Glucosamine
and Arthritis Information - benefit and side effects, natural and alternative
treatment, dosage, 500 mg and 1500 mg
Glucosamine is made from the combination of a sugar - hence the first part of the name glucos(e) - and an amine, which is a derivative of ammonia containing nitrogen (N) and hydrogen (H) atoms. Glucosamine is found largely in cartilage and plays an important role in its health and resiliency. As we age, we lose some of the glucosamine and other substances in cartilage. This can lead to thinning of cartilage and the onset and progression of osteoarthritis. It is important to note that there are a variety of important substances within cartilage and glucosamine ingestion, by itself, should not be viewed as the complete answer. In fact, not all studies show glucosamine to be helpful by itself. Some studies show glucosamine is more likely to be effective when taken with other nutrients such as MSM and chondroitin. Joint Power Rx is a formula that has these nutrients, and many others for joint health.
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Glucosamine and arthritis
Glucosamine has hardly been evaluated in conditions other than arthritis. Hence it is not clear whether glucosamine is helpful in those with damage
to cartilage or joints due to musculoskeletal injuries. Glucosamine appears to help rebuild
cartilage in arthritis patients, but it is unlikely that it would help joints where
the cartilage has been surgically removed.
Similarly, glucosamine has not been
tested in autoimmune diseases involving joints such as lupus and rheumatoid arthritis. Those with artificial joints are not likely to be helped by glucosamine
since they have no cartilage.
After a glucosamine supplement is taken by mouth, it makes itself
into the bloodstream and in joints.
There is disagreement in the medical community regarding the health
benefits of glucosamine and whether this nutrient is helpful in reducing
symptoms of arthritis and reducing joint pain. Most studies indicate that
glucosamine does play a role in improving symptoms of arthritis.
Glucosamine and patellal
cartilage
Glucosamine sulfate effect on the degenerated patellar cartilage:
preliminary findings by pharmacokinetic magnetic resonance modeling.
Eur Radiol. 2009 Feb 13. Radiology Department, Dr Peset University
Hospital, Av Gaspar Aguilar 90, 46017, Valencia, Spain.
Sixteen patients with patella degeneration, were randomly
distributed into glucosamine sulfate or control groups. In the glucosamine
group, pain and functional outcomes statistically improved. Glucosamine
sulfate decreased pain while improving functional outcome in patients with
cartilage degeneration.
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Additional
Formulas for arthritis and osteoarthritis
Arthred Arthritis formula
with hydrolyzed collagen without a prescription
Hylan G F 20
intra articular injection benefit and side effects for osteoarthritis. Hylan
GF20 is only available by prescription.
Inflama-Rest Cox-2 Inhibitor,
by Source Naturals with high quality herbs
N.A.G.
N acetyl glucosamine supplement is available over the counter
Perna Canaliculus oil extract is used for arthritis treatment and is known
by the product name Lyprinol.
Glucosamine sulfate of
glucosamine hydrochloride?
Glucosamine is available as glucosamine sulfate or glucosamine hydrochloride (glucosamine
hcl). A review of
the scientific literature shows glucosamine is likely to be helpful for many
patients with osteoarthritis. Almost all of
the studies done with glucosamine have used the sulfate form since a company in Europe
funded the studies, and we know that it works. However, the hydrochloride form has
been used by doctors for many years and it seems to work just as well. The hydrochloride
form is cheaper. The positive effects of glucosamine
reducing joint pain are often noticed within a few weeks.
Glucosamine and allergies
Those who are allergic to sulfates may take glucosamine hydrochloride and not glucosamine
sulfate, and they should avoid chondroitin sulfate. Glucosamine is derived from shrimp,
oyster and crab shells and chondroitin is derived from cartilage of cows, pigs, and
sharks. There is no synthetically made glucosamine on the market.
Combining glucosamine with drugs
Glucosamine may be taken together with acetaminophen or NSAIDs such
as ibuprofen and naproxen. After glucosamine starts working in a few weeks, hopefully the
dose of the drugs can be reduced or eliminated. I am not aware of glucosamine interacting
with other medicines. It appears that glucosamine, chondroitin and other
arthritis herbs are safer than the pain medicines.
