Episode 30: Glucosamine & Chondroitin – Think again! – Natural Health & Nutrition

00:02:46 Glenn:        Welcome back to Natural Health for People and Pets. I'm co-host of the show, Glen Cooke, but I'm gonna introduce the smart person of the show,  Narelle Cooke. 

00:02:53 Narelle: I do try. Hello everyone. 

00:02:55 Glenn:       You don't just try. You succeed. You do.  

00:02:57 Narelle:         Well, yeah, I'm good at researching. That's my strength.  

00:02:59 Glenn:       Good at researching. And you're also very good at product development.   

00:03:03 Narelle:         I will take that. Love product development and I've got such a long list, a wishlist of products that I'd love to bring to market. But it's just a matter of time.  

00:03:11 Glenn:       You're gonna do it eventually. You’ll get there.  

00:03:13 Narelle:       Yep, so be patient, everyone. Your favourite product will come to market at some point over the next year or so.

00:03:18 Glenn:      I was doing an episode with Verity on the podcast for Pet Carers the other day. We were talking about you. It just came up in conversation, and I just said that you remind me a lot of a line in the movie 300 where the Persians are invading, Sparta, King Leonidas, gets met by an army who offered to help him out. The Arcadian army remarks to him that he's only got 300 soldiers and said, what are you gonna do against the might of Persia? And he looks at the Arcadian army, asks them questions and he finds out that none of them are actually soldiers. They're just part-time people who are taking up a shield and a sword to help out in the cause. And then he turns back to his army of 300 and he says, Spartans, what's your occupation? And they all chant basically we're soldiers.  

00:04:00 Glenn:       And then he turns to the Arcadian leader and says, there you go my friend. I did bring more soldiers than you. The reason that that reminds me of you, is with your products is there's a lot of people that hit the market. They've got products on the market, but I don't know of many who would be more diligent and spend as much time on product development and knowledge around their products as you do. I'm not just saying that 'cause I'm your husband and we have a vested interest in CanineCeuticals. I'm saying that because some people just are very cheap about their products. It's profits above people where the cheapest product they can literally put to market with some pretty fancy marketing around it, or a popular face that they just bring in and swipe in. What I'm trying to do is give you a compliment. 

00:04:44 Narelle: Thank you.

00:04:44 Glenn:       Because I know that you and I have talked about this a couple of times, but what I'm saying is, and for the people who do listen to this podcast and have been on this product journey with you since conception, there are a lot more people joining the CanineCeuticals team now who are getting their dogs on it and some of their cats as well.  You're marketing it to cats. But one thing I do love about it is that it's not about just a product that we're just trying to make money on. That's not what it is. It is a business first and foremost. So I'm not gonna say it's not about making money, because there's no point in being in any business if at the end of the day you don't make money. But there are certain businesses that have ethics, and you've surrounded yourself with a good team of mainly women in business who are very ethical and are doing very ethical things in their business with their products.  

00:05:33 Glenn:       Some of them are show sponsors, and you've got other colleagues as well who have got forums and so forth that are doing fantastic things in the raw feeding space. Fantastic things in the supplement space, fantastic things in dental health and so forth with dogs that's been absolutely fantastic for you, and for all of the other people who are running small businesses who are doubting themselves at times. What I say to you, Narelle, and what I say to them, is the proof is in the pudding. When you've got people coming back in hundreds and now even thousands in your case, that are giving you five star reviews and it's from the heart, not that you are trying to push them to do it, they're actually coming back showing you progress photos of their dogs saying, I can't believe it. I can't believe the change. That's what you should be looking at.  

00:06:18 Glenn:       That's what you should be after. That's what you should be looking for in any ethos of any business. Is not just about nice wrapping with sciency stuff on there that looks impressive, that people go ooh and ah, that's gimmicks. It's a baited hook. It's marketing. It's just to get you in the door. What you should be looking for in anything that you're doing in any products and service doesn't matter whether we're talking about training dogs in our industry, or we're talking about supplementation, or whatever it is. What we should be seeking, is somebody who can genuinely provide because they are an industry professional. I'm proud of you, I'm proud of all of the people that you've associated with. I'm proud of the league of people that you've created, a really good network, that are doing those sort of things. And they should be proud of themselves as well, as so should you.  

00:07:04 Narelle:         Absolutely. 

00:07:04 Glenn:       That's when you're supposed to say, thank you husband.  

00:07:06 Narelle:        Thank you husband.  

00:07:10 Narelle:         But with everything I do with CC, and I might have said this before, I always think like what would I want with my dogs? Because there's nothing worse when your dog's health is compromised. Most people feel that they feel helpless, they're not sure what to do. They want to do the best thing. But there's so much confusion and so many questions and you know, I know how people feel. I mean that the whole origin story of CC was the Ladybug incident. And when I was in that situation, I mean it was such a horrible feeling of helplessness. So I always think, if I'm going to create a product, it has to work. Like that's the bottom line. There's no point being in this game just creating fluff for the sake of it. And luckily for me, I absolutely love researching ingredients, combinations of ingredients, doses of ingredients. I could just sit on the computer for hours.  

00:07:54 Glenn:       You do sit on the computer for hours looking at different ways and tweaks and mods and everything. That's what people don't realise. Like I know how often when you are not doing business with CC, I know your spare time is researching products and materials. I know before we actually sit down to do this podcast, you can't just sit down like Pat and I do for the Canine Paradigm and just riff a podcast, like you have to study for weeks too, so you know the science behind it. And that's just who you are. Like your ethics and your ethos is about, I can't put something out into the public space, or to market that. I don't feel comfortable knowing that it's not going to be the best of its capability.  

