Asthma Exacerbation Associated With Glucosamine-Chondroitin Supplement

Alfred F. Tallia, MD, MPH, Dennis A. Cardone, DO

Disclosures

J Am Board Fam Med. 2002;15(6) 

In This Article

Abstract and Introduction

Background: Although dietary supplements are in widespread use, and some have been endorsed by the medical community and complementary and alternative practitioners, not much is known about their potential side effects or drug interactions.
Methods: A case of asthma exacerbated by the use of a glucosamine-chondroitin supplement for osteoarthritis pain is described. The literature was searched from 1980 to 2002 using the terms "glucosamine," "chondroitin sulfate," "alternative medicine," and "dietary supplements," combined with "asthma."
Results and Conclusions: The biological link between both chondroitin and glucosamine and secretions from the respiratory tree of persons with asthma lends biologic plausibility to the hypothesis that the patient's asthmatic episode was related to the dietary substance. Physicians would be wise to question their patients about use of dietary supplements as self-medication and consider the possibility of such supplements causing exacerbations of underlying conditions.

The use of over-the-counter dietary supplements is widespread in our society. Patients spend an estimated $15 billion per year on these products, which are not regulated by the Food and Drug Administration.[1] Many of these supplements have found support for their use in the medical community or among parallel complementary-alternative medicine practitioners. Little is known, however, about potential side effects, untoward effects, or drug interactions of many of these substances, even those in widespread use.[2]

Arthritis, particularly degenerative osteoarthritis, which is more common in older persons, is a condition afflicting an increasing number of the US population.[3] Although a broad range of traditional pharmaceuticals exist for the treatment of pain associated with this condition, many patients avail themselves of nonprescription supplements for pain relief. Glucosamine-chondroitin sulfate preparations are particularly popular, though there is mixed evidence of efficacy.[4,5,6,7] Available in various forms in many pharmacies, supermarkets, and health food stores, this drug combination is often recommended as an adjunct to traditional prescription pharmaceuticals and nonpharmacologic treatments.[8] In this case report, we describe a probable side effect of this drug combination in a patient with underlying intermittent asthma.

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