Glucosamine side effects - Long term safety
As of January 2008, based on our current understanding, glucosamine has few side effects, and can be taken for
extended periods, months and years. Thus far, after being on the market for quite a number
of years, there have not been any reports in the medical literature of any significant
glucosamine side effects. However, as with most nutrients
and medicines, long term effects are not clearly known. It is best
pregnant women not take glucosamine until more is known about this interaction.
Cholesterol
Apparently glucosamine does not
seem to influence blood levels of cholesterol.
The effect of glucosamine sulfate on the blood levels of cholesterol or
triglycerides
Ugeskr Laeger. 2007 Jan 29;169(5):407-10. Østergaard K, Hviid T,
Hyllested-Winge JL. Slidgigtinstituttet A/S, Ishøj.
This study was conducted in order to determine if glucosamine sulfate
taken by patients as treatment for chronic joint pain influences the fasting
blood levels of cholesterol and triglycerides. A study performed with parallel groups of 66 patients over 40 years of
age with joint pain of long duration receiving either recommend dosage
(1500 mg per day) of glucosamine sulfate or placebo. No significant differences
between the glucosamine sulfate group and the placebo group with respect
to cholesterol and triglycerides were observed. There were no differences
between the treatment groups with respect to side-effects. This study
demonstrates that glucosamine sulfate does not significantly influence
blood levels of cholesterol or triglycerides.
Glucosamine and diabetes blood sugar control
Glucosamine supplements, at commonly consumed doses, do not have
significant effects on glycemic control, cholesterol and lipid profile, or
levels of apoAI in patients with diabetes.
We are not aware of any significant changes to blood sugar resulting from glucosamine
ingestion. The dose of glucosamine, one or two grams a day, is minimal as a sugar source
compared to the amounts of carbohydrates found in the foods we consume. One study indicates that glucosamine is safe in diabetes.
In a study published in Archives of Internal Medicine, 38 elderly patients
with type 2 diabetes were divided into two groups. The first group took 1500 mg
of glucosamine a day combined with 1200 mg of chondroitin sulfate. Chondroitin
is another supplement often used in combination with glucosamine to treat
osteoarthritis. The other group took placebo pills. Two-thirds of the dose was
taken in the morning and one-third in the evening. The study lasted for 90 days.
Blood studies were done to evaluate blood sugar levels, and also levels of
hemoglobin A1c, a specific blood marker than can tell us average blood sugar
levels over long periods of time. There was no statistically significant rise in
hemoglobin A1c levels in those who took glucosamine.
Patients with
diabetes are often at risk from toxic effects from many of the current
treatments for osteoarthritis, such as the NSAIDs like ibuprofen or naprosyn.
These medicines cause stomach ulcers and kidney damage if used for prolonged
periods. Glucosamine provides a safer and more natural alternative.
Timing of glucosamine ingestion
It's difficult to say when the best time or frequency to take glucosamine, whether with or
without food, but a good option is to take glucosamine before meals. All 1,500 mg a day
can be taken at one time or split in two or three divided doses throughout the day.
Glucosamine and chondroitin
If glucosamine itself is not helpful in relieving arthritic symptoms, it may be combined
with chondroitin and other
nutrients. Alternatively, glucosamine and chondroitin can be started together
with several other nutrients.
Can glucosamine pills be absorbed from the stomach
and end up in cartilage?
Yes. After oral administration of glucosamine sulfate (GS), 90% is absorbed.
(Sulfate means that the glucosamine is attached to a sulfur and oxygen atoms.)
In a study done in Italy, two healthy male volunteers were given 250 mg of
oral GS, tagged with radioactive carbon 14 as a tracer, in the morning on an
empty stomach. The radioactive GS was found an hour later in blood and then
later in other tissues. The researchers state, "GS very rapidly diffuses in most
tissues and organs and that it has a special tropism (attraction) for articular
tissue (cartilage) and for bone." These volunteers were also given GS
intravenously (IV) and intramuscularly (IM). The amount of GS in blood after
oral administration was only a quarter of the amount available by IV and IM.
