Chondroitin sulfate (Chondroitin): can joints and ligaments be healed?

Bones, muscles and joints together form the human musculoskeletal system, which should always be taken care of. To maintain mobility in old age, special attention must be paid to the condition of joints and cartilage, since they are more often subject to destruction processes. The prevalence of degenerative-dystrophic changes in these structures is quite high. Glucosamine chondroitin complexes are presented as drugs with chondroprotective activity. They are well tolerated and have a prolonged effect.

Pharmacological properties

Chondroethyl sulfate belongs to high molecular weight polysaccharides and is considered a natural component of cartilage tissue. It is part of synovial fluid, as well as various medications and dietary supplements (Wikipedia). According to the manufacturer, unlike other chondroprotectors and anti-inflammatory drugs, the medication has the following advantages.

1. Stimulates the production of collagen and hyaluronic acid.
2. Improves the regeneration of cartilaginous structural components, activates the synthesis of synovial fluid.
3. Reduces fluid loss.
4. Has an anti-inflammatory and analgesic effect.
5. Slows down the destruction of bone structures.
6. Reduces the severity of symptoms and prevents the progression of these diseases.
7. Stimulates phosphorus-calcium metabolism.

The biological role of Chondroitin sulfate is its ability to retain water molecules, providing elasticity to connective tissue.

How does taking chondroitin affect joints?

Once in the body, chondroitin is absorbed in the intestines and enters the connective tissue through the bloodstream, where it is used in the same way as its natural counterpart. Due to the similar structure of the substance, the body does not see the difference between internal and external chondroitin, so it actively uses chondroitin taken orally. In joints, chondroitin is “embedded” in cartilage tissue, where it stimulates metabolic processes and the formation of synovial fluid. First, it slows down and stops the destruction of cartilage, then gradually reverses the process, starting restoration. But this is only possible with a continuous and long-term intake of chondroitin into the body, therefore drugs containing it (chondroprotectors) are prescribed in long courses.

What is chondroitin used for?

The purpose of prescribing medications with chondroitin sulfate in the form of tablets, capsules or ointments is pathological changes in the spinal column or joints:

• osteochondrosis;
• deforming arthrosis of the joints;
• osteoporosis;
• bone fractures.

Practice has shown the effectiveness of using the drug in dentistry in the treatment of periodontopathy. At the same time, experts recommend using it to maintain ODA function as an external source of glucosamine and chondroitin, as well as vitamin C.

Method for producing chondroitin sulfate from tissues of marine aquatic organisms

The invention relates to biochemistry and biotechnology, in particular to methods for producing chondroitin sulfate from the tissues of marine hydrobionts, such as fish cartilage tissue. The method involves preparing raw materials for enzymatic hydrolysis. Alkaline hydrolysis is carried out with proteolytic enzyme preparations with neutralization of the resulting solution to pH 7. Salt is added to the resulting enzymatic hydrolyzate to a value of at least 0.1 mol/l. Its sequential ultrafiltration is carried out first on a membrane with a retention limit of 50 kDa with the separation of high molecular weight impurities, then on a membrane with a retention limit of 5 kDa with the separation of low molecular weight substances. Wash the solution of chondroitin sulfate retained on the membrane on the same membrane with distilled water until the salts are completely removed. A final rinse is carried out with distilled water on a membrane with a retention limit of 50 kDa. The invention makes it possible to obtain a chondroitin sulfate preparation with a mass fraction of the main substance of 90-95%. 7 ave.

The invention relates to the fishing industry, in particular to methods for producing chondroitin sulfate from the tissues of marine hydrobionts, such as fish cartilage tissue, the muscular-muscular sac of mollusks, etc., and can be used in the food, cosmetics and medicine industries.