00:08:35 Narelle:         Yeah, and I guess the reason for that is too, like I could sit down without research and talk about topics, but you tend to only know things at a superficial level. Like even when you learn things at university. Yes, that was years ago. I might've learned the in-depth mechanisms of action of something. But then you know, life goes on and you forget the details. Plus I don't want to sit here, give you my opinion about what I think is good. I want people to understand what the science is saying.  

00:08:58 Glenn:       But the science also updates as well. So, even though you were at Uni 20 years ago or something like that, the science has updated, some may stay the same, and some has changed.  

00:09:08 Narelle:         Yeah. Which is why, you know, as dog trainers it's really important to be going to seminars as constantly as the healthcare professional. You know, we're required every year to do so much education and training to make sure that we are up to date with the latest and greatest in science.  

00:09:21 Glenn:       I've always been of a belief that no matter what professional I want to seek out myself for any endeavour I want to partake in, I don't want to be with a person who doesn't care and doesn't wanna update what they're doing. Not just to me, but to many of the people that I speak with, that I surround myself, my friends, my colleagues, people that I do business with. Most of them feel the same way as well, is they don't want to just go to a person who has fraudulently gotten through life by big witt. Lots of charismatic behaviour. I mean that really isn't a good space for pet health and pet care and pet training and so forth. That really is, as I said before, it's fraudulent, and lots of people get trapped in those areas. I've been subject to it myself where I've believed that a certain thing that I'm feeding my dogs, or our dogs have been the best of the best.  

00:10:11 Glenn:       Only to find out that it is flash marketing and it's a lot of sales. There's a lot of money behind it. There's big pushes. There's people who have been paid to speak on its behalf. Those sort of things. That's frightening, because a lot of big revenue, a lot of big pushes in money can really influence people that they're doing something that they think they should be doing, and in fact they're not. Anyway, I don't wanna ramble on too much about it 'cause it's not our topic of conversation. It just came to mind. A lot of these things, when you and I sit down to talk about these sorts of things, they come to my head, they frustrate me, they worry me, they concern me for the public, because I love this industry. I love the greater dog industry. Not just the training side of it, but now the nutrition side of it.  

00:10:51 Glenn:       And now that you have been such an influence on my education in that space and shown me to the light, more about the problems that we've created with bad feeding and you know, falling victim to marketing, I'm passionate about other people knowing that as well, 'cause I know you won't do it. So I think, yeah it's my place to, to try and help people avoid the pitfalls that others of us have done in the past. Anyway, you've got a topic. Let's talk about the topic so people don't get frustrated and say, Glen just rambles on for 10 minutes at the start of episodes, and it suffocates my Narelle time.  

00:11:22 Narelle:         But just to make a point about what you were saying, I did the NDTF course 20 years ago now. 

00:11:26 Glenn:       20 years ago. Yeah.  

00:11:27 Narelle:       And I haven't, once I finished being a professional dog trainer, I did my stint for a few years, realised it wasn't for me. And you know this, like I do not call myself a dog trainer anymore. Technically I could. I've got that qualification but I have not kept up with training concepts. I think that would just be unethical to say to someone here, give me your money, I'm a dog trainer,  when my qualification was 20 years ago and I haven't done anything with it since.  

00:11:50 Glenn:       Yeah. Even though you were employed as a full-time dog trainer for a couple of years.  

00:11:54 Narelle:         So that's just a skill I have now for our own dogs.  

00:11:57 Glenn:       That's right. Exactly.  

00:11:58 Narelle:         So in today's show, I'd actually like to discuss a couple of the main ingredients, or nutrients I should say, that are recommended to support joint health in both us and our dogs. And they are glucosamine and chondroitin. I've decided to limit it to just those two for today. Just for the sake of time because you know, I do tend to put a lot of information in around everything. And then, hopefully in the next episode I'll talk about collagen. Now I was going to talk about collagen and omega threes, but oh my goodness. Every time I think about doing a podcast that involves omega 3 fatty acids, not just atinol, but the topic is so vast, all these different angles. It's so overwhelming that I always just put my head in the sand whenever I think about doing a podcast on omega 3’s, 'cause there's a discussion about the types of omega. So 3, 6, 9, what that means for us and our dogs. The different sources of omegas, plant-based, marine base. And then from the marine base you've got fish, you've got krill, you've got Green Lipped, mussel. What does that mean for us and our dogs? And then all the health conditions. But then looking at them from the evidence of the different sources. So you can see it just snowballs.  

00:13:01 Glenn:      I'm already starting to hyperventilate.  

00:13:03 Narelle:      So one day there will be a podcast, or multiple podcasts on various aspects of omega 3 fatty acids.  

00:13:09 Glenn:       Well maybe we could do like a series of them instead of like just one massive hit. We could do like, part one of omega 3’s, part two, et cetera

00:13:17 Narelle:         Yeah. And I think the first one that would be probably most relevant to the listeners would be the role of omega 3’s, in let's say joint health for dogs, and just try and keep it the topic narrow.  

00:13:27 Glenn:       That sounds good. Yep.  

00:13:28 Narelle:        Okay. Watch this space. But let's jump in and start with glucosamine. Are you familiar Glenn with glucosamine and chondroitin?  

00:13:35 Glenn:       I have used it for my own joints before because I've been involved in martial arts and strenuous activities, weightlifting and so forth. At one stage, my adolescence, it was always advised to me that glucosamine and chondroitin was good for joint health. Yep. And in order to keep the uh, viscosity of the fluids and keep the joint health itself, I should be taking glucosamine and chondroitin. That's my limited knowledge.  

00:14:00 Narelle:         I think that's where most people sit. I mean, I'm gonna dig right into the details of everything,  

00:14:05 Glenn:       That'd be good, 'cause I'll learn something.  

