Commonly Asked Questions of 1999: MSM, CMO and Chondroitin Sulfate

Q: What do you know about MSM?

A: MSM (is a normal oxidation product of dimethyl sulfoxide (DMSO). It is a white, odor-free powder, unlike DMSO, which has a strong, unpleasant smell.

MSM is 34% sulfur. Sulfur is an important mineral that is distributed throughout the body. It forms parts of the amino acids methionine and cysteine, and the vitamins thiamin and biotin.

Sulfur is also part of glycosaminoglycans molecules. Proponents claim that MSM can reduce scar tissue and calcium deposits by breaking soft water bonds of calcium in synovial fluid. The sulfur in MSM is also used to regulate the sodium potassium pump, thus increasing cell membrane permeability. This in turn enables fluid and vital nutrients to enter the cells, and allows toxic byproducts and inflammatory debris to exit. Normalizing cell membrane dynamics reduces inflammation that leads to an improvement in flexibility and a decrease in pain and stiffness.

In equine studies, it was found that the sulfur amount in arthritic cartilage is reduced 67 percent, thus, there is a rationale for human use.

Dosing varies widely from 500 to 6,000 mg per day. The majority of the research I have seen on MSM was done on animals or was extrapolated from DMSO studies. Human studies in the near future may allow us to learn what MSM can accomplish.

Q: What do you think of CMO?

A: CMO (cetylmyristoleate) is a medium chain fatty acid made from cetyl alcohol and imyristoleic acid. It is promoted to reduce inflammation and "lubricate joints."

The research on CMO is scant, but the marketing has been tremendous. Like MSM, I eagerly await human studies by researchers who have no financial stake in the compound. CMO dosing rate is from one to three grams per day. You can bet that the results of human studies on both CMO and MSM will make big news due to their hype and rate of sales. If the studies are positive, buy stock in the companies who manufacture it. Conversely, if good research fails to confirm the claims seen in advertisements, you can bet that the marketers will cry foul or conspiracy. In any event, as soon as I see a decent human study, I will write about it in this column.

Q: I was told chondroitin sulfates do not work. What do you think?

A: It is well-known that the amount of chondroitin sulfate in human cartilage declines with age. Thus, it does make sense that one would want to increase levels by using glucosamine (a precursor) or chondroitin sulfate itself.

A few years ago, when I first came upon chondroitin sulfate, my review of the literature revealed that the best results with chondroitin sulfate were done in studies that used injectable forms. There was information from some top doctors and scientists that the chondroitin sulfate molecule was simply too large to be absorbed by humans. There were also reports that most of the chondroitin sulfate sold on the market was of very low quality.

Since glucosamine sulfate does have a high absorption rate and is a precursor to chondroitin sulfate, my recommendation from 1994 and 1998 was to use glucosamine. Earlier this year, I wrote an article titled "Chondroitin Sulfate Update 99" (available at www.chiroweb.com/archives/17/09/04.html ). Five double-blind studies using oral chondroitin sulfate were reviewed. The results showed that chondroitin sulfate clearly benefits humans with osteoarthritis. Somehow, the molecule is absorbed. Thus, my current recommendations for patients with arthritis are as follows:

1. Take glucosamine sulfate at approximately 10 mg per pound of body weight.

    

2. Take chondroitin sulfate at approximately 8 mg per pound of body weight.

    

3. Stay on this dose for at least two months.

    

4. Depending on the patient's response, reduce the dose (usually by 50-67%) to the smallest amount required for pain control and mobility maintenance.