I have many patients who swear by alternative therapies that are unproven or, worse, proven not to work.  How should I counsel them?  On the one hand, each individual is unique and it’s possible that what applies to thousands of patients in a study shouldn’t be generalized to the specific patient sitting in my office right now.  On the other hand, we all (I included) have a staggering capacity for self-delusion, and it’s possible that my patient is just engaging in wishful thinking because he sincerely wants the therapy to help.

This week’s Annals of Internal Medicine published a study which offers a case in point.  The study was the most rigorous review of previous studies that tested chondrointin’s benefits for arthritis pain.  The study was also discussed in this editorial in Annals, and it was covered in this LA Times article.

The conclusion of the study was fairly definitive.

Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent.

Well, that’s that, right?  The only reason to take chondrointin over placebo is if the chondrointin is cheaper.  Nevertheless, many of my patients use chondrointin for arthritis pain and swear by it.  The editorial offers them, and me, some advice.

However, some patients are convinced that it helps, which could be because of a placebo response or even a therapeutic response resulting from enhanced absorption or limited metabolism of chondroitin. Because no frequent or severe adverse effects have been reported, chondroitin sulfate should not be considered dangerous. If patients say that they benefit from chondroitin, I see no harm in encouraging them to continue taking it as long as they perceive a benefit.

So like chicken soup, chondrointin might not help, but it probably won’t hurt.