phy, education, and licensing in the latter half of
the twentieth century solidified chiropractic as a
beneficial, reputable health-care profession and
practice. In 1994 the US Agency for Health Care
Policy and Research (AHCPR) endorsed chiroprac-
tic as a safe and appropriate first-line treatment for
low back pain. Most insurers in the United States
pay for limited chiropractic care.
Chiropractors may not prescribe medications,
diagnose health conditions, provide medical treat-
ments outside those necessary for spinal manipu-
lations, or perform surgery. People who have
health conditions that affect the spine such as
ANKYLOSING SPONDYLITIS or RHEUMATOID ARTHRITIS
should talk with their orthopedists before under-
going chiropractic treatment. A conventional doc-
tor should evaluate back pain with FEVER, as this
may be an indication of MENINGITISor other poten-
tially life-threatening infection.
See also NATUROPATHY; OSTEOPATHIC MANIPULATIVE
TREATMENT(OMT).
chondroitin A chemical compound that occurs
naturally in the CARTILAGEand other tissues in the
joints, chondroitin appears to protect JOINTtissues
from damage and deterioration by blocking the
actions of certain destructive enzymes. There is
substantial evidence, through clinical studies, that
this blocking action can arrest and even reverse
OSTEOARTHRITIS. In some studies, chondroitin was at
least as effective as the commonly prescribed NON-
STERIODAL ANTI-INFLAMMATORY DRUGS (NSAIDS) that
are the standard treatment for osteoarthritis in the
United States. Combining chondroitin with
another natural compound, GLUCOSAMINE, intensi-
fies the benefit.
Though researchers and practitioners have
known of glucosamine and have recommended it
to relieve jointINFLAMMATIONand PAINfor decades,
researchers discovered chondroitin only in the
1960s. A number of clinical studies conducted in
the 1980s and 1990s began to make clear chon-
droitin’s effects and benefits. Chondroitin seems
most effective for osteoarthritis affecting the hips
and knees and does not have any effect on
RHEUMATOID ARTHRITIS, a deformative autoimmune
disorder.
There seem to be few side effects or interactions
with chondroitin. People who are taking anticoag-
ulant medications should check with their doctors
before taking chondroitin. Though chondroitin
does not directly affect clotting, many substances
that affect inflammation have the potential for
interfering with blood chemistry. It typically takes
two to four months to notice appreciable results
after starting chondroitin.CHONDROITIN
Uses Risks/Side Effects Interactions
OSTEOARTHRITIS none known possibly anticoagulantsSee also ANTICOAGULANT THERAPY; AUTOIMMUNE
DISORDERS; SAME.coenzyme Q10 An ANTIOXIDANTfound in every
nucleated cell in the body. It has numerous func-
tions related to cell activity and repair. As a coen-
zyme, coenzyme Q10 facilitates or works in
collaboration with enzymes in the cells. Enzymes
carry out the genetic instructions of the cell. The
more active the cell, the more coenzyme Q10 the
cell contains. A HEARTcell has considerably more
coenzyme Q10 than does a SKINcell, for example.
Researchers discovered coenzyme Q10 in 1957
and continue to investigate how it works and
what it does in the body.
People who have certain forms of heart disease,
such as HYPERTENSION(high BLOOD PRESSURE) and
HEART FAILURE, have lower than normal levels of
coenzyme Q10. In some studies, giving them
coenzyme Q10 improved heart function, most
notably hypertension. Though researchers do not
fully understand its mechanisms, boosting coen-
zyme Q10 levels in cardiac cells seems to improve
their efficiency. This effect is less conclusive in
people recovering from HEART ATTACKor who have
other forms of heart disease.
There is some evidence that coenzyme Q10
supplementation has numerous beneficial effects
on health. Researchers are exploring its role in
preventing BREAST CANCER, periodontitis (INFLAM-
MATION and INFECTION of the gums), and
ALZHEIMER’S DISEASE. Some health experts believe
coenzyme Q10 may improve symptoms and QUAL-
ITY OF LIFEfor people with MITOCHONDRIAL DISOR-
DERS, MUSCULAR DYSTROPHY, and degenerative
neurologic conditions such as PARKINSON’S DISEASE.
Studies investigating the ability of coenzyme Q1064 Alternative and Complementary Approaches