Safety of Popular Arthritis Supplements Questioned;
Experts Investigate Whether or Not Chondroitin Supplements are Safe From Mad Cow Disease Contamination

April 10, 2001 PR Newswire

In an exclusive story published today on Vertibrae's e-magazine RheumatologyWeb (, world renowned rheumatology expert Dr. Gerald Weissmann chronicles his investigation into whether or not the widely marketed and hugely popular dietary supplement chondroitin sulfate -- which is derived from cow cartilage -- is safe from contamination with bovine spongiform encephalopathy (BSE), or mad cow disease.

The possibility of BSE contamination would have far-reaching implications for many of the nearly 40 million Americans suffering from osteoarthritis who are currently taking chondroitin. Like all dietary supplements, chondroitin is unregulated by the U.S. Food and Drug Administration (FDA) and consumers must rely on manufacturers for information regarding a supplement's safety and purity.

"Everything sold for human health should be regulated by the FDA," said Gerald Weissmann, M.D., professor of medicine and director of the Biotechnology Study Center at New York University School of Medicine, member of the RheumatologyWeb Advisory Board, and instigator of this investigation. "This issue typifies what happens when dietary supplements such as herbals or animal products are brought into the clinic without the FDA's rigorous regulation of purity, efficacy, safety, manufacturing practices and postmarketing surveillance."

According to Dr. Weissmann, in order for a chondroitin sulfate supplement to be considered safe with regards to BSE, it must be derived solely from the cartilage of American cows. "With many of these supplements being manufactured in Europe, the specter is certainly raised that this may not be the case. The use of other tissues or cartilage from European cows significantly increases the risk of BSE contamination," explained Dr. Weissmann.

Published exclusively on RheumatologyWeb, "The Chondroitin Sulfate Letters, a.k.a. The Mad Cow Memos" was prompted by a recommendation that appeared on the website The site is written by Jason Theodosakis, M.D., assistant clinical professor at the University of Arizona College of Medicine and author of the best-selling The Arthritis Cure. On the website, "Dr. Theo" urges arthritis sufferers to use chondroitin along with glucosamine as first-line treatment for arthritis -- a recommendation at distinct odds with the current standard of care for osteoarthritis.

RheumatologyWeb's "Mad Cow Memos" follows Dr. Weissmann's e-mail correspondence with Dr. Theo regarding the safety of these supplements, as well as his exchanges with rheumatology thought-leaders, including the president of the American College of Rheumatology, the clinical director of the Arthritis Foundation, and a consultant to the National Institutes of Health.

"The replies to my correspondence suggest that good people -- some with the best of intentions and some with the best of credentials -- are often caught in a cat's cradle of populist belief," said Dr. Weissmann. "What can be done if food supplements cannot be federally regulated? If you can take St. John's Wort for depression and echinacea for colds, why not pop ground-up cow cartilage for arthritis?"

Bruce N. Cronstein, M.D., professor of medicine and pathology at New York University School of Medicine, and chair of the RheumatologyWeb Advisory Board, added: "Although I'm sure chondroitin proponents are sincere in their belief that the supplements are derived solely from 'safe' sources, it is quite difficult to establish the source without some form of regulation. I am heartened to hear that these manufacturers plan to adopt the FDA's Good Manufacturing Practice standards, but I'll believe it only when I see it."

The full story can be viewed at

Osteoarthritis, the most common type of arthritis, is a painful condition in which the cushioning cartilage between bones is gradually destroyed. Because both chondroitin and glucosamine are components of normal cartilage that work in the body to stimulate and maintain cartilage growth, it is thought that the animal-derived dietary supplements may be able to help the body repair damaged cartilage. However, to date there has been no definitive evidence that glucosamine and chondroitin sulfates can help rebuild cartilage or prevent damage to cartilage, and the American College of Rheumatology currently does not recommend their use.

The National Center for Complementary and Alternative Medicine, in collaboration with the National Institute of Arthritis and Musculoskeletal and Skin Diseases, has recently begun patient enrollment for the first, large-scale, multicenter study in the U.S. to investigate glucosamine and chondroitin dietary supplements -- in combination or alone -- as natural remedies for osteoarthritis. Final results are expected in March 2005. However, the chondroitin being used in the study comes from a Spanish company, albeit one that claims to use only material from U.S. cows.

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