Long-term Glucosamine Has Few  Side Effects

Dear Dr. Roach: I am in my 70s and was diagnosed with “serious lower-back arthritis” a few years ago. The pain was occasionally excruciating. My current doctor put me on glucosamine and chondroitin, and the change has come close to being miraculous. The pain is greatly lessened, and some other arthritis areas (e.g., my neck) have subsided almost completely. Bending down can still be difficult and it can be painful to do my PT exercises, but the condition is tolerable now.

Senior-citizen friends disagree: Some have had my experience, but others claim the supplement does nothing for them. Is there a downside to long-term use? — D.J.

Answer: People tend to have strong opinions about combination glucosamine and chondroitin. For those in whom it works, it can have great effect. My experience is that only about a third of people who take it have that good a response. Another rough third get some benefit, but maybe not even enough to keep taking it. For the last third, it is useless. That being said, well-designed trials have failed to show benefit with glucosamine and chondroitin. However, the medications appear to be safe and there are few side effects, even in long-term use. I have often recommended that people who want to try it to give it a few weeks, and continue only if it really works.

Dear Dr. Roach: My mother is 86 and still can go to the grocery store, but needs assistance. She walks very slowly with a cane. She won’t go with the assisted-living facility bus because she wants me to go with her and let her hold on to me while she gets out of the car and, using a cane, crosses the street from the parking lot to the store. Once she is in the store, using a grocery cart is enough to support her. But it takes hours for her to shop then she is worn out and complaining about hurting feet, legs, etc. I’ve suggested the electric carts, but she won’t use them because she “does not know how to.” She could be taught. So, as her daughter, what is my prime responsibility? To help her shop so it takes her less time, even though she enjoys the outing? The complaints get worse and worse as time goes on. Is it better for her to walk or use the cart? Should her doctor recommend using the cart? She does enjoy the outing and needs the cognitive stimulation. — N.L.B.

Answer: I have mixed emotions about this. On the one hand, you want to make things easier for her; on the other, she clearly has her own mind about it. From a medical perspective, more exercise (not using the motorized cart) is probably better for her.

At some point, your mother will decide when it’s too much. If the choice ever becomes using an electric cart for outings versus not going on outings, then I would recommend the cart. Until then, as long as she is safe (not in danger of falling), I would let her decide how she wants to go out and shop with you.

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