Therefore oral administration is effective, but not as good as IV or IV. When
oral GS is absorbed, it first goes to the liver where a large portion gets
broken down into smaller molecules such as carbon dioxide, urea and water.
Glucosamine
availability
Most often glucosamine is sold as glucosamine sulfate or glucosamine
hydrochloride. Very frequently glucosamine and chondroitin are combined
together. Lately, more products are being sold with glucosamine, chondrotin, and
MSM. Furthermore, more recently, these last three nutrients have been combined
with other herbs and nutrients that play a role in joint health including CMO,
curcumin, boswellia, etc.
Glucosamine is also sold as a liquid and glucosamine
formulas for dogs are also found in stores.
Q. Does a glucosamine tablet absorb faster
than a glucosamine capsule?
A. We doubt there would be much of an absorption difference.
Glucosamine liquid
Various supplement companies now make glucosamine available in liquid
form. Glucosamine liquid may be appropriate for those who are not able to
swallow capsules.
Q. Would you discuss the benefits or lack
thereof from taking glucosamine sulfate in liquid form rather than as a
pill? There is quite a bit of controversy going on regarding glucosamine
liquid versus glucosamine pills.
A. As of October 2008, we have not seen studies with glucosamine
liquid compared to glucosamine pills. Therefore, I can't say whether
glucosamine liquid is any more or less effective than glucosamine pills.
Glucosamine powder
Q. Does glucosamine powder offer benefit for arthritis more than an oral
glucosamine supplement?
A. We have not seen any research comparing glucosamine powder to
oral glucosamine pills. We doubt glucosamine powder offers any advantages except
to those who have difficulty swallowing pills.
Does every patient
with osteoarthritis benefit from glucosamine and chondroitin?
No. Based on our experience, the results of published studies,
and discussions with doctors who use glucosamine, we would estimate that about a
third of patients notice a moderate to significant improvement while another
third notice slight improvement. Other patients are disappointed. The reasons
why some individuals do not respond adequately are not known. We should keep in
mind that the biochemistry of cartilage tissue is complicated and many factors
besides glucosamine and chondroitin are involved in the process of cartilage
formation. It is possible that additional nutrients and herbs taken along may
benefit those who do not respond to glucosamine and chondroitin.
How does glucosamine work?
Scientists still don't have all the answers, but they think glucosamine
stimulates the biosynthesis (production) of some proteoglycans, restores damaged
chondrocytes (cells of cartilage tissue), and has some anti-inflammatory
abilities. The anti-inflammatory abilities of glucosamine are much less than
NSAIDs and glucosamine is not known to have pain-killing abilities. Therefore,
users should not expect immediate relief of their symptoms.
Anti-inflammatory agent
Studies on cartilage have shown anti-inflammatory effects of glucosamine related to inhibition of inflammatory mediators.
Glucosamine can suppress the IL-1beta-mediated activation of synoviocytes (such
as IL-8-, nitric oxide- and PGE(2)-production, and phosphorylation of p38 MAPK),
thereby possibly exhibiting antiinflammatory actions in arthritis.
Antioxidant
in chondrocytes - benefit for arthritis
Glucosamine sulphate reduces oxidative stress on chondrocytes by increasing haem
oxygenase. Treatment with sulfated glucosamine to human chondrocytes and
macrophages inhibits radical simulated oxidation of membrane lipids, proteins
and DNA in a dose-dependent manner.
COX-2
inhibitor
Glucosamine hydrochloride inhibits COX-2 activity by preventing COX-2
co-translational N-glycosylation and by facilitating COX-2 protein turnover
during translation in a proteasome-dependent manner.
Boswellic acid
A synergistic effect can be expected when glucosamine is combined with boswellic
acids ( found in the herb boswellia).
Can I find
glucosamine in foods?
No food sources of glucosamine are known that would provide this nutrient
in the dosages required for arthritic relief. Hence, the best source of glucosamine is through taking supplements.
Is glucosamine
toxic?