00:14:07 Narelle:         Honestly, researching this topic for today really did my head in with what I discovered. So be prepared to question what you think you know about glucosamine and chondroitin. Cool, glucosamine to start with. It's a compound, it's naturally occurring in the body, but it's particularly high in the joints and the cartilage. It's considered a chondro protective agent. So what that means is that it protects the chondrocytes. They're the primary cell type that make up cartilage.  

00:14:36 Glenn:       Oh, you're gonna have to explain what a chondrocyte is.  

00:14:39 Narelle:         It's a cell  type, and here's a little biology lesson for everyone. So if you ever see a word with ‘cyte’ at the end of it, like CYTE, it's generally a type of cell. So we've got chondrocytes, which are a type of cell in cartilage. We've got things like adipocytes, which store fat. They're a fat cell. We've got hepatocytes, a liver cell, we've got keratinocytes, which make keratin, We've got erythrocytes, red blood cells. So you get the idea. There is a type of cell, and because glucosamine is stated to have this protective effect, it is often used in the treatment of inflammatory joint conditions such as arthritis, whether it's in humans, dogs, horses, or other animals. So glucosamine, like your experience, it probably is one of the most well-known joint supplements.  

00:15:23 Narelle:         And the mechanism by which glucosamine is claimed to alleviate the symptoms of joint damage is by playing a critical role in the production of compounds which form the essential building blocks of joints. Well not just the joints, but you know, the ligaments and the tendons and the cartilage and the synovial fluid that makes up the whole joint. So technically, taking a supplement with glucosamine in it may help to increase the cartilage and the fluid around the joints and to stop the breakdown of the substances. So that's a little bit of a background on what glucosamine actually is. So if we look at the supplemental form, glucosamine is mostly harvested from the exoskeleton of shellfish. So think about the hard shell of crabs, lobsters, prawns, or for our US listeners Shrimp. It can also be made in a lab.  

00:16:14 Narelle:         So you can get a pure synthetic glucosamine as well. Less commonly it's made using the fungus, aspergillus niger. And the way they grow that fungus is by fermenting grains, such as corn or wheat. When we start to look at the evidence a bit later, it becomes really important to understand the different forms of glucosamine. So there's glucosamine sulphate, there's glucosamine hydrochloride, and there's n-acetyl glucosamine. So if we just start by looking at the difference between the main two glucosamine hydrochloride, as the name would suggest, it is a glucosamine molecule that's been bound to hydrochloric acid and it's about 99% pure glucosamine. Glucosamine sulphate on the other hand, it's only about 74% pure. And because of that it requires stabilising with additional compounds. And these are in the form of salts because of this difference in purity. If you took a 1500 milligram dose of glucosamine hydrochloride, and this is just me rounding down slightly, that would be the equivalent of like a 2,600 milligram dose of glucosamine sulphate because it's not as pure.  

00:17:20 Narelle:         So you need more of it to get the equivalent dose of glucosamine that you'd find in the glucosamine hydrochloride. And as I mentioned, because the glucosamine sulphate form needs to be stabilised with salts, these are commonly potassium chloride or sodium chloride. So sodium chloride is table salt. and a glucosamine sulphate tablet can contain as much as 30% potassium or sodium. And this is really important for people to know because that's a huge consideration for people or animals who need to reduce their dietary intake of sodium or potassium for health reasons. So someone might have hypertension, so high blood pressure, they might have impaired kidney function, for example, they might have cardiovascular disease. So in all of those cases, be aware of the potential salt or potassium that may be coming in through the glucosamine sulphate supplement.  

00:18:07 Glenn:       It would also affect fluid retention as well, wouldn't it?  

00:18:11 Narelle:       Yeah, and look, I wasn't aware of this back in the day. So when I was studying naturopathy, I worked part-time in a health food store and we're always promoting glucosamine and conjoin supplements for people with joint problems. And it was just that one of the other naturopaths in the store, her father had really, really severe high blood pressure. So she was so knowledgeable about all the sources of sodium. So I actually learned that from her, like years ago to be mindful of the form of glucosamine in case someone does have hypertension. So there you go. But with both forms, once we ingest them and they get to the intestines, they're hydrolyzed, which means they're broken down and that glucosamine molecule is released to be absorbed. And the research suggests that the sulphate form actually has a greater bioavailability in the body than the hydrochloride form.  

00:18:56 Narelle:         And as you'll learn shortly, the sulphate form also tends to have more positive results in the clinical trials. So even though it's not as pure, it's potentially better absorbed and more effective. And if we just touch really briefly on the third form, so that n-acetyl glucosamine, which is abbreviated to NAG, generally it's completely different in structure from the glucosamine sulphate and hydrochloride forms. It's handled by the body differently. So while it can be used for joint health, it's typically used for gut health issues. So I really like the n-acetyl glucosamine for supporting gut health in people and dogs. In terms of side effects, there's very few side effects observed in people or animals that are using a glucosamine supplement. But the main one that is really important is the potential for an allergic reaction. So if someone's got an allergy to seafood and they're buying a glucosamine supplement that comes from crab or lobster or prawns, that's potentially a life threatening issue.  

00:19:50 Glenn:      Wow. Okay. That's a big red flag right there potentially.  

00:19:53 Narelle:       Some people can be sensitive, like everyones…  

00:19:56 Glenn:       Different, everyone metabolises differently.  