The main properties of chondroitin sulfate, which are of decisive importance for its successful use in various fields, are high bioavailability, biocompatibility, low toxicity, and the ability to selectively accumulate in cartilage tissue (Kofuji K., Ito T., Murata Y., Kawashima S. Effect of chondroitin sulfate on the biodegradation and drug release of chitosan gel beads in subcutaneous air pouches of mice // Biological and Pharmaceutical Bulletin. - 2002. - Vol. 25, No. 2. - P. 268-271). The listed properties are determined by the chemical structure of chondroitin sulfate molecules, namely molecular weight, degree and location of sulfation. (Michelacci YM, Dietrich S.R. Structure of chondroitin sulphate from whale cartilage: distribution of 6- and 4-sulphated oligosaccharides in the polymer chains // International Journal of Biological Macromolecules. -1986. - Vol. 8, No. 2. - P. 108-113. Toida T., Amornrut C., Linhardt RJ Structure and bioactivity of sulfated polysaccharides // Trends in Glycoscience and Glycotechnology.-2003.-Vol.15, No. 81.-P. 29-46) .

To obtain chondroitin sulfate, the most widely used method involves dissolving chondroitin sulfate in an alkaline medium, enzymatic hydrolysis of proteins, separation of a high molecular weight carbohydrate fraction by precipitation from low molecular weight protein hydrolysis products remaining in solution, washing the resulting precipitate and drying the finished product (Takai M., Kono N. Salmon-origin chondroitin sulfate: European Patent EP 1270599, IPC A61K 31/737. Application 12/15/2000; No. EP 20000981747; published 01/02/2003).

This generally accepted technology is implemented by different authors in different ways: the sequence, number of operations, temperature conditions, nature and concentrations of the reagents used change.

The closest technical solution is a method for producing chondroitin sulfate using ultrafiltration (Khare A.V., Houliston SA, Black T.J. Isolating chondroitin sulfate: USPTO Application 20070166798. - Application 02/14/2007; No. 11/674695; publ. 07 /19/2007).

This method of producing chondroitin sulfate includes the collection (preparation) of the starting material, including connective tissue, hydrolysis of the starting material with proteolytic enzyme preparations to obtain a solution of the hydrolyzate and undissolved substance, treatment of the liquid hydrolyzate with a reagent including hydroxide of a divalent alkaline earth metal with a pH greater than 10 to precipitate protein impurities from hydrolyzate, separation of at least part of the sediment from the hydrolyzate solution and processing of the liquid hydrolyzate using a membrane to form a filtrate (permeate) of low molecular weight substances and a “retained” concentrate, which contains a high molecular weight fraction - chondroitin sulfate. The patent proposes the use of membranes with a molecular weight retention limit of 5 to 15 kDa (preferably 8 to 10 kDa).

The product obtained in this way is a concentrate that, among other substances, contains chondroitin sulfate. Thus, the degree of purification of the target product is not high enough.

The inventive method is also based on ultrafiltration separation of hydrolyzate fractions with different molecular weights and uses the property of high molecular weight chondroitin sulfate molecules to be separated from low molecular weight protein hydrolysis products on ultrafiltration membranes.

The technical result of this method is to increase the degree of purification of the target product by using the ability of chondroitin sulfate molecules to greatly change the hydrodynamic radius when changing the ionic strength of the solution (electrolyte concentration, for example, NaCl), which makes it possible to achieve higher purification of the target product by sequential ultrafiltration compared to the prototype the resulting hydrolyzate on membranes with different retention thresholds.

As a raw material for the production of chondroitin sulfate, raw materials containing cartilaginous tissue obtained from the processing of various marine aquatic organisms can be used. When using frozen raw materials, they are first defrosted.

The prepared raw materials are crushed and loaded into a reaction vessel, in which alkaline and then enzymatic hydrolysis is carried out.

The hydrolyzate of cartilage tissue contains various protein breakdown products, salts, and high molecular weight polysaccharides (chondroitin sulfate).

The dissolution of alkali-soluble substances, including proteins and chondroitin sulfate, is carried out at a temperature of 25 to 50 ° C for 3 hours with constant stirring.