We know that NSAIDs can cause stomach ulcers and bleeding. A 1991 study
published in the journal Drug Research showed glucosamine to be safe. When daily
oral doses of GS up to 2700 mg/kg were given in the rat and 2100 mg/kg in the
dog for one year and six months, respectively, no anatomical lesions were found
in the gastrointestinal system or other organs. The dose given to the dogs would
be equivalent to 150,000 mg in a 70 kg human. Most of the recommended dosages
for patients with arthritis are about 500 mg three times a day. However, Italian
researchers have found that the LD50 (the lethal dose at which half of the
animals die) of GS is 8000 mg/kg. In humans this would be equivalent to
ingesting over 500,000 mg at one time or 1,000 pills each containing 500 mg.
Glucosamine use
during pregnancy
Can a women who is pregnant use glucosamine safely? Limited data indicate that
glucosamine is safe to use by pregnant women.
Glucosamine use in pregnancy: an
evaluation of pregnancy outcome.
J Womens Health (Larchmt). 2007 Apr;16(3):345-8. Sivojelezova A, Koren G,
Einarson A. The Motherisk Program, Division of Clinical Pharmacology, The
Hospital for Sick Children, The University of Toronto, Canada.
Glucosamine is used as a disease-modifying agent for the treatment of arthritis.
There is no information regarding its use in pregnancy. Our objective was to
determine whether glucosamine treatment in pregnancy is associated with an
increased risk of major malformations or other adverse outcomes. Pregnant women
were recruited from The Motherisk Program at the Hospital for Sick Children,
Toronto, Canada. Women exposed to glucosamine were compared with women exposed
to nonteratogenic agents. We were able to ascertain the outcomes of 54 women who
used glucosamine during pregnancy (34 during organogenesis). There were 50 live
births (two sets of twins), 4 spontaneous abortions, 1 therapeutic abortion, and
1 stillbirth, with no major malformations. These limited data suggest no
increased risk for major malformations or other adverse fetal effects following
the use of glucosamine during pregnancy.
Glucosamine allergy
Do shrimp-allergic individuals tolerate shrimp-derived glucosamine?
Clin Exp Allergy. 2006 Nov;36(11):1457-61. Villacis J, Rice TR, Bucci LR,
El-Dahr JM, Wild L, Demerell D, Soteres D, Lehrer SB. Tulane University Health
Sciences Center, Department of Clinical Immunology, Allergy, and Rheumatology,
New Orleans, LA 70112, USA.
There is concern that shrimp-allergic individuals may react to glucosamine-containing
products as shrimp shells are a major source of glucosamine used for human
consumption. The purpose of this study was to determine whether shrimp-allergic
individuals can tolerate therapeutic doses of glucosamine. Subjects with a
history of shrimp allergy were recruited and tested for both shrimp reactivity
via a prick skin test and shrimp-specific IgE by an ImmunoCAP assay. Fifteen
subjects with positive skin tests to shrimp and an ImmunoCAP class level of two
or greater were selected for a double-blind placebo-controlled food challenge
using glucosamine-chondroitin tablets containing 1,500 mg of synthetically
produced (control) or shrimp-derived glucosamine. Immediate reactions, including
changes in peak flow and blood pressure, and delayed reactions (up to 24 h
post-challenge) via questionnaire were noted and assessed. All subjects
tolerated 1,500 mg of both shrimp-derived or synthetic glucosamine without
incident of an immediate hypersensitivity response. Peak flows and blood
pressures remained constant, and no subject had symptoms of a delayed reaction
24 h later. This study demonstrates that glucosamine supplements from specific
manufacturers do not contain clinically relevant levels of shrimp allergen and
therefore appear to pose no threat to shrimp-allergic individuals.
Types of arthritis
There are more than 120 kinds of arthritis and musculoskeletal disorders exist,
the most common being osteoarthritis, rheumatoid arthritis, and osteoporosis.
Arthritis and
sexuality
Because of the pain, fatigue, and joint stiffness associated with arthritis,
physical intimacy may be difficult. These symptoms can be ameliorated during
sexual activity by good communication between the partners, timing medication,
and experimenting with different positions. The regular use of glucosamine and
other natural supplements can help reduce the pain of arthritis in many
patients.
