Arthritis is the pits. We all know that. I knew that when I was in my 20s, but I didn’t give it a second thought. I was more interested in, shall we say, other things.

But now that I’m in my 70s, I think about arthritis every morning. It wakes me up before my alarm rings. The ski injuries, the trekking-in-the-Himalayas injuries, the just plain “I’m old” injuries have taken their toll.

Treatment for arthritis has improved dramatically. My mom used aspirin – that’s all they had. Then came Tylenol, much safer but not pristine. It wasn’t until the late ‘80s that we realized taking too much acetaminophen, especially with booze, caused liver failure. (Side note: The safe dose is 4,000 milligrams a day; if you drink two drinks or more per day, then drop that to 2,000 milligrams a day.)

But for many, Tylenol is not that effective. Enter anti-inflammatories – non-steroidal anti-inflammatory drugs, or NSAIDs. They are stronger for sure, better but not riskier. Still, side effects of NSAIDs may include gastrointestinal bleeds from your stomach, increased heart attack risk for those so prone, especially if you’ve had one before, and kidney disease. So we doctors have been moving away from these.

So what’s a guy to do? The answer may be chondroitin sulfate.

Now, let me tell you, I’ve been skeptical about this. I haven’t seen enough evidence to show that it does something. But a recent study from the Annals of Rheumatic Diseases is very encouraging. It shows chondroitin sulfate is as capable of treating arthritis as Celebrex, the safest effective anti-inflammatory around.

It was a double-blind study of 600 patients, all with symptomatic osteoarthritis – the arthritis of old age. They were divided into three groups.

One group took 800 milligrams of pharmaceutical-grade chondroitin sulfate (we’ll talk a bit later about what I mean by pharmaceutical grade). The other group took 200 milligrams of Celebrex. And the third group took dummy tablets.

At one month, three months and six months, everyone was asked about their pain, joint function and how they felt and functioned. At one month, the Celebrex group was in front. Good response and quick action. But at three months and six months, that advantage had disappeared. The chondroitin group did just as well.

This is good news. Taking this might be your answer to morning pain.

So which chondroitin sulfate product should you buy? That’s where the “pharmaceutical grade” comes in, and it’s a problem. Why? Because the Food and Drug Administration regulates them the same way it does cosmetics – with a light hand. The label may say 800 milligrams, but the stuff inside may be much less.

My spin: I would go one of two ways with this. Consider the “store brand” chondroitin sulfate – as big companies want to make sure they are selling a reliable product. Or go to my favorite go-to website www.consumerlab.com.

It costs money to join because they don’t have advertising, but you get what you pay for. They test every brand they talk about and they tell you how much per milligram you’re paying.

For me this is a great benefit because I want the right dose for the cheapest price. I highly recommend it. Stay well.

This column provides general health information and is not specific advice intended for particular individual(s). It is not a professional medical opinion or diagnosis. Always consult your personal health care provider about concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Paster to people submitting questions.

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