After completion of alkaline hydrolysis, the mixture is neutralized to pH 7 and the undissolved precipitate is separated by filtration or centrifugation.

Carrying out alkaline hydrolysis ensures preliminary separation of undissolved impurities and, as a result, helps to increase the yield of the target product and improve its purity.

An enzyme preparation (EP) or a pre-prepared EP solution with proteolytic activity is added to the resulting solution, for example an enzyme preparation obtained from the hepatopancreas of Kamchatka crab.

Enzymatic hydrolysis of proteins is carried out at the optimal temperature of the incubation mixture for a given EP and the duration of treatment (when using EP from the Kamchatka hepatopancreas - temperature from 45 to 55 ° C and hydrolysis duration from 4 to 8 hours), the solid precipitate is separated.

Salt, for example sodium chloride, is added to the resulting solution, bringing the salt concentration to 0.1 mol.

Then the solution is ultrafiltrated through a membrane with a molecular weight retention limit of less than 50 kDa to separate high-molecular proteins and suspended particles remaining after hydrolysis.

The concentrated solution containing chondroitin sulfate is washed with a salt solution, for example sodium chloride or other salt with a concentration of 0.1 mol/l.

To do this, sodium chloride or another salt is added to the resulting solution to maintain its concentration in the solution to a value of at least 0.1 mol/l. If, after neutralizing the alkali, the NaCl concentration is higher than specified, then no additional sodium chloride is added.

When the concentration of NaCl in solution is above 0.1 mol/l, the molecules of chondroitin sulfate are highly globulated, which does not allow the components of the hydrolyzate to be separated.

The salt concentration used ensures a decrease in the hydrodynamic radius of chondroitin sulfate molecules and the possibility of their passage through the membrane with a molecular weight retention limit of less than 50 kDa, while non-hydrolyzed proteins, such as collagen, are retained on the membrane.

The resulting solution of chondroitin sulfate, low molecular weight peptides, amino acids and salts is subjected to ultrafiltration separation on a membrane with a molecular weight retention limit of 5 kDa, which ensures the retention of chondroitin sulfate molecules and the separation of molecules of salts, amino acids and low molecular weight peptides.

It is known that when the concentration of salt in a solution decreases to less than 0.001 mol/l, for example NaCl, the molecules of chondroitin sulfate unfold, which leads to an increase in their hydrodynamic radius. The maximum radius is observed in distilled water.

Chondroitin sulfate retained on the membrane is washed with distilled water, as a result the salt concentration decreases and chondroitin sulfate molecules, the hydrodynamic radius of which has significantly increased, can be concentrated on membranes with a molecular weight retention limit of 50 kDa.

On a membrane with a retention limit of 50 kDa, chondroitin sulfate is finally washed with distilled water to remove the remaining peptides of average molecular weight, and its solution is concentrated by ultrafiltration.

The high molecular weight fraction of chondroitin sulfate is concentrated on the membrane, and low molecular weight peptides and amino acids pass through it.

The resulting concentrated solution of chondroitin sulfate is then used to isolate the dry preparation or as a solution in the preparation of preparations with chondroitin sulfate.

Isolation of dry hodroitin sulfate is carried out by precipitation by adding an excess of a precipitant (for example, ethyl alcohol) or by drying (sublimation, spray drying, etc.).

For example, the resulting solution is precipitated by adding alcohol in a ratio of 1:2, kept until chondroitin sulfate is completely precipitated, the precipitate is separated by filtration or centrifugation, washed with alcohol, acetone, and dried in a freeze dryer, vacuum or other dryer.

A preparation of purified chondroitin sulfate is obtained with a mass fraction of the main substance of at least 90%.

The target product - chondroitin sulfate is a white amorphous powder, odorless, hygroscopic, the mass fraction of water is not more than 10%, the mass fraction of chondroitin sulfate is 90-95%

Determination of the mass fraction of the main substance was carried out by acid hydrolysis in hydrochloric acid (26% HCl, 100°C, 1 h) and determination of the resulting glucuronic acid by the Dische method.