Glucosamine and chondroitin slow
bone loss in osteoarthritis
In experiments with bone tissue samples from patients with knee arthritis,
chondroitin and glucosamine affect osteoblasts in a manner that slows
arthritis-related bone loss. Bone remodeling is a continuous process in which
existing bone is broken down and replaced with new bone tissue. Osteoarthritis
occurs when the cartilage cushioning the joints begins to break down; but there
is also a breakdown in the bone underneath the cartilage.This bone loss is
related to an imbalance in the activity of the cells that break down bone (osteoclasts)
and cells that build bone (osteoblasts). When osteoblast cells taken from
patients undergoing knee-joint replacement for severe knee arthritis are exposed
to chondroitin, glucosamine or a combination of the two affected osteoblast
activity in a way that may inhibit bone breakdown. Arthritis Research & Therapy,
online November 9, 2007.
Glucosamine
arthritis questions
Q. Does the combination of glucosamine chondroitin msm benefit arthritis
more than glucosamine and chondroitin by themselves?
A. We have not seen human studies with the a glucosamine chondroitin
MSM combination for arthritis. There is some early research that found
glucosamine and msm together offer more benefit. Therefore, it makes sense that
the combination of all three nutrients would work better.
Additional links on
this website
Diabetes
glucosamine - does glucosamine raise blood sugar levels, is it safe for
patients with diabetes?
Glucosamine chondroitin benefit for osteoarthritis
Glucosamine chondroitin MSM - as of October 2007, we cannot find studies
published with this combination pill
Glucosamine chondroitin side effects - are there any dangers using a
glucosamine chondroitin combination pill?
Glucosamine chondroitin sulfate
is beneficial to arthritis patients who have moderate to severe joint pain
Glucosamine
cream - is topical application of glucosamine helpful to relieve joint ache?
Glucosamine for dog
- it appears that glucosamine and chondroitin are helpful for our canine
friends.
Glucosamine MSN - many people misspell msm for msn
Glucosamine osteoarthritis research,
more doctors should be prescribing glucosamine to their patients
Glucosamine side effects
- is glucosamine safe or are there dangers in the use of this supplement?
Glucosamine sulphate
helpful in arthritis pain relief. Sulfate is used more commonly than the word
sulphate.
Liquid glucosamine - as of
May 2008, we cannot find studies published with
liquid glucosamine
Glucosamine MSM - as of
May 2008, we cannot not find human studies regarding
the combination of glucosamine and MSM.
Glucosamine sulfate for osteoarthritis, studies show benefit.
Glucosamine
arthritis emails
Q. What is glucosamine complex and how is it different than a plain glucosamine
supplement?
A. We are not sure what the word complex means in terms of
glucosamine. We have not seen this word used in relation to glucosamine studies
in the medical literature.
Q. I understand glucosamine is of benefit to those with regular
degenerative arthritis, but does glucosamine benefit those with rheumatoid
arthritis?
A. We doubt glucosamine would benefit patients with rheumatoid
arthritis since the joint damage is due to an autoimmune reaction. However, we
can't be sure until studies are completed.
Q.
I am currently taking a glucosamine msn product for arthritis
and find it to be helpful. I wonder if taking chondroitin would offer more
benefit than just glucosamine msn complex.
A. Adding a chondroitin supplement along with a glucosamine pill may help but it is not possible
to predict in any one person what the benefits would be.
Licorice,
Glycyrrhizae
radix, is one of the herbal medicines in East Asia that has been commonly
used for treating various diseases.
Glycyrrhetinic acid is a triterpenoid
derivative of the beta-amyrin type obtained from the hydrolysis of
glycyrrhizic
acid, which is found in the herb licorice.
Glycyrrhetinic acid is also as a major metabolite of
glycyrrhizin.
Q. What do you think of the combination of
Lyprinol in addition to glucosamine for arthritis
symptoms?
A. We have not seen any studies that have combined Lyprinol with
glucosamine, but we don't see any major safety issues with this combination.
Glucosamine is a safe nutrient that can be combined with many different herbs
and nutritional supplements.