Cartilage

Cartilage is a type of connective tissue in the body that has a tough, flexible matrix made of collagen, protein, and sugar. Cartilage is found in the nose and ears, as well as joints, including the knees, hips, shoulders, and fingers.

The cartilage used in supplements usually comes from either sharks or cows, called bovine cartilage. Shark cartilage was proposed as a treatment for cancer, based on the false idea that sharks do not get cancer (they do). In test tubes, cartilage seemed to stop new blood vessels from forming. Cancerous tumors need new blood vessels to keep growing, so researchers wondered if shark cartilage could shrink tumors. But so far, studies in people have not found any evidence that shark cartilage stops, prevents, or even slows the growth of cancerous tumors.

Cartilage has also been proposed as a treatment for osteoarthritis, which is the "wear and tear" arthritis that happens when cartilage in your joints breaks down. The idea is that taking shark or bovine cartilage, or a supplement called chondroitin, which is part of cartilage, will help your body repair or grow new cartilage in your joints. There is not any evidence that taking cartilage helps, but the story is a little more complicated when it comes to chondroitin.

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Uses

Cartilage is sometimes suggested for the following health conditions:

Psoriasis

Preliminary studies suggest that extracts of shark cartilage may reduce inflammation and itching from psoriasis. Psoriasis is a skin disorder that shows up as raised, reddish-pink areas covered with silvery scales and red borders.

Osteoarthritis

Two substances that make up cartilage, glucosamine and chondroitin, have been studied for osteoarthritis (OA). A number of these studies suggest that chondroitin may help treat OA. In OA, cartilage in the joints breaks down, either because of injury or to normal wear and tear. OA is common as people get older. In some studies, chondroitin supplements have reduced the pain of OA. Not all studies are positive, though, and recent research has not shown any benefit from taking chondroitin. It is not clear why the studies have different findings, and experts disagree on whether chondroitin is helpful in treating OA.

So far studies have not shown conclusively that chondroitin helps repair or grow new cartilage, or stops cartilage from being further damaged. Chondroitin is often taken with glucosamine. Like chondroitin, glucosamine also has conflicting results.

Cancer

Although there is no scientific evidence that it works, shark cartilage has been widely used as an alternative treatment for cancer. Researchers wondered if cartilage could produce substances that stop new blood vessels from growing. Cancerous tumors rely on blood vessels to survive because blood provides oxygen and nutrients necessary for their growth. If cartilage could "starve" cancerous tumors of oxygen and nutrients, then researchers thought it might help treat cancer.

Several clinical studies have been done on cartilage as a treatment for cancer, but only a few have been published in scientific journals. None of these have found any benefit in using cartilage supplements for cancer, including breast, colon, lung, prostate, brain, and lymphoma. According to the National Cancer Institute (NCI), the evidence so far is inconclusive. The NCI halted its own research on cartilage supplements because the preparations were contaminated, and the Federal Trade Commission (FTC) has taken legal action against several companies selling cartilage products as a "cancer cure."

Dietary Sources

You cannot get cartilage from food. It is only available in supplements.

Available Forms

Cartilage is available in powdered form or in capsules that contain the powder. It is also available as a topical cream. Most cartilage supplements are made from bovine (cow) or shark sources.

How to Take It

Pediatric

Children under 18 should not take cartilage.

Adult

For adults 18 years and older: Doses of 200 to 2,000 mg per kilogram of body weight, 2 to 3 times a day, have been used. Ask your health care provider for the best dosage. It is possible that high doses of cartilage could mean you would get more calcium than is recommended.

Precautions

Because of the potential for side effects and possible interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

Side effects may include nausea, vomiting, constipation, and change in taste.

Tell your doctor immediately if any of these serious side effects occur: weakness, tiredness, dizziness, unusual thirst or urination, shakiness, changes in mood, or mental symptoms.

Tell your provider immediately if any of these rare but serious side effects occur: symptoms of liver disease including yellowing of eyes or skin, severe stomach ache, persistent nausea, or dark urine.

Buy shark and bovine cartilage from a reputable manufacturer to reduce the risk of contamination. Check labels carefully, and buy only supplements that contain 100% pure shark cartilage.

There has been at least one case of hepatitis reported from taking shark cartilage.

Pregnant and breastfeeding women, children, and people recovering from surgery or a heart attack should not take cartilage supplements.

DO NOT use cartilage by itself to treat cancer. Cancer requires conventional medical treatment.

Shark cartilage products may contain high levels of calcium. People with kidney disease, abnormal heart rhythms, a tendency to form kidney stones, and those with cancers that raise calcium levels should not take cartilage.

Shark cartilage may lower blood sugar levels. People with diabetes should talk to their provider before taking cartilage, so their blood sugar levels can be monitored.

Acidic fruit juices, such as apple, grape, or cranberry, may reduce the amount of shark cartilage your body absorbs.

Possible Interactions

If you are being treated with any of the following medications, you should not use cartilage supplements without first talking to your health care provider.