Identification was carried out using infrared spectroscopy. Chondroitin 6-sulfate sodium salt from shark cartilage (Fluka Catalog, cat. No. 27043-1G-F) was used as a standard.

The comparison results showed that the samples of chondroitin sulfate obtained by the claimed method have almost similar indicators to those of the standard sample, which confirms the high degree of purification of the target product.

The use of ultrafiltration is possible immediately when isolating the drug chondroitin sulfate after enzymatic hydrolysis of the raw material or when purifying the drug precipitated with ethanol after its dissolution in water.

Examples of method implementation

Example 1

Preparation of chondroitin sulfate from salmon cartilage

1) Raw materials - salmon nasal cartilage was removed from the heads, cleared of the remains of surrounding tissue, and crushed.

2) 400 g of crushed raw material was loaded into a flask with 1600 g of NaOH solution (0.2 mol/dm3), heated in a boiling water bath to 37°C and at this temperature, alkali-soluble substances were dissolved for 3 hours with constant stirring.

3) After the end of the process, the mixture was neutralized to pH 7 with 0.1 N. acetic acid.

4) The undissolved sediment was separated in a centrifuge at 5000 rpm.

5) An enzyme preparation of the hepatopancreas of Kamchatka crab was loaded into the hydrolyzate at the rate of 3 g per 1 kg of raw material. Enzymatic hydrolysis was carried out at a temperature of 50°C for 5 hours. The precipitate was separated in a centrifuge at 5000 rpm.

The enzyme preparation used was obtained from the hepatopancrosis of the Kamchatka crab Paralithodes Camtschaticus using known technology (Sakharov, I.Yu. Method for producing collagenase. / I.Yu. Sakharov A.V. Dzhunkovskaya, A.A. Artyukov, V.V. Sova, O G. Sakandelidze, E. P. Kozlovskaya Institute of Immunology and Pacific Institute of Bioorganic Chemistry: AS SU 1343591 A1, MKI4 A61K 35/56 - Application 12/13/85; No. 3992368 /28-14 - 2 s .) and had proteolytic activity for sodium caseinate A = 280 µmol tyrosine*g-1*min-1. (Substrate: 1% sodium caseinate solution. Enzyme: 1 mg/ml FP solution. Incubation conditions: 37°C, 10 min.)

6) Ultrafiltration of the solution was carried out through a 50 kDa membrane. The concentrated solution was washed with a sodium chloride solution with a concentration of 0.1 mol/l. (To increase the ionic strength, 9.36 g of sodium chloride was added to the hydrolyzate.)

7) Then the resulting solution of chondroitin sulfate, low molecular weight peptides, amino acids and salts was subjected to ultrafiltration separation on a 5 kDa membrane, which ensures the retention of chondroitin sulfate molecules.

Rinsing with distilled water. The chondroitin solution was finally washed on the 50 kDa membrane to remove any remaining medium molecular weight peptides.

9) Finally, the chondroitin sulfate solution was concentrated by ultrafiltration.

10) The resulting solution was precipitated by adding alcohol in a ratio of 1:2, and the solution was kept for 20 hours.

11) The precipitate was separated by centrifugation at 5000 rpm, washed with 100 ml of alcohol.

12) The resulting substance was dried in a freeze dryer.

We obtained 6.15 g of dry chondroitin sulfate, the mass fraction of the main substance, determined by reaction with carbazole (Dichet method), 91%.

Example 2

Preparation of chondroitin sulfate from shark cartilage

The same as in example 1, but shark cartilage was used as raw material.

We obtained 6.15 g of dry chondroitin sulfate, the mass fraction of the main substance being 93%.

