DEAR DR. DONOHUE: In your article on osteoarthritis, you mentioned glucosamine, chondroitin or MSM to relieve it. Do they help? – R.P.

Osteoarthritis is the most common arthritis variety. It comes from a fraying of joint cartilage. The cartilage serves as a cushion for joints. Without it, bone rubs against bone when a joint is bent.

Glucosamine is a constituent of joint cartilage and joint fluid. It holds water, and that, in turn, gives cartilage its cushioning effect. Glucosamine also adjusts the viscosity of joint fluid. The source of most glucosamine is the shells of shrimp, crab and lobster. People allergic to shellfish ought to check with their doctors before taking it.

Sound medical assessment of glucosamine gives it a restrained thumbs up for the relief of osteoarthritic joint pain. It does not appear to have serious side effects. It might cause some people gas, bloating and headaches, but that’s rare. Early on, there was a suspicion that it might interfere with blood sugar control, but that does not seem to be a major problem. Diabetics should still be on guard when taking it.

Chondroitin is a constituent of joint cartilage only and gives cartilage its elasticity.

It too has been subjected to close scrutiny, and it has shown some benefits for the treatment of osteoarthritic joints. How great the benefits are is a matter of debate.

Whether taking both together bestows better results than taking either one separately is an unresolved question.

MSM – methylsulfonylmethane – has not gone under the more rigorous testing that glucosamine and chondroitin have had. There is a great deal of anecdotal praise for it. In conjunction with Coumadin, it might thin the blood too much, so Coumadin users must keep that in mind. Aside from that, there are no reports of major problems.

The many faces of arthritis are discussed in the pamphlet on that topic. People can order a copy of it by writing to: Dr. Donohue – No. 301, Box 536475, Orlando, FL 32853-6475.

Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What do you think about SAMe for arthritis? I have started to take it, and within two weeks I have noticed a big improvement. – E.T.

SAMe (“sammy”) is another arthritis supplement that does not have a great deal of information on effectiveness. It was originally used to treat depression. When doctors discovered their depressed patients who also had osteoarthritis noted an improvement in their arthritis, SAMe began a new career as an arthritis medicine.

I cannot supply you with a definitive answer of its worth at the present time.

“SAMe” stands for s-adenosylmethionine.

DEAR DR. DONOHUE: What rate should the pulse be? I take it, but I don’t know what normal is. – M.R.

A normal resting pulse should be 60 to 100. The heartbeat and pulse are one and the same.

DEAR DR. DONOHUE: At every office visit, the nurse weighs you and takes your pulse and blood pressure. I wonder if doctors ever take body weight into consideration when they order a dose of medicine. It seems to me that a larger person needs a larger dose, and a smaller person a smaller dose. True or false? – E.S.

Your question is quite astute. The answer is “true.” Body size should figure into medicine dose. So should age. Infant doses are calculated not just on body size but also on the fact that infants’ immature livers do not process drugs like fully mature ones do. The same should hold true in old age. The body handles medicine differently than it did at younger ages.

Body size is in almost all doctors’ minds when they write prescriptions. However, the issue does not get the attention or precision that it should.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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