Thiazide diuretics (water pills): Cartilage contains high amounts of calcium. Thiazide diuretics, such as hydrochlorothiazide, can raise calcium levels in the blood. Taking cartilage along with diuretics could lead to dangerously high levels of calcium.

Thyroid medication: Shark cartilage may interact with thyroid medications.

Calcium supplements: Taking shark cartilage along with calcium supplements may lead to high levels of calcium in the blood.

Diabetes medication: Shark cartilage may lower blood sugar levels, raising the risk of hypoglycemia or low blood sugar.

Antibiotics: Some antibiotics may interact with shark cartilage.

Supporting Research

Bargahi A, Rabbani-Chadegani A. Angiogenic inhibitor protein fractions derived from shark cartilage. Biosci Rep. 2008;29(1):15-21.

da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother. 1998;32:580-587.

Das A, Hammad TA. Combination of glucosamine and chondroitin in knee OA. Osteoarthritis Cartilage. 2000;8(5):343-350.

Deal CL, Moskowitz RW. Nutraceuticals as therapeutic agents in osteoarthritis: the role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999;25(2):379-395.

Delafuente JC. Glucosamine in the treatment of osteoarthritis. Rheum Dis Clin North Am. 2000;26(1):1-11.

De Silva V, El-Metwally A, Ernst E, Lewith G, Macfarlane GJ; on behalf of the Arthritis Research UK working group on complementary and alternative medicines. Evidence for the efficacy of complementary and alternative medicines in the management of osteoarthritis: a systematic review. Rheumatology (Oxford). 2010 Dec 17. (Epub ahead of print)

Dupont E, Savard PE, Jourdain C, et al. Antiangiogenic properties of a novel shark cartilage extract: potential role in the treatment of psoriasis. J Cutan Med Surg. 1998;2:146-152.

Ernst E. A primer of complementary and alternative medicine commonly used by cancer patients. Med J Aust. 2001;174:88-92.

Ernst E, Cassileth BR. How useful are unconventional cancer treatments? Eur J Can. 1999;35(11):1608-1613.

Federal Trade Commission. "Operation Cure.all" nets shark cartilage promoters: two companies charged with making false and unsubstantiated claims for their shark cartilage and skin cream as cancer treatments. June 29, 2000.

Fontenele JB, Araujo GB, de Alencar JW, Viana GS. The analgesic and anti-inflammatory effects of shark cartilage are due to a peptide molecule and are nitric oxide (NO) system dependent. Biol Pharm Bull. 1997;20(11):1151-1154.

Gonzalez RP, Leyva A, Moraes MO. Shark cartilage as a source of antiangiogenic compounds: from basic to clinical research. Biological and Pharmaceutical Bulletin. 2001;24(10):1097-1101.

Gottlieb MS. Conservative management of spinal osteoarthritis with glucosamine sulfate and chiropractic treatment. [Review]. J Manipulative Physiol Ther. 1997;20(6):400-414.

Horsman MR, Alsner J, Overgaard J. The effect of shark cartilage extracts on the growth and metastatic spread of the SCCVII carcinoma. Acta Oncol. 1998;37:441-445.

Leeb BF, Schweitzer KM, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol. 2000;27(1):205-211.

Loprinzi CL, Levitt R, Barton DL, et al., Evaluation of shark cartilage in patients with advanced cancer: a North Central Cancer Treatment Group trial. Cancer. 2005;104(1):176-82.

Matsumoto T, Tsurumoto T. Serum YKL-40 levels in rheumatoid arthritis: correlations between clinical and laboratory parameters. Clin Exp Rheumatol. 2001;19(6):655-660.

McAlindon T. Glucosamine for osteoarthritis: dawn of a new era? Lancet. 2001;357:247.

McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. 2000;283(11):1469-1475.

Merly L, Simjee S, Smith SL. Induction of inflammatory cytokines by cartilage extracts. Int Immunopharmacol. 2007;7(3):383-91.

Miller DR, Anderson GT, Stark JJ, Granick JL, Richardson D. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol. 1998;16:3649-3655.

Ratel D, Glazier G, Provencal M, Boivin D, Beaulieu E, Gingras D, Beliveau R. Direct-acting fibrinolytic enzymes in shark cartilage extract: potential therapeutic role in vascular disorders. Thromb Res. 2005;115(1-2):143-52.

Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357:251-256.

Romano CF, Lipton A, Harvey HA, Simmonds MA, Romano PJ, Imboden SL. A phase II study of Catrix-S in solid tumors. J Biol Response Mod. 1985;4:585-589.

Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010 Aug;69(8):1459-64.

Sheu JR, Fu CC, Tsai Ml, Chung WJ. Effect of U-995, a potent shark cartilage-derived angiogenesis inhibitor, on anti-angiogenesis and anti-tumor activities. Anticancer Res. 1998;18:4435-4441.

Towheed TE, Anastassiades TP. Glucosamine and chondroitin for treating symptoms of osteoarthritis: evidence is widely touted but incomplete. JAMA. 2000;283(11);1483-1484.

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Review Date: 12/28/2014  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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