Dear Pharmacist,
In a recent column, you said that a person should NOT take glucosamine if they have Rheumatoid Arthritis, but that it was useful for people with Osteoarthritis.  I have just been diagnosed with Rheumatoid Arthritis and my doctor started me on glucosamine and chondroitin immediately.  Why is this a problem?
CP Coral Springs, Florida

Answer: I can see why this is confusing for people with arthritis.  As you know, glucosamine and chondroitin are used to build cartilage within the joints.  And in osteoarthritis, there is a deficit of cartilage in the joints, so these supplements are helpful. Any supplement that improves the shock-absorbing quality of the joints is useful to an osteoarthritic sufferer.  But the most important point here, is that osteoarthritis is basically limited to joint degeneration. Now, people with Rheumatoid Arthritis (RA) have what’s called an auto-immune disorder. It’s an inflammatory process affecting the entire person. Essentially, something goes wrong and causes the immune system to go berserk.  The body suddenly views itself as a foreign substance and launches attack on itself.  In RA, the joints are destroyed the most, even though the whole body is affected.

So if you give a person with rheumatoid arthritis any supplement which builds up cartilage, you are fueling the fire because the body can attack itself with more fury.  Glucosamine and chondroitin are definitely not for people with RA, but there are other natural substances which may benefit.  For example, anything that calms down the immune system or reduces inflammation would be great.  Things like Omega 3 fish oils, SAMe, Boswellia and Turmeric are just a few of many options.