Mad Cow Disease Mania
The fact that dietary supplements are not regulated by the FDA has long been cause for concern, but a new debate focuses on chondroitin and the fear of Mad Cow Disease (also known as BSE, bovine spongiform encephalopathy) contamination.
Mad Cow Disease is a degenerative neurological disorder which appeared in Europe in the late 1980's. The disorder developed when farmers used ground up sheep as part of feed for cattle. Some of the sheep were affected by a similar disease, a disease which could pass between species and also infect cows. So what's the connection to chondroitin? Chondroitin is derived from cow cartilage.
Chondroitin For Osteoarthritis
Reportedly 40 million Americans take chondroitin as a treatment for osteoarthritis. But the mere possibility of Mad Cow Disease contamination is shocking and frightening. To be free from possible Mad Cow Disease contamination, chondroitin sulfate would have to be derived from only American cows. As reported by Gerald Weissmann M.D. on RheumatologyWeb, in "The Chondroitin Sulfate Letters", aka, The Mad Cow Memos, questioned whether this is the case, since many of the supplements are manufactured in Europe. If any European cows are used to make chondroitin, the risk of Mad Cow Disease contamination escalates!
Chondroitin With Glucosamine
Causing even more concern is a recommendation which appears on the site of Jason Theodosakis, M.D. advising arthritis patients to take chondroitin with glucosamine as a first-line treatment for arthritis. In an article called, "Taking glucosamine without chondroitin? You fool you!", Dr. Theodosakis (author of "The Arthritis Cure") attempts to dispel the belief that glucosamine, not chondroitin, is more effective for joint health. Dr. Theodosakis concludes that:
- Chondroitin is more effective than glucosamine.
- The combination of glucosamine and chondroitin is best.
- It is "foolish" to use glucosamine alone, without chondroitin.
In response to the advice offered by Dr. Theodosakis and in an effort to determine what the medical community is doing to ensure the safety of chondroitin sulfate products, Dr. Weissmann corresponded with Jason Theodosakis, M.D., Roland Moskowitz, M.D., John Klippel, M.D. and Michael E. Weinblatt, M.D., and posted some of the exchange on RheumatologyWeb. Initially, Dr. Weissmann asked Dr. Theodosakis how certain a doctor could be that the chondroitin sulfate products recommended on his site are derived from cow cartilage which is not obtained from a Mad Cow Disease cow in Europe. Dr. Weissmann also asked about the liability involved for a physician who recommends such a product. Dr. Theodosakis' reply suggested that the manufacturers guarantee:
- Only U.S. cows are used.
- The trachea of the cow is used, which is not a significant reservoir for Mad Cow Disease, as is the brain or spinal cord.
- The processing involves enzymatic digestion of all proteins
Dr. Theodosakis also implied that the liability question was a non-issue.
The counterpoints offered back by Dr. Weissmann in response to Dr. Theodosakis included:
- A person must take the word of the manufacturer on the origin of the cow.
- The method of production is not FDA-supervised.
- De-proteination protocols are not made available to the public.
Upon being drawn into the debate, highly-respected rheumatology expert, Roland Moskowitz, M.D., commented that it was his understanding that all chondroitin products used in the U.S. are derived from U.S. herds. Though that claim offers some reassurance, Moskowitz believes that it needs to be proven and:
- The source of products needs to be defined.
- The trachea as a reservoir cannot be totally excluded.
- Enzymatic digestion may not be enough to destroy prions (the abnormal protein believed to be the infective agent of Mad Cow Disease).
John Klippel M.D., clinical director of the Arthritis Foundation (AF), said that the AF has only recently become aware of the debate, and has made no official statement. The adoption of the FDA's Good Manufacturing Practice Standards by major dietary supplement manufacturers and proper labeling would be an encouraging step with regard to safety concerns, according to Klippel.
As the debate rages on, consumers must use common sense. Without regulation of the dietary supplement industry, consumers are left to decide if only the information offered by manufacturers is enough to ensure safety and establish a level of confidence. If you take chondroitin or are considering it, you must ask yourself, "Is that good enough?"
Sources: Safety Of Popular Arthritis Supplements Questioned, Press Release, RheumatologyWeb, 4/10/01; The Chondroitin Sulfate Letters, aka, The Mad Cow Memos, Gerald Weissmann M.D., RheumatologyWeb, 4/10/01; Taking glucosamine without chondroitin? You fool you!, Dr. Theo Online; Chondroitin And Mad Cow Disease? Why You Should Not Be Concerned, Dr. Theo Online