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I dont want to offend anyone here nor is it my intent to dismiss the subjective experience of the vetaran members whos opinions I value.
It is and always will be my intent to question and discriminate without prejudice any treatment , practice, or medication's efficacy. This is essential in nursing which is a practice that should be based on specific and measurable criteria defendable by science, research, and observation.
This is a practice that I carry into my personal life as well as my professionl one. If its not effective or efficient then it should be at least candidate for the chopping block.
A professional example is the Amiodarnone vs Lidocaine debate in the advanced cardiac life support arena. Lidocaine has been the big gun for certain arrhythmias for years. Then along came Amiodarone which was put in favor by the AHA. Their favor was so lop sided that it became a joke. People accused the AHA of being paid off. Now in 2004 their new ACLS recommendations dont necessarily favor amiodarone anymore.In fact the latest research is showing that none of the ACLS medications we are using show efficacy over placebo. Not very comforting is it?
My subjective experience is otherwise. Ive seen these meds save peoples lives in the ER and ICU.. In 2005 AHA will supposedly come out with radical changes in ACLS protocols based upon research.
As far as glucosamine and chondroitin the verdict is still out from my perspect.
Ive seen research that supports it, mostly that done by the manufacturer. Ive seen the 25 horse study that supports glucosamine/chondroitin. It apparently was done via measurable criteria ie lameness grade, flexion test and stride length. However it wasnt a double blind study with a placebo control group and the trainers knew their animals were on the supplement. Also that study involved Cosamine DS and Cosequin which are much stronger than OTC supplements available for human consumption here in the USA so cannot be extrapolated to other glucosamine/chondroitin products. It was for six weeks compared to the six month ARC study.
Speaking of which it is my understanding the studies in the EU involve prescription strength products not the comparitively lower strength OTC supplements available here.
Which leads to another issue. My searching reveals there have been studies of products for human and equine use here in the US and dose strength, consistancy, and impurities are an issue also.
One study claims that neither product is absorbed by the human GI tract, Another claims it is. Yet another claims that only 20% of the product is absorbed at all. If it is in fact absorbed at all how does having an overabundance of a molecule found naturally in the body effect the matrix of cartilage if at all?
Some of the claims of product manufacturers are tainted with studies that involve IM injections as opposed to oral administration, and injections directly into joints. This is all in the fine print to be read freely on product websites.
Much of the manufacturer based research states that their products have regenerative properties. Independent double blind placebo research does not duplicate this at this point to my knowledge. There does appear to be some anti inflammotory properties which in itself would be valuable especially with the inherent hazards of NSAID use.
"As of May 2004, the data from the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) were being analyzed, with the results to be published in a peer-reviewed medical or scientific journal." I do not know which one and I dont understand why I have to be careful at all regarding this issue Mr Harsey (respecfully), it might be a peer review by the allopathic medicine community or other scientific body.
My position is that I hope they find out exactly what the actions of glucasamine HCI, glucosamine sulfate, or chondriotin are. At the very least it would be fantastic to know exactly what results are achivied by its therapy. Other medications actions are unkown and so too may be gl/ch. But if its efficacy can be known and side effects as well as complications it would aide persons taking this supplemt as well as other supplents andmedications. At the very least it would be nice to have label regulations applied to both.
The medical community and general population has everything to gain if this can be done-
ccrn
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