Scleroderma

In an article titled, "Glucosamine, Chondroitin and MSM as Alternative Therapies for Scleroderma", Dr. Robert B. Buckingham, M.D., discussed three alternative medicines for treating the pain and the other features associated with Scleroderma. Here, we sought to share some of the more pertinent and considerable aspects of his article.

Dr. Buckingham noted that much is known and is being discovered, about the pathological mechanisms that occur in Scleroderma. However, approved treatments were scarce and there is considerable disagreement about the effectiveness of such. This has led patients with Scleroderma to explore alternative approaches to their healthcare, including nutritional materials and foods, and natural and organic substances which were generally less expensive than the products offered by the pharmaceutical industry. He added that testimonials to their effectiveness tend to be numerous and very convincing. Thus, these products have been used by many patients with Scleroderma and other various forms of rheumatic diseases.

Glucosamine, as one such alternative, is available without prescription in pharmacies, grocery stores, and nutritional supplement outlets. Dr. Buckingham noted that an immense literature has accumulated supporting the effectiveness of Glucosamine for almost any illness, especially inflammatory diseases and Scleroderma. Glucosamine can be used alone or in combination with other agents, such as Chondroitin Sulfate.

Patients with inflammatory and rheumatic conditions of all kinds try these products (even though they are first recommended for osteoarthritis) as they are viewed as being building blocks for the joint cartilage, which is lost in the process of this disease. Nevertheless Glucosamine has become a panacea, a "cure-all", a remedy for all ills; the word derived from the Greek panakeia , meaning "all-healing". In much of the rest of the world though, Glucosamine is taken alone, without the many additives so common on the US market, including Chondroitin Sulfate. MSM (methylsulfonylmethane) is sometimes added. However, literature has suggested that these combinations may be superior to the single product Glucosamine alone.

It has also been argued that all of the articles supporting the effectiveness of these agents, alone, and in combination, were financed by industry, meaning that the company that made the agent paid for the study. Increasingly, in the case of Glucosamine as Dr. Buckingham explained, we are seeing increasing reports not financed by the companies that produce and market these products, most of which support its effectiveness. He cited an article on the effectiveness of Glucosamine and MSM for osteoarthritis by authors from India, who claimed no support from industry. Either agent, Glucosamine nor MSM alone worked, but the combination worked best. The article was published in 2004. Glucosamine is derived from the shells of sea crustaceans, is inexpensive and easily purified. Chondroitin sulfate, generally derived from cow cartilage, is more expensive to obtain and to purify.

Very little is known though about many aspects of Glucosamine Sulfate use. It is not known how well an oral preparation is absorbed. One study presented at the October, 2004 annual Rheumatology meeting said that it was well absorbed, while another presentation said that it was so poorly absorbed that it could not be effective. Further, the mechanism of action is not clear. It has been described as a building block for cartilage. Many scientists think that it blocks important inflammatory mediators and thus is anti-inflammatory in all tissues. Side effects and drug interactions are unknown. Still, many thousands of people use it alone or combined with other additives. No known problems have arisen. Many other studies are still needed.

MSM is said to be a nutrient that is effective in relieving muscle and joint pain in Scleroderma, interstitial cystitis, and many other rheumatic diseases; even allergies are said to be helped by this agent alone, as well as in combination with Glucosamine and Chondroitin. MSM is important because it provides dietary sulfur. MSM is 34% sulfur by weight, and is found in all plants, soils, fruits, meats and vegetables. This naturally occurring sulfur is not similar to inorganic sulfides, sulfites, sulfates and sulphonamides, to which many people are allergic.

Dr. Stanley W. Jacob from the Oregon Health and Science University in Portland, Oregon, has written extensively about its effectiveness as an anti-inflammatory and as an aid in building disulfide bonds which are necessary in the structure of joint components. These components are made in part from Glucosamine and Collagen, which are sulfur dependent. MSM is a derivative of DMSO (dimethyl sulfoxide), which is believed to be anti-inflammatory and analgesic, but causes an unpleasant taste and odor.

Roughly 15% of DMSO is converted in the body to dimethyl sulfone, another name for MSM. The difference is the inclusion of a single additional oxygen atom. MSM does not have a disagreeable taste or odor. DMSO is approved by the Food and Drug Administration (FDA) for treatment of interstitial cystitis; but neither DMSO nor MSM are FDA approved for any other indication. DMSO is used to protect human tissue such as bone marrow, stem cells and embryos when frozen for storage. The DMSO which is used for interstitial cystitis is called "Rimso". Rimso-50 solution, available at some pharmacies, is a medical rather than industrial grade of DMSO. It can be used for "off-label" medical conditions such as Scleroderma.  

Dr. Buckingham went on to note that Dr. Jacob, in his books "The Miracle of MSM" and "MSM: The Definitive Guide", advised using the agent for the treatment of Scleroderma administered orally, intravenously for severe cases, and also by topical application to soften the skin. Although MSM does not cure Scleroderma, according to the doctor, 70% of patients experience some degree of improvement. Dr. Jacob claims to have treated hundreds of patients with Scleroderma.

The Foundation would like to encourage you to share any feedback that you may have on this issue, here in our comments, or within a discussion that we started on Facebook. We also aim in the near future, to update this article to include links to other resources which provide adidtional information.

Source: Athritis & Rheumatic Disease Associates (ARDA)