00:19:58 Narelle:        Yeah. So some people may get some bloating or gas or diarrhoea from it, but it's not common. And then as I mentioned, you know, there's the caution around the sodium and potassium content. In terms of drug interactions, the main one is with anticoagulant drugs. So think of things like warfarin. So if you are on a blood thinner, it could potentially increase the risk of bleeding. And there's also a warning with chemotherapy drugs, really safe, it's been around for decades. In dogs glucosamine, you know, it's mainly used to alleviate pain, and joint wear and tear, due to structural changes. You know, they might have hip dysplasia or something like that. It's used to aid in the recovery of surgeries, spinal injuries. And a lot of people will actually just use glucosamine supplements to keep their performance dogs, or their working dogs just in peak condition. Really commonly used.  

00:20:49 Narelle:         But, and this is a huge, but despite all of that, despite its popularity and it's just been recommended by doctors and vets for decades, there's always been controversy around the evidence for the benefits of taking it. And that's in the human space and the animal space. But before we get to the evidence, let me quickly touch on chondroitin. They tend to be paired up. You can get them separately, but most products will, if they're gonna use one, they'll often combine them together. So like glucosamine chondroitin, it's a molecule that occurs naturally in the body. It's a major component of cartilage. I should say the proper name is actually chondroitin sulphate. It's just easier to say chondroitin because there's just one chondroitin as opposed to glucosamine hydrochloride and glucosamine sulphate. On the market, it tends just to be chondroitin sulphate. It can be extracted from the cartilage of shark, cows, pigs. It can also be manufactured synthetically in a lab as well.  

00:21:47 Glenn:       Is there a better type, is there one that you would say is the preferable, or the go-to?  

00:21:52 Narelle:        In terms of from what animal it comes from?. I actually haven't looked into the benefits. So what I would need to do with all the studies on chondroitin, I would need to go and look at the methodology and see if they actually even say the animal source of that chondroitin.  

00:22:07 Glenn:       Because I think they were doing, like a lot of studies around shark cartilage and the benefits that it actually had on anti-aging.   

00:22:16 Glenn:       There was a whole phase of that. But I don’t know where it went.  

00:22:20 Narelle:         Yeah, I'm not sure either.

00:22:20 Glenn:       You can't study everything.,  

00:22:23 Narelle:         No, but I know when I was at the health food store working, there was, like this period of time where people were just coming in asking for shark cartilage.  

00:22:29 Glenn:       Yeah. It was a big thing. Probably about, oh, 15 years ago shark cartilage was all rage..  

00:22:35 Narelle:         Yeah, it's interesting how certain compounds have become popular and then they wane and then the next one comes up.  

00:22:40 Glenn:      Isn't this something that you’re always tell me off about, looking at these popular things on marketing? See, I'm a victim of it myself. This is why I say that. Something that you could give me in better strength, better quality, or better dose rate or something like that. I'll go and look at it on a men's health forum or something like that. People will be talking about it, and Narelle often comes back to me and goes, why? Why wouldn't you come to me first and ask me? And you're right, you're a hundred percent right.  

00:23:06 Narelle:         And particularly because you're drawn to the jelly versions of the little gummy bear type supplements  

00:23:13 Glenn:       I am.  

00:23:14 Narelle:         And I'm like, no you don't need all that sugar with your supplement.  

00:23:17 Glenn:       Very true.  

00:23:17 Narelle:         So back to chondroitin,  

00:23:18 Glenn:       Back to chondroitin.  

00:23:20 Narelle:         The proposed mechanisms of action of chondroitin include restoring the extracellular matrix of cartilage, preventing further degradation of cartilage. It also provides a dietary source of sulphur containing amino acids, which is really essential as part of the building blocks for that cartilage matrix. And because it's got a negative charge, it's chondroitin that's more responsible for water attention in the joint. So you'll often see that promoted in terms of pushing in the joint with the improvements in synovial fluid, for example. With the use of chondroitin, again, super safe, excellent safety profile, really well tolerated. 

00:23:57 Glenn:       And very good science to support it.  

00:23:59 Narelle:         That's what we're gonna get into.  

00:24:02 Glenn:       Okay. All right. Sorry, I'm skipping, I'm skipping ahead on the record.  

00:24:05 Narelle:         You are, and similar to glucosamine, it can interact with anticoagulant drugs and increase the risk of bleeding. So here's the juicy part of the show, looking at the evidence behind glucosamine and chondroitin. So I'm gonna start with humans. As usual, like the evidence in humans, like it's so much more extensive and robust. There's been hundreds of clinical trials that have been conducted in thousands of people. There have been dozens of systematic reviews that have been published, all evaluating the evidence for using glucosamine to treat arthritis in specific joints. And what people may be surprised about here because I know I was, is that most of the studies, but particularly those studies of higher quality with the most robust controls for placebo effects, they actually find no benefit overall. If you google the benefits of glucosamine for arthritis, you will find positive studies that show that it helps.  

00:24:58 Narelle:         But when you step back and you look at all of the research that's been conducted over time, the conclusion is it's not doing much. So that blew my mind. And what's interesting, is that even organisations of specialists in the management of arthritis for humans find the evidence for glucosamine unconvincing. So for example, the American College of Rheumatology and Arthritis Foundation, their guidelines strongly recommend patients not to take glucosamine for arthritis of the hand, hip, or knee. Because, and I'll quote it from the guideline, the weight of the evidence indicates a lack of efficacy and a large placebo effect. And there are other organisations, such as the American Academy of Orthopedic Surgeons who agree that basically there's no point in people taking glucosamine. But like I said, it's complicated and it's controversial because then you've got an osteoarthritis research society and another European arthritis organisation that do recommend glucosamine. But they say, if you're gonna try it, use the sulfated form. So remember I said there's the hydrochloride in the sulphate form.  They said try the sulphate form, not the hydrochloride form. And then they go on to say that if you do try glucosamine sulphate and after six months you don't really feel like it's hitting the spot or making much positive difference, then just discontinue.  

