Many people prefer to try a natural approach when it comes to preventing conditions or treating symptoms by taking various vitamins and supplements. There are many options for supplements and vitamins out there, but are they really effective? Unfortunately, there is little education or research on these products.
Remember, the FDA does not regulate supplements and vitamins. Talk to your healthcare provider before beginning any supplements or vitamins. If you are pregnant or breastfeeding, discuss supplements and vitamins with your provider.
Here are a few common vitamins and supplements we discuss with our patients in orthopedics.
Turmeric
Known for its anti-inflammatory properties, turmeric is a great tool to help combat full body inflammation. We recommend a turmeric supplement that contains extract instead of ground root powder, 95% curcuminoids, curcumin, and bioperine (black pepper) to help with absorption. Daily dose recommendation is 500mg-2,000mg. Turmeric can slow blood clotting and should be avoided in those who take blood thinners, have bleeding disorders, anemia, gallbladder conditions, or pregnant. Caution should be used in those who take diabetes medication, as turmeric may make the effects of these medications stronger and therefore may result in hypoglycemia. Note: cooking occasionally with turmeric does not provide the amount needed to reach anti-inflammatory effects.
Glucosamine
Glucosamine is thought to increase cartilage and fluid around joints and/or help prevent cartilage breakdown, therefore, decreasing pain and improving function. Research studies’ results have shown conflicting information. Taking this does not reduce your risk of getting osteoarthritis. The recommended dose is 1,500mg daily. Do not take this supplement if you take warfarin (coumadin) as it increases the effects of warfarin, elevating your risk of serious bruising or bleeding. Do not take this supplement if you have personal or family history of glaucoma, are on cancer treatments, or have allergies to shellfish. Take caution if you have diabetes, as glucosamine has been shown to increase blood sugar levels and decrease the effectiveness of diabetic medications. Also, take caution if you are pregnant and/or breastfeeding, have asthma, glaucoma, hyperlipidemia (high cholesterol/triglycerides), and hypertension.
Chondroitin
Usually taken in combination with glucosamine, chondroitin sulfate is one of the building blocks of cartilage. Used to help decrease osteoarthritis pain and improve function. Recommended daily dose is 800-1,200mg. Do not take if you have prostate cancer or are pregnant/breastfeeding. Take caution in those with asthma. There is an increased risk of bleeding if taken with warfarin.
Hyaluronic Acid (HA)
HA’s action in orthopedics is to lubricate the joints and maintain normal joint cushioning to provide more support, resulting in decreased pain and increased functioning. In osteoarthritis and as we age, this substance becomes naturally depleted due to wear and tear. It comes in many different forms, but injections are the most widely used and most effective in sports medicine and orthopedics. We like to tell our patients to think of HA injections like an oil change for your knee; the oil is the HA substance and, your joints are the car. HA oral supplements have not shown to be effective for musculoskeletal use.
Vitamin D
Most people do not receive enough daily vitamin D from food and sun alone. Vitamin D has many benefits. From an orthopedic standpoint, vitamin D modulates inflammation, prevents involuntary muscle spasms, and cramps, and enhances calcium absorption into the bone which helps with bone growth and bone remodeling. Vitamin D plays a key role in helping prevent osteopenia and osteoporosis (thin and brittle bones). The recommended dose is 600-800 international units (IUs) daily, yet supplementing with 1000-2000 IUs of D3 is safe for most patients. Some patients are found to have vitamin D deficiencies with a blood test and will require higher dosing often for at least a month. Foods high in vitamin D include salmon, sardines, tuna, egg yolks, mushrooms, cow’s milk, soy milk, yogurt, orange juice, cheese, fortified cereal, and oatmeal.
Calcium
Calcium helps build and protect bones. A low calcium intake can result in fractures, osteopenia, and osteoporosis. Most people get enough calcium in their normal diet. The daily recommended amount of calcium needed is dependent on age.
1-3 years old: 700mg
4-8 years old: 1,000mg
9-18 years old: 1,300mg
19-50 years: 1,000mg,
51 years to 70 years: males 1,000mg and females 1,200mg
71 years and older: 1,200mg.
Who needs a calcium supplement? Those who are vegans, lactose intolerance, consume large amounts of protein or sodium, on long term steroid treatment, those who have inflammatory bowel disease and celiac disease, and those who do get enough calcium in the foods they eat. Overall, it is better to get the calcium your body needs through food instead of a supplement. There are some studies that have linked calcium supplements to heart disease, colon polyps, kidney stones, and heart attacks. Foods high in calcium: almonds, oranges, dried figs, soybeans, garbanzo beans, white beans, pinto beans, milk, yogurt, dark leafy green vegetables.
Ashwagandha
Ashwagandha helps in reducing anxiety and stress. On the label you want to look for root extract, as this is more potent that ground root powder. KSM-66 ashwagandha root extract has been studied in many clinical trials with positive outcomes. Daily dose recommended is between 500-1,500mg.
Potential side effects include gastrointestinal upset or headache. It can potentially lower blood pressure, lower blood sugar, and affect thyroid hormones, and in rare cases, have a negative effect on the liver. Women who are pregnant or breastfeeding should not take this.
Taylor Moore, FNP-C
Impact Sports Medicine and Orthopedics