Example 3

Preparation of chondroitin sulfate from northern stingray cartilage

The same as in example 1, but northern stingray cartilage was used as raw material. The raw materials were preliminarily degreased with acetone. In step 5, enzymatic hydrolysis was carried out in two stages of 3 hours each with the additional introduction of an enzyme preparation of the appropriate concentration.

We obtained 5.43 g of dry chondroitin sulfate, the mass fraction of the main substance being 92%.

Example 4

Purification of chondroitin sulfate from salmon cartilage

Chondroitin sulfate, obtained by the method from example 1, with the exception of points 6-9, was again dissolved in 500 ml of distilled water, 2.93 g of sodium chloride was added, the solution was stirred for 60 minutes. Then ultrafiltration treatment of the solution was carried out, as described in example 1 in paragraphs 6-9 and further 10-12.

We obtained 5.85 g of dry chondroitin sulfate, the mass fraction of the main substance being 94%.

Example 5

Preparation of chondroitin sulfate from salmon cartilage

The same as in example 1, but potassium hydroxide KOH (0.2 mol/dm3) was used as an alkali for the operation according to step 2) instead of NaOH. When ultrafiltration according to item 6), instead of NaCl, a 0.1 mol/dm3 solution of potassium chloride KCl was used.

We obtained 6.10 g of dry chondroitin sulfate, the mass fraction of the main substance being 92%.

Example 6

Preparation of chondroitin sulfate from salmon cartilage

The same as in example 1, but instead of NaCl during ultrafiltration according to point 6) a 0.05 mol/dm3 solution of calcium chloride was used.

We obtained 6.15 g of dry chondroitin sulfate, the mass fraction of the main substance being 91%.

Example 7

Preparation of chondroitin sulfate from salmon cartilage

The same as in example 1, but instead of the enzyme preparation from the hepatopancreas of the Kamchatka crab, protosubtilin G3X was used at the rate of 4.5 g per 1 kg of raw materials (the activity of protosubtilin G3X in relation to fish protein was 1.5 times lower than the activity of FP from hepatopancreas of the king crab).

We obtained 6.35 g of dry chondroitin sulfate, the mass fraction of the main substance being 89%.

The invention makes it possible to obtain a chondroitin sulfate preparation with a mass fraction of the main substance of at least 90% (90-95%), as well as to increase the yield of the target product.

A method for producing chondroitin sulfate from the tissues of marine aquatic organisms, involving the preparation of raw materials for enzymatic hydrolysis, hydrolysis with proteolytic enzyme preparations with precipitation of protein impurities and separation of the precipitate from the hydrolyzate solution, isolation of the target product by means of ultrafiltration, characterized in that alkaline hydrolysis is first carried out with neutralization of the resulting solution to pH 7 and separation of solid sediment, salt is added to the enzymatic hydrolyzate to a value of at least 0.1 mol/l, ultrafiltration of the enzymatic hydrolyzate is carried out on a membrane with a retention limit of 50 kDa and separation of high molecular weight impurities, the resulting solution with a salt concentration in it of at least 0, 1 mol/l is subjected to ultrafiltration on a membrane with a retention limit of 5 kDa and low molecular weight substances are separated, chondroitin sulfate retained on the membrane is washed on the same membrane with distilled water until the salts are completely removed, then washing with distilled water is carried out and the chondroitin sulfate solution is concentrated by ultrafiltration on a membrane with retention limit 50 kDa.

The role of supplements in sports

The drug "Glucosamine chondroitin" is indispensable for athletes who experience high stress during exercise. The type of sport does not play a role here, since muscles, ligaments, and joints experience stress both when running and during weight training. The product is considered indispensable for the prevention of joint pain, but according to the results of clinical studies, many experts question its effectiveness.

The drug is often prescribed in the complex treatment of pathologies caused by injuries or inflammation of joints, ligaments, and cartilage tissue. According to the survey, the effect appears 10-14 days after the start of use. Patients noted a decrease in pain, swelling, and improved mobility of bone joints.