00:26:19 Narelle:         It's not gonna work. And if we bring that closer to home, this is from the Arthritis Australia website, and I'll read it just because it's easier. So to quote Arthritis Australia, ‘While there have been some claims that glucosamine and chondroitin, either together or separately, can help to reduce pain in people living with osteoarthritis, these claims are now being questioned. Evidence around the effectiveness of these supplements has always been mixed. However, recent reviews of this evidence now suggests that studies that show positive results may be of low quality, and unreliable higher quality independent studies suggest that glucosamine and chondroitin are no better than placebos at reducing pain or slowing the impacts of osteoarthritis as a result of this. While glucosamine and chondroitin remain safe for most people, many doctors no longer recommend these supplements as a way of managing arthritis. And to date, there is no evidence that these supplements are effective for any other forms of arthritis’. So that's pretty full on, that's such a major shift in the recommendation around those two compounds.  

00:27:25 Glenn:       Well that blew my mind, because I thought differently from everything that I was told.  

00:27:31 Narelle:         Same. And just on the placebo effect. So it comes up a lot in the literature on this topic, and I swear I remember this from like 20 years ago, being on a current affair in the news. They did a study in 2002 looking at patients with osteoarthritis of the knee. So they had 180 patients, they divided them into three groups. So two groups, they actually got some form of arthroscopic surgery done, and one group had simulated arthroscopic surgeries. I think they just put little superficial cuts on the surface of the skin so that those patients thought that they had had surgery, but nothing was inserted into them. Like no treatment was done. There was just nothing. What's fascinating is, they had a two year follow up period and for those patients who underwent the placebo arthroscopic surgery, absolutely nothing done to their knees, they were just as likely to report pain relief as those who actually had the real procedure. And in what I was reading, there were times within that two year follow-up where the placebo group actually reported greater benefits than those who got the surgery. And I remember at the time it was so controversial because I think the thing was, well why should Medicare, for example, be paying for all these knee surgeries when a placebo effect  

00:28:47 Glenn:       When the power of the mind heals their knees?  

00:28:50 Narelle:         Exactly. So that was how strong the placebo effect was, looking at osteoarthritis of the knee. And in the animal literature, it's actually been stated multiple times as well, that that caregiver placebo effect is absolutely real. So that was primarily looking at the evidence, or lack thereof, of glucosamine for arthritis. If we focus a bit more now on chondroitin in 2015, there was a high level review done looking at the use of chondroitin for osteoarthritis in humans. They did say that many of the trials were of low quality, but they were able to conclude that chondroitin was better than placebo for improving pain in people with osteoarthritis. That it did improve knee pain by about 20%. They said it probably improves quality of life slightly and they say chondroitin slightly slows down the narrowing of joint space when they do an x-ray of the affected joint.  

00:29:45 Narelle:         Not super duper results, but definitely more positive outcomes than demonstrated with glucosamine. Then in 2019, there was another comprehensive meta-analysis done that looked at the inconsistencies in all of these randomised placebo controlled trials that were assessing the efficacy of chondroitin in people with osteoarthritis. They found as well that chondroitin provides a moderate benefit for pain, but it has a large effect on function in knee osteoarthritis. They didn't have a caveat saying there were large inconsistencies, but overall there is some benefit to chondroitin, but still not as great as I think everyone's been led to believe all of these years. When I was reading a bit more about chondroitin, part of that inconsistency is coming from the quality of the chondroitin itself. So I actually stumbled across a report by Meat and Livestock Australia that was released in 2015. They stated that the market for chondroitin is predominantly supplied by product manufactured in China, which is reported by the International Nutraceutical Industry to be of low and variable quality impurity, low and variable concentration, unknown bioactivity of ill-defined or unknown animal origin and subject to intentional adulteration.  

00:30:58 Narelle:         Don't quote me on this, because I didn't read the whole report, but basically the report was saying most of the chondroitin coming out of China it's  really low quality. You know, we can't trust it. We've got all this amazing cattle here in Australia, why aren't we in on the game? Basically the report did go on to say that the nutraceuticals industry believes that chondroitin is one of the most adulterated supplements in the market, and that it's probably underestimated just how bad it is. THe quality of it. 

00:31:25 Glenn:      That's concerning.  

00:31:26 Narelle:         It is, and in one study they took 16 samples of pharmaceutical grade chondroitin, only five contained more than 90% chondroitin. 11 of them contain less than 15% chondroitin. And for those, the main contaminant was a substance called maltodextrin. 

00:31:43 Glenn: Which is? 

00:31:44 Narelle: Essentially, maltodextrin, it's a sweetener and a carbohydrate. So it doesn't really have a lot of nutritional value and tends to come in powdered form. It can be made from corn, rice, potato, starch, and wheat. But most of it comes from GMO corn because it's used as a cheap filler.  

00:31:58 Glenn:       I was just about to say, it sounds like a cheap filler,  

00:32:00 Narelle:        But yeah. And look, it's deemed safe for humans. It's deemed safe for animals, but it has a really high glycemic index. And what that means is that it can rapidly spike blood glucose and blood insulin levels. So that can become an issue with diabetic people or dogs. So if you're taking a supplement, and you have no idea that 85% of it has this cheap maltodextrin filler added to it, I mean that's crazy for trying to manage blood glucose levels. Studies have been done suggesting that maltodextrin can change the bacterial composition in the gut that makes this more susceptible disease. It can suppress the growth of beneficial bacteria in the gut. It can increase the growth of harmful bacteria such as e coli. There's studies that have shown that it can upset the release of mucus from the intestinal barrier, which can lead to a lot of other inflammatory bowel conditions like colitis and things like that.  

