Topical Glutamine?

Don't get me wrong. I am a big Scott Snyder fan. American Vampire is one of the most interesting takes on vampires in a long time and his run on Detective Comics is one I will always remember. However, as a medical student, I could not help but notice a weird medical factoid that showed up in The New 52's Swamp Thing #1. In the opening pages, we find Dr. Alec Holland, brilliant botanist and former Swamp Thing, doing some good ol' hard labor, presumably to put his life as Swamp Thing behind him. Holland has apparently been doling out medical advice to his coworkers, telling one man to put cabbage on his knee to relieve the joint pain because cabbage is a good source of glutamine.

This set off a red light in my head. Glutamine for joint pain? Glutamine is not an anti-inflammatory and is not available in topical form (however, cabbage is indeed a good source of glutamine). Glutamine is medically used to maintain nutrition in people with short bowel syndrome and is often available as a supplement for muscle growth.

I really think that Mr. Snyder meant glucosamine. Glucosamine is a biochemical precursor to glycosaminoglycans which is a major component of joint cartilage. It is believed to have some anti-inflammatory action and can be applied topically. However, glucosamine is available over the counter so the construction would not need to go see a doctor and get a prescription. But at least Dr. Holland looked smart to the layman and earned his respect, right?

Interestingly enough, I came across a POEM (Patient-Oriented Evidence that Matters) that said that glucosamine and non-steroidal anti-inflammatory drugs (NSAIDS, like aspirin and ibuprofen) had no greater effect than placebo when used for knee osteoarthirtis (NSAID = glucosamine = chondroitin = placebo for knee OA, Essential Evidence Plus). So maybe it did not matter that Dr. Holland mixed up glutamine and glucosamine, after all.

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