Chondroitin is believed to help speed up the weight loss process, especially with proper nutrition and moderate exercise. The effect is due to the ability to absorb lipid molecules and prevent the absorption of fats.

What do clinical studies say?

Numerous studies have been conducted to confirm the effectiveness of various chondroprotective drugs in the correction and prevention of pathologies of the musculoskeletal system. The results of some of them will be reviewed below.

The drug Artra in the treatment of osteochondrosis and intervertebral osteochondrosis

Author - V.V. Badokin, publication 2012, journal “Neurology, neuropsychiatry, psychosomatics”

. The work examines the results of a number of clinical trials confirming the effectiveness of this complex remedy for restoring the functionality of joints, inhibiting degenerative processes, preventing pathologies of the musculoskeletal system and improving the quality of life of patients in general.

Conclusions from the analysis of the results of using the drug Artra:

• the drug is an effective, slow-acting symptom-modifying medication;
• confirmed analgesic and anti-inflammatory effects;
• taking the complex improves the functionality of the joints;
• safety and good tolerability;
• taking the Artra complex creates the opportunity to reduce the daily dosage of non-steroidal anti-inflammatory drugs.

To confirm the structure-modifying properties of the drug, further long-term studies are required with analysis of the results of radiography, magnetic resonance imaging, sonography, and laboratory tests.

The effectiveness of Theraflex in patients not taking NSAIDs

The authors of the work are I. Z. Gaidukova, I. A. Romanova, A. P. Rebrov. The results were published in the journal Modern Rheumatology, 2015.

The work examines and analyzes data from a clinical study that involved 84 patients diagnosed with arthrosis of the knee joint, aged from 47 to 62 years, with a disease duration of 5 to 7 years, among whom there were 78 women and 6 men. Patients were randomized blindly into two groups. Patients from the main group received Teraflex with/without acetaminophen, patients from the comparison group received only acetaminophen. At the beginning of the study, and then after 3 months and six months, the severity of arthrosis was assessed using various indices and an analogue scale. The occurrence of adverse reactions was taken into account.

The study allowed us to draw the following conclusions:

• patients who took Theraflex for six months experienced a decrease in Lequesne and WOMAC indices, relief of pain, and a decrease in the need for analgesics;
• While taking Theraflex, no adverse reactions occurred, including among patients who had diagnosed diseases of the kidneys, digestive system, and hypertension.

Dynamics of antioxidant protection against the background of glucosamine and chondroitin

Authors of the work: E. S. Elovikova, O. V. Bugrova, V. G. Leizerman, S. I. Krasikov. The results of the study were published in the Kazan Medical Journal in 2009.

The dynamics of antioxidant protection was assessed in 34 patients while taking glucosamine hydrochloride and chondroitin sulfate. It was found that the use of these substances normalizes the activity of antioxidant enzymes such as catalase and superoxide dismutase.

Evaluation of the effectiveness and safety of simultaneous use of the drugs Artradol and Artracam

Authors of the work: S. A. Lapshina, M. A. Afanasyeva, E. V. Sukhorukova, I. F. Akhtyamov, L. I. Myasoutova. The test results were published in the journal “Bulletin of Modern Clinical Medicine” in 2021.

A study was carried out on 30 patients diagnosed with osteoarthritis of the knee joints with intense pain. The age of the patients ranged from 53 to 63 years, the duration of the pathology was from 3 to 9 years. The drugs Artradol (active component - chondroitin sulfate) and Artracam (active component - glucosamine sulfate) were prescribed in addition to the course of therapy with non-steroidal anti-inflammatory drugs. The effectiveness of treatment was assessed after 1 and 2 months of treatment using the WOMAC index, pain intensity, need for NSAIDs and a number of other indicators.

The following conclusions were drawn:

• while taking Artradol and Artracam, a significant decrease in the intensity of pain was observed;
• a decrease in the WOMAC index was recorded;
• the time to travel a distance of 15 meters has decreased;
• the need for non-steroidal drugs has decreased.