00:32:50 Narelle:         So not a great compound. It all is very confusing and conflicting. Some studies with chondroitin say that it elevates blood levels. Other studies say that it doesn't. There are studies that say that if you combine glucosamine and chondroitin together that they compete for absorption so you're not getting as much benefit from either of them. But on that, I mean that's pretty common with supplements. Like you hear that a lot with magnesium and zinc and calcium competing for absorption. But it really comes down to the dose of the individual. So if we look at the dog research, that's pretty eye-opening as well. Lucky for me, there was a review done on the use of glucosamine and chondroitin for canine osteoarthritis that was done in 2017.  

00:33:34 Glenn:       By who?  

00:33:35 Narelle:         I'm actually not sure how to pronounce the various author's surnames, but the journal was the Open Veterinary Journal Volume 7 Issue 1. We can link that in the show notes.  

00:33:45 Glenn:       Yeah, that's a good idea. If people are poo-pooing your research, then you can put it all up there and they can go look at it themselves and then they can decide for themselves.  

00:33:54 Narelle:         Yeah. So they looked at the various studies out there and assessed their therapeutic benefits and their clinical outcomes. They did comment that the majority of animal supplements actually use the glucosamine hydrochloride form, and they gave a few reasons for that. They said it's more pure, which we've touched on already. They commented about the increased sodium, potentially, and the potassium. But, and I think this is the kicker, apparently the hydrochloride version is a lot cheaper to produce than the sulphate version. So I imagine that's the primary reason why it's more used in animal supplements than not.  

00:34:29 Glenn:       Profit margins always dictate the market.  

00:34:33 Narelle:         Yeah, and again, what makes things challenging even with these reviews, is the trials are using different products which have different forms of glucosamine. So even though the majority of animal supplements are using the hydrochloride form, some still use the sulphate form, there's different doses, there's different dosing regimes, there's different combinations of ingredients, different durations of treatment. Even though the overall results of the review state one thing, it's never straightforward.  

00:35:01 Glenn:       Do you know what I really hate in these marketplaces, which is a real irk of mine. It's not just an irk of mine. It's an irk of many people, especially in this industry, the canine industry. But in the health industry or whatever the feeding industry, let's call it the food industry or food and medicines industry as a whole conglomerate. What really irks me is when people develop a really good product and it's a game changer in health and nutrition and then it gets sold to X company and then all they do, because they've sunk a lot of money into it, is look at a way they can cheapen and nasty it up. That's really sad 'cause I've seen that happen to some really good dog products over the years. There used to be foods that I fed before, which were reasonable foods.  

00:35:46 Glenn:       I've got good results off 'em. The dog seemed to do well and the minute it changed, the marketing looked good. The packaging it came in looked lovely. It was all really glossy and lots of sciency images there, but you just notice the results had bottomed out of it. And that really is a sad thing when people care more about the margin of profit than they do the actual ingredients itself. Like they grab it and they think this person who started this company with their heart, they put some really good work into it. They've studied, they've found some really good products, some really good material to put into this item. Let's use the same thing, but at a nastier substance or a cheaper, horrible complexity or whatever you want to call it. And nobody's the wiser, they don’t know, the formula changed as far as they know. They're still standing behind a product that's now literally robbed of all its nutrition and all its quality. Hate that.

00:36:41 Narelle:         Yeah. So do I. And it is common because often the consumer isn't aware of that change, and then they're trying to figure out suddenly why things are not going so well with their dog anymore.  

00:36:51 Glenn:       And nobody tells them. 

00:36:52 Narelle:         And thinking they're still feeding exactly the same food. For example, if we use food, it's horrible, it's complicated and it's, yeah,  

00:36:58 Glenn:       It's not even criminal. There's no regulation around it where people get exposed for it or caught for it. They completely get away with it. And we're none the wiser. 

00:37:07 Narelle:         With that 2017 review, you can look up the full paper online, the authors concluded that the potential benefits of glucosamine and chondroitin for use in osteoarthritic canines, can neither be confirmed nor denied. So very vague. They went on to say that further clinical study using improved methodology is needed, because with the trials conducted to date the results have been so mixed, but with higher quality studies, and the paper I think goes on to outline what a high quality trial protocol might look like going forward. So that's good. So that was 2017. Then in 2022 there was a systematic review looking at dogs and cats with osteoarthritis. And they were looking at a more broad range of supplements to support joint health. So it wasn't just glucosamine and chondroitin, but I'm just gonna focus on the most relevant results from that paper and I can link that paper too. That's a really good paper.

00:38:00 Narelle:        Overall, they said previous systematic reviews support their findings. They did highlight the major difference between their review and previous ones, where the number of articles identified, so theirs was a much more comprehensive review. Looking at more of the literature out there as part of their conclusions, they found that chondroitin and glucosamine supplements showed strong evidence of non-effect. So 88.9% of cases didn't show benefit with those supplements. From that they concluded that glucosamine chondroitin nutraceuticals should not be prescribed in canine or feline osteoarthritis. So that's a pretty strong statement. Just for a couple of the other relevant joint supplements, they found that collagen hydrolysate had a positive beneficial effect with only a non-effect in 18% of cases. Like I said, I'll talk about collagen more in the next show. They found that Omega 3 supplementation had a high positive effect and they were confident that these products are doing what they say they're gonna do and they're highly effective for canine and feline osteoarthritis.  

00:39:04 Narelle:         So when I finally get to the Omega 3 podcast, we'll talk more about that. Interestingly, they looked at cannabinoids as well. So I think CBD, and they found that was really positive for joint health, and which reminds me Big Dog recently did a podcast with Dr. Nicole Rouse, the holistic vet from Melbourne and she also has Shy Tiger, and they were talking about all things CBD with our pets.So if you wanna learn a bit more about CBD, check out the Pause and Listen podcast by Big Dog Pet Foods. 

