chondroitin with glucosamine increases the effect of warfarin (Coumadin) on blood clotting. This can cause bruising and bleeding that can be serious. Don’t take chondroitin if you are taking warfarin (Coumadin).

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.