Patients and doctors rated the effectiveness of therapeutic correction as “good” or “satisfactory.” The study confirmed the effectiveness of the combination of Artradol and Artracam in the treatment of osteoarthritis of the knee joint.

Thus, clinical trials confirm that substances such as glucosamine and chondroitin have a positive effect when necessary in the treatment of various joint pathologies. Only a qualified doctor can select a combination of drugs and their dosage. It is recommended to combine the use of chondroprotective agents with proper nutrition and moderate physical activity, then the effectiveness of treatment and prevention of diseases of the musculoskeletal system will be maximum.

What foods can you get chondroitin from?

Chondroprotectors are important means of ensuring the health of the musculoskeletal system. They stimulate the production of all elements that provide the natural structure of cartilage tissue and joints. Therefore, it is so important not only to receive them with medications, but also to consume them daily with food.

Figure 1. Which foods contain glucosamine and chondroitin

Based on clinical data, sodium chondroitin sulfate from fish is 100 times more active than that of animal origin. A substance obtained from the fin of a shark or stingray is considered very valuable. It is not much less present in the tissue of fish: trout, salmon, chum salmon, and salmon.

Nutritionists also recommend including avocado and soy in your diet. They contain polyunsaturated fatty acids and substances that are natural chondroprotectors.

The described substances are found in the bones or cartilage of large animals. With certain heat treatment, they are able to compensate for the lack of these elements in the body. The diet of a modern person does not contain these products, and for many they are generally contraindicated. Therefore, the best option would be to obtain them from medicines and nutritional supplements.

Sources and properties of glucosamine

There are several sources for obtaining this substance. Depending on the specific source, the different forms of glucosamine, listed below, are named.

Glucosamine of animal origin

Glucosamine hydrochloride or glucosamine sulfate is obtained from raw materials of animal origin. They are made from the shells of crabs, shrimp, crayfish, lobsters, lobsters

. Glucosamine hydrochloride is a common and available form of the substance. However, it may contain admixtures of allergenic substances. Therefore, glucosamine supplements made from animal sources should not be taken by people with seafood allergies.

Glucosamine sulfate is less stable and therefore requires stabilization with potassium or sodium chloride during production. These supplements are safe, but if you consume sodium chloride-stabilized sulfate, you should adjust your diet and reduce your intake of salty foods.

N-acetylglucosamine can be found somewhat less frequently in mono- and complex chondroprotective drugs. It is also obtained from crustaceans. The substance has good bioavailability and has a positive effect on the musculoskeletal system, the structure of blood vessels, skin and mucous membranes.

Plant-derived glucosamine

Glucosamine hydrochloride is also obtained from plant materials. The source of the active substance is corn husks, which are ground and fermented.

. The production technique allows us to obtain highly purified glucosamine hydrochloride, which cannot cause hypersensitivity reactions. This form of the substance is considered the best, but is more expensive.

Contraindications

Drugs with chondroprotective activity are usually prescribed by the attending physician after diagnosis. The prohibitions on medications in tablets and capsules are:

• vein diseases (varicose veins, blood clots);
• tendency to hemorrhage;
• lack of lactase;
• hypersensitivity to the components included in the composition;
• diabetes;
• liver failure;
• severe kidney disease;
• phenylketonuria (disorder of amino acid metabolism);
• malabsorption of glucose-galactose.

It is not recommended to use ointment products if there are damaged areas on the skin. It should be prescribed with great caution to women during pregnancy, breastfeeding, and children under 15 years of age.

Methods of use and dosage of chondroitin

The daily dose of Chondroitin sulfate is 800-1200 mg. If the doctor has prescribed a product with a high concentration of the active substance, then during the first three weeks it is recommended to take it in the morning, at lunch and before bed. Next, the dose should be reduced and the number of doses reduced to two.