00:39:36 Glenn:       Fantastic.  

00:39:37 Narelle:         To summarise that, they spoke about the non-effect percentages. But if we put it in the opposite context, they found that omega 3’s were effective in 90% of cases. Again, it's why I love Antinol for our dogs. Cannabinoids had a positive effect in 85% of cases, collagen in 82% of cases, glucosamine and chondroitin in 10% of cases. 

00:39:58 Glenn:       Oh wow.  

00:39:59 Narelle:         So it really highlights that spectrum. So you've got the Omegas, the CBDs, and the Collagens, all clustered at the top end of being beneficial. And then you've got glucosamine and chondroitin showing some benefit, but way down the other end of the spectrum,  

00:40:12 Glenn:        I feel bad now because the other day a colleague of mine was talking about his rickety knees and I said, you really need to get on glucosamine and chondroitin and now I just have to bite my fingers. 

00:40:29 Narelle:         Well just tell him like collagen or CBD or Omega 3.  

But like we said, it's not all or nothing. The evidence is mixed. Yes,while it's showing overwhelmingly not a great benefit for glucosamine, and just a little bit better for chondroitin, they're safe. Like it doesn't hurt to try them. So for your friend you can say, look, give it a go. But in six months if nothing has changed.  

00:40:46 Glenn:       All right. Let's not sit on the fence here. You're a scientist. As a scientist, where do you go with this? If I came to you and said Narelle, as a scientist with what you have just researched, would you be recommending it yourself?  

00:40:59 Narelle:         Look, I wouldn't bother using it for any of my dogs. I wouldn't recommend it to clients.  

00:41:04 Glenn:       Based on the research?  

00:41:05 Narelle:        Based on the research I did in preparation for this podcast. To me the evidence just isn't strong enough to justify spending the money. And I think that the 2022 review paper, yes, they looked at chondroitin, glucosamine, omega 3’s, cannabinoids, collagen, they looked at some other comments. I've gone blank on what they are. So there are other options out there. So I think, given that there are other options that are showing clinically significant benefits for arthritis in people and dogs spend your money there. Like I seriously was blown away by this research.

00:41:34 Glenn:       Me too. Because it's something that I was always of the belief that those two combinations were very beneficial in joint health, 'cause you didn't tell me what we were talking about, up until now, and that has just ripped the carpet from under my feet in my belief of joint health. 

00:41:50 Narelle:         But just to reiterate, with chondroitin, there is some evidence to show that it's beneficial for reducing pain and improving physical function. I just wanna stress that it's probably not as strong as evidence that we thought it was. But there is still some benefit. So out of the two, if you're going to try something, chondroitin supplement might be the way to go. But definitely adding in those other supportive joint supplements, you know, your collagens, your omega 3’s and if you've got, you know, a dog that's quite bad with their joints, like Opie he's on CBD. For supporting his little body.

00:42:22 Glenn:       Yes, his little potato body. 

00:42:24 Narelle:         I think that's a good spot to leave it.  

00:42:25 Glenn:       Yeah, now that you've just kicked me in the stomach. 

00:42:27 Narelle:         Opened a can of worms  

00:42:28 Glenn:       Here, I was thinking I was just gonna get schooled on how good it was and you were gonna support it all, and now I've just found out it's not what I believed it was.  

00:42:37 Narelle:         I can't stress enough how much this threw me.  

00:42:39 Glenn:       It's probably good to talk about it. You'll probably get some heat over it, expect that, 'cause there'll be people who have, like myself, have blindly followed into a product just because old mate down the road told us it's the best for you. I talk about this a lot in training, and Cameron Ford who's coming to do a seminar here, probably by the time this podcast comes out, he's probably here and he's done it by now. But he and I talked about sacred cows. It's the gods that we always used to pray to in our belief. And it's the person, you know, who was our first mentor or our teacher or something like that. And it was their belief that that's right. But sometimes historical data on this is decades of years old. And that's the problem with holding true to these beliefs and refusing to let 'em go. Now I'm concerned about it now before I run off to the health food place.  

00:43:27 Narelle:         Or to my clinic.  

00:43:28 Glenn:       To your clinic.  Well it's not to say that I wouldn't grab something off the shelf. If I was going by and thought, you know, I should get this product and then come home and have you say to me, why did you get that? And why didn't you speak to me first? Which I submit to and say, yes I should have. And I fully acknowledge that you're the authority on that and I'm not. That is a concern, but more so a concern, like I said, in training and in supplementation or any of those beliefs that we hold it, just because somebody told us without doing any research ourselves. And I know that you're a scientist, most scientists that I know, most ethical scientists that I know, their whole ethos is to try and find the truth. Not to try and sway the market so much on their beliefs, but to try and bring to light what the truth is about any products or services that are out there. And I'm glad you did that. But I'm also disappointed on all of it that I've taken over the years. And maybe it was just the power of the mind that helped me get through.  

00:44:27 Narelle:         But the other thing that I think will make a big difference, as highlighted in that dog osteoarthritis review. A lot of the clinical trials done in animals particularly, are of poor quality. So potentially going forward, if they can produce higher quality clinical studies, ensuring that the quality of the ingredients is good, you know, more uniform dosing and all of that around the protocol use, potentially then we might start to see a shift in the evidence. So it might start to show a more positive benefit if we can get the quality of the trials to a better standard. It really is, like you said, science, it's constantly changing and evolving. Like what we knew 20 years ago is different to what we know now. If I'm looking at probiotics and gut health and I see a paper from 20 years ago, I pretty much ignore it because science has evolved so rapidly in the space of gut health and probiotics, and everything they know about it now and all the different testing methodologies. So, to me it's like, oh that's pretty irrelevant now. So I'd be looking at research done in the last five years ideally. But yeah, everything changes. Like in 10 years time someone might listen to this and go, oh, that's a load of rubbish. Because look at all the evidence to show the benefits of chondroitin.  

