Question
QUESTION: Dear Mr. Durnin,

I live in Stockholm, Sweden. I was diagnosed with cox arthritis this summer. My orthopedic specialist said I will eventually need a hip replacement and that there is nothing else to do. He didn't even suggest to me that supplements could help, but merely prescribed painkillers (which I haven't taken).

However, I read up on your replies to other people and promptly started taking Glucossamine sulfate (3000 mg daily) and MSN (3000 mg daily) in pure powder form. As you can see, I even take double dosage of what you recommend (yup, I'm desperate), but so far, after 12 weeks, I feel no improvement yet. How long would it take to notice any results?

I am wondering if I should ALSO try Chondroitin, SAM-E, or something else? Or would it just be a waste of money?

I am a 46 year old news photographer and rather desperate to get back to my former pain-free self.

I'm also curious as to why this so called specialist didn't mention the resurfacing procedure they can apparently do instead of hip replacement these days. Is this not an internationally  widespread technique yet?

I would greatly appreciate your opinions and advice!

With warm regards,
Monica


ANSWER: Hi Monica,

Glucosamine Sulfate will not help if the arthropathy has developed to a point where it is bone on bone. It needs some cartilage to "seed". Without this, resurfacing is the best option. It was approved by the FDA one year ago this October and University of Chicago has been the first to do them. By now, it is an established procedure and should be contemplated before THR. Chondrotin is a larger molecule and poorly absorbed so it would be a waste of money. I need to see the MRI's before making any concrete judgement calls but I would try the SAM-E and continue the GS with MSM for the simple fact it will spare other articulations from deteriorating. As always, get another ortho opinion before one sells you on THR when resurfacing is a viable alternative with much better efficacy and less morbidity.

Feel free to ask any further questions if the need arises.

Good Luck!

Dr. Timothy Durnin

---------- FOLLOW-UP ----------

QUESTION: Thank you Dr. Durnin!

Yes, I do have a few follow up questions:

How long time should I wait before I can expect the GS & MSN cartilage regrowth effect to kick in (if it's not already too late as far as my bad hip goes)?  Are we talking a few months, or a few years, or what?

Also, what dosage would you recommend for the SAM-e, and are there any other supplements you would also recommend?

I really would like to give this a serious chance to heal/improve on its own before I resort to any surgical measures.

Thank you again!

Monica

Answer
Hi Monica,

I can only recommend what is proven and researched to work, GS and MSM should take 3 months to work at 3 grams/day. Sam-E is not researched in randomized trials so I would take what the recommended dosage says on the bottle. The GS must be taken higher than than bottle dose for active OA, and the therapeutic dose is 3 gram's/day. That was the dosage studied, so I would at least take that amount.

Good Luck!


Dr. T