Alternative medicine bites back

I was talking to a practitioner of Ayurvedic medicine. This is an Indian-originated wholistic/traditional/form, developed over a few thousand years.

He illustrated some of the problems with western medical practice, particularly the corruption by pharmaceutical companies, who routinely bias their research and bribe doctors to use their products. That's a fair cop, and I depicted this aspect as being one of the cruder manifestations of capitalistic infiltration of the western "tradition".

There are of course other aspects of evidence based treatment that are not so tainted, and in fact the analysis and research that takes place outside pressures of profit are manifestly more worthy of being taken seriously. I would also suggest in turn that tradition (stretching back for centuries) does not ipso facto amount to proof.


One interesting point he mentioned was that in his practice, he often referred his patients on to regular medical doctors when he felt it appropriate - and that they in turn sometimes referred patients to him. This was a new one on me - although I guess that amounts to the "complementary" in the term "complementary and alternative medicine". This is by no means the norm. I have in the past, at the urging of friends, tried a couple of alternative treatments. I vaguely recall an acupuncture session once that seemed to ease some flu symptoms. But another time, I attended a naturopath, who prescribed a homeopathic remedy for what seemed to be rashes on my legs and feet. However, they turned out to be mosquito bites (from exposing my feet in bed at night to keep cool). That experience greatly reduced my confidence in alternative treatment. Later, there was a case in the news about a naturopath in the Hunter region who, from memory, treated a girl who turned out to have major organ failure, and died because she wasn't given proper treatment. The naturopath, naturally, ended up before the courts.

My trust in alternative medicine is improved whenever I see that the practice is more properly integrated with the western stream which, whatever its faults, can generally tell when a horse is a horse. You get your cowboys in any profession. And how much more emphasis does that complementary/alternative medicine place on wholistic health - that is, keeping people in good health rather than treating the failures? Lord knows western medicine doesn't plough enough resource into prevention - which is far cheaper than cure.

Glucosamine questioned

Choice, Australia's leading consumer advocacy organisation, has characterised glucosamine as a placebo.

Glucosamine, derived from sources such as crustaceans and grain starch, is a widely-used medicine for arthritis.


Choice's research (overview here) was effectively a literature review, taking in studies up to 2005, although it also examined the stated content of a number of products containing the substance.

As a result, Choice expressed doubt that glucosamine is effective for osteoarthritis pain, suggesting strongly that the only benefit was the placebo effect.

Further, they said there's more benefit to sufferers in regular exercise and losing weight.


I have a personal stake in this, having been diagnosed with osteoarthritis of the knee a few years ago. This condition has two outward effects for me: some aching in the knees, and the occasional quite bad twinge when a leg twists about the knee.

The doctor had some x-rays done, and showed me in them a build-up of spurs of cartilage around the knee. He prescribed glucosamine, and said it would help reduce further buildup of the unwanted cartilage that was causing the problems.

So I set out on a course of this over-the-counter medicine, at the dosage that he recommended. However, having been back to a doctor to verify the recommended daily dosage, I found GPs are somewhat more vague on this area than I first thought.

Now glucosamine of itself is an unstable substance, and usually compounded with any of several other substances, including sulphate (as my doctor prescribed), hydrochloride, potassium chloride, etc. But I can vouch that the range of available products is difficult to compare, as they quite frequently don't state their equivalent dosage of the active ingredient. This Choice mentions, perversely stating that some products don't have enough glucosamine sulphate to be effective. This from an organisation that said it wasn't effective anyway.

At one point, not being confident that the doctors were confident of an 'appropriate' dosage, I bought a product that contained a fair bit more active ingredient than I had been taking to date.
Within a few days of bumping up the dosage, the intensity and presence of the osteoarthritis reduced very noticeably. Placebo? I was sceptical, and not optimistic of any change, but was surprised by the result.

I still don't know if it is effective in reducing excess cartilage buildup. The Wikipedia article actually states the opposite - cartilage increase - as a positive effect may occur.

Uncertainty on a number of fronts: effectiveness for pain relief, effect on cartilage, and dosage. Wikipedia's article suggests there remains insufficient scientific consensus, although various international bodies recommend it as a treatment, including recommending the sulphate compound for the knee.


An industry ad in Saturday's Herald responded to Choice: "independent research proves glucosamine helps maintain the normal structure of cartilage in the joints". Also: "Choice Magazine found about 75% of their online members who were arthritis sufferers claimed... benefit from using glucosamine" - although that begs a question of who was motivated to respond.


Meantime, I'm going to keep taking a decent dose of glucosamine sulphate, plus regular swimming, as the best I can do for my knees.