00:45:38 Glenn:       Well they upped their standard and have raised the bar. That's absolutely fantastic. And you and I and the rest of the people that are listening to this in one way or another, we're a consumer of something. And it's up to us to ask better questions or to find out, or if you have taken the time to put this out there, to pay it some credence and listen to it. And if the show notes are linking the studies, read them yourself, because it's not just your opinion. It's literature that's been put out there by the scientific and the research communities. Those are the things, you know, as I learned from Dr. Berantes many years ago, is that there are a lot of hypotheses in the world, but they're also facts as well. And facts. Uh, when you come across facts, they are solid. Especially peer reviewed papers. Are these peer reviewed papers, do you know?   

00:46:23 Narelle:         Well that was the other thing. A lot of the human ones would be, but, a lot of the animal ones probably I'd say wouldn't be. So that's another fault in the research and the evidence around the animal studies.  

00:46:36 Glenn:       Yeah, there were, I mean look, there's so little put into animal health, medicines research and so forth like that. Some there is, and in a lot there is not. That's criminal in itself. So it's good to know that people want to raise the bar. It's good to know that people are listening more and paying more attention. You know, when I see evidence of people on those fresh food feeding forums, I read people's comments on there, it's nice to see that there is a vast gathering of people, thanks to Sasha and Brittany for collecting all those people and starting to educate them, and put them in a better head space of actually paying attention to what's coming to market, what people are doing, the ethics, even some of the villainous things that some companies are doing and trying to trade it off as a food or a medicine. We do need to ask questions. We do need to raise the bar. We do need to be thinking better about our animals and even ourselves. And until you do that, you won't see a positive shift in any direction, 'cause companies will get away with it and they'll keep putting profits above people and pets.  

00:47:39 Narelle:         Yeah. Very good. What a show.  

00:47:41 Glenn:       What a show. I didn't expect that. So now that we've gone down that rabbit hole. What's next?  

00:47:47 Narelle:         The next episode, I'd like to delve into the collagen research. I started actually looking at that today, but I'm so research fatigued from the glucosamine chondroitin deep dive. So in the next couple of weeks hopefully, well, I'll have the collagen research all sussed out. And who knows what will come after that.  

00:48:05 Glenn:       Well that's another wonderful episode, on Natural Health for People and Pets as indicated by Narelle. We're gonna have the studies in the show notes, have a look at ‘em for yourself, read 'em, see what you think, and if you've got questions, how do they get in contact with you?  

00:48:20 Narelle:         Look, I'll just put two or three of the main animal studies in the show notes because you know, the human ones, there's just an abundance of them. I think most of the listeners would probably be more interested in the animal papers. But you can contact me at info@canineceuticals.com.au. check out the website canineceuticals.com au. There's been some tweaking and there's going to continue to be some tweaking to the website to put more resources onto it. So I've now got a resource tab that's got a link to these podcasts, so that people can access them through the CanineCeuticals website. Over time, I'm going to be developing various guides that people can download for free. So we've got a cat dosing guide.  

00:49:00 Glenn:       Fantastic.  

00:49:01 Narelle:         You may not be aware because I haven't really told anyone until now that all of the products in the CanineCeuticals range bar two are completely safe and suitable for cats.  

00:49:10 Glenn:       What are the two that aren't?  

00:49:11 Narelle:         The two that aren't are the pure Turkey Tail, and the Stress Ease. And that's just because they've got a small alcohol content to preserve them. Completely safe for dogs. Cats are a little bit more sensitive, so I just said no to those.  

00:49:26 Glenn:       Yep, fair enough.  

00:49:27 Narelle:         And they metabolise things differently, but we've got a whole cat guide now that you can download that has the products listed and the cat dosing.  

00:49:34 Glenn:       Pay attention to the dosing rate.  

00:49:36 Narelle:         Yes, What's that saying?  

00:49:38 Glenn:       The difference between the poison and the cure is in the dose.  

00:49:42 Narelle:         Absolutely.  

00:49:42 Glenn:       And don't forget, you can also look on any of the podcast directories, Spotify, Apple, or whatever Google app you're on. If you don't have an iPhone, you can find us on any one of those episodes. Plus, as Narelle said, there's a backlog of other episodes that we've done on other important topics and matters around canine health and nutrition.  

00:50:01 Narelle:        And one last thing, for those people in Sydney or Melbourne, or if someone wants to do a road trip, if they're not in Sydney or Melbourne, CanineCeuticals will be at the Dog Lovers Festival in Sydney. I think it's in August. Oh my goodness. I should know that. And in Melbourne in October. So, would love to see you all there. Come and have a chat. Come and see the stand. We're gonna have little show bags. We're gonna have a raffle prize. So lots of good reasons, but just come and have a chat with me. I'd love to meet you all.  

00:50:29 Glenn:        And you've done a bunch of webinars and other episodes on other podcasts and so forth, so there's lots that you've been up to lately.  

00:50:36 Narelle:        Yeah. I don’t know how many of you checked out Ness Jones' ‘Decoding Your Canine Summit’, which was held recently and there were close to two dozen industry pet professionals talking about various aspects of training. I was talking about diet and health and that should, don't quote me on this either, still be available to purchase. I know the free event has passed. You should still be able to purchase the recordings, I imagine. That's it. Thanks everyone. Bye.