The 4 Benefits and 6 Precautions of Chondroitin Sulfate
Chondroitin sulfate is a widely used over-the-counter dietary supplement. It is a sulfated glycosaminoglycan. It is one of the basic components that make up the extracellular matrix of human cartilage. Like other ingredients such as glucosamine, chondroitin sulfate has been used in the medical field for over 40 years. So, in evidence-based medicine, what are the actual benefits of chondroitin sulfate? What side effects and precautions should be considered when using it?
What is Chondroitin Sulfate?
Chondroitin sulfate is a major component of the extracellular matrix in mammalian connective tissues. It is present in cartilage, blood vessels, bone, skin, ligaments, and tendons.
The high content of chondroitin in the collagen matrix plays an important role. It gives cartilage resilience and elasticity under various loading conditions. And this allows cartilage to resist external stress.
At the molecular, cellular, and organ levels, chondroitin provides specific biological functions. These include cell adhesion, cell division and differentiation, morphogenesis, organogenesis, and the formation of neural networks.
Besides these, chondroitin has been shown to have multiple effects. These include anti-inflammatory, anti-metabolic, anti-apoptotic, antioxidant, and regulation of cell signaling pathways.
What are the Evidence-Based Benefits of Chondroitin Sulfate?
1. Chondroitin Sulfate Benefits Osteoarthritis
Osteoarthritis is the most common type of arthritis. It particularly affects large weight-bearing joints like the knees and hips. It is characterized by the gradual degeneration of the cartilage matrix, subchondral bone sclerosis, and osteophyte formation.
Clinical symptoms include pain, stiffness, joint effusion, and joint deformity. Risk factors have an important influence on the cause of osteoarthritis. These factors include age, gender, prior joint injury, obesity, genetic predisposition, joint misalignment, and abnormal joint morphology.
A meta-analysis covering 18 randomized controlled trials (with 3791 patients) found that chondroitin sulfate significantly reduces pain and improves joint function.[1] This effect was especially notable when analyzing data from studies with a low risk of bias. Pharmaceutical-grade chondroitin sulfate showed more significant pain-relieving and functional improvement effects.
2. Chondroitin Sulfate May Reduce the Risk of Colorectal Cancer
Colorectal cancer is defined as cancer arising from the epithelium of the colon or rectum. Due to tumor growth, the intestine may start to bleed and become blocked. Possible symptoms include changes in bowel habits (such as diarrhea or constipation lasting more than a few days), rectal bleeding, weakness and fatigue, weight loss, and cramping or abdominal pain.
Two large prospective cohort studies found that using glucosamine alone was not associated with colorectal cancer risk. However, the combined use of glucosamine and chondroitin sulfate was associated with a significantly reduced risk.[2] This suggests that the combination may have potential for preventing colorectal cancer, but further research is needed for confirmation.
3. Chondroitin Sulfate Benefits Recurrent Urinary Tract Infections
Urinary tract infections are common in women, the elderly, immunocompromised patients, and catheterized patients. Almost half of all women experience at least one UTI in their lifetime.
A meta-analysis indicated that intravesical instillation of either glycosaminoglycan hyaluronic acid alone or HA plus chondroitin sulfate can significantly reduce cystitis recurrence, the average time to UTI recurrence, pelvic pain, and urgency/frequency scores.[3]
4. Chondroitin Sulfate Benefits Interstitial Cystitis
This is a chronic bladder condition. It is characterized by bladder pain, urinary frequency, and nocturia, but without a clear infection or other identifiable pathology.
In US population surveys, the female-to-male ratio of occurrence is about 9:1.
A systematic review and meta-analysis (including 10 studies with 390 patients) showed that intravesical instillation of hyaluronic acid or HA plus chondroitin sulfate can improve pain symptoms, enhance quality of life, and increase bladder capacity.[4] Again, due to limitations in sample size and study duration, these conclusions should be viewed with caution.
Does Chondroitin Sulfate Have Side Effects?
For most healthy individuals, oral chondroitin is considered safe. However, possible side effects or adverse reactions include: bloating, nausea, diarrhea, constipation, stomach pain, headache, swollen eyelids, swollen legs, hair loss, skin rash, and irregular heartbeat.
We have summarized 6 precautions for using Chondroitin Sulfate:
- Do not use if pregnant or breastfeeding.
- Do not use if you have asthma, as it may worsen symptoms.
- Do not use if you have a bleeding disorder, as it may increase the risk of bleeding.
- Early research found that higher concentrations of chondroitin sulfate in tissues surrounding prostate cancer were associated with higher rates of cancer recurrence and spread. However, this phenomenon has not been observed with chondroitin sulfate supplements. Still, until more is known, individuals with prostate cancer or at high risk for it should avoid use.
- Do not use if you are taking anticoagulant medications. This is because it may affect the drug’s effectiveness and increase the risk of bruising and bleeding.
- It may trigger allergic reactions. If you experience difficulty breathing, swelling of the face, lips, tongue, or throat, or a rash after consumption, seek immediate medical help.
For high-quality chondroitin sulfate powder and hyaluronic acid powder, visit Stanford Chemicals Company (SCC).
[1] Honvo G, Bruyère O, Geerinck A, Veronese N, Reginster JY. Efficacy of Chondroitin Sulfate in Patients with Knee Osteoarthritis: A Comprehensive Meta-Analysis Exploring Inconsistencies in Randomized, Placebo-Controlled Trials. Adv Ther. 2019 May;36(5):1085-1099. doi: 10.1007/s12325-019-00921-w. Epub 2019 Mar 16. PMID: 30879253; PMCID: PMC6824370.
[2] Kantor ED, Zhang X, Wu K, Signorello LB, Chan AT, Fuchs CS, Giovannucci EL. Use of glucosamine and chondroitin supplements in relation to risk of colorectal cancer: Results from the Nurses’ Health Study and Health Professionals follow-up study. Int J Cancer. 2016 Nov 1;139(9):1949-57. doi: 10.1002/ijc.30250. Epub 2016 Jul 18. PMID: 27357024; PMCID: PMC4990485.
[3] De Vita D, Antell H, Giordano S. Effectiveness of intravesical hyaluronic acid with or without chondroitin sulfate for recurrent bacterial cystitis in adult women: a meta-analysis. Int Urogynecol J. 2013 Apr;24(4):545-52. doi: 10.1007/s00192-012-1957-y. Epub 2012 Nov 6. PMID: 23129247.
[4] De Vita D, Antell H, Giordano S. Effectiveness of intravesical hyaluronic acid with or without chondroitin sulfate for recurrent bacterial cystitis in adult women: a meta-analysis. Int Urogynecol J. 2013 Apr;24(4):545-52. doi: 10.1007/s00192-012-1957-y. Epub 2012 Nov 6. PMID: 23129247.