To prevent joint pain, the complex is prescribed at a dose of 800 mg per day for a monthly course. Therapy should be carried out twice a year, and repeated after a break, the period of which is determined by the doctor. For pain in the joints or regular sprains, the daily amount of medication is increased to 1200 mg. The course of treatment should be at least 2 months, with a break of 30 days. Within a year, you need to repeat this therapy three times.

It is necessary to take glucosamine chondroitin orally before meals. In patients over 15 years of age and adults, the regimen is as follows: 2-3 times a day, 2 capsules. Duration of therapy is 1-2 months.

Ointment or gel products are used in elderly patients. They should be applied in a thin layer to the damaged area at least three times a day. Depending on the diagnosis, treatment can last from two weeks to three months. A second course of therapy is permitted no earlier than six months later.

Recommendations for dosing of bioactive substances

Before starting to take medications that contain glucosamine, chondroitin, or both substances together, you should consult with a specialist about the most appropriate dosage regimen, which depends on the individual characteristics of the clinical case.

Dr. Jason Theodosakis suggested prescribing drugs with chondroitin and glucosamine based on the patient’s body weight:

“Doctors are hiding the truth!”

Even “advanced” joint problems can be cured at home! Just remember to apply this once a day...

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These recommendations are based on research conducted by this specialist. The daily dose can be divided into 2 or 3 doses. The drugs should be taken orally with food.

The duration of the course of taking chondroprotective drugs should not be less than 3 months. Doctors advise that after 3-4 months of taking it, take a break for 2-2.5 months, then resume the course.

In order for the course use of chondroprotectors to be as effective as possible, you should eat properly, drink a sufficient amount of fluid, not overload the body as a whole and the musculoskeletal system in particular, but exercise regularly in a gentle manner.

Preparations with chondroitin and glucosamine should not be taken in case of hypersensitivity to the components, with a tendency to bleeding, with thrombophlebitis, impaired renal function and phenylketonuria.

Course duration

The recommended duration of therapy with drugs based on Chondroitin sulfate is at least six months. The period of action of the drug, taking into account the stage of the disease and the localization of the lesion, lasts 3-5 months. The first effect can be noticed after 8-12 weeks from the start of therapy, and it can persist for at least 1-2 months.

Recent clinical studies have shown that intermittent therapy with chondroitin with glucosamine is equally effective as continuous medication. Therefore, in order to save money, it is permissible to undergo only a course of treatment.

Figure 2. Glucosamine chondroitin complex

Are there any side effects from taking chondroitin?

Specific reactions when taking Chondroitin sulfate orally are observed in isolated cases. Doctors include undesirable symptoms:

• pain in the intestines;
• stool disorders;
• nausea;
• vomiting

When treated with ointment forms of the drug, redness and swelling of the skin, rash and itching, urticaria, and dermatitis are possible. The occurrence of such symptoms requires discontinuation of the drug and contact a specialist.

Cases of drug overdose have not been registered. Systematic excess of the dosage can lead to a negative reaction of the digestive system. If characteristic signs appear, it is recommended to rinse the stomach and carry out symptomatic treatment.

Drug interactions

Chondroitin can interact with drugs of certain groups, so a person taking any medications must notify his doctor in advance.

1. During therapy with indirect anticoagulants, fibrinolytics and antiplatelet agents, taking capsules is extremely undesirable, since this combination can provoke the development of hemorrhage. If discontinuation of the above medications is not possible for any reason, a coagulogram should be periodically performed to monitor the level of blood clotting.
2. Patients undergoing antibiotic therapy need to know that Chondroitin Sulfate prevents the absorption of penicillin, chloramphenicol, and chloramphenicol into the gastrointestinal tract, but increases the absorption of tetracycline.
3. The medication goes well with NSAIDs and corticosteroids, so they are prescribed in combination, and it is possible to reduce the dosage of these drugs.

It is permissible to combine an ointment or gel with any medications, since there is no data on any interactions.